docid: uohzlqvc

title: A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT

text: The definite diagnosis of corona virus disease 2019 (COVID-19) is based on the viral isolation or positive result of polymerase chain reaction (PCR) from sputum, or nasal swab, or throat swab. However, the sensitivity to detect COVID-19 of real time (RT)-PCR is reported to be lower than that of chest CT. We report a case of 34-year-old man who was diagnosed as negative for COVID-19 based on the four sequential RT-PCR tests of his pharyngeal swab. Chest CT showed patchy ground-glass opacity on admission, and it rapidly progressed to segmental mixed consolidation and ground-glass opacity 3 days after admission, and it resolved in left upper lobe, but showed multifocal ground-glass opacities 7 days after admission, and they resolved within 2 weeks. The fifth RT-PCR test finally revealed positive results at the fifth day after admission. It is difficult to distinguish COVID-19 pneumonia from other viral pneumonia on CT findings alone; however, we emphasize the utility of chest CT to detect early change of COVID-19 in cases which RT-PCR tests show negative results.


title: Standardization of elective tracheostomies at the Central Institute of the Hospital das Clínicas in São Paulo during the COVID-19 pandemic

text: The COVID-19 Pandemic has resulted in a high number of hospital admissions and some of those patients need ventilatory support in intensive care units. The viral pneumonia secondary to Sars-cov-2 infection may lead to acute respiratory distress syndrome (ARDS) and longer mechanical ventilation needs, resulting in a higher demand for tracheostomies. Due to the high aerosolization potential of such procedure, and the associated risks of staff and envoirenment contamination, it is necesseray to develop a specific standardization of the of the whole process involving tracheostomies. This manuscript aims to demonstrate the main steps of the standardization created by a tracheostomy team in a tertiary hospital dedicated to providing care for patients with COVID-19.


title: Estimating, monitoring and minimizing the travel footprint associated with the development of the Athena X-ray Integral Field Unit -- An on-line travel footprint calculator released to the science community

text: Global warming imposes us to reflect on the way we carry research, embarking on the obligation to minimize the environmental impact of our research programs, with the reduction of our travel footprint being one of the easiest actions to implement, thanks to the advance of digital technology. The X-ray Integral Field Unit (X-IFU), the cryogenic spectrometer of the Athena space X-ray observatory of the European Space Agency will be developed by a large international consortium. The travel footprint associated with the development of the X-IFU is to be minimized. For that purpose, a travel footprint calculator has been developed and first released to the X-IFU consortium members. The calculator uses seven different emission factors and methods differing by up to a factor of ~5 for the same flying distance. The observed differences illustrate the lack of standards and regulations for computing the footprint of flight travels and are explained primarily, though partly, by different accountings of non-CO2 effects. The calculator enables us to compute the travel footprint of a large set of travels and can help identify a meeting place that minimizes the overall travel footprint for a large set of possible city hosts, e.g. cities with large airports. The calculator also includes the option for a minimum distance above which flying is considered the most suitable transport option ; below that chosen distance, the emission of train journeys are considered. To demonstrate its full capabilities, the calculator is first run on one of the largest scientific meetings; the fall meeting of the AGU and meetings of the IPCC for which it is used to compute the location that would minimize the travel footprint. Then the travel footprint of X-IFU is estimated to be ~500 tons of CO2-eq/yr. With this paper, the on-line travel footprint calculator is released to the science community (abridged).


docid: ejbmjhqj

title: The first pregnant woman with COVID-19 in Venezuela: Pre-symptomatic transmission


COVID-19 puts the spotlight on food insecurity in rural and remote Australia


title: Modeling, state estimation, and optimal control for the US COVID-19 outbreak

text: The novel coronavirus SARS-CoV-2 and resulting COVID-19 disease have had an unprecedented spread and continue to cause an increasing number of fatalities worldwide. While vaccines are still under development, social distancing, extensive testing, and quarantining of confirmed infected subjects remain the most effective measures to contain the pandemic. These measures carry a significant socioeconomic cost. In this work, we introduce a novel optimization-based decision-making framework for managing the COVID-19 outbreak in the US. This includes modeling the dynamics of affected populations, estimating the model parameters and hidden states from data, and an optimal control strategy for sequencing social distancing and testing events such that the number of infections is minimized. The analysis of our extensive computational efforts reveals that social distancing and quarantining are most effective when implemented early, with quarantining of confirmed infected subjects having a much higher impact. Further, we find that "on-off" policies alternating between strict social distancing and relaxing such restrictions can be effective at "flattening" the curve while likely minimizing social and economic cost.


Regional differences in hospital admissions for ST-elevation and non-ST-elevation myocardial infarctions during the Coronavirus disease-19 (COVID-19) pandemic in Austria


docid: uutpzscf

title: Keeping lupus patients on hydroxychloroquine during the COVID-19 pandemic

text: Hydroxychloroquine (HCQ) is in short supply as a result of the coronavirus disease 2019 (COVID-19) pandemic, presenting a challenge to rheumatologists to ensure their patients with systemic lupus erythematosus (SLE) continue to take this essential drug. HCQ is the only SLE treatment shown to increase survival and any change in the HCQ regimen is potentially dangerous. Changes in the HCQ regimen should be made jointly with the patient after a discussion of the available evidence and expert opinion and the patient's preferences. Providers need to make thoughtful, informed decisions in this time of medication shortage.


The UK's public health response to covid-19


Coronavirus Disease 2019 Test Results After Clinical Recovery and Hospital Discharge Among Patients in China


title: CLUE: COVID-19 lung ultrasound in emergency department

text: Lung ultrasound (LUS) plays a critical role in the SARS-CoV-2 pandemic. Evidence is mounting on its utility to diagnose, assess the severity and as a triage tool in the ED. Sonographic features correlate well to computed tomography (CT) chest findings and a bedside LUS performed by a trained clinician along with clinical examination, could be an alternative to chest X-ray and CT chest in these highly infectious patients. In this article, we have described a step-by-step approach to LUS in COVID patients and the CLUE (COVID-19 LUS in the ED) protocol, which involves an anatomical parameter, the severity of lung changes, objectively scored using the validated LUS scoring system and a physiological parameter, oxygen requirement. We believe this CLUE protocol can help risk-stratify patients presenting to ED with suspected COVID-19 and aid clinicians in making appropriate disposition decisions.


Anosmia in a healthcare worker with COVID-19 in Madrid, Spain


title: SARS-CoV-2 infection in infants under 1 year of age in Wuhan City, China

text: BACKGROUND: The clinical characteristics and outcome of COVID-19 in children are different from those in adults. We aimed to describe the characteristics of infants under 1 year of age (excluding newborns) with COVID-19. METHODS: We retrospectively retrieved data of 36 infants with SARS-CoV-2 infection in Wuhan Children's Hospital from January 26 to March 22, 2020. Clinical features, chest imaging findings, laboratory tests results, treatments and clinical outcomes were analyzed. RESULTS: The mean age of the infected infants was 6.43 months, with a range of 2-12 months. 61.11% of the patients were males and 38.89% females. 86.11% of the infants were infected due to family clustering. Cough (77.78%) and fever (47.22%) were the most common clinical manifestations. Chest CT scan revealed 61.11% bilateral pneumonia and 36.11% unilateral pneumonia. 47.22% of the infants developed complications. Increased leucocytes, neutrophils, lymphocytes, and thrombocytes were observed in 11.11, 8.33, 36.11 and 44.44% of infants, respectively. Decreased leucocytes, neutrophils, thrombocyte and hemoglobin were observed in 8.33, 19.44, 2.78 and 36.11% of infants, respectively. Increased C-reactive protein, procalcitonin, lactate dehydrogenase, alanine aminotransferase, creatine kinase and D-dimer were observed in 19.44, 67.74, 47.22, 19.44, 22.22 and 20.69% of infants, respectively. Only one infant had a high level of creatinine. Co-infections with other respiratory pathogens were observed in 62.86% of infants. CD3 (20.69%), CD4 (68.97%), CD19 (31.03%) and Th/Ts (44.83%) were elevated; CD8 (6.9%) and CD16+CD56 (48.28%) was reduced. IL-4 (7.69%), IL-6 (19.23%), IL-10 (50%), TNF-α (11.54%) and IFN-Î³ (19.23%) were elevated. Up to March 22, 97.22% of infants recovered, while a critical ill infant died. When the infant's condition deteriorates rapidly, lymphocytopenia was discovered. Meanwhile, C-reactive protein, D-dimer, alanine aminotransferase, creatine kinase, creatinine, IL-6 and IL-10 increased significantly. CONCLUSIONS: In the cohort, we discovered that lymphocytosis, elevated CD4 and IL-10, and co-infections were common in infants with COVID-19, which were different from adults with COVID-19. Most infants with COVID-19 have mild clinical symptoms and good prognosis.


title: Spondweni virus causes fetal harm in Ifnar1-/- mice and is transmitted by Aedes aegypti mosquitoes

text: Spondweni virus (SPONV) is the most closely related known flavivirus to Zika virus (ZIKV). Its pathogenic potential and vector specificity have not been well defined. SPONV has been found predominantly in Africa, but was recently detected in a pool of Culex quinquefasciatus mosquitoes in Haiti. Here we show that SPONV can cause significant fetal harm, including demise, comparable to ZIKV, in a mouse model of vertical transmission. Following maternal inoculation, we detected infectious SPONV in placentas and fetuses, along with significant fetal and placental histopathology, together suggesting vertical transmission. To test vector competence, we exposed Aedes aegypti and Culex quinquefasciatus mosquitoes to SPONV-infected bloodmeals. Aedes aegypti could efficiently transmit SPONV, whereas Culex quinquefasciatus could not. Our results suggest that SPONV has the same features that made ZIKV a public health risk.


Uncertainty and the Risk of Occupational Exposure to Severe Acute Respiratory Syndrome-Coronavirus-2


Go back to the basics: Cardiac surgery residents at the time of COVID-19


title: COVID-19 and Cancer Patients

text: COVID-19 has now been declared a global pandemic with evolving incidence rates and fatalities It is important to identify vulnerable populations who will be impacted most by this pandemic leading to higher mortality rates compared to the general healthy population Although older patients and patients with co-morbidities fall into this vulnerable group, patients with hematologic and oncologic malignancies on active cytotoxic treatments are at even greater risk as they are both myelosuppressed and immunosuppressed In addition to following the universal guidelines recommended by the Centers for Disease Control (CDC), it is important to also institute guidelines for cancer centers to help protect this vulnerable population We review the current data, risks, and recommendations for COVID-19 in cancer patients


Comparisons of viral shedding time of SARS-CoV-2 of different samples in ICU and non-ICU patients


docid: imrtlnnx

title: Covid-19: Timing is critical for antibody tests, finds Cochrane review


Warning Against the Use of Anti-Inflammatory Medicines to Cure COVID-19: Building Castles in the Air


title: Models for plasma kinetics during simultaneous therapeutic plasma exchange and extracorporeal membrane oxygenation

text: This paper focuses on the derivation and simulation of mathematical models describing new plasma fraction in blood for patients undergoing simultaneous extracorporeal membrane oxygenation and therapeutic plasma exchange. Models for plasma exchange with either veno-arterial or veno-venous extracorporeal membrane oxygenation are considered. Two classes of models are derived for each case, one in the form of an algebraic delay equation and another in the form of a system of delay differential equations. In special cases, our models reduce to single compartment ones for plasma exchange that have been validated with experimental data. We also show that the algebraic delay equations are forward Euler discretizations of the delay differential equations, with timesteps equal to transit times through model compartments. Numerical simulations are performed to compare different model types, to investigate the impact of plasma device port switching on the efficiency of the exchange process, and to study the sensitivity of the models to their parameters.


2019 Novel Coronavirus Disease Epidemic: Skin Protection for Healthcare Workers Must Not Be Ignored


Managing ocular allergy in the time of COVID-19


COVID-19 and Indigenous Peoples: An imperative for action


More awareness is needed for severe acute respiratory syndrome coronavirus 2019 transmission through exhaled air during non-invasive respiratory support: experience from China


Infection Control in the Medical Imaging Department During the COVID-19 Pandemic


title: Advices on the prevention and control of nosocomial infection of novel coronavirus within children’s hospitals/ 中华医院管理杂志

text: The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.


docid: bkjbcfsu

title: Do patients with cancer have a poorer prognosis of COVID-19? An experience in New York City


docid: snuprsrz

title: Nitric oxide dosed in short bursts at high concentrations may protect against Covid 19

text: It has long been suggested that NO may inhibit an early stage in viral replication. Furthermore, in vitro tests have shown that NO inhibits the replication cycle of severe acute respiratory syndrome coronavirus. Despite smoking being listed as a risk factor to contract Covid-19, only a low proportion of the smokers suffered from SARS-corona infection in China 2003, and from Covid-19 in China, Europe and the US. We hypothesize, that the intermittent bursts of high NO concentration in cigarette smoke may be a mechanism in protecting against the virus. Mainstream smoke from cigarettes contains NO at peak concentrations of between about 250 ppm and 1350 ppm in each puff as compared to medicinal use of no more than 80 to a maximum of 160 ppm. The diffusion of NO through the cell wall to reach the virus should be significantly more effective at the very high NO concentration in the smoke, according to classic laws of physics. The only oxide of nitrogen in the mainstream smoke is NO, and the NO2 concentration that is inhaled is very low or undetectable, and methemoglobin levels are lower in smokers than non-smokers, reasonably explained by the breaths of air in between the puffs that wash out the NO. Specialized iNO machines can now be developed to provide the drug intermittently in short bursts at high concentration dose, which would then provide both a preventative drug for those at high risk, as well as an effective treatment, without the health hazards associated with smoking.


title: Surgical treatment of latent infection of 2019 novel coronavirus (SARS-CoV-2) with esophageal foreign body perforation: A case report

text: This study reports the surgical treatment of a female patient at age of 64 years with novel coronavirus (SARS-CoV-2) latent infection complicated with esophageal foreign body perforation with no significant changes in the lung CT The patient was confirmed as SARS-CoV-2 infection on the 4th day after surgery and then was transferred into the Department of Infectious Disease in our hospital for treatment This case has guiding value for the operation of thoracic surgery during the outbreak of novel coronavirus pneumonia


title: [Comparison of Recovery Phase CT Features between Mild/moderate and Severe/critical Coronavirus Disease 2019 Patients]

text: Objective To investigate the computed tomographc(CT)features of mild/moderate and severe/critical cases of coronavirus disease 2019(COVID-19)in the recovery phase. Methods Totally 63 discharged patients in Wuhan,China,who underwent both chest CT and reverse transcription-polymerase chain reaction(RT-PCR)from February 1 to February 29,2020,were included.With RT-PCR as a gold standard,the performance of chest CT in diagnosing COVID-19 was assessed.Patients were divided into mild/moderate and severe/critical groups according to the disease conditions,and clinical features such as sex,age,symptoms,hospital stay,comorbidities,and oxygen therapy were collected.CT images in the recovery phase were reviewed in terms of time from onset,CT features,location of lesions,lobe score,and total CT score. Results There were 37 patients in the mild/moderate group and 26 in the severe/critical group. Compared with the mild/moderate patients,the severe/critical patients had older age [(43±16) years vs. (52±16) years; t=2.10, P=0.040], longer hospital stay [(15±6)d vs. (19±7)d; t=2.70, P=0.009], higher dyspnea ratio (5.41% vs. 53.85%; χ2=18.90, P<0.001), lower nasal oxygen therapy ratio (81.08% vs. 19.23%;χ2=23.66, P<0.001), and higher bi-level positive airway pressure ventilation ratio (0 vs. 57.69%; χ2=25.62, P<0.001). Time from onset was (23±6) days in severe/critical group, significantly longer than that in mild/moderate group [(18±7) days] (t=3.40, P<0.001). Severe/critical patients had significantly higher crazy-paving pattern ratio (46.15% vs.10.81%;χ2=4.24, P=0.039) and lower ground-glass opacities ratio (15.38% vs. 67.57%; χ2=16.74, P<0.001) than the mild/moderate patients. The proportion of lesions in peripheral lung was significantly higher in mild/moderate group than in severe/critical group (78.38% vs.34.61%; χ2=13.43, P<0.001), and the proportion of diffusely distributed lesions was significantly higher in severe/critical group than in mild/moderate group (65.38% vs.10.81%; χ2=20.47, P<0.001). Total CT score in severe/critical group was also significantly higher in severe/critical group than in mild/moderate group [11 (8,17) points vs. 7 (4,9) points; Z=3.81, P<0.001]. Conclusions The CT features in the recovery stage differ between mild/moderate and severe/critical COVID-19 patients.The lung infiltration is remarkably more severe in the latter.


title: Association of the COVID-19 pandemic with Internet Search Volumes: A Google TrendsTM Analysis

text: OBJECTIVES: To assess the association of public interest in coronavirus infections with the actual number of infected cases for selected countries across the globe. METHODS: We performed a Google TrendsTM search for "Coronavirus" and compared Relative Search Volumes (RSV) indices to the number of reported COVID-19 cases by the European Center for Disease Control (ECDC) using time-lag correlation analysis. RESULTS: Worldwide public interest in Coronavirus reached its first peak end of January when numbers of newly infected patients started to increase exponentially in China. The worldwide Google TrendsTM index reached its peak on the 12th of March 2020 at a time when numbers of infected patients started to increase in Europe and COVID-19 was declared a pandemic. At this time the general interest in China but also the Republic of Korea has already been significantly decreased as compared to end of January. Correlations between RSV indices and number of new COVID-19 cases were observed across all investigated countries with highest correlations observed with a time lag of -11.5 days, i.e. highest interest in coronavirus observed 11.5 days before the peak of newly infected cases. This pattern was very consistent across European countries but also holds true for the US. In Brazil and Australia, highest correlations were observed with a time lag of -7 days. In Egypt the highest correlation is given with a time lag of 0, potentially indicating that in this country, numbers of newly infected patients will increase exponentially within the course of April. CONCLUSIONS: Public interest indicated by RSV indices can help to monitor the progression of an outbreak such as the current COVID-19 pandemic. Public interest is on average highest 11.5 days before the peak of newly infected cases.


Optimal Management of Electrodiagnostic Studies during Covid-19 Outbreak


Psychological stress of ICU nurses in the time of COVID-19


Getting the right PPE: five minutes with . . . Sarah Hallett


Where have all the children gone? Reflections on a flowerless "COVID" spring


docid: tfwyuhmx

title: Developing Covid-19 Vaccines at Pandemic Speed


title: COVID-19 and the Social Distancing Paradox: dangers and solutions

text: Background: Without proven effect treatments and vaccines, Social Distancing is the key protection factor against COVID-19. Social distancing alone should have been enough to protect again the virus, yet things have gone very differently, with a big mismatch between theory and practice. What are the reasons? A big problem is that there is no actual social distancing data, and the corresponding people behavior in a pandemic is unknown. We collect the world-first dataset on social distancing during the COVID-19 outbreak, so to see for the first time how people really implement social distancing, identify dangers of the current situation, and find solutions against this and future pandemics. Methods: Using a sensor-based social distancing belt we collected social distance data from people in Italy for over two months during the most critical COVID-19 outbreak. Additionally, we investigated if and how wearing various Personal Protection Equipment, like masks, influences social distancing. Results: Without masks, people adopt a counter-intuitively dangerous strategy, a paradox that could explain the relative lack of effectiveness of social distancing. Using masks radically changes the situation, breaking the paradoxical behavior and leading to a safe social distance behavior. In shortage of masks, DIY (Do It Yourself) masks can also be used: even without filtering protection, they provide social distancing protection. Goggles should be recommended for general use, as they give an extra powerful safety boost. Generic Public Health policies and media campaigns do not work well on social distancing: explicit focus on the behavioral problems of necessary mobility are needed.


title: CORD-19: The COVID-19 Open Research Dataset

text: The COVID-19 Open Research Dataset (CORD-19) is a growing resource of scientific papers on COVID-19 and related historical coronavirus research. CORD-19 is designed to facilitate the development of text mining and information retrieval systems over its rich collection of metadata and structured full text papers. Since its release, CORD-19 has been downloaded over 200K times and has served as the basis of many COVID-19 text mining and discovery systems. In this article, we describe the mechanics of dataset construction, highlighting challenges and key design decisions, provide an overview of how CORD-19 has been used, and describe several shared tasks built around the dataset. We hope this resource will continue to bring together the computing community, biomedical experts, and policy makers in the search for effective treatments and management policies for COVID-19.


No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection


title: Incidental diagnosis of Covid-19 pneumonia on chest computed tomography

text: PURPOSE: The purpose of this study was to determine the prevalence and imaging characteristics of incidentally diagnosed COVID-19 pneumonia on computed tomography (CT). MATERIALS AND METHODS: This retrospective study was conducted between March 20th and March 31st, 2020 at Cochin hospital, Paris France. Thoracic CT examinations of all patients referred for another reason than a suspicion of SARS-CoV-2 infection were reviewed. CT images were analyzed by a chest radiologist to confirm the presence of findings consistent with COVID-19 pneumonia and quantify disease extent. Clinical and biological data (C-reactive protein serum level [CRP] and white blood cell count) of patients with CT findings suggestive for COVID-19 pneumonia were retrieved from the electronic medical chart. RESULTS: During the study period, among 205 diagnostic CT examinations, six examinations (6/205, 3%) in 6 different patients (4 men, 2 women; median age, 57 years) revealed images highly suggestive of COVID-19 pneumonia. The final diagnosis was confirmed by RT-PCR. Three inpatients were suspected of extra thoracic infection whereas three outpatients were either fully asymptomatic or presented with fatigue only. All had increased CRP serum level and lymphopenia. Disease extent on CT was mild to moderate in 5/6 patients (83%) and severe in 1/6 patient (17%). CONCLUSION: Cumulative incidence of fortuitous diagnosis if COVID-19 pneumonia did not exceed 3% during the highest pandemic phase and was predominantly associated with limited lung involvement.


title: Factors associated with insomnia among Chinese frontline nurses Fighting against COVID-19 in Wuhan: A cross-sectional survey

text: AIM: To investigate the prevalence of insomnia among frontline nurses fighting against COVID-19 in Wuhan, China and analyze its influencing factors. BACKGROUND: Insomnia is an important factor that can affect the health and work quality of nurses. However, There is a lack of big-sample studies exploring factors that affect the insomnia of nurses fighting against COVID-19. METHOD: This cross-sectional study using the Ascension Insomnia Scale, Fatigue Scale-14, and Perceived Stress Scale took place in March 2020. Participants were 1,794 frontline nurses from four tertiary-level general hospitals. RESULTS: The prevalence of insomnia among participants was 52.8%. Insomnia was predicted by gender, working experience, chronic diseases, midday nap duration, direct participation in rescue of patients with COVID-19, frequency of night shifts, professional psychological assistance during the pandemic, negative experiences (such as family, friends, or colleagues being seriously ill or dying due to COVID-19), the degree of fear of COVID-19, fatigue, and perceived stress. CONCLUSION: The level of insomnia among participants was higher than the normal level. Interventions based on influencing factors should be implemented to ensure nurses' sleep quality. IMPLICATIONS FOR NURSING MANAGEMENT: An in-depth understanding of the influencing factors of insomnia among frontline nurses can help nurse managers develop solutions to improve frontline nurses' sleep quality, which will enhance the physical and mental conditions of nurses and promote the quality of care.


title: A Modified Epidemiological Model to Understand the Uneven Impact of COVID-19 on Vulnerable Individuals and the Approaches Required to Help them Emerge from Lockdown

text: COVID-19 has shown a relatively low mortality rate in young healthy individuals, with the majority of this group being asymptomatic or having mild symptoms, while the severity of the disease among individuals with underlying health conditions has caused signiffcant mortality rates worldwide. Understanding these differences in mortality amongst different sectors of society and modelling this will enable the different levels of risk and vulnerabilities to be determined to enable strategies exit the lockdown. However, epidemiological models do not account for the variability encountered in the severity of the SARS-CoV-2 disease across different population groups. To overcome this limitation, it is proposed that a modiffed SEIR model, namely SEIR-v, through which the population is separated into two groups regarding their vulnerability to SARS-CoV-2 is applied. This enables the analysis of the spread of the epidemic when different contention measures are applied to different groups in society regarding their vulnerability to the disease. A Monte Carlo simulation indicates a large number of deaths could be avoided by slightly decreasing the exposure of vulnerable groups to the disease. From this modelling a number of mechanisms can be proposed to limit the exposure of vulnerable individuals to the disease in order to reduce the mortality rate among this group. One option could be the provision of a wristband to vulnerable people and those without a contact-tracing app. By combining very dense contact tracing data from smartphone apps and wristband signals with information about infection status and symptoms, vulnerable people can be protected and kept safer. Widespread utilisation would extend the protection further beyond these high risk groups.


Philanthropy and humanity in the face of a pandemic-A letter to the editor on "World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)" (Int J surg 2020; 76:71-6)


title: Diabetes and COVID-19: psychosocial consequences of the COVID-19 pandemic in people with diabetes in Denmark-what characterizes people with high levels of COVID-19-related worries?

text: AIM: To map COVID-19-specific worries and overall psychosocial health among people with diabetes in the initial phase of the COVID-19 pandemic in Denmark, and to explore characteristics of people with diabetes and high levels of worries related to the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted by distributing online questionnaires to 2430 adult members (> 18 years) of two user panels consisting of people with diabetes who have volunteered to share information about their life with diabetes. The questionnaire included items on COVID-19-specific worries as well as such worries related to diabetes, sociodemographic and health status, social relations, diabetes-specific social support, diabetes distress and changes in diabetes-specific behaviours. Responses were analysed with descriptive statistics and logistic regressions. RESULTS: People with diabetes have COVID-19-specific worries related to their diabetes. More than half were worried about being overly affected due to diabetes if infected with COVID-19, about one-third about being characterized as a risk group due to diabetes and not being able to manage diabetes if infected. Logistic regressions showed that being female, having type 1 diabetes, diabetes complications and diabetes distress, feeling isolated and lonely, and having changed diabetes behaviours were associated with being more worried about COVID-19 and diabetes. CONCLUSION: People with diabetes have COVID-19-specific worries related to their diabetes which is associated with poorer psychosocial health. These worries should be addressed through support targeting specific questions and needs of individuals with diabetes as well as frequent updates on new knowledge regarding COVID-19 and diabetes.


title: Admission decisions to intensive care units in the context of the major COVID-19 outbreak: local guidance from the COVID-19 Paris-region area

text: SARS-CoV-2 has caused a global pandemic unprecedented in size, spread, severity, and mortality. The influx of patients with severe or life-threatening disease means that in some cases, the available medical resources are not sufficient to meet the needs of all patients. Hence, healthcare providers may be forced to make difficult choices about which patients should be referred to the ICU. This document is intended to provide conceptual support to all healthcare teams currently engaged in the frontline management of the COVID-19 pandemic. It aims to assist physicians in the decision-making process for ICU admission and to help them provide uninterrupted and high-quality care.


title: Efficacy of VRD(Bortezomib, Lenalidomide, and Dexamethasone) Consolidation Therapy and Maintenance Therapy with Immunomodulatory Drugs(Thalidomide or Lenalidomide) after Autologous Peripheral Blood Stem Cell Transplantation in the Era of Bortezomib-Containing Induction Therapy-A Single Institution Experience

text: Autologous stem cell transplantation(ASCT)for newly-diagnosed multiple myeloma(NDMM)has underwent recent improvements in combination with novel agents-containing induction and post-ASCT therapy. Since the approval of bortezomib for NDMM in Japan, we conducted the following regimen(BD arm)in transplant-eligible patients with NDMM: BD (bortezomib and dexamethasone)induction, ASCT, VRD consolidation, and maintenance therapy with immunomodulatory drugs(IMIDs). The efficacy and safety of the BD arm were compared to those of patients treated with vincristine, doxorubicin, and dexamethasone(VAD)induction followed by ASCT(VAD arm)retrospectively. Thirty-three patients were treated with the BD arm, and 92 patients with the VAD arm. Thirty-one patients in the BD arm proceeded to ASCT. Thereafter, 23 and 17 patients received VRD consolidation and IMIDs maintenance therapy, respectively. The rates of complete response/Bvery good partial response after ASCT, consolidation, and maintenance therapy were 43%/61%, 76%/90% and 87%/93%, respectively. The response rates after ASCT did not differ between BD and VAD arms. The median PFS was 46.2 months(BD arm)and 30.6 months(VAD arm)(HR 0.48[0.27-0.85], p=0.0106). The median OS was not-reached(BD arm)and 90.6 months(VAD arm)(HR 0.21[0.05-0.87], p=0.0172). VRD consolidation and IMIDs maintenance therapies improved disease status after ASCT and prolonged PFS and OS.


title: Heart Rate Estimation from Face Videos for Student Assessment: Experiments on edBB

text: In this study we estimate the heart rate from face videos for student assessment. This information could be very valuable to track their status along time and also to estimate other data such as their attention level or the presence of stress that may be caused by cheating attempts. The recent edBBplat, a platform for student behavior modelling in remote education, is considered in this study1. This platform permits to capture several signals from a set of sensors that capture biometric and behavioral data: RGB and near infrared cameras, microphone, EEG band, mouse, smartwatch, and keyboard, among others. In the experimental framework of this study, we focus on the RGB and near-infrared video sequences for performing heart rate estimation applying remote photoplethysmography techniques. The experiments include behavioral and physiological data from 25 different students completing a collection of tasks related to e-learning. Our proposed face heart rate estimation approach is compared with the heart rate provided by the smartwatch, achieving very promising results for its future deployment in e-learning applications.


title: Clinical course of COVID-19 in a liver transplant recipient on hemodialysis and response to tocilizumab therapy: A case report

text: The novel coronavirus disease 2019 (COVID-19) is a highly infectious and rapidly spreading disease. There are limited published data on the epidemiology and outcomes of COVID-19 infection among organ transplant recipients. After initial flulike symptoms, progression to an inflammatory phase may occur, characterized by cytokine release rapidly leading to respiratory and multiorgan failure. We report the clinical course and management of a liver transplant recipient on hemodialysis, who presented with COVID-19 pneumonia, and despite completing a 5-day course of hydroxychloroquine, later developed marked inflammatory manifestations with rapid improvement after administration of off-label, single-dose tocilizumab. We also highlight the role of lung ultrasonography in early diagnosis of the inflammatory phase of COVID-19. Future investigation of the effects of immunomodulators among transplant recipients with COVID-19 infection will be important.


Data Quarantine in the Time of the COVID-19 Pandemic


title: A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak

text: OBJECTIVE: Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers. METHODS: Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated. RESULTS: Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54-5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36-3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27-7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12-4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales. CONCLUSIONS: Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded.


title: [Clinical features of coronavirus disease 2019 in children aged <18 years in Jiangxi, China: an analysis of 23 cases]

text: OBJECTIVE: To study the clinical features of coronavirus disease 2019 (COVID-19) in children aged <18 years. METHODS: A retrospective analysis was performed from the medical data of 23 children, aged from 3 months to 17 years and 8 months, who were diagnosed with COVID-19 in Jiangxi, China from January 21 to February 29, 2020. RESULTS: Of the 23 children with COVID-19, 17 had family aggregation. Three children (13%) had asymptomatic infection, 6 (26%) had mild type, and 14 (61%) had common type. Among these 23 children, 16 (70%) had fever, 11 (48%) had cough, 8 (35%) had fever and cough, and 8 (35%) had wet rales in the lungs. The period from disease onset or the first nucleic acid-positive detection of SARS-CoV-2 to the virus nucleic acid negative conversion was 6-24 days (median 12 days). Of the 23 children, 3 had a reduction in total leukocyte count, 2 had a reduction in lymphocytes, 2 had an increase in C-reactive protein, and 2 had an increase in D-dimer. Abnormal pulmonary CT findings were observed in 12 children, among whom 9 had patchy ground-glass opacities in both lungs. All 23 children received antiviral therapy and were recovered. CONCLUSIONS: COVID-19 in children aged <18 years often occurs with family aggregation, with no specific clinical manifestation and laboratory examination results. Most of these children have mild symptoms and a good prognosis. Epidemiological history is of particular importance in the diagnosis of COVID-19 in children aged <18 years.


title: Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China ;Clinical Infectious Diseases ;Oxford Academic

text: Abstract Background From December 2019 to February 2020, 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a serious outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China Related clinical features are needed Methods We reviewed 69 patients who were hospitalized in Union hospital in Wuhan between January 16 to January 29, 2020 All patients were confirmed to be infected with SARS-CoV-2 and the final date of follow-up was February 4, 2020 Results The median age of 69 enrolled patients was 42 0 years (IQR 35 0-62 0), and 32 patients (46%) were men The most common symptoms were fever (60[87%]), cough (38[55%]), and fatigue (29[42%]) Most patients received antiviral therapy (66 [98 5%] of 67 patients) and antibiotic therapy (66 [98 5%] of 67 patients) As of February 4, 2020, 18 (26 9%) of 67 patients had been discharged, and five patients had died, with a mortality rate of 7 5% According to the lowest SpO2 during admission, cases were divided into the SpO2≥90% group (n=55) and the SpO2<90% group (n=14) All 5 deaths occurred in the SpO2<90% group Compared with SpO2≥90% group, patients of the SpO2<90% group were older, and showed more comorbidities and higher plasma levels of IL6, IL10, lactate dehydrogenase, and c reactive protein Arbidol treatment showed tendency to improve the discharging rate and decrease the mortality rate Conclusions COVID-19 appears to show frequent fever, dry cough, and increase of inflammatory cytokines, and induced a mortality rate of 7 5% Older patients or those with underlying comorbidities are at higher risk of death


title: Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China

text: BACKGROUND: From December 2019 to February 2020, 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a serious outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China. Related clinical features are needed. METHODS: We reviewed 69 patients who were hospitalized in Union hospital in Wuhan between January 16 to January 29, 2020. All patients were confirmed to be infected with SARS-CoV-2 and the final date of follow-up was February 4, 2020. RESULTS: The median age of 69 enrolled patients was 42.0 years (IQR 35.0-62.0), and 32 patients (46%) were men. The most common symptoms were fever (60[87%]), cough (38[55%]), and fatigue (29[42%]). Most patients received antiviral therapy (66 [98.5%] of 67 patients) and antibiotic therapy (66 [98.5%] of 67 patients). As of February 4, 2020, 18 (26.9%) of 67 patients had been discharged, and five patients had died, with a mortality rate of 7.5%. According to the lowest SpO2 during admission, cases were divided into the SpO2≥90% group (n=55) and the SpO2<90% group (n=14). All 5 deaths occurred in the SpO2<90% group. Compared with SpO2≥90% group, patients of the SpO2<90% group were older, and showed more comorbidities and higher plasma levels of IL6, IL10, lactate dehydrogenase, and c reactive protein. Arbidol treatment showed tendency to improve the discharging rate and decrease the mortality rate. CONCLUSIONS: COVID-19 appears to show frequent fever, dry cough, and increase of inflammatory cytokines, and induced a mortality rate of 7.5%. Older patients or those with underlying comorbidities are at higher risk of death.


Ethical reflections on the COVID-19 pandemic: The epidemiology of panic


title: weg2vec: Event embedding for temporal networks

text: Network embedding techniques are powerful to capture structural regularities in networks and to identify similarities between their local fabrics. However, conventional network embedding models are developed for static structures, commonly consider nodes only and they are seriously challenged when the network is varying in time. Temporal networks may provide an advantage in the description of real systems, but they code more complex information, which could be effectively represented only by a handful of methods so far. Here, we propose a new method of event embedding of temporal networks, called weg2vec, which builds on temporal and structural similarities of events to learn a low dimensional representation of a temporal network. This projection successfully captures latent structures and similarities between events involving different nodes at different times and provides ways to predict the final outcome of spreading processes unfolding on the temporal structure.


Nursing education after COVID-19: Same or different?


COVID-19: Impact and challenges at breast imaging unit


Challenge for Rehabilitation After Hospitalization for COVID-19


COVID-19-Looking Beyond Tomorrow for Health Care and Society


docid: buchzofy

title: Role of Aging and the Immune Response to Respiratory Viral Infections: Potential Implications for COVID-19

text: Aging impairs immunity to promote diseases, especially respiratory viral infections. The current COVID-19 pandemic, resulting from SARS-CoV-2, induces acute pneumonia, a phenotype that is alarmingly increased with aging. In this article, we review findings of how aging alters immunity to respiratory viral infections to identify age-impacted pathways common to several viral pathogens, permitting us to speculate about potential mechanisms of age-enhanced mortality to COVID-19. Aging generally leads to exaggerated innate immunity, particularly in the form of elevated neutrophil accumulation across murine and large animal studies of influenza infection. COVID-19 patients who succumb exhibit a 2-fold increase in neutrophilia, suggesting that exaggerated innate immunity contributes to age-enhanced mortality to SARS-CoV-2 infection. Further investigation in relevant experimental models will elucidate the mechanisms by which aging impacts respiratory viral infections, including SARS-CoV-2. Such investigation could identify therapies to reduce the suffering of the population at large, but especially among older people, infected with respiratory viruses.


title: ENT management of children with adenotonsillar disease during COVID-19 pandemic. Ready to start again?

text: Clinical manifestations of COVID-19 in children are milder, but the real burden of disease is unknown. After the lockdown, in our Region Lombardia we have been requested to progressively resume medical services including outpatient assessment and priority surgery. Therefore, we screened surgical waiting lists with identification of 47 children candidates to priority surgery (among 358). No homogeneous national health surveillance/screening programs are ongoing or have been conceived to test susceptible population among children/healthcare workers in preparation of coming down to routinely daily activities, and diagnostic strategies are not completely accurate in children. So, restoring medical services now might be untimely.


title: Brief Summary of Potential SARS-CoV-2 Prophylactic and Treatment Drugs in the Emergency Department

text: As of March 30th, 2020 there were 161,807 total cases and 2,953 total deaths of SARS-CoV-2 in the United States, with the number of cases expected to rise. Other than supportive care, there are no SARS-CoV-2 specific treatments available for patients discharged from the emergency department (ED) or those admitted to the hospital. In addition, there are no vaccines available to protect our at-risk healthcare workers. The National Institutes of Health is conducting a Phase 1 clinical trial to evaluate for a potential vaccine and the recipients have started to receive the investigational vaccine.2 We present a brief overview of the potential prophylactic and treatment agents under investigation, some which could be initiated in the ED if proven effective.


title: Wound Center Without Walls: The New Model of Providing Care During the COVID-19 Pandemic

text: The COVID-19 pandemic poses a major challenge in delivering care to wound patients. Due to multiple comorbidities, wound patients are at an increased risk for the most extreme complications of COVID-19 and providers must focus on reducing their exposure risk. The Federal, State, and local governments, as well as payers, have urged hospitals and providers to reduce utilization of nonessential health services, but they also have given more flexibility to shift the site of necessary care to lower risk environments. Providers must be prepared for disruption from this pandemic mode of health care for the next 18 months, at minimum. The wound provider must accept the new normal during the pandemic by adapting their care to meet the safety needs of the patient and the public. The Wound Center Without Walls is a strategy to untether wound care from a physical location and aggressively triage and provide care to patients with wounds across the spectrum of the health system utilizing technology and community-centered care.


title: Low dose lung radiation therapy for pneumonia: an examination of historical dose distributions

text: The novel coronavirus, SARS-CoV-2, that causes the COVID-19 disease currently has healthcare systems around the world dealing with unprecedented numbers of critically ill patients. One of the primary concerns associated with this illness is acute respiratory distress syndrome (ARDS) and the pneumonia that accompanies it. Historical literature dating back to the 1940s and earlier contains many reports of successful treatment of pneumonias with ionizing radiation. Although these were not randomized controlled trials, they do suggest a potential avenue for further investigation. Technical details in these reports however were limited. In this work we review the literature and identify details including nominal kilovoltage ranges, filtration, and focus-skin distances (FSDs). Using a freely available and benchmarked code, we generated spectra and used these as sources for Monte Carlo simulations using the EGSnrc software package. The approximate sources were projected through a radiologically anthropomorphic phantom to provide detailed dose distributions within a targeted lung volume (approximate right middle lobe). After accounting for the reported exposure levels, mean lung doses fell in a relatively narrow range: 30 - 80 cGy. Variation in patient dimensions and other details are expected to result in an uncertainty on the order of ± 20%. This result is consistent with the dose range expected to induce anti-inflammatory effects.


Lesiones cutáneas tipo perniosis durante la epidemia COVID-19./ [Perniosis-like skin lesions during the COVID-19 epidemic]


COVID reverse transcriptase PCR in private laboratories: From theory to reality


title: Body Composition Findings by Computed Tomography in SARS-CoV-2 Patients: Increased Risk of Muscle Wasting in Obesity

text: Obesity is a characteristic of COVID-19 patients and the risk of malnutrition can be underestimated due to excess of fat: a paradoxical danger. Long ICU hospitalization exposes patients to a high risk of wasting and loss of lean body mass. The complex management precludes the detection of anthropometric parameters for the definition and monitoring of the nutritional status. The use of imaging diagnostics for body composition could help to recognize and treat patients at increased risk of wasting with targeted pathways. COVID-19 patients admitted to the ICU underwent computed tomography within 24 hours and about 20 days later, to evaluate the parameters of the body and liver composition. The main results were the loss of the lean mass index and a greater increase in liver attenuation in obese subjects. These could be co-caused by COVID-19, prolonged bed rest, the complex medical nutritional therapy, and the starting condition of low-grade inflammation of the obese. The assessment of nutritional status, with body composition applied to imaging diagnostics and metabolic profiles in COVID-19, will assist in prescribing appropriate medical nutritional therapy. This will reduce recovery times and complications caused by frailty.


title: Reorganizing Cross-Sectional Interventional Procedures Practice During the Coronavirus Disease (COVID-19) Pandemic

text: OBJECTIVE. The purpose of this article is to present strategies and guidelines that can be implemented in the performance of cross-sectional interventional procedures during the coronavirus disease (COVID-19) pandemic. CONCLUSION. Radiologists who perform cross-sectional interventional procedures can take several steps to minimize the risks to patients and radiology personnel, including screening referred patients to decide which procedures can be postponed, using appropriate personal protective equipment (PPE), minimizing the number of people involved in procedures, preserving PPE when possible, and applying proper room and equipment cleaning measures.


title: Public Health and Privacy in the Pandemic

text: The fundamental ethical, legal, and policy challenge of public health is balancing public and individual interests, often conceptualized as the conflict between utilitarianism and libertarianism. During the COVID-19 (coronavirus disease 2019) pandemic, this struggle has involved the imposition of extraordinary levels of government-mandated social distancing to protect public health followed by impassioned efforts to lessen these constraints in the interests of individual liberty and economic renewal. (Am J Public Health. Published online ahead of print July 2, 2020: e1-e2. doi:10.2105/AJPH.2020.305849).


Evaluating amblyopia during the era of COVID-19


title: Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study

text: OBJECTIVES: To investigate the incidence of clinical, ultrasonographic and biochemical findings related to pre-eclampsia (PE) in pregnancies with COVID-19, and to assess their accuracy to differentiate between PE and the PE-like features associated with COVID-19. DESIGN: A prospective, observational study. SETTING: Tertiary referral hospital. PARTICIPANTS: Singleton pregnancies with COVID-19 at >20+0 weeks. METHODS: Forty-two consecutive pregnancies were recruited and classified into two groups: severe and non-severe COVID-19, according to the occurrence of severe pneumonia. Uterine artery pulsatility index (UtAPI) and angiogenic factors (soluble fms-like tyrosine kinase-1/placental growth factor [sFlt-1/PlGF]) were assessed in women with suspected PE. MAIN OUTCOME MEASURES: Incidence of signs and symptoms related to PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, abnormal UtAPI and increased sFlt-1/PlGF. RESULTS: Thirty-four cases were classified as non-severe and 8 as severe COVID-19. Five (11.9%) women presented signs and symptoms of PE, all five being among the severe COVID-19 cases (62.5%). However, abnormal sFlt-1/PlGF and UtAPI could only be demonstrated in one case. One case remained pregnant after recovery from severe pneumonia and had a spontaneous resolution of the PE-like syndrome. CONCLUSIONS: Pregnant women with severe COVID-19 can develop a PE-like syndrome that might be distinguished from actual PE by sFlt-1/PlGF, LDH and UtAPI assessment. Healthcare providers should be aware of its existence and monitor pregnancies with suspected pre-eclampsia with caution. TWEETABLE ABSTRACT: This study shows that a pre-eclampsia-like syndrome could be present in some pregnancies with severe COVID-19.


title: Complex networks and human language

text: This paper introduces how human languages can be studied in light of recent development of network theories. There are two directions of exploration. One is to study networks existing in the language system. Various lexical networks can be built based on different relationships between words, being semantic or syntactic. Recent studies have shown that these lexical networks exhibit small-world and scale-free features. The other direction of exploration is to study networks of language users (i.e. social networks of people in the linguistic community), and their role in language evolution. Social networks also show small-world and scale-free features, which cannot be captured by random or regular network models. In the past, computational models of language change and language emergence often assume a population to have a random or regular structure, and there has been little discussion how network structures may affect the dynamics. In the second part of the paper, a series of simulation models of diffusion of linguistic innovation are used to illustrate the importance of choosing realistic conditions of population structure for modeling language change. Four types of social networks are compared, which exhibit two categories of diffusion dynamics. While the questions about which type of networks are more appropriate for modeling still remains, we give some preliminary suggestions for choosing the type of social networks for modeling.


docid: vqujdxhf

title: Very low reporting rate of connective tissue diseases among coronavirus disease 2019 (Covid-19) patients and the renin-angiotensin system - An overlooked association?


title: DeepPurpose: a Deep Learning Library for Drug-Target Interaction Prediction and Applications to Repurposing and Screening

text: Accurate prediction of drug-target interactions (DTI) enables drug discovery tasks, including virtual screening and drug repurposing, which can shorten the time to identify promising drug candidates and provide cures to patients. Recently, there is a growing number of research that developed deep learning (DL) models for DTI. Despite their superior performance, these research models are difficult to use in real drug discovery practice due to the complexity of deploying the research code as well as the restricted data formatting, model capacity, and evaluation setting. We present DeepPurpose, a comprehensive and easy-to-use software toolkit for DL based drug-target interaction (DTI) prediction with applications to drug screening and repurposing. The unique feature of DeepPurpose is that it enables non-computational drug development scientists to identify drug candidates based on five pre-trained DL models with only a few lines of codes. Further, computer scientists can use DeepPurpose to train customized DTI prediction models with 15 drug and target encodings and 50+ novel DL architectures. To tackle method development challenges, DeepPurpose also supports various data split settings and preloads five benchmarking datasets. We demonstrated that DeepPurpose allows users to obtain state-of-the-art prediction performance on several benchmark datasets. We also presented several case studies, including a study on drug repurposing for COVID-19, where promising drug candidates currently investigated in clinical trials are ranked high in DeepPurpose predictions.


title: UVGI Scientific Calculator

text: The physical basis and algorithm of the ultraviolet germicidal irradiation (UVGI) scientific calculator are presented herein. The algorithm was implemented in the web application UVGI Scientific Calculator (found at www.covid-19-clean.org) that has been used to facilitate the engineering and design of air-purifying equipment being developed for use in hospitals, commercial and residential applications. Presented examples of the calculations illustrate how different factors of the construction of a UVGI air-purifier may influence the degree of virus inactivation.


title: COVID-19 infection: the China and Italy perspectives

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the COVID-19 pandemic. Since its first report in December 2019, despite great efforts made in almost every country worldwide, this disease continues to spread globally, especially in most parts of Europe, Iran, and the United States. Here, we update the recent understanding in clinical characteristics, diagnosis strategies, as well as clinical management of COVID-19 in China as compared to Italy, with the purpose to integrate the China experience with the global efforts to outline references for prevention, basic research, treatment as well as final control of the disease. Being the first two countries we feel appropriate to evaluate the evolution of the disease as well as the early result of the treatment, in order to offer a different baseline to other countries. It is also interesting to compare two countries, with a very significant difference in population, where the morbidity and mortality has been so different, and unrelated to the size of the country.


docid: zsmcjisc

title: Guidance for anticoagulation management in venous thromboembolism during the coronavirus disease 2019 pandemic in Poland: an expert opinion of the Section on Pulmonary Circulation of the Polish Cardiac Society

text: The coronavirus disease 2019 (COVID-19) pandemic affects anticoagulation not only in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but also in most patients who require daily anticoagulant therapy and are facing substantial limitations in medical care these days. Concomitant venous thromboembolism (VTE), a potential cause of unexplained deaths, has frequently been reported in patients with COVID-19, but its management is still challenging due to the complexity between antithrombotic therapy and hematological alterations. In the era of COVID-19 pandemic, it is highly recommended for patients who require chronic anticoagulation to continue therapy to prevent thromboembolic events. To avoid regular and frequent blood tests and unnecessary exposure to SARS-CoV-2 during contacts with medical personnel, direct oral anticoagulants should be strongly preferred whenever possible. Current evidence is insufficient to recommend routine pharmacological antithrombotic prophylaxis in all hospitalized patients with COVID-19. In patients with COVID-19 who are suspected of VTE or in whom the diagnosis is confirmed, parenteral therapy with low-molecular-weight heparin should be initiated in the absence of contraindications. If heparin-induced thrombocytopenia is suspected, nonheparin anticoagulants should be used such as bivalirudin or fondaparinux. In case of confirmed acute pulmonary embolism, treatment should be guided by risk stratification as defined in the current guidelines.


Response to Gal Almogy. Superspreaders do matter


Evaluation of seven commercial SARS-CoV-2 RNA detection kits based on real-time polymerase chain reaction (PCR) in China


Outcome of a patient with refractory Hodgkin lymphoma on pembrolizumab, infected with SARS-CoV-2


title: A review on histotechnology practices in COVID-19 pathology investigations

text: COVID-19 disease in humans, caused by the novel SARS-CoV-2 virus, was first reported in the city of Wuhan, China in December 2019. This disease has quickly developed into a global pandemic, resulting in over 350,000 deaths worldwide and over 5 million confirmed infections in a matter of 6 months. Although the genome of this novel viral RNA was sequenced quickly and testing kits were manufactured to assist in combatting COVID-19, the diagnosis and treatment will remain relatively unsuccessful until the pathology of this disease is fully understood. Histotechnology plays an important role in understanding the pathology of many diseases, including COVID-19. The first postmortem biopsy of a COVID-19 patient was collected on 27 January 2020, and the pathology finding was published in mid-February 2020. Since then, more studies have been published in scientific literatures as the global outbreak continues. This mini-review summarizes the published articles in which histotechnology aspects were utilized with the intent to understand the pathology of COVID-19. In addition, it is anticipated there will be more molecular and immunohistochemical studies to further understand the mechanism of the disease in the near future.


Maintenance Hemodialysis and Coronavirus Disease 2019 (COVID-19): Saving Lives With Caution, Care, and Courage


From China: hope and lessons for COVID-19 control


Measurement of body temperature to prevent pandemic COVID-19 in hospitals in Taiwan: repeated measurement is necessary


title: The challenge of intracellular antibiotic accumulation, a function of fluoroquinolone influx versus bacterial efflux

text: With the spreading of antibiotic resistance, the translocation of antibiotics through bacterial envelopes is crucial for their antibacterial activity. In Gram-negative bacteria, the interplay between membrane permeability and drug efflux pumps must be investigated as a whole. Here, we quantified the intracellular accumulation of a series of fluoroquinolones in population and in individual cells of Escherichia coli according to the expression of the AcrB efflux transporter. Computational results supported the accumulation levels measured experimentally and highlighted how fluoroquinolones side chains interact with specific residues of the distal pocket of the AcrB tight monomer during recognition and binding steps.


title: Recommendations in covid-19 times: a view for home care

text: OBJECTIVE: To suggest recommendations for the practice of Home Nursing in the context of COVID-19. METHOD: Reflective study, originated from readings associated with the theme, available in current guidelines from the Pan American Health Organization, World Health Organization and the Ministry of Health. RESULTS: Recommendations were developed from current scientific evidence for prevention of infections, control of epidemics and pandemics in the Brazilian home scenario. FINAL CONSIDERATIONS: the reflections achieved contribute to guiding actions for better assistance to the patient, family caregivers and the community in the perspective of safe home care with COVID-19, and it is characterized as an introductory discussion on the theme, encouraging new studies to be carried out from the unfolding of the current scenario.


title: Adjustments in the Use of Intravesical Instillations of Bacillus Calmette-Guérin for High-risk Non-muscle-invasive Bladder Cancer During the COVID-19 Pandemic

text: Non-muscle-invasive bladder cancer patients with COVID-19 are more likely to develop acute respiratory distress syndrome. Thus, several adjustments to the use of intravesical instillations of bacillus Calmette-Guérin should be made during the current pandemic to limit the risk of contamination.


Dramatic decrease of laboratory-confirmed influenza A after school closure in response to COVID-19


Assessment of patients who tested positive for COVID-19 after recovery


title: The G-Quadruplex/Helicase World as a Potential Antiviral Approach Against COVID-19

text: G-Quadruplexes (G4s) are non-canonical secondary structures formed within guanine-rich regions of DNA or RNA. G4 sequences/structures have been detected in human and in viral genomes, including Coronaviruses Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and SARS-CoV-2. Here, we outline the existing evidence indicating that G4 ligands and inhibitors of SARS-CoV-2 helicase may exert some antiviral activity reducing viral replication and can represent a potential therapeutic approach to tackle the COVID-19 pandemic due to SARS-CoV-2 infection. We also discuss how repositioning of FDA-approved drugs against helicase activity of other viruses, could represent a rapid strategy to limit deaths associated with COVID-19 pandemic.


Developing Trust With Early Medical School Graduates During the COVID-19 Pandemic


title: Effect of restricted emissions during COVID-19 on air quality in India

text: The effectiveness and cost are always top factors for policy-makers to decide control measures and most measures had no pre-test before implementation. Due to the COVID-19 pandemic, human activities are largely restricted in many regions in India since mid-March of 2020, and it is a progressing experiment to testify effectiveness of restricted emissions. In this study, concentrations of six criteria pollutants, PM10, PM2.5, CO, NO2, ozone and SO2 during March 16th to April 14th from 2017 to 2020 in 22 cities covering different regions of India were analysed. Overall, around 43, 31, 10, and 18% decreases in PM2.5, PM10, CO, and NO2 in India were observed during lockdown period compared to previous years. While, there were 17% increase in O3 and negligible changes in SO2. The air quality index (AQI) reduced by 44, 33, 29, 15 and 32% in north, south, east, central and western India, respectively. Correlation between cities especially in northern and eastern regions improved in 2020 compared to previous years, indicating more significant regional transport than previous years. The mean excessive risks of PM reduced by ~52% nationwide due to restricted activities in lockdown period. To eliminate the effects of possible favourable meteorology, the WRF-AERMOD model system was also applied in Delhi-NCR with actual meteorology during the lockdown period and an un-favourable event in early November of 2019 and results show that predicted PM2.5 could increase by only 33% in unfavourable meteorology. This study gives confidence to the regulatory bodies that even during unfavourable meteorology, a significant improvement in air quality could be expected if strict execution of air quality control plans is implemented.


Safety briefing and visual design key to protecting health care workers during the COVID-19 pandemic


title: Emergence of a Novel Coronavirus (COVID-19): Protocol for Extending Surveillance Used by the Royal College of General Practitioners Research and Surveillance Centre and Public Health England

text: BACKGROUND: The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) have successfully worked together on the surveillance of influenza and other infectious diseases for over 50 years, including three previous pandemics. With the emergence of the international outbreak of the coronavirus infection (COVID-19), a UK national approach to containment has been established to test people suspected of exposure to COVID-19. At the same time and separately, the RCGP RSC's surveillance has been extended to monitor the temporal and geographical distribution of COVID-19 infection in the community as well as assess the effectiveness of the containment strategy. OBJECTIVES: The aims of this study are to surveil COVID-19 in both asymptomatic populations and ambulatory cases with respiratory infections, ascertain both the rate and pattern of COVID-19 spread, and assess the effectiveness of the containment policy. METHODS: The RCGP RSC, a network of over 500 general practices in England, extract pseudonymized data weekly. This extended surveillance comprises of five components: (1) Recording in medical records of anyone suspected to have or who has been exposed to COVID-19. Computerized medical records suppliers have within a week of request created new codes to support this. (2) Extension of current virological surveillance and testing people with influenza-like illness or lower respiratory tract infections (LRTI)-with the caveat that people suspected to have or who have been exposed to COVID-19 should be referred to the national containment pathway and not seen in primary care. (3) Serology sample collection across all age groups. This will be an extra blood sample taken from people who are attending their general practice for a scheduled blood test. The 100 general practices currently undertaking annual influenza virology surveillance will be involved in the extended virological and serological surveillance. (4) Collecting convalescent serum samples. (5) Data curation. We have the opportunity to escalate the data extraction to twice weekly if needed. Swabs and sera will be analyzed in PHE reference laboratories. RESULTS: General practice clinical system providers have introduced an emergency new set of clinical codes to support COVID-19 surveillance. Additionally, practices participating in current virology surveillance are now taking samples for COVID-19 surveillance from low-risk patients presenting with LRTIs. Within the first 2 weeks of setup of this surveillance, we have identified 3 cases: 1 through the new coding system, the other 2 through the extended virology sampling. CONCLUSIONS: We have rapidly converted the established national RCGP RSC influenza surveillance system into one that can test the effectiveness of the COVID-19 containment policy. The extended surveillance has already seen the use of new codes with 3 cases reported. Rapid sharing of this protocol should enable scientific critique and shared learning. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/18606.


Editorial: Nicotine and SARS-CoV-2: COVID-19 may be a disease of the nicotinic cholinergic system


title: Evolution of clinical radiotherapy physics practice under COVID-19 constraints

text: As the COVID-19 spread continues to challenge the societal and professional norms, radiotherapy around the globe is pushed into an unprecedented transformation. We will discuss how clinical physics has transformed to ascertain safety and quality standards across four facilities around the world through diversity of action, innovation, and scientific flexibility.


title: Multicenter Evaluation of the Cepheid Xpert Xpress SARS-CoV-2 Test

text: Background. Nucleic acid amplification tests (NAATs) are the primary means of identifying acute infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Accurate and fast test results may permit more efficient use of protective and isolation resources and allow for rapid therapeutic interventions.Methods. We evaluated the analytical and clinical performance characteristics of the Xpert® Xpress SARS-CoV-2 (Xpert) test, a rapid, automated molecular test for SARS-CoV-2. Analytical sensitivity and specificity/interference were assessed with infectious SARS-CoV-2, other infectious coronavirus species including SARS-CoV, and 85 nasopharyngeal swab specimens positive for other respiratory viruses including endemic human coronaviruses (hCoVs). Clinical performance was assessed using 483 remnant upper and lower respiratory specimens previously analyzed by standard of care (SOC) NAATs.Results. The limit of detection of the Xpert test was 0.01 plaque forming units (PFU)/mL. Other hCoVs, including Middle East Respiratory Syndrome coronavirus, were not detected by the Xpert test. SARS-CoV, a closely related species in the Sarbecovirus subgenus, was detected by a broad-range target (E) but was distinguished from SARS-CoV-2 (SARS-CoV-2-specific N2 target). Compared to SOC NAATs, the positive agreement of the Xpert test was 219/220 (99.5%) and the negative agreement was 250/261 (95.8%). A third tie-breaker NAAT resolved all but three of the discordant results in favor the Xpert test.Conclusions. The Xpert test provided sensitive and accurate detection of SARS-CoV-2 in a variety of upper and lower respiratory tract specimens. The high sensitivity and fast time to results of approximately 45 minutes may impact patient management.


Liver injury without liver failure in COVID-19 patients: how to explain, in some cases, elevated ammonia without hepatic decompensation


title: Spatial modelling, risk mapping, change detection, and outbreak trend analysis of coronavirus (COVID-19) in Iran (days between 19 February to 14 June 2020)

text: OBJECTIVES: Coronavirus disease 2019 (COVID-19) represents a major pandemic threat that has spread to more than 212 countries and 2 international conveyance with more than 432,902 recorded deaths and 7,898,442 confirmed global worldwide so far (on June 14, 2020). It is crucial to investigate the spatial drivers to prevent and control the epidemic of COVID-19. METHODS: This is the first comprehensive study of COVID-19 in Iran and it undertakes spatial modeling, risk mapping, change detection, and outbreak trend analysis of the disease spread. Four main steps were taken: comparison of Iranian coronavirus data with the global trends; prediction of mortality trends using regression modelling; spatial modelling, risk mapping, and change detection using the random forest (RF) machine learning technique (MLT); and validation of the modelled risk map. RESULTS: The results show that from February 19 to June 14, 2020 the average growth rates (GR) of COVID-19 deaths and the total number of COVID-19 cases in Iran were 1.08 and 1.10, respectively. Based on World Health Organisation (WHO) data, Iran's fatality (deaths/0.1 M pop) is 10.53. Other countries' fatality rates were, for comparison, Belgium - 83.32, UK - 61.39, Spain - 58.04, Italy - 56.73, Sweden - 48.28, France - 45.04, USA - 35.52, Canada - 21.49, Brazil - 20.10, Peru - 19.70, Chile - 16.20, Mexico- 12.80, and Germany - 10.58. This fatality rate for China is 0.32 (deaths/0.1 M pop). The heatmap of the infected areas over time identified two critical time intervals for the COVID-19 outbreak in Iran. The provinces were classified in terms of disease and death rates into a large primary group and three provinces that had critical outbreaks that were separate from others. The heatmap of countries of the world show that China and Italy were distinguished from other countries in terms of nine viral infection-related parameters. The regression models for death cases showed an increasing trend but with some evidences of turning. A polynomial relationship was identified between coronavirus infection rate and province population density. In addition, a third-degree polynomial regression model for deaths showed an increasing trend recently, indicating that subsequent measures taken to cope with the outbreak have been insufficient and ineffective. The general trend of deaths in Iran is similar to the worlds, but it shows lower volatility. Change detection of COVID-19 risk maps with a random forest model for the period from March 11th to March 18th showed an increasing trend in COVID-19 in Iran's provinces. It is worth noting that using the LASSO MLT to evaluate variables' importance indicated that the most important variables were distance from bus stations, bakeries, hospitals, mosques, ATMs (automated teller machines), banks, and the minimum temperature of the coldest month. CONCLUSIONS: We believe that the risk maps provided by this study is the primary, fundamental step for managing and controlling COVID-19 in Iran and its provinces.


Where do we stand as dermatologists in combat with COVID-19


title: The COVID-19 Pandemic and the Pathology of the Economic and Political Architecture in Cameroon

text: This article examines the factors restricting an effective response to the COVID-19 pandemic in Cameroon. It argues that structural adjustment policies in the 1980s and 1990s as well as corruption and limited investment in recent times have severely weakened the country's health system. This article also emphasises the interconnection between poverty, slums, and COVID-19. This interconnection brings to the fore inequality in Cameroon. Arguably, this inequality could facilitate the spread of COVID-19 in the country. This article draws attention to the political forces shaping the response to the pandemic and contends that in some regions in the country, the lack of an effective response to the pandemic may not necessarily be due to a lack of resources. In so doing, it critiques the COVID-19 orthodoxy that focuses exclusively on the pathology of the disease and advocates "technical" solutions to the pandemic, while ignoring the political and socio-economic forces that shape the fight against the pandemic. At times, medical supplies and other forms of assistance may be available, but structural violence impairs access to these resources. Politics must be brought into the COVID-19 discourse, as it shapes the response to the pandemic.


title: You Need a Plan: A Stepwise Protocol for Operating Room Preparedness During an Infectious Pandemic

text: Background: The worldwide spread of SARS-CoV-2, the coronavirus that causes the syndrome designated COVID-19, presents a challenge for emergency operative management The transmission and virulence of this new pathogen has raised concern for how best to protect operating room staff while effectively providing care to the infected patient requiring urgent or emergent surgery Observations: Establishment of a clear protocol that adheres to rigorous infection control measures while providing a safe system for interfacility transport and operative care is vital to a successful surgical pandemic response While emergency protocols must be rapidly developed, they should be collaboratively improved and incorporate new knowledge as and when it becomes available These measures combined with practice drills to keep operating room personnel ready and able should help construct processes that are useful, easy to follow, and tailored to the unique local environment of each health care setting Conclusions: After the initial apprehensions and struggles during our confrontation with the COVID-19 crisis, it is our hope that the experience we share will be helpful to surgical staff at other institutions grappling with the challenges of operative care in the pandemic environment While this protocol focuses on the current COVID-19 pandemic, these recommendations serve as a template for surgical preparedness that can be readily adapted to infectious disease crisis that unfortunately might emerge in the future


Neurosurgery during the COVID-19 pandemic: update from Lombardy, northern Italy


Scientists in a time of COVID-19


title: The intriguing commonality of NETosis between COVID-19 & Periodontal disease

text: NETosis, being an alternative form of cell death is the creation of web-like chromatin decondensates by suitably primed neutrophils as a response to stimulus aimed at containing and eliminating the same. In certain situations, it causes more harm than benefit in the form of bystander damage directly or via activation of autoimmune mechanisms. Such pathophysiology finds evidence in both Periodontal disease and COVID-19. Coupled with impaired removal, NETs have been implicated in both these disease forms to promote a state of inflammation and be a source of constant harm to the tissues involved. This potentially forms groundwork to implicate Periodontal disease as predisposing towards adverse COVID-19 related outcomes.


Maladies respiratoires, allergies et infections à COVID-19. Premières nouvelles de Wuhan./ [Respiratory diseases, allergy and COVID-19 infection. First news from Wuhan]


docid: gmuweznc

title: We need more researchers in Women's History Month


title: Neonates Hospitalized with Community-Acquired SARS-CoV-2 in a Colorado Neonatal Intensive Care Unit

text: IMPORTANCE: The novel coronavirus 2019 (SARS-CoV-2) has been well described in adults. Further, the impact on older children and during the perinatal time is becoming better studied. As community spread increases, it is important to recognize that neonates are vulnerable to community spread as well. The impact that community-acquired SARS-CoV-2 has in the neonatal time period is unclear, as this population has unique immunity considerations. OBJECTIVE: To report on a case series of SARS-CoV-2 in neonates through community acquisition in the USA. DESIGN: This is an early retrospective study of patients admitted to the Neonatal Intensive Care Unit (NICU) identified as having SAR-CoV-2 through positive real-time polymerase chain reaction assay of nasopharyngeal swabs. FINDINGS: Three patients who required admission to the NICU between the ages of 17 and 33 days old were identified. All 3 had ill contacts in the home or had been to the pediatrician and presented with mild to moderate symptoms including fever, rhinorrhea, and hypoxia, requiring supplemental oxygen during their hospital stay. One patient was admitted with neutropenia, and the other 2 patients became neutropenic during hospitalization. None of the patients had meningitis or multiorgan failure. CONCLUSIONS AND RELEVANCE: Infants with community-acquired SARS-CoV-2 may require hospitalization due to rule-out sepsis guidelines if found to have fever and/or hypoxia. Caregivers of neonates should exercise recommended guidelines before contact with neonates to limit community spread of SARS-CoV-2 to this potentially vulnerable population, including isolation, particularly as asymptomatic cases become prevalent.


ISUOG Safety Committee Position Statement on safe performance of obstetric and gynecological scans and equipment cleaning in context of COVID-19


title: Prevention and Treatment of Venous Thromboembolism Associated with Coronavirus Disease 2019 Infection: A Consensus Statement before Guidelines

text: Coronavirus disease 2019 (COVID-19) has caused a global pandemic in just a few months, causing millions infected. Nearly 20% of COVID-19 patients present severe coagulation abnormalities, which may occur in almost all of the severe and critical ill COVID-19 cases. Concomitant venous thromboembolism (VTE), a potential cause of unexplained deaths, has been frequently reported in COVID-19 cases, but its management is still challenging due to the complexity between antithrombotic therapy and coagulation disorders. Based on frontline practical experience and comprehensive literature review, here a panel of experts and physicians from China and Europe developed an evidence and opinion-based consensus on the prophylaxis and management of VTE associated with COVID-19. This statement aims for clinicians treating COVID-19 and provides practical recommendations in detailed situations, for example, how to choose thromboprophylactic measures for patients with diverse severity of disease and bleeding risk, or which kind of anticoagulant should be prescribed. With limited experience on COVID19-associated VTE, this expert consensus statement should be helpful for clinicians worldwide with specific suggestions.


docid: zwgqnhhc

title: Untersuchung zur Wirkung von Kinesio-Tape und IQ-Tape auf die neuromuskuläre Aktivität beim Joggen, Treppensteigen und Drop-Jump./ [Examination of the Effects of Kinesiotape and IQ Tape on Neuromuscular Activity during Running, Stair Climbing and Drop Jumps]


Androgenic hormones and the excess male mortality observed in COVID-19 patients: new convergent data


docid: uaizxcae

title: Epidemic preparedness in urban settings: new challenges and opportunities


title: Diversity and inclusion for the All of Us research program: A scoping review

text: The All of Us Research Program (All of Us) is a national effort to accelerate health research by exploring the relationship between lifestyle, environment, and genetics. It is set to become one of the largest research efforts in U.S. history, aiming to build a national resource of data from at least one million participants. All of Us aims to address the need for more diversity in research and set the stage for that diversity to be leveraged in precision medicine research to come. This paper describes how the program assessed demographic characteristics of participants who have enrolled in other U.S. biomedical research cohorts to better understand which groups are traditionally represented or underrepresented in biomedical research. We 1) reviewed the enrollment characteristics of national cohort studies like All of Us, and 2) surveyed the literature, focusing on key diversity categories essential to the program's enrollment aims. Based on these efforts, All of Us emphasizes enrollment of racial and ethnic minorities, and has formally designated the following additional groups as historically underrepresented: individuals-with inadequate access to medical care; under the age of 18 or over 65; with an annual household income at or below 200% of the federal poverty level; who have a cognitive or physical disability; have less than a high school education or equivalent; are intersex; identify as a sexual or gender minority; or live in rural or non-metropolitan areas. Research accounting for wider demographic variability is critical. Only by ensuring diversity and by addressing the very barriers that limit it, can we position All of Us to better understand and tackle health disparities.


title: Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series

text: BACKGROUND: Pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with high intensive care unit (ICU) mortality. We aimed to describe the clinical characteristics and outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) in a Canadian setting. METHODS: We conducted a retrospective case series of critically ill patients with laboratory-confirmed SARS-CoV-2 infection consecutively admitted to 1 of 6 ICUs in Metro Vancouver, British Columbia, Canada, between Feb. 21 and Apr. 14, 2020. Demographic, management and outcome data were collected by review of patient charts and electronic medical records. RESULTS: Between Feb. 21 and Apr. 14, 2020, 117 patients were admitted to the ICU with a confirmed diagnosis of COVID-19. The median age was 69 (interquartile range [IQR] 60-75) years, and 38 (32.5%) were female. At least 1 comorbidity was present in 86 (73.5%) patients. Invasive mechanical ventilation was required in 74 (63.2%) patients. The duration of mechanical ventilation was 13.5 (IQR 8-22) days overall and 11 (IQR 6-16) days for patients successfully discharged from the ICU. Tocilizumab was administered to 4 patients and hydroxychloroquine to 1 patient. As of May 5, 2020, a total of 18 (15.4%) patients had died, 12 (10.3%) remained in the ICU, 16 (13.7%) were discharged from the ICU but remained in hospital, and 71 (60.7%) were discharged home. INTERPRETATION: In our setting, mortality in critically ill patients with COVID-19 admitted to the ICU was lower than in previously published studies. These data suggest that the prognosis associated with critical illness due to COVID-19 may not be as poor as previously reported.


Oculofacial Plastic Surgery and the COVID-19 Pandemic: Current Reactions and Implications for the Future


title: A novel COVID-19 based truck driver syndemic? Implications for public health, safety, and vital supply chains

text: U.S. long-haul truck drivers traverse great distances and interact with numerous individuals, rendering them vulnerable to acquiring and transmitting coronavirus disease 2019 (COVID-19). Together, the unique co-occurrence of pronounced health disparities and known COVID-19 infection, morbidity, and mortality risks suggest the possibility of a novel COVID-19 based truck driver syndemic due to advanced driver age and endemic health issues. In turn, COVID-19 sequelae may perpetuate existing health disparities. The co-occurrence of afflictions may also result in compromised safety performance. To curb the likelihood of a COVID-19 based truck driver syndemic, several action stepsare needed. First, key COVID-19 metrics need to be established for this population. Second, relationships between long-haul trucker network attributes and COVID-19 spread need to bedelineated. Third, mutually reinforcing interactions between endemic health disparities and COVID-19 vulnerability need to be elucidated. Finally, grounded in the aforementioned steps, policies and interventions need to be identified and implemented.


title: Drug repurposing prediction for COVID-19 using probabilistic networks and crowdsourced curation

text: Severe acute respiratory syndrome coronavirus two (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, represents an unprecedented global health challenge. Consequently, a large amount of research into the disease pathogenesis and potential treatments has been carried out in a short time frame. However, developing novel drugs is a costly and lengthy process, and is unlikely to deliver a timely treatment for the pandemic. Drug repurposing, by contrast, provides an attractive alternative, as existing drugs have already undergone many of the regulatory requirements. In this work we used a combination of network algorithms and human curation to search integrated knowledge graphs, identifying drug repurposing opportunities for COVID-19. We demonstrate the value of this approach, reporting on eight potential repurposing opportunities identified, and discuss how this approach could be incorporated into future studies.


title: Metabolic dysfunction associated fatty liver disease increases risk of severe Covid-19

text: BACKGROUND AND AIMS: Liver involvement is common in COVID-19. Elevated aspartate and alanine amino transaminase (AST/ALT) and borderline increase in serum bilirubin and serum alkaline phosphatase (ALP) are the commonest findings. Patients with associated co morbid conditions like obesity, cardiovascular disease, renal disease, malignancy, hypertension and old age are prone to develop severe disease. Limited data is available in patients with COVID-19 and metabolic dysfunction associated fatty liver disease (MAFLD).The aim of this review is to analyse the effect of MAFLD on severity of COVID-19. METHODS: We systematically searched the PubMed database till May 20, 2020 and retrieved all the articles published on COVID-19 and fatty liver/MAFLD/NAFLD. RESULTS: Limited studies done had shown four to six fold high risk of severe COVID-19 in patients with MAFLD. Patients with MAFLD and associated obesity, severe fibrosis and age <60 yrs are more prone to develop severe COVID-19. CONCLUSION: MAFLD is associated with 4-6 fold increase in severity of COVID-19 compared to non MAFLD patients. Physician and hepatologist should follow these patients cautiously and preventive measures to be taken strictly in these high risk patients.


Update Alert: Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults


title: Mathematical Modeling of the Spread of COVID-19 in Moscow and Russian Regions

text: To model the spread of COVID-19 coronavirus in Russian regions and in Moscow, a discrete logistic equation describing the increase in the number of cases is used. To check the adequacy of the mathematical model, the simulation results were compared with the spread of coronavirus in China, in a number of European and Asian countries, and the United States. The parameters of the logistics equation for Russia, Moscow and other large regions were determined in the interval (01.03 - 08.04). A comparative analysis of growth rates of COVID-19 infected population for different countries and regions is presented. Various scenarios of the spread of COVID-19 coronavirus in Moscow and in the regions of Russia are considered. For each scenario, curves for the daily new cases and graphs for the increase in the total number of cases were obtained, and the dynamics of infection spread by day was studied. Peak times, epidemic periods, the number of infected people at the peak and their growth were determined.


Coagulopathy and mesenteric ischaemia in severe SARS-CoV-2 infection


docid: lorltril

title: COVID-19 on the Chest Radiograph: A Multi-Reader Evaluation of an AI System

text: Background Chest radiography (CXR) may play an important role in triage for COVID-19, particularly in low-resource settings. Purpose To evaluate the performance of an artificial intelligence (AI) system for detection of COVID-19 pneumonia on chest radiographs. Methods An AI system (CAD4COVID-Xray) was trained on 24,678 CXR images including 1,540 used only for validation while training. The test set consisted of a set of continuously acquired CXR images (n=454) obtained in patients suspected for COVID-19 pneumonia between March 4th and April 6th 2020 in a single center (223 RT-PCR positive subjects, 231 RT-PCR negative subjects). The radiographs were independently analyzed by six readers and by the AI system. Diagnostic performance was performed by receiver operating characteristic curve analysis. Results For the test set, the mean age of the patients was 67.3 (+/-14.4) years (56% male). Using RT-PCR test results as the reference standard, the AI system correctly classified CXR images as COVID-19 pneumonia with an AUC of 0.81. The system significantly outperforms each reader (p < 0.001 using McNemar test) at their highest possible sensitivities. At their lowest sensitivities, only one reader can significantly outperform the AI system (p=0.04). Conclusions An AI system for detection of COVID-19 on chest radiographs was comparable to six independent readers.