title: The first two cases of 2019-nCoV in Italy: Where they come from?

text: A novel Coronavirus, 2019-nCoV, has been identified as the causal pathogen of an ongoing epidemic, with the first cases reported in Wuhan, China, last December 2019, and has since spread to other countries worldwide, included Europe and very recently Italy. In this short report, phylogenetic reconstruction was used to better understand the transmission dynamics of the virus from its first introduction in China focusing on the more recent evidence of infection in a couple of Chinese tourists arrived in Italy on 23rd January 2020 and labeled as Coronavirus Italian cases. A maximum clade credibility tree has been built using a dataset of 54 genome sequences of 2019-nCoV plus two closely related bat strains (SARS-like CoV) available in GenBank. Bayesian time-scaled phylogenetic analysis was implemented in BEAST 1.10.4. The Bayesian phylogenetic reconstruction showed that 2019-2020 nCoV firstly introduced in Wuhan on 25 November 2019, started epidemic transmission reaching many countries worldwide, including Europe and Italy where the two strains isolated dated back 19 January 2020, the same that the Chinese tourists arrived in Italy. Strains isolated outside China were intermixed with strains isolated in China as evidence of likely imported cases in Rome, Italy, and Europe, as well. In conclusion, this report suggests that further spread of 2019-nCoV epidemic was supported by human mobility and that quarantine of suspected or diagnosed cases is useful to prevent further transmission. Viral genome phylogenetic analysis represents a useful tool for the evaluation of transmission dynamics and preventive action.


Catastrophic Intracranial Hemorrhage in Two Critically Ill Patients with COVID-19


Changes in Routine Pediatric Practice in Light of COVID-19


title: Strategies for Optimizing the Supply of N95 Filtering Facepiece Respirators During the Coronavirus Disease 2019 (COVID-19) Pandemic

text: N95 respirators are personal protective equipment most often used to control exposures to infections transmitted via the airborne route. Supplies of N95 respirators can become depleted during pandemics or when otherwise in high demand. In this paper, we offer strategies for optimizing supplies of N95 respirators in health care settings while maximizing the level of protection offered to health care personnel when there is limited supply in the United States during the 2019 coronavirus disease pandemic. The strategies are intended for use by professionals who manage respiratory protection programs, occupational health services, and infection prevention programs in health care facilities to protect health care personnel from job-related risks of exposure to infectious respiratory illnesses. Consultation with federal, state, and local public health officials is also important. We use the framework of surge capacity and the occupational health and safety hierarchy of controls approach to discuss specific engineering control, administrative control, and personal protective equipment measures that may help in optimizing N95 respirator supplies.


docid: xlrnqbtg

title: Epidemic update of COVID-19 in Hubei Province compared with other regions in China

text: AIMS & BACKGROUND: The COVID-19 outbreak spread in China and is a threat to the world. The aims of this study to help health workers better understand the epidemic of the COVID-19 and provide different control strategies toward Hubei Province and other regions in China. METHODS: A comprehensive search of the Chinese Center for Disease Control and Prevention official websites and announcements was performed between 20 Jan 2019 and 29 Feb 2020. The relevant data of the distribution of the infection on each reported day were obtained. RESULTS& FINDINGS: Up to 29 Feb 2020, 79,824 confirmed cases with the COVID-19 including 66,907 in Hubei Province and 12,377 in other administrative regions were reported. The SARS-COV-2 showed faster epidemic trends compared with the 2003-SARS-CoV. A total of 2,870 deaths have been reported nationwide among 79,824 confirmed cases, with a mortality of 3.6%. The mortality of the COVID-19 was significantly higher in Hubei Province than that in other regions(4.1% versus 0.84%). Since 1 Feb 2020 the number of discharged cases exceeded the number of the dead. By 29 Feb 2020, the number of discharged patients was 41,625, which exceeded the number of hospitalized patients, and the trend has further increased. CONCLUSIONS: The infection of the SARS-COV-2 is spreading and increasing nationwide, and Hubei Province is the main epidemic area, with higher mortality. The outbreak is now under initial control especially in other regions outside of Hubei Province. Due to the different epidemic characteristics between Hubei Province and other regions, we should focus on different prevention and control strategies.


A case of a readmitted patient who recovered from COVID-19 in Chengdu, China


Making decisions to mitigate COVID-19 with limited knowledge


title: The time scale of asymptomatic transmission affects estimates of epidemic potential in the COVID-19 outbreak

text: The role of asymptomatic carriers in transmission poses challenges for control of the COVID-19 pandemic. Study of asymptomatic transmission and implications for surveillance and disease burden are ongoing, but there has been little study of the implications of asymptomatic transmission on dynamics of disease. We use a mathematical framework to evaluate expected effects of asymptomatic transmission on the basic reproduction number R0 (i.e., the expected number of secondary cases generated by an average primary case in a fully susceptible population) and the fraction of new secondary cases attributable to asymptomatic individuals. If the generation-interval distribution of asymptomatic transmission differs from that of symptomatic transmission, then estimates of the basic reproduction number which do not explicitly account for asymptomatic cases may be systematically biased. Specifically, if asymptomatic cases have a shorter generation interval than symptomatic cases, R0 will be over-estimated, and if they have a longer generation interval, R0 will be under-estimated. Estimates of the realized proportion of asymptomatic transmission during the exponential phase also depend on asymptomatic generation intervals. Our analysis shows that understanding the temporal course of asymptomatic transmission can be important for assessing the importance of this route of transmission, and for disease dynamics. This provides an additional motivation for investigating both the importance and relative duration of asymptomatic transmission.


Respiratory support for patients with COVID-19 infection


title: Proceedings of the OMS COVID-19 Response Conference

text: The coronavirus disease 2019 (COVID-19) pandemic has affected the world in unprecedented ways. It is clear that this pandemic, unlike any public health challenge in recent memory, has the potential to fundamentally alter the delivery of many healthcare services, including the practice of oral and maxillofacial surgery. In response to this global health crisis, the Oral and Maxillofacial Surgery (OMS) COVID-19 Response Conference was held virtually on April 9, 2020, organized by oral and maxillofacial surgeons (OMSs) and administrators from multiple institutions to provide a forum for OMSs to discuss how COVID-19 has affected the specialty. As evidence-based information on COVID-19 continues to emerge, the present report serves as a method to disseminate the current opinions and management strategies from a variety of experts in OMS.


Lung Ultrasound early detection and monitoring in Covid-19 Pneumonia: fact and fiction


Africa in the Path of Covid-19


title: Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis

text: Importance: Risk factors associated with the severity of coronavirus disease 2019 (COVID-19) in patients with multiple sclerosis (MS) are unknown. Disease-modifying therapies (DMTs) may modify the risk of developing a severe COVID-19 infection, beside identified risk factors such as age and comorbidities. Objective: To describe the clinical characteristics and outcomes in patients with MS and COVID-19 and identify factors associated with COVID-19 severity. Design, Setting, and Participants: The Covisep registry is a multicenter, retrospective, observational cohort study conducted in MS expert centers and general hospitals and with neurologists collaborating with MS expert centers and members of the Société Francophone de la Sclérose en Plaques. The study included patients with MS presenting with a confirmed or highly suspected diagnosis of COVID-19 between March 1, 2020, and May 21, 2020. Exposures: COVID-19 diagnosed with a polymerase chain reaction test on a nasopharyngeal swab, thoracic computed tomography, or typical symptoms. Main Outcomes and Measures: The main outcome was COVID-19 severity assessed on a 7-point ordinal scale (ranging from 1 [not hospitalized with no limitations on activities] to 7 [death]) with a cutoff at 3 (hospitalized and not requiring supplemental oxygen). We collected demographics, neurological history, Expanded Disability Severity Scale score (EDSS; ranging from 0 to 10, with cutoffs at 3 and 6), comorbidities, COVID-19 characteristics, and outcomes. Univariate and multivariate logistic regression models were used to estimate the association of collected variables with COVID-19 outcomes. Results: A total of 347 patients (mean [SD] age, 44.6 [12.8] years, 249 women; mean [SD] disease duration, 13.5 [10.0] years) were analyzed. Seventy-three patients (21.0%) had a COVID-19 severity score of 3 or more, and 12 patients (3.5%) died of COVID-19. The median EDSS was 2.0 (range, 0-9.5), and 284 patients (81.8%) were receiving DMT. There was a higher proportion of patients with a COVID-19 severity score of 3 or more among patients with no DMT relative to patients receiving DMTs (46.0% vs 15.5%; P < .001). Multivariate logistic regression models determined that age (odds ratio per 10 years: 1.9 [95% CI, 1.4-2.5]), EDSS (OR for EDSS ≥6, 6.3 [95% CI. 2.8-14.4]), and obesity (OR, 3.0 [95% CI, 1.0-8.7]) were independent risk factors for a COVID-19 severity score of 3 or more (indicating hospitalization or higher severity). The EDSS was associated with the highest variability of COVID-19 severe outcome (R2, 0.2), followed by age (R2, 0.06) and obesity (R2, 0.01). Conclusions and Relevance: In this registry-based cohort study of patients with MS, age, EDSS, and obesity were independent risk factors for severe COVID-19; there was no association found between DMTs exposure and COVID-19 severity. The identification of these risk factors should provide the rationale for an individual strategy regarding clinical management of patients with MS during the COVID-19 pandemic.


Troubleshoot It: Accuracy of Various Thermometer Types Is Important to Consider During the COVID-19 Pandemic


Changes to calf bTB testing during Covid-19


title: Systemic and mucosal antibody secretion specific to SARS-CoV-2 during mild versus severe COVID-19

text: Background Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes an acute illness termed coronavirus disease 2019 (COVID-19) Humoral immune responses likely play an important role in containing SARS-CoV-2, however, the determinants of SARS-CoV-2-specific antibody responses are unclear Methods Using immunoassays specific for the SARS-CoV-2 spike protein, we determined SARS-CoV-2-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) in sera and mucosal fluids of two cohorts, including patients with quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR)-confirmed SARS-CoV-2 infection (n = 56;median age 61 years) with mild versus severe COVID-19, and SARS-CoV-2-exposed healthcare workers (n = 109;median age 36 years) with or without symptoms and tested negative or positive by RT-qPCR Findings On average, SARS-CoV-2-specific serum IgA titers in mild COVID-19 cases became positive eight days after symptom onset and were often transient, whereas serum IgG levels remained negative or reached positive values 9--10 days after symptom onset Conversely, patients with severe COVID-19 showed a highly significant increase of SARS-CoV-2-specific serum IgA and IgG titers as a function of duration since symptom onset, independent of patient age and comorbidities Very high levels of SARS-CoV-2-specific serum IgA correlated with severe acute respiratory distress syndrome (ARDS) Interestingly, some of the SARS-CoV-2-exposed healthcare workers with negative SARS-CoV-2-specific IgA and IgG serum titers had detectable SARS-CoV-2-specific IgA antibodies in their nasal fluids and tears Moreover, SARS-CoV-2-specific IgA levels in nasal fluids of these healthcare workers were inversely correlated with patient age Interpretation These data show that systemic IgA and IgG production against SARS-CoV-2 develops mainly in severe COVID-19, with very high IgA levels seen in patients with severe ARDS, whereas mild disease may be associated with transient serum titers of SARS-CoV-2-specific antibodies but stimulate mucosal SARS-CoV-2-specific IgA secretion The findings suggest four grades of antibody responses dependent on COVID-19 severity


title: How to Safely Reopen Colleges and Universities During COVID-19: Experiences From Taiwan

text: Reopening colleges and universities during the coronavirus disease 2019 (COVID-19) pandemic poses a special challenge worldwide. Taiwan is one of the few countries where schools are functioning normally. To secure the safety of students and staff, the Ministry of Education in Taiwan established general guidelines for college campuses. The guidelines delineated creation of a task force at each university; school-based risk screening based on travel history, occupation, contacts, and clusters; measures on self-management of health and quarantine; general hygiene measures (including wearing masks indoors); principles on ventilation and sanitization; regulations on school assemblies; a process for reporting suspected cases; and policies on school closing and make-up classes. It also announced that a class should be suspended if 1 student or staff member in it tested positive and that a school should be closed for 14 days if it had 2 or more confirmed cases. As of 18 June 2020, there have been 7 confirmed cases in 6 Taiwanese universities since the start of the pandemic. One university was temporarily closed, adopted virtual classes, and quickly reopened after 14 days of contact tracing and quarantine of possible contacts. Taiwan's experience suggests that, under certain circumstances, safely reopening colleges and universities this fall may be feasible with a combination of strategies that include containment (access control with contact tracing and quarantine) and mitigation (hygiene, sanitation, ventilation, and social distancing) practices.


Healthcare simulation to prepare for the COVID-19 pandemic


title: Managing healthcare worker well-being in an Australian emergency department during the COVID-19 pandemic

text: Emergency Medicine staff in Australia and New Zealand are at the forefront of the healthcare response to COVID-19. This article describes a well-being plan for ED staff that has been devised to mitigate against the negative psychological impact of the COVID-19 pandemic.


title: The Need for Community Practice to Support Aging in Place during COVID-19

text: The COVID-19 pandemic has disrupted systems that support older adults, including older adults aging in their own homes and communities. While much of the calls for gerontological social work practice in response have rightfully focused on direct service provision for health care and basic needs, innovative responses from advocacy and professional organizations, as well as grassroots community groups, have demonstrated the importance of community practice in aging as well. Social work leadership in aging and communities is especially important for addressing issues of equity, inclusion, and meaningful participation across diverse stakeholder groups as local and regional authorities, as well as grassroots groups and community-based organizations, respond to the pandemic. Heightened involvement of social workers in leading place-based communities during this crucial moment has the potential to address long-standing issues within systems to support aging in place and healthy aging, especially with and on behalf of those most directly disadvantaged from multiple forms of injustice.


title: COVID-19 and rhinology, from the consultation room to the operating theatre

text: The purpose of this article is to give rhinologists advice on how to adapt their standard practice during the COVID-19 pandemic. The main goal of these recommendations is to protect healthcare workers against COVID-19 while continuing to provide emergency care so as to prevent loss of chance for patients. We reviewed our recommendations concerning consultations, medical prescriptions and surgical activity in rhinology.


[Stress comprehensive treatment strategies for patients with mild novel coronavirus pneumonia]


Covid-19 and the future of mental health in primary care


title: Considerations in the Triage of Urologic Surgeries During the COVID-19 Pandemic

text: We present a suggested list of urologic surgeries that should be prioritized if COVID-19 surges warrant cancellation of elective surgeries to free up health care resources. The recommendations should be tailored to locally available resources and situations and can be used as a framework for other specialties.


title: Preliminary analysis on the incidence trend of novel coronavirus pneumonia in Shanghai/ 上海预防医学

text: Objective To investigate the epidemical characteristics and analyze the incidence trend of novel coronavirus pneumonia (NCP) in Shanghai. Methods The epidemical data on NCP in Shanghai from January 20 to February 3, 2020 were collected for epidemiological descriptive analysis. Results The number of cumulative confirmed and suspected cases increased first and then decreased from January 20 to February 3, with the peak date being January 30 and January 29 respectively. The day-on-day growth rate of the suspected cases and the cumulative confirmed cases declined after January 27. Among the confirmed cases, the proportion of the exposure history of relevant confirmed cases was on the rise. The total number of confirmed cases of the resident population exceeded that of the population from other places to Shanghai, and Pudong new area had the largest number of confirmed cases. Conclusion The incidence of NCP showed a slowdown trend in shanghai, but it also faces the pressure of the peak of population returning to city, which should be paid enough attention to.


Response to Smith et al.: Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)


title: Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

text: BACKGROUND: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course. METHODS: Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups. FINDINGS: 81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4). INTERPRETATION: COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1-3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia. FUNDING: None.


title: In Silico Trial to test COVID-19 candidate vaccines: a case study with UISS platform

text: SARS-CoV-2 is a severe respiratory infection that infects humans. Its outburst entitled it as a pandemic emergence. To get a grip on this, outbreak specific preventive and therapeutic interventions are urgently needed. It must be said that, until now, there are no existing vaccines for coronaviruses. To promptly and rapidly respond to pandemic events, the application of in silico trials can be used for designing and testing medicines against SARS-CoV-2 and speed-up the vaccine discovery pipeline, predicting any therapeutic failure and minimizing undesired effects. Here, we present an in silico platform that showed to be in very good agreement with the latest literature in predicting SARS- CoV-2 dynamics and related immune system host response. Moreover, it has been used to predict the outcome of one of the latest suggested approach to design an effective vaccine, based on monoclonal antibody. UISS is then potentially ready to be used as an in silico trial platform to predict the outcome of vaccination strategy against SARS-CoV-2.


title: Laboratory characteristics of patients infected with the novel SARS-CoV-2 virus

text: A subgroup of COVID-19 patients develop very severe disease with requirement for ICU treatment, ventilation, and ECMO therapy. Laboratory tests indicate that the immune and clotting system show marked alterations with hyper-activation, hyper-inflammation, cytokine storm development. Furthermore, organ-specific biomarkers demonstrate the involvement of cardiac muscle, kidney, and liver dysfunction in many patients. In this article the use of laboratory biomarkers is discussed with regard to their use for diagnosis, disease progression, and risk assessment.


When the Others Become Us: A Chemist's Perspective of the COVID-19 Outbreak in Italy


Superficial thrombophlebitis in a patient with COVID 19: Heparin treatment after evaluation of D-Dimer


Superficial thrombophlebitis in a patient with COVID 19: Heparin treatment after evaluation of D - Dimer: COVID 19 and Superficial thrombophlebitis


Telepsychiatry and healthcare access inequities during the COVID-19 pandemic


title: Containment effort reduction and regrowth patterns of the Covid-19 spreading

text: In all Countries the political decisions aim at the Covid-19 spreading reduction and at reaching an almost stable configuration of coexistence with the disease, where a small number of new infected individuals per day is sustainable. In such a phase, the containment effort will be reduced in favor of a gradual reopening of the social life and of the various economical sectors and the evaluation of the possible infection regrowth should be very useful. Microscopic models, which take into account the details of the new social and economical conditions, would require a complex dynamics of the stakeholders. We discuss a less detailed approach which, on the basis of the collected data after few days from the beginning of the new phase, outlines different scenarios of the Covid-19 diffusion for longer time. The method applies a time dependent carrying capacity, analogously to many macroscopic growth laws in biology, economics and population dynamics. The illustrative cases of Singapore, Italy and Sicily are analyzed.


title: Case Report: A COVID-19 Patient Presenting with Mild Rhabdomyolysis

text: The news was reported from the Wuhan region of China about a novel corona virus in the end of 2019. After spreading around the world, a pandemic was declared by the WHO. Depending on the different involvement of the disease, the most common symptoms are fever, cough, and dyspnea. However, some indeterminate symptoms that make diagnosis difficult, such as myalgia and fatigue, can also be seen alone, without the typical clinical picture. We describe a patient with COVID-19 pneumonia, the only complaint of which is myalgia, and the first diagnosis is mild rhabdomyolysis. The patient had no evidence or history other than viral infection that could explain muscle pain and also increased level of muscle enzymes. When mild rhabdomyolysis lack of myoglobinuria and complications was diagnosed, treatment-related rhabdomyolysis was also avoided as no treatment related to COVID-19 was initiated yet. Apart from the typical symptoms leading to the typical diagnosis of COVID-19 at the first admission, SARS-CoV-2 related with rhabdomyolysis should also be kept in mind.


title: Information Consumption and Social Response in a Segregated Environment: the Case of Gab

text: Most of the information operations involve users who may foster polarization and distrust toward science and mainstream journalism, without these users being conscious of their role. Gab is well known to be an extremist-friendly platform that performs little control on the posted content. Thus it represents an ideal benchmark for studying phenomena potentially related to polarization such as misinformation spreading. The combination of these factors may lead to hate as well as to episodes of harm in the real world. In this work we provide a characterization of the interaction patterns within Gab around the COVID-19 topic. To assess the spreading of different content type, we analyze consumption patterns based on both interaction type and source reliability. Overall we find that there are no strong statistical differences in the social response to questionable and reliable content, both following a power law distribution. However, questionable and reliable sources display structural and topical differences in the use of hashtags. The commenting behaviour of users in terms of both lifetime and sentiment reveals that questionable and reliable posts are perceived in the same manner. We can conclude that despite evident differences between questionable and reliable posts Gab users do not perform such a differentiation thus treating them as a whole. Our results provide insights toward the understanding of coordinated inauthentic behavior and on the early-warning of information operation.


title: Rapid, Sensitive, Full-Genome Sequencing of Severe Acute Respiratory Syndrome Coronavirus 2

text: We describe validated protocols for generating high-quality, full-length severe acute respiratory syndrome coronavirus 2 genomes from primary samples. One protocol uses multiplex reverse transcription PCR, followed by MinION or MiSeq sequencing; the other uses singleplex, nested reverse transcription PCR and Sanger sequencing. These protocols enable sensitive virus sequencing in different laboratory environments.


title: Changes in infection control policies and advancing infection control advanced practice nurse education in the Republic of Korea

text: After the Middle East respiratory syndrome outbreak of 2015, the Korean government became the payer for infection control (IC) and prevention when hospitals developed IC offices and appointed IC doctors and IC advanced practice nurses The goal was to enhance IC for all hospitalized patients to prevent the occurrence and spread of infection among them Measures resulted in increased demand for IC personnel, especially IC advanced practice nurses This study addressed changes in Korea's IC policies and their impact on the IC advanced practice nursing education program


title: Reappearance of effector T cells is associated with recovery from COVID-19

text: BACKGROUND: Elucidating the role of T cell responses in COVID-19 is of utmost importance to understand the clearance of SARS-CoV-2 infection. METHODS: 30 hospitalized COVID-19 patients and 60 age- and gender-matched healthy controls (HC) participated in this study. We used two comprehensive 11-colour flow cytometric panels conforming to Good Laboratory Practice and approved for clinical diagnostics. FINDINGS: Absolute numbers of lymphocyte subsets were differentially decreased in COVID-19 patients according to clinical severity. In severe disease (SD) patients, all lymphocyte subsets were reduced, whilst in mild disease (MD) NK, NKT and Î³Î´ T cells were at the level of HC. Additionally, we provide evidence of T cell activation in MD but not SD, when compared to HC. Follow up samples revealed a marked increase in effector T cells and memory subsets in convalescing but not in non-convalescing patients. INTERPRETATION: Our data suggest that activation and expansion of innate and adaptive lymphocytes play a major role in COVID-19. Additionally, recovery is associated with formation of T cell memory as suggested by the missing formation of effector and central memory T cells in SD but not in MD. Understanding T cell-responses in the context of clinical severity might serve as foundation to overcome the lack of effective anti-viral immune response in severely affected COVID-19 patients and can offer prognostic value as biomarker for disease outcome and control. FUNDING: Funded by State of Lower Saxony grant 14-76,103-184CORONA-11/20 and German Research Foundation, Excellence Strategy - EXC2155"RESIST"-Project ID39087428, and DFG-SFB900/3-Project ID158989968, grants SFB900-B3, SFB900-B8.


Viral dynamics of SARS-CoV-2 across a spectrum of disease severity in COVID-19


title: CoAID: COVID-19 Healthcare Misinformation Dataset

text: As the COVID-19 virus quickly spreads around the world, unfortunately, misinformation related to COVID-19 also gets created and spreads like wild fire. Such misinformation has caused confusion among people, disruptions in society, and even deadly consequences in health problems. To be able to understand, detect, and mitigate such COVID-19 misinformation, therefore, has not only deep intellectual values but also huge societal impacts. To help researchers combat COVID-19 health misinformation, therefore, we present CoAID (Covid-19 heAlthcare mIsinformation Dataset), with diverse COVID-19 healthcare misinformation, including fake news on websites and social platforms, along with users' social engagement about such news. CoAID includes 1,896 news, 183,564 related user engagements, 516 social platform posts about COVID-19, and ground truth labels. The dataset is available at: https://github.com/cuilimeng/CoAID.


Early look at the future of healthcare during the COVID-19 pandemic


title: Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study

text: OBJECTIVE: To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients. STUDY DESIGN: Multicenter case series. SETTING: Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany). SUBJECTS AND METHODS: In total, 394 polymerase chain reaction (PCR)-confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing. RESULTS: Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. CONCLUSIONS: Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.


title: 2019 Novel Coronavirus (COVID-19) Pneumonia with Hemoptysis as the Initial Symptom: CT and Clinical Features

text: Recently, some global cases of 2019 novel coronavirus (COVID-19) pneumonia have been caused by second- or third-generation transmission of the viral infection, resulting in no traceable epidemiological history. Owing to the complications of COVID-19 pneumonia, the first symptom and imaging features of patients can be very atypical and early diagnosis of COVID-19 infections remains a challenge. It would aid radiologists and clinicians to be aware of the early atypical symptom and imaging features of the disease and contribute to the prevention of infected patients being missed.


title: Augmented curation of clinical notes from a massive EHR system reveals symptoms of impending COVID-19 diagnosis

text: Understanding temporal dynamics of COVID-19 patient symptoms could provide fine-grained resolution to guide clinical decision-making. Here, we use deep neural networks over an institution-wide platform for the augmented curation of clinical notes from 77,167 patients subjected to COVID-19 PCR testing. By contrasting Electronic Health Record (EHR)-derived symptoms of COVID-19-positive (COVIDpos; n=2,317) versus COVID-19-negative (COVIDneg; n=74,850) patients for the week preceding the PCR testing date, we identify anosmia/dysgeusia (27.1-fold), fever/chills (2.6-fold), respiratory difficulty (2.2-fold), cough (2.2-fold), myalgia/arthralgia (2-fold), and diarrhea (1.4-fold) as significantly amplified in COVIDpos over COVIDneg patients. The combination of cough and fever/chills has 4.2-fold amplification in COVIDpos patients during the week prior to PCR testing, and along with anosmia/dysgeusia, constitutes the earliest EHR-derived signature of COVID-19. This study introduces an Augmented Intelligence platform for the real-time synthesis of institutional biomedical knowledge. The platform holds tremendous potential for scaling up curation throughput, thus enabling EHR-powered early disease diagnosis.


docid: ovvjbilo

title: Departments of Radiation Oncology Must Prepare for COVID-19 Outbreak


title: Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?

text: The effects of smoking on Corona Virus Disease 2019 (COVID-19) are currently unknown. The purpose of this study was to systematically examine the prevalence of current smoking among hospitalized patients with COVID-19 in China, considering the high-population smoking prevalence in China (26.6%). A systematic review of the literature (PubMed) was performed on April 1. Thirteen studies examining the clinical characteristics of hospitalized COVID-19 patients in China and presenting data on the smoking status were found. The pooled prevalence of current smoking from all studies was calculated by random-effect meta-analysis. To address the possibility that some smokers had quit shortly before hospitalization and were classified as former smokers on admission to the hospital, we performed a secondary analysis in which all former smokers were classified as current smokers. A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0-3.4%) to 12.6% (95% CI 10.6-14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9-8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7-8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19.


Against pandemic research exceptionalism


title: Contingency management strategies of the Nursing Department in centralized rescue of patients with coronavirus disease 2019

text: Objectives: This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19). Methods: The strategies of the Nursing Department included early warning for prevention and control, taking functions of vertically commanding and horizontally coordinating, and reasonably allocating nursing workforce, to facilitate centralized treatment work in the in-hospital fever clinic, isolation wards and ICU, and referral and admission of critical patients. Five special groups were established in charge of training and examination, management and supervision, psychological support, logistical support, and reporting and publicity, respectively. Results: It was achieved that no deaths from critical patients and no medical staff, no other patients were infected. Conclusion: Through the implementation of these strategies, safe and efficient centralized treatment was ensured timely, orderly and sustainably.


title: "Slowing the Spread and Minimizing the Impact of COVID-19: Lessons from the Past and Recommendations for the Plastic Surgeon"

text: BACKGROUND: COVID-19, a novel coronavirus originating in December 2019 in Wuhan, China, has spread rapidly throughout the globe over 3 months. On March 11, 2020 the World Health Organization declared COVID-19 a global pandemic. COVID-19 represents a nearly unprecedented threat to both the public health and the durability of our healthcare systems and will profoundly affect the field of plastic and reconstructive surgery. The objective of this paper is to provide a natural history of COVID-19 - including virology, epidemiology and transmission patterns - and a guide for plastic surgeons regarding patient and resource management. METHODS: The authors reviewed existing literature regarding COVID-19, both primary research and secondary reviews, via PubMed queries, and recommendations from relevant professional organizations (e.g., American College of Surgeons and American Society of Plastic Surgeons). The literature and recommendations were summarized to provide a specific guide for plastic surgeons. RESULTS: Internationally, over 5.7 million cases and 357,000 deaths from COVID-19 have been reported at time of writing. No pharmacological treatments have been identified, but epidemiological strategies were identified to prevent viral spread, preserve healthcare resources, and protect patients and surgeons globally. Specific recommendations for plastic and reconstructive surgeons include postponing elective cases and transitioning to telecommunication platforms for patient consultations and education. CONCLUSIONS: COVID-19 represents a nearly unprecedented threat to the public health and the durability of healthcare systems in the contemporary era. While plastic and reconstructive surgery may seem relatively remote from the pandemic in direct patient care and exposure, our field can significantly enhance healthcare resource management.


title: Epidemiology and clinical features of emergency department patients with suspected COVID-19: Results from the first month of the COVED Quality Improvement Project (COVED-2)

text: OBJECTIVE: The aim of this study was to describe the epidemiological and clinical features of emergency department (ED) patients with suspected and confirmed COVID-19. METHODS: The COVID-19 Emergency Department (COVED) Project is an ongoing prospective cohort study that includes all adult patients presenting to The Alfred Hospital ED who undergo testing for SARS-CoV-2. Current guidelines recommend testing for patients with fevers or chills, acute respiratory symptoms or a high-risk exposure history, as well as implementation of infection control and prevention (IPC) precautions for all suspected and confirmed cases. Study outcomes include a positive SARS-CoV-2 test result and intensive respiratory support. RESULTS: In the period 1-30 April 2020, 702 of 3453 ED patients (20%; 95%CI: 19-22) were tested, with a significant increase during the study period (IRR 1.019; 95%CI: 1.017-1.021, p<0.001). The primary outcome of a positive SARS-CoV-2 test was recorded in 14 patients (2%; 95%CI: 1-3). Shortness of breath (77%), fatigue (100%), myalgia (67%) and diarrhoea (67%) were common among positive cases, while close contact (9%), fever (0%) and healthcare occupation (0%) were not. No positive cases required intensive respiratory support in the ED. CONCLUSIONS: The volume of ED patients with suspected COVID-19 is increasing. Low numbers of positive cases precluded development of accurate predictive tools, but the COVED Project is fulfilling an important role in monitoring the burden of IPC requirements on the ED. The increasing number of patients meeting isolation criteria has the potential to impact on patient flow and may lead to ED overcrowding.


title: [Advances in the research of mechanism and related immunotherapy on the cytokine storm induced by coronavirus disease 2019]

text: Coronavirus disease 2019 (COVID-19) has seriously affected the safety of patients and social stability. Some COVID-19 patients in the later stage of disease may develop into acute respiratory distress syndrome or even multiple organ failure. However, one of the most important mechanisms underlying the deterioration of disease is cytokine storm. At present, some therapies such as interleukin-6 antibody blocker, stem cell therapy, and transfusion of convalescent plasma have been applied to counteract the cytokine storm with some progresses being achieved. This article reviews the influences of cytokine storm syndrome on the COVID-19 and the corresponding immunotherapies to resist cytokine storm.


title: [Advances in the research of cytokine storm mechanism induced by Corona Virus Disease 2019 and the corresponding immunotherapies]

text: Corona Virus Disease 2019 (COVID-19) has seriously affected the treatment of patients and social stability. In the later stage of disease, some COVID-19 patients may develop into acute respiratory distress syndrome or even multiple organ failure. However, one of the most important mechanism underlying the deterioration of disease is cytokine storm. At present, some therapies such as interleukin-6 antibody blocker, stem cell therapy, and transfusion of convalescent plasma have been applied to counteract the cytokine storm and have made some progress. This article reviews the influences of cytokine storm syndrome on the COVID-19 and the corresponding immunotherapies to resist cytokine storm.


Epitopes for a 2019-nCoV vaccine


title: The genetic sequence, origin, and diagnosis of SARS-CoV-2

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new infectious disease that first emerged in Hubei province, China, in December 2019, which was found to be associated with a large seafood and animal market in Wuhan. Airway epithelial cells from infected patients were used to isolate a novel coronavirus, named the SARS-CoV-2, on January 12, 2020, which is the seventh member of the coronavirus family to infect humans. Phylogenetic analysis of full-length genome sequences obtained from infected patients showed that SARS-CoV-2 is similar to severe acute respiratory syndrome coronavirus (SARS-CoV) and uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS-CoV. The possible person-to-person disease rapidly spread to many provinces in China as well as other countries. Without a therapeutic vaccine or specific antiviral drugs, early detection and isolation become essential against novel Coronavirus. In this review, we introduced current diagnostic methods and criteria for the SARS-CoV-2 in China and discuss the advantages and limitations of the current diagnostic methods, including chest imaging and laboratory detection.


Answering the initial 20 questions on COVID-19 (January-February 2020)


title: Strategy for treating vascular emergencies during the COVID-19 pandemic in China

text: Coronavirus-caused pneumonia (COVID-19) broke out in Dec 2019. The virus soon proved to be extremely contagious and caused an international pandemic. Clinicians treating COVID-19 patients face considerable danger of occupational exposure due to the highly infectious nature of the virus and precautions must be taken to prevent medical staff infections. This article lists important measures that may save the lives of patients and medical staff during the COVID-19 pandemic and help to stop the transmission of COVID-19 on hospital grounds. The suggestions include: 1. Establishing detailed Infection Control and Prevention Protocols in the operating room; 2. Expediting testing procedures and patient screening for COVID-19; 3. Utilizing case-specific treatment planning for vascular patients with COVID-19, favoring minimally invasive methods; 4. Establishing and reinforcing protective awareness within medical personnel.


title: Expression of the SARS-CoV-2 Entry Proteins, ACE2 and TMPRSS2, in Cells of the Olfactory Epithelium: Identification of Cell Types and Trends with Age

text: The COVID-19 pandemic revealed that there is a loss of smell in many patients, including in infected but otherwise asymptomatic individuals. The underlying mechanisms for the olfactory symptoms are unclear. Using a mouse model, we determined whether cells in the olfactory epithelium express the obligatory receptors for entry of the SARS-CoV-2 virus by using RNAseq, RT-PCR, in situ hybridization, Western blot, and immunocytochemistry. We show that the cell surface protein ACE2 and the protease TMPRSS2 are expressed in sustentacular cells of the olfactory epithelium but not, or much less, in most olfactory receptor neurons. These data suggest that sustentacular cells are involved in SARS-CoV-2 virus entry and impairment of the sense of smell in COVID-19 patients. We also show that expression of the entry proteins increases in animals of old age. This may explain, if true also in humans, why individuals of older age are more susceptible to the SARS-CoV-2 infection.


Some African countries begin to ease coronavirus lockdowns


title: Traditional Chinese Medicine treatment of COVID-19

text: A new kind of Pneumonia caused by new corona virus has been widespread in China since winter of 2019. No effective treatment for this disease was verified, so the morbidity and mortality rate were supposed higher than flu. The Traditional Chinese Medicine is widely used in clinical practice in China, but many other countries of the world to deal with diseases that remain clinically challenging.


Prevention of the cytokine storm in COVID-19


title: Challenges at the Time of COVID-19: Opportunities and Innovations in Antivirals from Nature

text: As viral infections are an increasing threat to human societies, the need for new therapeutic strategies is becoming even more obvious. As no vaccine is available for COVID-19, the development of directly acting antiviral agents and preventive strategies have to be considered. Nature provides a huge reservoir of anti-infectious compounds, from which we can deduce innovative ideas, therapies, and products. Anti-adhesive natural products interact with the receptor-mediated recognition and early interaction of viruses with the host cells, leading to a reduced internalisation of the virus and reduced infections (e.g., procyanidin-B-2-di-O-gallate against influenza and herpes virus). Lignans like podophyllotoxin and bicyclol show strong antiviral activities against different viruses, and essential oils can directly interact with viral membranes and reduce the host's inflammatory responses (e.g., 1,8-cineol). Echinacea extracts stimulate the immune system, and bioavailable alkamides are key players by interacting with immunomodulating cannabinoid receptors. COVID-19 and SARS-CoV-2 infections have, in part, successfully been treated in China by preparations from traditional Chinese medicine and, while it is too early to draw conclusions, some promising data are available. There is huge potential, but intensified research is needed to develop evidence-based medicines with a clearly defined chemical profile. Intensified research and development, and therefore funding, are needed for exploiting nature's reservoir against viral infections. Combined action for basic research, chemistry, pharmacognosy, virology, and clinical studies, but also supply chain, sustainable sourcing, and economic aspects have to be considered. This review calls for intensified innovative science on natural products for the patients and for a healthier world!


Surgical practice and operative surgical strategies during the COVID-19 pandemic: A commentary


title: Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study

text: BACKGROUND AND PURPOSE: COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Apart from respiratory complications, acute cerebrovascular disease (CVD) has been observed in some patients with COVID-19. Therefore, we described the clinical characteristics, laboratory features, treatment and outcomes of CVD complicating SARS-CoV-2 infection. MATERIALS AND METHODS: Demographic and clinical characteristics, laboratory findings, treatments and clinical outcomes were collected and analysed. Clinical characteristics and laboratory findings of patients with COVID-19 with or without new-onset CVD were compared. RESULTS: Of 219 patients with COVID-19, 10 (4.6%) developed acute ischaemic stroke and 1 (0.5%) had intracerebral haemorrhage. COVID-19 with new onset of CVD were significantly older (75.7±10.8 years vs 52.1±15.3 years, p<0.001), more likely to present with severe COVID-19 (81.8% vs 39.9%, p<0.01) and were more likely to have cardiovascular risk factors, including hypertension, diabetes and medical history of CVD (all p<0.05). In addition, they were more likely to have increased inflammatory response and hypercoagulable state as reflected in C reactive protein (51.1 (1.3-127.9) vs 12.1 (0.1-212.0) mg/L, p<0.05) and D-dimer (6.9 (0.3-20.0) vs 0.5 (0.1-20.0) mg/L, p<0.001). Of 10 patients with ischemic stroke; 6 received antiplatelet treatment with aspirin or clopidogrel; and 3 of them died. The other four patients received anticoagulant treatment with enoxaparin and 2 of them died. As of 24 March 2020, six patients with CVD died (54.5%). CONCLUSION: Acute CVD is not uncommon in COVID-19. Our findings suggest that older patients with risk factors are more likely to develop CVD. The development of CVD is an important negative prognostic factor which requires further study to identify optimal management strategy to combat the COVID-19 outbreak.


title: Structural features of coronavirus SARS-CoV-2 spike protein: Targets for vaccination

text: Various human pathogenic viruses employ envelope glycoproteins for host cell receptor recognition and binding, membrane fusion and viral entry. The spike (S) glycoprotein of betacoronavirus SARS-CoV-2 is a homotrimeric class I fusion protein that exists in a metastable conformation for cleavage by host cell proteases furin and TMPRSS2, thereby undergoing substantial structural rearrangement for ACE2 host cell receptor binding and subsequent viral entry by membrane fusion. The S protein is densely decorated with N-linked glycans protruding from the trimer surface that affect S protein folding, processing by host cell proteases and the elicitation of humoral immune response. Deep insight into the sophisticated structure of SARS-CoV-2 S protein may provide a blueprint for vaccination strategies, as reviewed herein.


Letter: Strategies for Prevention and Control of 2019 Novel Coronavirus Infection Among Medical Staff


title: Pandemic Programming: How COVID-19 affects software developers and how their organizations can help

text: Context. As a novel coronavirus swept the world in early 2020, thousands of software developers began working from home. Many did so on short notice, under difficult and stressful conditions. Objective. This study investigates the effects of the pandemic on developers' wellbeing and productivity. Method. A questionnaire survey was created mainly from existing, validated scales and translated into 12 languages. The data was analyzed using non-parametric inferential statistics and structural equation modeling. Results. The questionnaire received 2225 usable responses from 53 countries. Factor analysis supported the validity of the scales and the structural model achieved a good fit (CFI = 0.961, RMSEA = 0.051, SRMR = 0.067). Findings include: (1) developers' wellbeing and productivity are suffering; (2) productivity and wellbeing are closely related; (3) disaster preparedness, fear related to the pandemic and home office ergonomics all affect wellbeing or productivity; (4) women, parents and people with disabilities may be disproportionately affected. Conclusions. To improve employee productivity, software companies should focus on maximizing employee wellbeing and improving the ergonomics of employees' home offices. Women, parents and disabled persons may require extra support.


title: Seroprevalence of SARS-CoV-2 Among Frontline Healthcare Personnel During the First Month of Caring for COVID-19 Patients - Nashville, Tennessee

text: Among 249 healthcare personnel who worked in hospital units with COVID-19 patients for one month, 19 (7.6%) tested positive for SARS-CoV-2 antibodies. Only 11 (57.9%) of the 19 personnel with positive serology reported symptoms of a prior illness, suggesting asymptomatic healthcare personnel could be an important source of SARS-CoV-2 transmission.


title: Presentation of pulmonary infection on CT in COVID-19: initial experience in Brazil

text: The disease caused by the new coronavirus (SARS-CoV-2), designated COVID-19, emerged in late 2019 in China, in the city of Wuhan (Hubei province), and showed exponential growth in that country. It subsequently spread to all continents, and infection with SARS-CoV-2 is now classified as a pandemic. Given the magnitude achieved, scientific interest in COVID-19 has also grown in the international literature, including its manifestations on imaging studies, particularly on CT. To date, no case series have been published in Brazil. Therefore, our objective was to describe the CT findings in an initial series of 12 patients.


title: Work-related COVID-19 transmission in six Asian countries/areas: A follow-up study

text: OBJECTIVE: There is limited evidence of work-related transmission in the emerging coronaviral pandemic. We aimed to identify high-risk occupations for early coronavirus disease 2019 (COVID-19) local transmission. METHODS: In this observational study, we extracted confirmed COVID-19 cases from governmental investigation reports in Hong Kong, Japan, Singapore, Taiwan, Thailand, and Vietnam. We followed each country/area for 40 days after its first locally transmitted case, and excluded all imported cases. We defined a possible work-related case as a worker with evidence of close contact with another confirmed case due to work, or an unknown contact history but likely to be infected in the working environment (e.g. an airport taxi driver). We calculated the case number for each occupation, and illustrated the temporal distribution of all possible work-related cases and healthcare worker (HCW) cases. The temporal distribution was further defined as early outbreak (the earliest 10 days of the following period) and late outbreak (11th to 40th days of the following period). RESULTS: We identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases). Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals). CONCLUSIONS: Work-related transmission is considerable in early COVID-19 outbreaks, and the elevated risk of infection was not limited to HCW. Implementing preventive/surveillance strategies for high-risk working populations is warranted.


title: Fecal-Oral Transmission of SARS-CoV-2 In Children: is it Time to Change Our Approach?

text: Starting from 2 pediatric cases of COVID-19, with confirmation at nasopharyngeal and rectal swabs, we considered the lesson learnt from previous Coronavirus epidemics and reviewed evidence on the current outbreak. Surveillance with rectal swabs might be extended to infants and children, for the implications for household contacts and isolation timing.


Potential of heparin and nafamostat combination therapy for COVID-19


'No one is allowed to go out': your stories from the coronavirus outbreak


COVID-19: Could India still escape?


The potential impact of vulnerability and coping capacity on the pandemic control of COVID-19


title: Aptamers, the bivalent agents as probes and therapies for coronavirus infections: A systematic review

text: The recently known coronavirus, SARS-CoV-2, has turn into the greatest global health challenge, affecting a large number of societies. The lack of specific treatment and gold-standard diagnostic system has made the situation more complicated. Efforts have led to production of several diagnostic kits that are associated with limitations such as inadequate sensitivity and accuracy. Aptamers as multipotent biological probes could be promising candidates to design sensitive and specific biosensors. Although few studies have introduced specific aptamer types of coronavirus, they may help us select the best approach to obtain specific aptamers for this virus. On the other hand, some of already-introduced aptamers have shown the inhibitory effects on coronavirus that could be applied as therapeutics. The present study has provided a systematic overview on use of aptamer-based biosensors and drugs to diagnose and treat coronavirus.


SARS-CoV-2 pulmonary infection revealed by subcutaneous emphysema and pneumomediastinum


Faecal-oral transmission of SARS-COV-2: practical implications


title: An Integrative Total Worker Health Framework for Keeping Workers Safe and Healthy During the COVID-19 Pandemic

text: OBJECTIVE: The aim was to recommend an integrated Total Worker Health (TWH) approach which embraces core human factors and ergonomic principles, supporting worker safety, health, and well-being during the COVID-19 pandemic. BACKGROUND: COVID-19 has resulted in unprecedented challenges to workplace safety and health for workers and managers in essential businesses, including healthcare workers, grocery stores, delivery services, warehouses, and distribution centers. Essential workers need protection, accurate information, and a supportive work environment with an unwavering focus on effective infection control. METHOD: The investigators reviewed emerging workplace recommendations for reducing workers' exposures to the novel coronavirus and the challenges to workers in protecting their health. Using a theoretical framework and guidelines for integrating safety and health management systems into an organization for TWH, the investigators adapted the framework's key characteristics to meet the specific worker safety and health issues for effective infection control, providing supports for increasing psychological demands while ensuring a safe work environment. RESULTS: The recommended approach includes six key characteristics: focusing on working conditions for infection control and supportive environments for increased psychological demands; utilizing participatory approaches involving workers in identifying daily challenges and unique solutions; employing comprehensive and collaborative efforts to increase system efficiencies; committing as leaders to supporting workers through action and communications; adhering to ethical and legal standards; and using data to guide actions and evaluate progress. CONCLUSION: Applying an integrative TWH approach for worker safety, health, and well-being provides a framework to help managers systematically organize and protect themselves, essential workers, and the public during the COVID-19 pandemic. APPLICATION: By using the systems approach provided by the six implementation characteristics, employers of essential workers can organize their own efforts to improve system performance and worker well-being during these unprecedented times.


Cardiovascular and immunological implications of social distancing in the context of COVID-19


Health system, public health, and economic implications of managing COVID-19 from a cardiovascular perspective


Letter to the Editor about the Article "Excess Mortality Estimation During the COVID-19 Pandemic: Preliminary Data from Portugal https://doi.org/10.20344/amp.13928"


Cardiac Surgery in the Time of Coronavirus


title: Small Solitary Ground-Glass Nodule on CT as an Initial Manifestation of Coronavirus Disease 2019 (COVID-19) Pneumonia

text: The 2019 novel coronavirus (2019-nCoV) outbreak in Wuhan, Hubei Province, China in 2019 led to large numbers of people being infected and developing atypical pneumonia (coronavirus disease 2019, COVID-19). Typical imaging manifestations of patients infected with 2019-nCoV has been reported, but we encountered an atypical radiological manifestation on baseline computed tomography (CT) images in three patients from Wuhan, China infected with the 2019-nCoV. Surprisingly, the only similar CT finding was a solitary sub-centimeter ground-glass nodule adjacent to bronchovascular bundles, which could be easily overlooked. In addition, the follow-up images in these patients showed how COVID-19 pneumonia evolved from these small nodules. The radiologic manifestation of the three cases will expand contemporary understanding of COVID-19.


COVID-19 pneumonia in patients with HIV - A Case Series


title: Maintaining Health and Well-Being by Putting Faith into Action During the COVID-19 Pandemic

text: Anxiety and fear adversely affect the physiological systems that protect individuals from infection. This article comments on the role that religious faith and practice can play in helping individuals remain free from infection by the coronavirus and in helping to moderate the effects of infection if that should occur. The author provides six recommendations to help individuals maintain spiritual, mental, and physical resilience during these anxious times of the COVID-19 pandemic.


title: Comment on "The neuroinvasive potential of SARS-CoV-2 may play a role in the respiratory failure of COVID-19 patients"

text: We have read with great care and interest the article by Li et al The authors provide interesting elements with respect to the possible entry of severe acute respiratory syndrome coronavirus 2 at the brain area and plead for an implication of the central nervous system in respiratory problems linked to coronavirus disease. Here we provide additional elements that support those observations, notably the role of brainstem structures located in the medulla oblongata in modulating respiration. We also discussed the possible pathways the virus uses to cross the brain blood barrier and reach the brainstem.


title: Comparison of criteria of International Association of Diabetes and Pregnancy Study Groups (IADPSG) with National Institute for Health and Care Excellence (NICE) for diagnosis of gestational diabetes mellitus

text: BACKGROUND: Different screening procedures and diagnostic criteria are being followed in the same as well as in different countries with no single standard criteria established for diagnosis of GDM. So far, there are no studies in the Indian population comparing IADPSG with NICE criteria. OBJECTIVE: To compare International Association of Pregnancy and Study Groups (IADPSG) criteria with the National Institute for Health and Care Excellence (NICE) for diagnosis of gestational diabetes mellitus and its influence on maternal and perinatal outcomes. METHOD: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care institute in South India from March 2017 to October 2018. Six-hundred and eighty women with or without risk factors for GDM were recruited in the study and screened for GDM based on IADPSG and NICE criteria. Women with preexisting diabetes mellitus or with fasting plasma glucose ≥ 126 mg/dl were excluded. RESULTS: The overall prevalence of GDM in our study was 27.2% by either IADPSG/NICE criteria. In this study, 25.1% women and 11.6% women were diagnosed as GDM using IADPSG and NICE criteria, respectively. The level of agreement between the two diagnostic criteria was found to be poor in our study and was statistically significant (kappa = 0.429, p < 0.001). Women testing IADPSG-positive NICE-negative had a higher risk of GHTN, abortions, PROM, preterm delivery, caesarean section and congenital anomalies, meconium-stained liquor, and low Apgar scores at 1 min when compared to non GDM group. In addition, except for preterm delivery, women diagnosed as GDM by both IADPSG and NICE criteria had adverse outcomes such as preeclampsia, urinary tract infection, and polyhydramnios. Women diagnosed as GDM in IADPSG-negative NICE-positive had no significant adverse maternal or perinatal outcomes. CONCLUSIONS: IADPSG criteria appear to be more robust than NICE criteria for diagnosis of GDM. Women with substantial risk of maternal and perinatal outcomes are better identified by IADPSG criteria who would have been missed if NICE criteria was used.


Management of ovarian cancer during the COVID-19 pandemic


Hypoxia in COVID-19: Sign of Severity or Cause for Poor Outcomes


title: COVID-19 in a Patient with ß-Thalassemia Major and Severe Pulmonary Arterial Hypertension

text: We here report the successful recovery from coronavirus disease-19 (COVID-19) pneumonia in a patient with ß-thalassemia major (ß-TM) and severe pulmonary arterial hypertension (PAH), focusing on the patient's comorbidities, therapeutic course and drug interaction.


title: Quantifying the influence of inter-county mobility patterns on the COVID-19 outbreak in the United States

text: As a highly infectious respiratory disease, COVID-19 has become a pandemic that threatens global health. Without an effective treatment, non-pharmaceutical interventions, such as travel restrictions, have been widely promoted to mitigate the outbreak. Current studies analyze mobility metrics such as travel distance; however, there is a lack of research on interzonal travel flow and its impact on the pandemic. Our study specifically focuses on the inter-county mobility pattern and its influence on the COVID-19 spread in the United States. To retrieve real-world mobility patterns, we utilize an integrated set of mobile device location data including over 100 million anonymous devices. We first investigate the nationwide temporal trend and spatial distribution of inter-county mobility. Then we zoom in on the epicenter of the U.S. outbreak, New York City, and evaluate the impacts of its outflow on other counties. Finally, we develop a"log-linear double-risk"model at the county level to quantify the influence of both"external risk"imported by inter-county mobility flows and the"internal risk"defined as the vulnerability of a county in terms of population with high-risk phenotypes. Our study enhances the situation awareness of inter-county mobility in the U.S. and can help improve non-pharmaceutical interventions for COVID-19.


title: Gaining insight into SARS-CoV-2 infection and COVID-19 severity using self-supervised edge features and Graph Neural Networks

text: Graph Neural Networks (GNN) have been extensively used to extract meaningful representations from graph structured data and to perform predictive tasks such as node classification and link prediction. In recent years, there has been a lot of work incorporating edge features along with node features for prediction tasks. In this work, we present a framework for creating new edge features, via a combination of self-supervised and unsupervised learning which we then use along with node features for node classification tasks. We validate our work on two biological datasets comprising of single-cell RNA sequencing data of \textit{in vitro} SARS-CoV-2 infection and human COVID-19 patients. We demonstrate that our method achieves better performance over baseline Graph Attention Network (GAT) and Graph Convolutional Network (GCN) models. Furthermore, given the attention mechanism on edge and node features, we are able to interpret the cell types and genes that determine the course and severity of COVID-19, contributing to a growing list of potential disease biomarkers and therapeutic targets.


COVID-19 Testing: The Threat of False-Negative Results


Necessitating repeated chest CT in COVID-19 pneumonia


title: COVID-19 pneumonia: infection control protocol inside computed tomography suites

text: A novel coronavirus (severe acute respiratory syndrome coronavirus 2) causes a cluster of pneumonia cases in Wuhan, China. It spread rapidly and globally. CT imaging is helpful for the evaluation of the novel coronavirus disease 2019 (COVID-19) pneumonia. Infection control inside the CT suites is also important to prevent hospital-related transmission of COVID-19. We present our experience with infection control protocol for COVID-19 inside the CT suites.


Covid-19: People in most deprived areas of England and Wales twice as likely to die


title: An Open Call for Influenza Vaccination Pending the New Wave of Covid-19

text: In their study, Yue et al. reported influenza co-infection among COVID-19 patients as 57.3%. The study included a period of January 12-February 21, 2020 in Wuhan, China. We have recently detected this rate as 0.54% in Turkey. This difference between rates of co-infection can be explained by the seasonality of the influenza virus. Our study included the period of March 10-May 10. Another study from Wuhan, including the period of 28 January-29 February 2020, reported the rate of influenza co-infection among critically ill COVID-19 patients as 49.5%. Zhu et al. reported 2.7% influenza co-infections among COVID-19 patients, in their study from January 22-February 2. Two studies from USA reported low rates of 0.08% in March 16-April 20, and 0.9% in March 3-March 25. Therefore, studies from the influenza season reported very high rates of co-infection. When the COVID-19 came to Europe and America, the influenza season was almost over and thus the co-infection rates are low. A recent research found moderate to strong correlation between higher influenza vaccine uptake in the elderly and lower COVID-19 deaths in Italy. This might be explained by the prevention of influenza co-infection. In elderly, both influenza and COVID-19 have higher rates of mortality. The impact of prevention of influenza in this fragile group is higher. Current influenza-COVID-19 co-infection reports suggest that co-infection rates are as high as 57% when influenza is circulating. Pending the new waves of COVID-19, it is reasonable to recommend influenza vaccination especially for elderly, but most probably, to general population. This article is protected by copyright. All rights reserved.


docid: wyqispom

title: Strategies for radiology departments in handling the COVID-19 pandemic

text: The world is facing an unprecedented global pandemic in the form of the coronavirus disease 2019 (COVID-19) which has ravaged all aspects of life, especially health systems. Radiology services, in particular, are under threat of being overwhelmed by the sheer number of patients affected, unless drastic efforts are taken to contain and mitigate the spread of the virus. Proactive measures, therefore, must be taken to ensure the continuation of diagnostic and interventional support to clinicians, while minimizing the risk of nosocomial transmission among staff and other patients. This article aims to highlight several strategies to improve preparedness, readiness and response towards this pandemic, specific to the radiology department.


COVID-19: Face masks and human-to-human transmission


docid: ygadghuf

title: How does COVID-19 kill? Uncertainty is hampering doctors' ability to choose treatments


docid: cvwshorl

title: Critical care physicians treating COVID-19: mind the nervous system!


title: Media use and acute psychological outcomes during COVID-19 outbreak in China

text: The COVID-19 outbreak in China led to an extraordinary threat to public health and wellbeing. This study examined the psychological impact of media use among people indirectly exposed to the disease during the initial phase of the outbreak. We conducted an internet-based survey on January 28, 2020 (one week after the official declaration of person-to-person transmission of the coronavirus). Media use (media forms, content of media exposure, and media engagement) related to the outbreak and psychological outcomes (positive and negative affect, anxiety, depression, and stress) of 917 Chinese adults was assessed. A series of multivariable regressions were conducted. The results showed that use of new media, rather than traditional media, was significantly associated with more negative affect, depression, anxiety, and stress. Viewing stressful content (i.e., severity of the outbreak, reports from hospital) was associated with more negative affect and depression. Media engagement was also associated with more negative affect, anxiety, and stress. However, viewing heroic acts, speeches from experts, and knowledge of the disease and prevention were associated with more positive affect and less depression. The study suggested new media use and more media engagement was associated with negative psychological outcomes, while certain media content was associated with positive psychological impact. The present study highlights the need for timely public health communication from official sources and suggests that reduced exposure to new media may be beneficial.


COVID-19 international neurological registries


"Possible protective role of contact Lens against SARS COV 2"


title: Action at a Distance: Geriatric Research during a Pandemic

text: BACKGROUND: "Action at a distance" may be the new norm for clinical researchers in the context of the COVID-19 pandemic that may require social distancing for the next 18 months. We must minimize face-to-face contact with vulnerable populations. But we must also persist, adapt, and help our older patients and study participants during the pandemic. METHODS: Clinical researchers have an obligation to help, and we can. Recommendations for clinical researchers working with older adults during the COVID-19 pandemic are discussed. RESULTS: Implement technology now: Minimize face-to-face contact with participants by utilizing digital tools, such as shifting to electronic informed consent and digital HIPAA-compliant tools such as e-mailed surveys or telehealth assessments. Assess the psychological and social impact of COVID-19: How are participants coping? What health or social behaviors have changed? How are they keeping up with current events? What are they doing to stay connected to their families, friends, and communities? Are their healthcare needs being met? Current studies should be adapted immediately to these ends. Mobilize research platforms for patient needs: Leverage our relationships with participants and rapidly deploy novel clinical engagement techniques such as digital tools to intervene remotely and reduce the negative effects of social isolation on our participants. Equip research staff with tangible resources, and provide timely population-specific health information to support patients and healthcare providers. CONCLUSIONS: We have an opportunity to make an impact on our older adult patients now as this pandemic continues to unfold. Above all, clinical researchers need to continue working, to help as many people as possible through the crisis. J Am Geriatr Soc 68:922-925, 2020.


title: The Challenges Associated with Generating Reliable Nanogram-Per-Liter Measurements of Hexavalent Chromium in Groundwater

text: The US EPA and several states are considering regulatory limits for hexavalent chromium (Cr(VI)) below 100 ng/L, increasing the importance of obtaining accurate and reliable data. This paper presents the results of two studies investigating the effectiveness of chemical preservation on ng/L concentrations of Cr(VI) in groundwater. Chemically preserved and unpreserved aliquots of a groundwater sample were spiked with a known amount of Cr(VI), then analyzed in tandem with sets of preserved and unpreserved performance test samples over 28 days. The studies showed that while Cr(VI) appears to be relatively stable over 28 days, it may be sensitive to minor matrix changes after collection. The studies also demonstrated significant challenges to measuring Cr(VI) below 100 ng/L, as the results can be subject to positive bias or contamination that may not be readily apparent. The authors concluded that Cr(VI) measurements using a US EPA published method below 100 ng/L may be categorized as semi-quantitative at best. This article is protected by copyright. All rights reserved.


Editorial: The explosive epidemic outbreak of novel coronavirus disease 2019 (COVID-19) and the persistent threat of respiratory tract infectious diseases to global health security


title: Elderly at time of COronaVIrus disease 2019 (COVID-19): possible role of immunosenescence and malnutrition

text: The unprecedented COVID-19 pandemic is rapidly and unpredictably evolving and the majority of deaths are occurring in older people. A partial description of the magnitude of the scenario is provided by numbers and statistics, which probably underestimate the ongoing tragedy. In the present opinion paper, we have focused our attention on the evidence of the relationship among malnutrition, immunosenescence, and the higher morbidity and mortality in elderly patients. In particular, we propose the intriguing hypothesis that correction of nutritional deficits may attenuate the age-dependent alterations of the innate and adaptive immune system which participate in the increased susceptibility and worse outcome observed in the elderly COVID-19 patients.


Prolonged presence of SARS-CoV-2 viral RNA in faecal samples


title: Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown

text: The aim of this paper was to review the literature on adolescent psychiatric disorders related to the COVID-19 pandemic and lockdown. Stressful life events, extended home confinement, brutal grief, intrafamilial violence, overuse of the Internet and social media are factors that could influence the mental health of adolescents during this period. The COVID-19 pandemic could result in increased psychiatric disorders such as Post-Traumatic Stress, Depressive, and Anxiety Disorders, as well as grief-related symptoms. Adolescents with psychiatric disorders are at risk of a break or change in their care and management; they may experience increased symptoms. The COVID-19 pandemic and lockdown may have a negative impact on the mental health of adolescents, although there is still no data on the long term impact of this crisis. Adolescents' individual, familial, and social vulnerability, as well as individual and familial coping abilities, are factors related to adolescent mental health in times of crisis. Adolescents are often vulnerable and require careful consideration by caregivers and healthcare system adaptations to allow for mental health support despite the lockdown. Research on adolescent psychiatric disorders in times of pandemics is necessary, as such a global situation could be prolonged or repeated.


title: The Framework for the Prediction of the Critical Turning Period for Outbreak of COVID-19 Spread in China based on the iSEIR Model

text: The goal of this study is to establish a general framework for predicting the so-called critical Turning Period in an infectious disease epidemic such as the COVID-19 outbreak in China early this year. This framework enabled a timely prediction of the turning period when applied to Wuhan COVID-19 epidemic and informed the relevant authority for taking appropriate and timely actions to control the epidemic. It is expected to provide insightful information on turning period for the world's current battle against the COVID-19 pandemic. The underlying mathematical model in our framework is the individual Susceptible-Exposed- Infective-Removed (iSEIR) model, which is a set of differential equations extending the classic SEIR model. We used the observed daily cases of COVID-19 in Wuhan from February 6 to 10, 2020 as the input to the iSEIR model and were able to generate the trajectory of COVID-19 cases dynamics for the following days at midnight of February 10 based on the updated model, from which we predicted that the turning period of CIVID-19 outbreak in Wuhan would arrive within one week after February 14. This prediction turned to be timely and accurate, providing adequate time for the government, hospitals, essential industry sectors and services to meet peak demands and to prepare aftermath planning. Our study also supports the observed effectiveness on flatting the epidemic curve by decisively imposing the Lockdown and Isolation Control Program in Wuhan since January 23, 2020. The Wuhan experience provides an exemplary lesson for the whole world to learn in combating COVID-19.


title: Az elso két sikeres, convalescens friss fagyasztott plazmával történo terápia hazai alkalmazása intenzív osztályon kezelt, kritikus állapotú, COVID19-fertozésben szenvedo betegekben: (A COVID19-pandémia orvosszakmai kérdései)/ Successful administration of convalescent plasma in critically ill COVID-19 patients in Hungary: the first two cases

text: INTRODUCTION: At present, neither specific curative treatment nor vaccines for novel coronavirus 2019 (COVID-19) are available. There is an urgent need to look for alternative strategies for COVID-19 treatment especially in the case of severe and/or critically ill patients with cytokine release syndrome (CRS). AIM: Convalescent plasma proved to increase survival rates in other severe viral infections. Therefore, convalescent plasma could be a promising treatment option for severe COVID-19 patients. METHOD: In our article, we present the first two critically ill Hungarian patients with COVID-19 infection treated with convalescent fresh frozen plasma. RESULTS: At the time of plasma therapy both patients were on mechanical ventilation and received antiviral agents and a full scale of supportive care. Each patient received 3 × 200 mL of convalescent plasma of recently recovered donors with sufficient novel anti-coronavirus IgG titers. Subsequent to convalescent plasma infusion, oxygenization improved and inflammatory markers decreased in both individuals. As compared to pretransfusion, lymphocyte counts increased and interleukin-6 level lessened. Both patients were weaned from mechanical ventilation within 2 weeks of treatment. No severe adverse effects were observed. CONCLUSIONS: Our experience indicates that convalescent plasma therapy is well tolerated and could potentially improve clinical outcomes. Optimal dose and timing as well as precise assessment of clinical benefit of convalescent plasma therapy will need further investigation in larger, well-controlled trials. This is the first report of the successful use of convalescent plasma in the treatment of critically ill patients with COVID-19 infection in Hungary. Orv Hetil. 2020; 161(27): 1111-1121.


Clinical features and outcome of HIV/SARS-CoV-2 coinfected patients in The Bronx, New York city


title: Early Outcomes of Outpatient Management of Kidney Transplant Recipients with Coronavirus Disease 2019

text: BACKGROUND AND OBJECTIVES: Outcomes of kidney transplant recipients diagnosed with coronavirus disease 2019 as outpatients have not been described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We obtained clinical data for 41 consecutive outpatient kidney transplant recipients with known or suspected coronavirus disease 2019. Chi-squared and Wilcoxon rank sum tests were used to compare characteristics of patients who required hospitalization versus those who did not. RESULTS: Of 41 patients, 22 (54%) had confirmed coronavirus disease 2019, and 19 (46%) were suspected cases. Patients most commonly reported fever (80%), cough (56%), and dyspnea (39%). At the end of follow-up, 13 patients (32%) required hospitalization a median of 8 days (range, 1-16) after symptom onset, and 23 (56%) had outpatient symptom resolution a median of 12 days (4-23) after onset. Patients who required hospitalization were more likely to have reported dyspnea (77% versus 21%, P=0.003) and had higher baseline creatinine (median, 2.0 versus 1.3 mg/dl, P=0.02), but there were no other differences between groups. CONCLUSIONS: In an early cohort of outpatient kidney transplant recipients with known or suspected coronavirus disease 2019, many had symptomatic resolution without requiring hospitalization.


title: A plan template-based automation solution using a commercial treatment planning system

text: PURPOSE: The purpose of this study was to develop an auto-planning platform to be interfaced with a commercial treatment planning system (TPS). The main goal was to obtain robust and high-quality plans for different anatomic sites and various dosimetric requirements. METHODS: Monaco (Elekta, St. Louis, US) was the TPS in this work. All input parameters for inverse planning could be defined in a plan template inside Monaco. A software tool called Robot Framework was used to launch auto-planning trials with updated plan templates. The template modifier external to Monaco was the major component of our auto-planning platform. For current implementation, it was a rule-based system that mimics the trial-and-error process of an experienced planner. A template was automatically updated by changing the optimization constraints based on dosimetric evaluation of the plan obtained in the previous trial, along with the data of the iterative optimization extracted from Monaco. Treatment plans generated by Monaco with all plan evaluation criteria satisfied were considered acceptable, and such plans would be saved for further evaluation by clinicians. The auto-planning platform was validated for 10 prostate and 10 head-and-neck cases in comparison with clinical plans generated by experienced planners. RESULTS: The performance and robustness of our auto-planning platform was tested with clinical cases of prostate and head and neck treatment. For prostate cases, automatically generated plans had very similar plan quality with the clinical plans, and the bladder volume receiving 62.5 Gy, 50 Gy, and 40 Gy in auto-plans was reduced by 1%, 3%, and 5%, respectively. For head and neck cases, auto-plans had better conformity with reduced dose to the normal structures but slightly higher dose inhomogeneity in the target volume. Remarkably, the maximum dose in the spinal cord and brain stem was reduced by more than 3.5 Gy in auto-plans. Fluence map optimization only with less than 30 trials was adequate to generate acceptable plans, and subsequent optimization for final plans was completed by Monaco without further intervention. The plan quality was weakly dependent on the parameter selection in the initial template and the choices of the step sizes for changing the constraint values. CONCLUSION: An automated planning platform to interface with Monaco was developed, and our reported tests showed preliminary results for prostate and head and neck cases.


title: SAGES primer for taking care of yourself during and after the COVID-19 crisis

text: COVID-19 is a pandemic which has affected almost every aspect of our life since starting globally in November 2019. Given the rapidity of spread and inadequate time to prepare for record numbers of sick patients, our surgical community faces an unforeseen challenge. SAGES is committed to the protection and care of patients, their surgeons and staff, and all who are served by the medical community at large. This includes physical health, mental health, and well-being of all involved. The fear of the unknown ahead can be paralyzing. International news media have chronicled the unthinkable situations that physicians and other health care providers have been thrust into as a result of the COVID-19 pandemic. These situations include making life or death decisions for patients and their families regarding use of limited health care resources. It includes caring for patients with quickly deteriorating conditions and limited treatments available. Until recently, these situations seemed far from home, and now they are in our own hospitals. As the pandemic broadened its reach, the reality that we as surgeons may be joining the front line is real. It may be happening to you now; it may be on the horizon in the coming weeks. In this context, SAGES put together this document addressing concerns on clinician stressors in these times of uncertainty. We chose to focus on the emotional toll of the situation on the clinician, protecting vulnerable persons, reckoning with social isolation, and promoting wellness during this crisis. At the same time, the last part of this document deals with the "light at the end of the tunnel," discussing potential opportunities, lessons learned, and the positives that can come out of this crisis.


title: Potential global pandemics: the role of the WHO and other public health bodies

text: In light of the emergence of the new coronavirus in China, Emeritus Professor Alan Glasper, from the University of Southampton, discusses the response strategies adopted by international and national public health agencies.


title: Ensuring safe practice during the pandemic

text: Sam Foster, Chief Nurse, Oxford University Hospitals, considers the range of issues that needs to be considered to enable retired nurses and those redeployed from other areas to care for patients with COVID-19.


Principles of ethics and critical communication during the COVID-19 pandemic


title: Perceived versus proven SARS-CoV-2-specific immune responses in health-care professionals

text: There have been concerns about high rates of thus far undiagnosed SARS-CoV-2 infections in the health-care system. The COVID-19 Contact (CoCo) Study follows 217 frontline health-care professionals at a university hospital with weekly SARS-CoV-2-specific serology (IgA/IgG). Study participants estimated their personal likelihood of having had a SARS-CoV-2 infection with a mean of 21% [median 15%, interquartile range (IQR) 5-30%]. In contrast, anti-SARS-CoV-2 IgG prevalence was about 1-2% at baseline. Regular anti-SARS-CoV-2 IgG testing of health-care professionals may aid in directing resources for protective measures and care of COVID-19 patients in the long run.


Developing guidelines for COVID-19 management: A moving target. An invited commentary on "Evidence based management guideline for the COVID-19 pandemic - Review article"


title: The Ethics of Creating a Resource Allocation Strategy During the COVID-19 Pandemic

text: The coronavirus disease 2019 pandemic has affected nearly every aspect of medicine and raises numerous moral dilemmas for clinicians. Foremost of these quandaries is how to delineate and implement crisis standards of care and, specifically, how to consider how health care resources should be distributed in times of shortage. We review basic principles of disaster planning and resource stewardship with ethical relevance for this and future public health crises, explore the role of illness severity scoring systems and their limitations and potential contribution to health disparities, and consider the role for exceptionally resource-intensive interventions. We also review the philosophical and practical underpinnings of crisis standards of care and describe historical approaches to scarce resource allocation to offer analysis and guidance for pediatric clinicians. Particular attention is given to the impact on children of this endeavor. Although few children have required hospitalization for symptomatic infection, children nonetheless have the potential to be profoundly affected by the strain on the health care system imposed by the pandemic and should be considered prospectively in resource allocation frameworks.


Bronchoalveolar lavage findings in severe COVID-19 pneumonia


Fulminant myocarditis and COVID-19. Response


Are Genetic Vaccines the Right Weapon against COVID-19?


Correction to Lancet Infect Dis 2020; published online March 11, https://doi.org/10.1016/ S1473-3099(20)30144-4


Acute pulmonary embolism and COVID-19 pneumonia: a random association?


Caring for children with neurological disorders in China during the COVID-19 pandemic


Covid-19, TMPRSS2, and whether android regulation affects pandemic virus gender incidence and age distribution of disease


title: Isolation and characterization of Salt Overly Sensitive family genes in spinach

text: The Salt Overly Sensitive (SOS) pathway regulates intracellular sodium ion homeostasis as a salt-stress response in plants. This pathway involves three main genes designated as SOS1, SOS2, and SOS3, which are members of the Na+ /H+ exchanger (NHX), CBL-interacting protein kinase (CIPK), and Calcineurin B-like (CBL) gene families, respectively. To identify and characterize SOS genes in spinach (Spinacia oleracea), a species of the Amaranthaceae family, we conducted genome-wide identification and phylogenetic analyses of NHX, CIPK, and CBL genes from four Amaranthaceae species, Arabidopsis, and rice. Most Amaranthaceae genes exhibited orthologous relationships with Arabidopsis and/or rice, except a clade of Vac-type Amaranthaceae NHX genes. Phylogenetic analyses also revealed gene gain/loss events in Amaranthaceae species and the intron-less to intron-rich evolution of CIPK genes. A bacterial protein-rooted CIPK tree allowed naming most of the phylogenetic clades based on their evolutionary history. Single S. oleracea (So) SOS1, SOS2, and SOS3 proteins were identified. Direct protein-protein interaction was observed between SoSOS2 and SoSOS3 but not between SoSOS2 and SoSOS1 based on yeast two-hybrid assay. This may suggest distinct modes of action of spinach SOS proteins compared to Arabidopsis SOS proteins. Unlike SoSOS1 and SoSOS2, which were expressed at similar or higher levels in leaves than roots, SoSOS3 expression was significantly higher in roots than leaves, suggesting its greater importance in roots. The expression of SoSOS3 was upregulated in both roots and leaves under salinity compared to the control; however, SoSOS1 was only upregulated in roots. Thus, this study demonstrated the conservation of SOS pathway genes in spinach and also highlighted the complexity of SOS signaling in Amaranthaceae species. This article is protected by copyright. All rights reserved.


title: Prediction of COVID-19 spreading profiles in South Korea, Italy and Iran by data-driven coding

text: This work applies a data-driven coding method for prediction of the COVID-19 spreading profile in any given population that shows an initial phase of epidemic progression. Based on the historical data collected for COVID-19 spreading in 367 cities in China and the set of parameters of the augmented Susceptible-Exposed-Infected-Removed (SEIR) model obtained for each city, a set of profile codes representing a variety of transmission mechanisms and contact topologies is formed. By comparing the data of an early outbreak of a given population with the complete set of historical profiles, the best fit profiles are selected and the corresponding sets of profile codes are used for prediction of the future progression of the epidemic in that population. Application of the method to the data collected for South Korea, Italy and Iran shows that peaks of infection cases are expected to occur before mid April, the end of March and the end of May 2020, and that the percentage of population infected in each city or region will be less than 0.01%, 0.5% and 0.5%, for South Korea, Italy and Iran, respectively.