docid: ysogcprc

title: An analysis of spatiotemporal pattern for COIVD-19 in China based on space-time cube

text: This study seeks to examine and analyze the spatial and temporal patterns of 2019 novel coronavirus disease (COVID-19) outbreaks and identify the spatiotemporal distribution characteristics and changing trends of cases. Hence, local outlier analysis and emerging spatiotemporal hot spot analysis were performed to analyze the spatiotemporal clustering pattern and cold/hot spot trends of COVID-19 cases based on space-time cube during the period from 23 January 2020 to 24 February 2020. The main findings are as follows: (1) The outbreak had spread rapidly throughout the country within a short time and the current totality incidence rate has decreased. (2) The spatiotemporal distribution of cases was uneven. In terms of the spatiotemporal clustering pattern, Wuhan and Shiyan city were the center as both cities had high-high clustering pattern with a surrounding unstable multiple-type pattern in partial areas of Henan, Anhui, Jiangxi, and Hunan provinces, and Chongqing city. Those regions are continuously in the hot spot on the spatiotemporal tendency. (3) The spatiotemporal analysis technology based on the space-time cube can analyze comprehensively the spatiotemporal pattern of epidemiological data and produce a visual output of the consequences, which can reflect intuitively the distribution and trend of data in space-time. Therefore, the Chinese government should strengthen the prevention and control efforts in a targeted manner to cope with a highly changeable situation.


Response to the emerging novel coronavirus outbreak


docid: wkbddypb

title: Atypical Presentation of COVID-19 Incidentally Detected at 18F-FDG PET/CT in an Asymptomatic Oncological Patient

text: The incidence of COVID-19, a severe acute respiratory syndrome caused by SARS-CoV-2, is rapidly growing worldwide. In this pandemic period, the chance of incidental pulmonary findings suggestive of COVID-19 at F-FDG PET/CT in asymptomatic oncological patients is not negligible. To suspect COVID-19 is more demanding whether its presentation is atypical. We describe the incidental PET/CT detection of an F-FDG-avid isolated centrilobular pulmonary consolidation in an asymptomatic lymphoma patient, which later resulted in an unexpected and atypical COVID-19 presentation. The nuclear medicine physicians should be prepared to suspect COVID-19 even in asymptomatic patients presenting with a "far-from-COVID-19" finding at PET/CT.


title: Changing paradigms of dermatology practice in developing nations in the shadow of COVID-19: Lessons learnt from the pandemic

text: At present, routine dermatology practices stay mostly disrupted worldwide owing to the ongoing COVID-19 pandemic. However, dermatology services need to be resumed in future and dermatologists especially in developing countries face a mammoth task of devising plans to tackle the upcoming surge of patients while still maintaining the precautions to avoid risk of infection to health care workers and our patients. Teledermatology practice is a viable alternative and there is need of starting functioning teledermatology centers at primary health care centers and training health care workers in telemedicine. Several steps like increasing the working hours of outpatient clinics, posting dermatologists and health staffs in shifts, encouraging online registration and payment, providing time slots to patients should be taken to prevent overcrowding at outpatient departments in hospitals of developing countries like India where the usual patient turnover during summers maybe around 600 to 800 per day. Once diagnosed by the dermatologist, a subsequent meticulous use of teledermatology can limit the number of follow-up visits. To avoid student gatherings, the undergraduate and postgraduate teaching schedule should be replaced by online or virtual teaching in form of webinars and video conferencing. Above all, intense upgradation of health care infrastructure, recruitment, training of new health care staffs on mass level and huge investment in health care sector is required in all the developing countries.


title: Laboratory Tests for COVID-19: A Review of Peer-Reviewed Publications and Implications for Clinical UIse

text: Diagnostic tests for the coronavirus infection 2019 (COVID-19) are critical for prompt diagnosis, treatment and isolation to break the cycle of transmission A positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR), in conjunction with clinical and epidemiologic data, is the current standard for diagnosis, but several challenges still exist Serological assays help to understand epidemiology better and to evaluate vaccine responses but they are unreliable for diagnosis in the acute phase of illness or assuming protective immunity Serology is gaining attention, mainly because of convalescent plasma gaining importance as treatment for clinically worsening COVID-19 patients We provide a narrative review of peer-reviewed research studies on RT-PCR, serology and antigen immune-assays for COVID-19, briefly describe their lab methods and discuss their limitations for clinical practice


title: Effects of COVID-19 Infection during Pregnancy and Neonatal Prognosis: What Is the Evidence?

text: BACKGROUND: This study's aims are to assess the current evidence presented in the literature regarding the potential risks of COVID-19 infection among pregnant women and consequent fetal transmission. METHODS: a systematic literature review assessing papers published in the most comprehensive databases in the field of health intended to answer the question, "What are the effects of COVID-19 infection during pregnancy, and what is the neonatal prognosis?" RESULTS: 49 papers published in 2020 were eligible, presenting low levels of evidence. A total of 755 pregnant women and 598 infants were assessed; more than half of pregnant women had C-sections (379/65%). Only 493 (82%) infants were tested for SARS-CoV-2, nine (2%) of whom tested positive. There is, however, no evidence of vertical transmission based on what has been assessed so far, considering there are knowledge gaps concerning the care provided during and after delivery, as well as a lack of suitable biological samples for testing SARS-CoV-2. CONCLUSIONS: We cannot rule out potential worsening of the clinical conditions of pregnant women infected with SARS-CoV-2, whether the infection is associated with comorbidities or not, due to the occurrence of respiratory disorders, cardiac rhythm disturbances, and acid-base imbalance, among others. We recommend relentless monitoring of all pregnant women in addition to testing them before delivery or the first contact with newborns.


title: Epidemiology of Coronavirus Disease in Gansu Province, China, 2020

text: To determine the epidemiology of coronavirus disease (COVID-19) in a remote region of China, far from Wuhan, we analyzed the epidemiology of COVID-19 in Gansu Province. From January 23 through February 3, 2020, a total of 35 (64.8%) of 54 reported cases were imported from COVID-19-epidemic areas. Characteristics that differed significantly during the first and second waves of illness in Gansu Province were mean patient age, occupation, having visited epidemic areas, and mode of transportation. Time from infection to illness onset for family clusters was shorter in Gansu Province than in Wuhan, consistent with shortened durations from onset to first medical visit or hospitalization. Spatial distribution pattern analysis indicated hot spots and spatial outliers in Gansu Province. As a result of adequate interventions, transmission of the COVID-19 virus in Gansu Province is decreasing.


title: Processamento dos grãos de milho melhoram a composição química e perfil fermentativo de silagem reidratada/ Corn grain processing improves chemical composition and fermentative profile of rehydrated silage

text: O objetivo da pesquisa foi avaliar os efeitos da reidratação do grão de milho em dois diâmetros geométricos médios (DGM = 0,55 e 1,83 mm) sobre perfil fermentativo e composição química das silagens. O experimento foi conduzido em delineamento inteiramente casualizado sendo os tratamentos: silagem de milho finamente reidratado (SMFR) e silagem de milho moído e reidratado (SMMR), com seis repetições. Os materiais foram reidratados com água objetivando níveis de umidade próximos a 350 g kg-1. Em ambas as silagens foram verificadas uma recuperação da matéria seca superior a 97%; porém sem diferença entre ambas. Houve influência do tamanho de partícula sobre a porção fibrosa, com valores inferiores observados para a SMFR. A concentração de ácido acético e lático foi maior para a SMFR, porém sem promover alterações significativas no pH da silagem. O pH foi diferente apenas na fase de exposição ao oxigênio, com valores de 4,25 e 4,38 para a SMFR e SMMR, respectivamente. Após a abertura dos silos, ambas as silagens demonstraram alta estabilidade aeróbia, acima de 90 horas, evidenciando menor atividade de espoliação e menor perda de qualidade. Concluiu-se que o DGM dos grãos de milho afetou o perfil fermentativo e nutricional da silagem.(AU)


COVID-19- Are telehealth and tele-education the answers to keep the ball rolling in Dentistry?


title: Targeting infectious Coronavirus Disease 2019 (COVID-19) with Artificial Intelligence (AI) applications: Evidence based opinion

text: The current COVID-19 pandemic has opened the new doors for AI based technology adoption in various health care sectors. This will be bringing opportunities as well as risks. These technologies, upon proper human interventions and directions, will be useful for making faster decisions in current crisis. However, this should not mean that AI could bypass the various regulatory processes. Besides multiple potential applications, we should know that these technologies will be only benefited with proper human interventions and un-biased data. With proper AI based approaches, we will be definitely benefited with rapid diagnosis of disease, early warnings, fastening drug development processes and proper social control measures during this pandemic.


docid: kxxixwad

title: Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatología: actitudes de los pacientes y los dermatólogos en Argentina./ Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatología: actitudes de los pacientes y los dermatólogos en Argentina./ Impact of the COVID-19 Pandemic on Immunomodulatory and Immunosuppressive Therapies in Dermatology: Patient and Physician Attitudes in Argentina


Thromboinflammation and the hypercoagulability of COVID-19


title: Risk factors for disease progression in COVID-19 patients

text: BACKGROUND: Coronavirus disease (COVID-19) is rapidly spreading worldwide. Although 10-20% of patients with COVID-19 have severe symptoms, little is known about the risk factors related to the aggravation of COVID-19 symptoms from asymptomatic or mild to severe disease states. METHODS: This retrospective study included 211 patients who were asymptomatic or with mild presentations of COVID-19. We evaluated the differences in demographic and clinical data between the cured (discharged to home) and transferred (aggravated to severe-stage COVID-19) groups. RESULTS: A multivariate logistic analysis showed that body temperature, chills, initial chest X-ray findings, and the presence of diabetes were significantly associated with predicting the progression to severe stage of COVID-19 (p < 0.05). The odds ratio of transfer in patients with COVID-19 increased by 12.7-fold for abnormal findings such as haziness or consolidation in initial chest X-ray, 6.32-fold for initial symptom of chills, and 64.1-fold for diabetes. CONCLUSIONS: Even if patients are asymptomatic or have mild symptoms, clinicians should closely observe patients with COVID-19 presenting with chills, body temperature > 37.5 °C, findings of pneumonia in chest X-ray, or diabetes.


Obesity and COVID-19: ACE 2, the Missing Tile


Covid-19 crisis forces CVS to cut services


title: Microbial burden and viral exacerbations in a longitudinal multicenter COPD cohort

text: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characterized by frequent exacerbation phenotypes independent of disease stage. Increasing evidence shows that the microbiota plays a role in disease progression and severity, but long-term and international multicenter assessment of the variations in viral and bacterial communities as drivers of exacerbations are lacking. METHODS: Two-hundred severe COPD patients from Europe and North America were followed longitudinally for 3 years. We performed nucleic acid detection for 20 respiratory viruses and 16S ribosomal RNA gene sequencing to evaluate the bacterial microbiota in 1179 sputum samples collected at stable, acute exacerbation and follow-up visits. RESULTS: Similar viral and bacterial taxa were found in patients from the USA compared to Bulgaria and Czech Republic but their microbiome diversity was significantly different (P < 0.001) and did not impact exacerbation rates. Virus infection was strongly associated with exacerbation events (P < 5E-20). Human rhinovirus (13.1%), coronavirus (5.1%) and influenza virus (3.6%) constitute the top viral pathogens in triggering exacerbation. Moraxella and Haemophilus were 5-fold and 1.6-fold more likely to be the dominating microbiota during an exacerbation event. Presence of Proteobacteria such as Pseudomonas or Staphylococcus amongst others, were associated with exacerbation events (OR > 0.17; P < 0.02) but more strongly associated with exacerbation frequency (OR > 0.39; P < 4E-10), as confirmed by longitudinal variations and biotyping of the bacterial microbiota, and suggesting a role of the microbiota in sensitizing the lung. CONCLUSIONS: This study highlights bacterial taxa in lung sensitization and viral triggers in COPD exacerbations. It provides a global overview of the diverse targets for drug development and explores new microbiome analysis methods to guide future patient management applications.


title: Risk for Transportation of Coronavirus Disease from Wuhan to Other Cities in China

text: On January 23, 2020, China quarantined Wuhan to contain coronavirus disease (COVID-19). We estimated the probability of transportation of COVID-19 from Wuhan to 369 other cities in China before the quarantine. Expected COVID-19 risk is >50% in 130 (95% CI 89-190) cities and >99% in the 4 largest metropolitan areas.


The Lancet COVID-19 Commission


Digital approaches for mental health in the age of covid-19


Pandemia da COVID-19 e Chirurgia Cardiaca: position paper della Task Force della Società Italiana di Chirurgia Cardiaca COVID-SICCH./ [COVID-19 outbreak and Cardiac Surgery: position paper from the COVID-SICCH Task Force of the Italian Society for Cardiac Surgery]


title: Psychopharmakotherapie in Zeiten der COVID-19-Pandemie./ [Psychopharmacotherapy during the COVID-19 pandemic]

text: In view of the current coronavirus disease 2019 (COVID-19) pandemic, patient care, including that of psychiatric patients, is facing unprecedented challenges. Treatment strategies for mental illness include psychotherapy and psychopharmacological interventions. The latter are associated with a multitude of adverse drug reactions (ADR); however, they may currently represent the preferred treatment due to restrictions regarding patient care (i.e. social distancing). Direct contact to patients may have to be reduced in favor of telephone calls or video conferences, so that new techniques in diagnosing and treating patients have to be established to guarantee patient safety. Patients should be extensively informed about relevant ADRs and physicians should actively ask patients about the timely recognition of ADRs. The use of psychotropic drugs may lead to an increased risk of developing ADRs, which are considered to be particularly unfavorable if they occur simultaneously with an acute infection or may even lead to an increased risk of infection. These include respiratory depression, agranulocytosis, intoxication by inhibition of metabolizing enzymes and venous thromboembolism, each of which may be associated with potentially fatal consequences; however, physicians should simultaneously ensure adequate efficacy of treatment, since the ongoing crisis may lead to a worsening of preexisting mental illnesses and to a surge in first onset of psychiatric disorders.


docid: amdtcucr

title: Tratamiento de pacientes de cardio-onco-hematología durante la pandemia actual por COVID-19./ [Cardio-onco-hamatology patients' management in the context of the current COVID-19 pandemic]


First case of persistent pancytopenia associated with SARS-CoV-2 bone marrow infiltration in an immunocompromised patient


title: Exploration of Interpretability Techniques for Deep COVID-19 Classification using Chest X-ray Images

text: The outbreak of COVID-19 has shocked the entire world with its fairly rapid spread and has challenged different sectors. One of the most effective ways to limit its spread is the early and accurate diagnosis of infected patients. Medical imaging such as X-ray and Computed Tomography (CT) combined with the potential of Artificial Intelligence (AI) plays an essential role in supporting the medical staff in the diagnosis process. Thereby, the use of five different deep learning models (ResNet18, ResNet34, InceptionV3, InceptionResNetV2, and DenseNet161) and their Ensemble have been used in this paper, to classify COVID-19, pneumoni{\ae} and healthy subjects using Chest X-Ray. Multi-label classification was performed to predict multiple pathologies for each patient, if present. Foremost, the interpretability of each of the networks was thoroughly studied using techniques like occlusion, saliency, input X gradient, guided backpropagation, integrated gradients, and DeepLIFT. The mean Micro-F1 score of the models for COVID-19 classifications ranges from 0.66 to 0.875, and is 0.89 for the Ensemble of the network models. The qualitative results depicted the ResNets to be the most interpretable model.


Approach to Surgical Interventions during Coronavirus disease Pandemic in Turkey


title: Increased stressful impact among general population in mainland China amid the COVID-19 pandemic: A nationwide cross-sectional study conducted after Wuhan city's travel ban was lifted

text: OBJECTIVES: Our study aimed to determine the impact of the COVID-19 pandemic on psychological responses and lifestyle changes among the general population in mainland China following the re-opening of the Wuhan city. METHODS: A cross-sectional survey was conducted in April 2020. Participants of Chinese nationality aged â©¾ 18 years were asked to complete a modified validated Chinese version of a questionnaire regarding the impact of event scale (IES), family and social support, mental health-related lifestyle changes, and indicators of negative mental health impacts. RESULTS: A total of 728 participants (i.e., 217 males and 511 females) completed the questionnaire. The mean age of the participants was 32.9 ± 10.4 years, with a majority of them (92.2%) having a higher educational qualification level. The overall mean IES in participants was 21.5 ± 7.0, reflecting mild stressful impact (i.e., following the re-opening of the Wuhan city); 25.5% of the participants had an IES score â©¾ 26. Being females and married were significantly associated with a higher mean IES score. The overall mean scores for intrusion and avoidance score scales in participants were 9.4 ± 3.7 and 12.1 ± 4.2, respectively. CONCLUSIONS: The COVID-19 pandemic was associated with increased stressful impact in our participants following the re-opening of the Wuhan city when compared with our previous study, which should not be taken lightly.


Mitigating the effect of the COVID-19 pandemic on sickle cell disease services in African countries


Use of apps in the COVID-19 response and the loss of privacy protection


title: A Lesson Learned from the Outbreak of COVID-19 in Korea

text: Despite the fact that making all efforts to deal with COVID-19 outbreak, Korea is in urgent need of moving away from a divided community approach and adopting a total community approach. Further, the nation needs to fully establish and activate the national emergency operation framework.


title: Rhinologic Procedures in the Era of COVID-19: Health-care Provider Protection Protocol

text: INTRODUCTION: SARS-CoV-2 has been identified as the pathogen causing the outbreak of Coronavirus Disease 2019 (COVID-19) that started in Wuhan, China, in December 2019. SARS-CoV-2 has human-to-human transmission ability and universally contagious to all populations. The main transmission patterns are respiratory droplets transmission and contact transmission. The purpose of this study is to propose a protocol that may be used as a guide to reduce the incidence of COVID-19 infections among otolaryngology care teams. METHODS: A prospective cohort study was conducted to show the efficacy of our protocol to prevent transmission to health-care providers from March 11, 2020 through April 14, 2020. The protocol consisted of a series of protective measures that we applied to all health-care providers, then testing of our providers for COVID-19 using reverse transcription polymerase chain reaction along with immunoglobulin M (IgM) and immunoglobulin G (IgG) testing at the end of the study period to ensure effectiveness. RESULTS: Our protocol resulted in zero transmissions to our health-care providers during the duration of the initial study. We were involved in greater than 150 sinonasal, skull base, open airway, and endoscopy procedures during this study. At the conclusion of the initial 5 weeks, we had no health-care providers test positive for SARS-CoV-2. CONCLUSION: According to our proposed protocol, we were able to provide care for all patients in clinic, hospital, emergent, intensive, and surgical settings with no transmission of SARS-CoV-2 by symptomatology and post evaluation testing.


title: Incremental validity of coronaphobia: Coronavirus anxiety explains depression, generalized anxiety, and death anxiety

text: The adverse psychological effects of COVID-19 have increased globally. Moreover, the psychological toll may be worsening for this health crisis due to the growing numbers of mass deaths and unemployment levels. Coronaphobia, a relatively new pandemic-related construct, has been shown to be strongly related to functional impairment and psychological distress. However, the extent to which coronaphobia is uniquely accountable for the psychological distress experienced during the COVID-19 crisis has not been systematically investigated. The current study examined this question of incremental validity using online data from 453 adult MTurk workers in the U.S. The results of a series of hierarchical multiple regression analyses demonstrated that coronaphobia explained additional variance in depression, generalized anxiety, and death anxiety, above sociodemographics, COVID-19 factors, and the vulnerability factors of neuroticism, health anxiety, and reassurance-seeking behaviors. These findings suggest that health professionals should be aware of coronaphobia as this expression of pandemic-related stress has reliably demonstrated incremental validity in accounting for major indicators of psychological distress.


No Evidence of Increased Hospitalization Rate for COVID-19 in Community-Dwelling Patients With Type 1 Diabetes


title: "Hot Zones" for Otolaryngologists: Assessing the geographic distribution of aerosol-generating procedures amidst the COVID-19 pandemic

text: OBJECTIVE: Given high COVID-19 viral load and aerosolization in the head and neck, otolaryngologists are subject to uniquely elevated viral exposure in most of their inpatient and outpatient procedures and interventions. While elective activity has halted across the board nationally, the slow plateau of COVID-19 case rates prompts the question of timing of resumption of clinical activity. We sought to prospectively predict geographical "hot zones" for otolaryngological exposure to COVID-19 based on procedural volumes data from 2013 to 2017. METHODS: Otolaryngologic CPT codes were stratified based on risk-level, according to recently published specialty-specific guidelines. Using the Medicare POSPUF database, aerosol-generating procedures (AGPs) were mapped based on hospital referral regions, against up-to-date COVID-19 case distribution data, as of April 24, 2020. RESULTS: The most common AGPs were diagnostic flexible laryngoscopy, diagnostic nasal endoscopy, and flexible laryngoscopy with stroboscopy. The regions with the most AGPs per otolaryngologist were Iowa City, IA, Detroit, MI, and Burlington, VT, while the states with the most COVID-19 cases as of April 24th are New York, New Jersey, and Massachusetts. CONCLUSIONS: Our study provides a model for predicting possible "hot zones" for otolaryngologic exposure based on both COVID-19 case density and AGP-density. As the focus shifts to resuming elective procedures, these potential "hot zones" need to be evaluated for appropriate risk-based decision-making, such as "reopening strategies" and allocation of resources.


Uncertainty in using chest computed tomography in early coronavirus disease (COVID-19)


title: Identification of the role of toxin B in the virulence of Clostridioides difficile based on integrated bioinformatics analyses

text: PURPOSE: Clostridioides difficile toxin B (TcdB) plays a critical role in C. difficile infection (CDI), a common and costly healthcare-associated disease. The aim of the current study was to explore the intracellular and potent systemic effects of TcdB on human colon epithelial cells utilizing Gene Expression Omnibus and bioinformatic methods. METHODS: Two datasets (GSE63880 and GSE29008) were collected to extract data components of mRNA of TcdB-treated human colon epithelial cells; "limma" package of "R" software was used to screen the differential genes, and "pheatmap" package was applied to construct heat maps for the differential genes; Metascape website was utilized for protein-protein interaction network and Molecular Complex Detection analysis, and Genome Ontology (GO) was used to analyze the selected differential genes. Quantitative real-time PCR (qRT-PCR) and Western blot were performed to validate the expression of hub genes. RESULTS: GO terms involved in DNA replication and cell cycle were identified significantly enriched in TcdB-treated human colon epithelial cells. Moreover, the decreased expression of DNA replication-related genes, MCM complex, and CDC45 in C. difficile (TcdA-/TcdB+)-infected Caco-2 cells were validated via qRT-PCR and Western blot assays. CONCLUSIONS: In conclusion, the integrated analysis of different gene expression datasets allowed us to identify a set of genes and GO terms underlying the mechanisms of CDI induced by TcdB. It would aid in understanding of the molecular mechanisms underlying TcdB-exposed colon epithelial cells and provide the basis for developing diagnosis biomarkers, treatment, and prevention strategies.


docid: yzdanrsj

title: Lymphocyte subset (CD4+, CD8+) counts reflect the severity of infection and predict the clinical outcomes in patients with COVID-19


title: The psychological impact of COVID-19 pandemic on health care workers in a MERS-CoV endemic country

text: BACKGROUND: The global pandemic of coronavirus disease of 2019 (COVID-19) has led to unprecedented psychological stress on health workers (HCWs). We aimed to assess the psychological impact of COVID-19 on HCWs in comparison to the stress brought on by the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic in Saudi Arabia. METHOD: Between February 5th and 16th, 2020, 811 health-care workers (HCWs) of a tertiary care teaching hospital were invited to fill a questionnaire regarding concerns and worries about the novel coronavirus pandemic, along with Generalized Anxiety Disorder (GAD-7) Anxiety Severity screening tool. RESULTS: Out of 582 HCWs who completed the survey questionnaire (response rate of 71.8%), about 40% were exposed previously to MERS-CoV infected or suspected patients during a previous hospital outbreak. While there were no COVID-19 cases reported yet in Saudi Arabia at the time of data collection, still, the anxiety level from COVID-19 was significantly higher than that from MERS-CoV or seasonal influenza: 41.1% were more worried about COVID-19, 41.4% were similarly worried about both MERS-CoV and COVID-19, and 17.5% were more stressed by the previous MERS-CoV hospital outbreak. The most frequent concern was transmitting the infection to family and friends (2.71/5) than to themselves only (2.57/5). CONCLUSION: Pandemic and epidemic infectious diseases such as COVID-19 or MERS-CoV impose a significant level of anxiety and stress on healthcare workers who are caring of infected patients, with their main concern being the risk of transmitting the infection to their families or to acquire it themselves. Therefore, optimizing the compliance of healthcare workers with the proper infection prevention and control measures is paramount during the infectious disease outbreak, to ensure their safety, to decrease the likelihood of getting infected or transmitting the infection to others, and consequently to alleviate their psychological stress and anxiety.


title: COVID-19 Pandemic in the Italian Population: Validation of a Post-Traumatic Stress Disorder Questionnaire and Prevalence of PTSD Symptomatology

text: Since December 2019, the COVID-19 pandemic has attracted worldwide attention for its rapid and exponential diffusion. The long-term psychological impact, of both the spread of the virus and the restrictive policies adopted to counteract it, remains uncertain. However, recent studies reported a high level of psychological distress and Post-Traumatic Stress Disorder (PTSD) symptoms. The purpose of this study is to assess the psychometric properties of a new questionnaire, to evaluate PTSD risk related to the COVID-19 emergency. A total of Italian people completed a web-based cross-sectional survey broadcasted through different social-media. Demographic data and some psychological dimensions, such as general distress and sleep disturbance, were collected. A new self-report questionnaire (COVID-19-PTSD), consisting of 19 items, was developed starting from the PTSD Check List for DSM-5 (PCL-5) questionnaire, and it was administered in order to analyze its psychometric properties. The results highlighted the adequate psychometric properties of the COVID-19-PTSD questionnaire. The confirmatory factor analysis indicated that a seven-factor model (Intrusion, Avoidance, Negative Affect, Anhedonia, Dysphoric arousal, Anxious arousal and Externalizing behavior) best fits the data. Significant correlations were found among COVID-19-PTSD scores, general distress and sleep disturbance. A high percentage of PTSD symptomatology (29.5%) was found in the Italian population. COVID-19-PTSD appears to be effective in evaluating the specific stress symptoms related to the COVID-19 pandemic in the Italian population. These results are relevant from a clinical point of view because they suggest that the COVID-19 pandemic could be considered as a traumatic event. Psychological interventions to counteract short- and long-term psychopathological effects, consequent to the COVID-19 pandemic, appear to be necessary.


COVID-19: Transforming Global Health


COVID-19-Related School Closings and Risk of Weight Gain Among Children


COVID-19 infection and sickle cell disease: a UK centre experience


COVID-19 Disaster Response Assessment


docid: hyirsflz

title: Infection Risk Assessment of COVID-19 through Aerosol Transmission: a Case Study of South China Seafood Market

text: The Corona Virus Disease 2019 (COVID-19) is rapidly spreading throughout the world. Aerosol is a potential transmission route. We conducted the quantitative microbial risk assessment (QMRA) to evaluate the aerosol transmission risk by using the South China Seafood Market as an example. The key processes were integrated, including viral shedding, dispersion, deposition in air, biologic decay, lung deposition, and the infection risk based on the dose-response model. The available hospital bed for COVID-19 treatment per capita (1.17 × 10-3) in Wuhan was adopted as a reference for manageable risk. The median risk of a customer to acquire SARS-CoV-2 infection via the aerosol route after 1 h of exposure in the market with one infected shopkeeper was about 2.23 × 10-5 (95% confidence interval: 1.90 × 10-6 to 2.34 × 10-4). The upper bound could increase and become close to the manageable risk with multiple infected shopkeepers. More detailed risk assessment should be conducted in poorly ventilated markets with multiple infected cases. The uncertainties were mainly due to the limited information on the dose-response relation and the viral shedding which need further studies. The risk rapidly decreased outside the market due to the dilution by ambient air and became below 10-6 at 5 m away from the exit.


Lessons from the Experience in Wuhan to Reduce Risk of COVID-19 Infection in Patients Undergoing Long-Term Hemodialysis


Theoretical orientation of a range of psychological approaches to address mental health concerns during the COVID-19 pandemic


title: Where to buy face masks? Survey of applications using Taiwan's open data in the time of coronavirus disease 2019

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) had spread rapidly since late December 2019. Personal protective equipment was essential to prevent transmission. Owing to shortage of face masks, Taiwan government began to implement quasi rationing on February 6, 2020, by allowing each resident to purchase two masks in seven days. Taiwan National Health Insurance Administration offered online data with real-time updates on face mask availability in all contracted pharmacies and selected local health centers. Based on the open data, numerous software applications quickly emerged to assist the public in finding sales locations efficiently. METHODS: Up until March 15, 2020, the Public Digital Innovation Space of Taiwan government had recorded 134 software applications of face mask availability, and 24 software applications were excluded due to defect, duplicate, and unavailability. These applications were analyzed according to platform, developer type, and display mode. RESULTS: Of the 110 valid software applications, 67 (60.9%) applications were deployed on websites, followed by 21 (19.1%) on social networking sites, 19 (17.3%) as mobile applications, and 3 (2.7%) in other modes. Nearly two thirds (n = 70) of applications were developed by individuals, one third (n = 37) by commercial companies, only two applications by central and local governments, and one by a nongovernmental organization. With respect to the display mode, 47 (42.7%) applications adopted map-view only, 41 (37.3%) adopted table-view only, and 19 (17.3%) adopted both modes. Of the remaining three applications, two offered voice user interfaces and one used augmented reality. CONCLUSION: Taiwan's open data strategy facilitated rapid development of software applications for information dissemination to the public during the COVID-19 crisis. The transparency of real-time data could help alleviate the panic of the public. The collaborative contributions from the grassroots in disasters were priceless treasures.


docid: khymooty

title: Three steps to flatten the mental health need curve amid the COVID-19 pandemic


title: An ARIMA model to forecast the spread and the final size of COVID-2019 epidemic in Italy

text: Coronavirus disease (COVID-2019) is a severe ongoing novel pandemic that is spreading quickly across the world. Italy, that is widely considered one of the main epicenters of the pandemic, has registered the highest COVID-2019 death rates and death toll in the world, to the present day. In this article I estimate an autoregressive integrated moving average (ARIMA) model to forecast the epidemic trend over the period after April 4, 2020, by using the Italian epidemiological data at national and regional level. The data refer to the number of daily confirmed cases officially registered by the Italian Ministry of Health (www.salute.gov.it) for the period February 20 to April 4, 2020. The main advantage of this model is that it is easy to manage and fit. Moreover, it may give a first understanding of the basic trends, by suggesting the hypothetic epidemic's inflection point and final size.


docid: xqrxdrnv

title: Optimizing screening strategies for coronavirus disease 2019: A study from Middle China

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) has been highly epidemic in China since January 2020. Rapid detection of the causative agent, severe acute respiratory coronavirus-2 (SARS-CoV-2), is very important due to its high rate of infectivity. This study aimed to clarify the epidemiology and clinical characteristics of COVID-19 outside of Hubei province, China, and to optimize screening strategies for COVID-19 in attempts to contain spread of the virus. METHODS: This retrospective study included all confirmed cases of COVID-19 in Hunan Provincial People's Hospital (Changsha, China) between January 22 and February 15, 2020. All cases were detected using a real-time reverse transcription polymerase chain reaction assay. The epidemiology and clinical characteristic of these cases were investigated according to outcome in attempts to optimize screening strategies for COVID-19. RESULTS: There were 24 confirmed cases of COVID-19 in the fever outpatient department of Hunan Provincial People's Hospital. Three patients were asymptomatic, and 3 exhibited mild and 3 moderate disease. There was a family cluster phenomenon. CONCLUSION: Individuals with COVID-19 can be asymptomatic or exhibit mild manifestations of disease. Close monitoring and an optimized screening strategy for COVID-19 could help deter spread of the virus.


Use of convalescent plasma in COVID-19 patients in China


title: Mesenchymal Stromal Cell Secretome for Severe COVID-19 Infections: Premises for the Therapeutic Use

text: From the end of 2019, the world population has been faced the spread of the novel coronavirus SARS-CoV-2 responsible for COVID-19 infection. In approximately 14% of the patients affected by the novel coronavirus, the infection progresses with the development of pneumonia that requires mechanical ventilation. At the moment, there is no specific antiviral treatment recommended for the COVID-19 pandemic and the therapeutic strategies to deal with the infection are only supportive. In our opinion, mesenchymal stem cell secretome could offer a new therapeutic approach in treating COVID-19 pneumonia, due to the broad pharmacological effects it shows, including anti-inflammatory, immunomodulatory, regenerative, pro-angiogenic and anti-fibrotic properties.


title: A physicist view of the airborne infection

text: Naturally produced droplets from humans (such as those produced by breathing, talking, sneezing, and coughing) include several types of cells (e.g., epithelial cells and cells of the immune system), physiological electrolytes contained in mucous and saliva (e.g. Na+, K+, Cl-), as well as, potentially, several infectious agents (e.g. bacteria, fungi, and viruses). In response to the novel coronavirus SARS-CoV-2 epidemic, which has become a major public health issue worldwide, we provide a didactic overview of airborne germ transmission as seen from a physics perspective. We also provide a recommendation that could help to slow down the spread of the virus.


title: Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic

text: OBJECTIVES: While the coronavirus disease 2019 (COVID-19) pandemic captures healthcare resources worldwide, data on the impact of prioritization strategies in urology during pandemic are absent. We aimed to quantitatively assess the global change in surgical and oncological clinical practice in the early COVID-19 pandemic. METHODS: In this cross-sectional observational study, we designed a 12-item online survey on the global effects of the COVID-19 pandemic on clinical practice in urology. Demographic survey data, change of clinical practice, current performance of procedures, and current commencement of treatment for 5 conditions in medical urological oncology were evaluated. RESULTS: 235 urologists from 44 countries responded. Out of them, 93% indicated a change of clinical practice due to COVID-19. In a 4-tiered surgery down-escalation scheme, 44% reported to make first cancellations, 23% secondary cancellations, 20% last cancellations and 13% emergency cases only. Oncological surgeries had low cancellation rates (%): transurethral resection of bladder tumor (27%), radical cystectomy (21-24%), nephroureterectomy (21%), radical nephrectomy (18%), and radical orchiectomy (8%). (Neo)adjuvant/palliative treatment is currently not started by more than half of the urologists. COVID-19 high-risk-countries had higher total cancellation rates for non-oncological procedures (78% vs. 68%, p = 0.01) and were performing oncological treatment for metastatic diseases at a lower rate (35% vs. 48%, p = 0.02). CONCLUSION: The COVID-19 pandemic has affected clinical practice of 93% of urologists worldwide. The impact of implementing surgical prioritization protocols with moderate cancellation rates for oncological surgeries and delay or reduction in (neo)adjuvant/palliative treatment will have to be evaluated after the pandemic.


Scientific networks are helping African countries to access coronavirus lab supplies


Pneumothorax: Eine konservative Behandlung ist einer interventionellen Therapie (Thoraxschlauch) nicht unterlegen


title: How did we rapidly implement a convalescent plasma program?

text: Since the beginning of the COVID-19 pandemic, the use of convalescent plasma as a possible treatment has been explored. Here we describe our experience as the first U.S. organization creating a COVID-19 convalescent plasma program to support its use through the single-patient emergency investigational new drug, the National Expanded Access Program, and multiple randomized controlled trials. Within weeks, we were able to distribute more than 8000 products, scale up collections to more than 4000 units per week, meet hospital demand, and support randomized controlled trials to evaluate the efficacy of convalescent plasma treatment. This was through strategic planning; redeployment of staff; and active engagement of hospital, community, and public health partners. Our partners helped with donor recruitment, testing, patient advocacy, and patient availability. The program will continue to evolve as we learn more about optimizing the product. Remaining issues to be resolved are antibody titers, dose, and at what stage of disease to transfuse.


docid: eemzfrbv

title: How an Epidemic Outbreak Impacts Happiness: Factors that Worsen (vs. Protect) Emotional Well-being during the Coronavirus Pandemic

text: What are the factors that worsen (vs. protect) emotional well-being during a pandemic outbreak such as COVID-19? Through two large-scale nationwide surveys (N1 = 11,131; N2 = 3,000) conducted in China immediately before versus during the coronavirus outbreak, we found that the onset of the coronavirus epidemic led to a 74% drop in overall emotional well-being. Factors associated with the likelihood of contracting the disease (e.g., residing near the epicenter), extent of potential harm (e.g., being an elderly), and relational issues (e.g., those within a marriage) exacerbated the detrimental effect of the outbreak on emotional well-being. Further, individuals' perception of their knowledge about coronavirus infection was another factor. Regardless of the actual amount of knowledge they possessed, those perceiving themselves as more knowledgeable, were able to experience more happiness during the outbreak. Higher perceived knowledge was associated with a stronger sense of control, which mediated the differences in emotional well-being. These patterns persisted even after controlling for a host of demographic and economic variables. In conclusion, public policies and mental health interventions aimed at boosting/protecting psychological well-being during epidemics should take account of these factors.


docid: shkxnqqc

title: Can glycopyrrolate come to the airway rescue in Covid-19 patients?


Development of a telehealth geriatric assessment model in response to the COVID-19 pandemic


Another Vision From the Coronavirus Health Crisis in Spain: The Perspective From the Plena inclusión Developmental Disabilities Associative Movement


The Coronavirus Disease 2019 (COVID-19)


title: Multi-Competitive Viruses over Static and Time--Varying Networks

text: Epidemic processes are used commonly for modeling and analysis of biological networks, computer networks, and human contact networks. The idea of competing viruses has been explored recently, motivated by the spread of different ideas along different social networks. Previous studies of competitive viruses have focused only on two viruses and on static graph structures. In this paper, we consider multiple competing viruses over static and dynamic graph structures, and investigate the eradication and propagation of diseases in these systems. Stability analysis for the class of models we consider is performed and an antidote control technique is proposed.


docid: ajpcpzdp

title: ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection

text: The COVID-19 pandemics is posing unprecedented challenges and threats to patients and healthcare systems worldwide. Acute respiratory complications that require intensive care unit (ICU) management are a major cause of morbidity and mortality in COVID-19 patients. Patients with worst outcomes and higher mortality are reported to include immunocompromised subjects, namely older adults and polymorbid individuals and malnourished people in general. ICU stay, polymorbidity and older age are all commonly associated with high risk for malnutrition, representing per se a relevant risk factor for higher morbidity and mortality in chronic and acute disease. Also importantly, prolonged ICU stays are reported to be required for COVID-19 patients stabilization, and longer ICU stay may per se directly worsen or cause malnutrition, with severe loss of skeletal muscle mass and function which may lead to disability, poor quality of life and additional morbidity. Prevention, diagnosis and treatment of malnutrition should therefore be routinely included in the management of COVID-19 patients. In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing concise guidance for nutritional management of COVID-19 patients by proposing 10 practical recommendations. The practical guidance is focused to those in the ICU setting or in the presence of older age and polymorbidity, which are independently associated with malnutrition and its negative impact on patient survival.


title: CT differential diagnosis of COVID-19 and non-COVID-19 in symptomatic suspects: a practical scoring method

text: BACKGROUND: Although typical and atypical CT image findings of COVID-19 are reported in current studies, the CT image features of COVID-19 overlap with those of viral pneumonia and other respiratory diseases. Hence, it is difficult to make an exclusive diagnosis. METHODS: Thirty confirmed cases of COVID-19 and forty-three cases of other aetiology or clinically confirmed non-COVID-19 in a general hospital were included. The clinical data including age, sex, exposure history, laboratory parameters and aetiological diagnosis of all patients were collected. Seven positive signs (posterior part/lower lobe predilection, bilateral involvement, rounded GGO, subpleural bandlike GGO, crazy-paving pattern, peripheral distribution, and GGO +/- consolidation) from significant COVID-19 CT image features and four negative signs (only one lobe involvement, only central distribution, tree-in-bud sign, and bronchial wall thickening) from other non-COVID-19 pneumonia were used. The scoring analysis of CT features was compared between the two groups (COVID-19 and non-COVID-19). RESULTS: Older age, symptoms of diarrhoea, exposure history related to Wuhan, and a lower white blood cell and lymphocyte count were significantly suggestive of COVID-19 rather than non-COVID-19 (p < 0.05). The receiver operating characteristic (ROC) curve of the combined CT image features analysis revealed that the area under the curve (AUC) of the scoring system was 0.854. These cut-off values yielded a sensitivity of 56.67% and a specificity of 95.35% for a score > 4, a sensitivity of 100% and a specificity of 23.26% for a score > 0, and a sensitivity of 86.67% and a specificity of 67.44% for a score > 2. CONCLUSIONS: With a simple and practical scoring system based on CT imaging features, we can make a hierarchical diagnosis of COVID-19 and non-COVID-19 with different management suggestions.


docid: xsadunsd

title: Dilemmas of a Physician in times of Covid-19


title: Prenatal Care Redesign: Creating Flexible Maternity Care Models Through Virtual Care

text: Each year, over 98% of the almost 4 million pregnant patients in the United States receive prenatal care-a crucial preventive service to improve outcomes for moms and babies. National guidelines currently recommend 12-14 in-person prenatal visits, a schedule unchanged since 1930. In scrutinizing the standard prenatal visit schedule, it quickly becomes clear that prenatal care is overdue for a redesign. We have strong evidence of the benefit of many prenatal services, like screening for gestational diabetes and maternal vaccination. Yet how to deliver these services is much less clear. Studies of prenatal services consistently demonstrate such care can be delivered in fewer than 14 visits, and that we do not need to provide all maternity services in person. Telemedicine has emerged as a promising care delivery option for patients seeking greater flexibility, and early trials leveraging virtual care and remote monitoring have shown positive maternal and fetal outcomes with high patient satisfaction. Our institution has worked for the past year on a new prenatal care pathway. Our initial work assessed the literature, elicited patient perspectives, and captured the insights of experts in patient-centered care delivery. Two key principles emerged to inform prenatal care redesign: 1) design care delivery around essential services, using in-person care for services that cannot be delivered remotely and offering video visits for other essential services; and 2) create flexible services for anticipatory guidance and psychosocial support that allow patients to tailor support to meet their needs through opt-in programs. The rise of COVID-19 prompted us to extend this early work and rapidly implement a redesigned prenatal care pathway. In this paper, we outline our experience rapidly transitioning prenatal care to a new model with 4 in-person visits, 1 ultrasound visit, and 4 virtual visits (the 4-1-4 prenatal plan). We then explore how lessons from this implementation can inform patient-centered prenatal care redesign during and beyond the COVID-19 pandemic.


title: Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent Radiotherapy during the COVID-19 Pandemic

text: Patients treated with curative-intent lung radiotherapy are in the group at highest risk of severe complications and death from COVID-19. There is therefore an urgent need to reduce the risks associated with multiple hospital visits and their anti-cancer treatment. One recommendation is to consider alternative dose-fractionation schedules or radiotherapy techniques. This would also increase radiotherapy service capacity for operable patients with stage I-III lung cancer, who might be unable to have surgery during the pandemic. Here we identify reduced-fractionation for curative-intent radiotherapy regimes in lung cancer, from a literature search carried out between 20/03/2020 and 30/03/2020 as well as published and unpublished audits of hypofractionated regimes from UK centres. Evidence, practical considerations and limitations are discussed for early-stage NSCLC, stage III NSCLC, early-stage and locally advanced SCLC. We recommend discussion of this guidance document with other specialist lung MDT members to disseminate the potential changes to radiotherapy practices that could be made to reduce pressure on other departments such as thoracic surgery. It is also a crucial part of the consent process to ensure that the risks and benefits of undergoing cancer treatment during the COVID-19 pandemic and the uncertainties surrounding toxicity from reduced fractionation have been adequately discussed with patients. Furthermore, centres should document all deviations from standard protocols, and we urge all colleagues, where possible, to join national/international data collection initiatives (such as COVID-RT Lung) aimed at recording the impact of the COVID-19 pandemic on lung cancer treatment and outcomes.


docid: cvprxpik

title: Editorial: Postcards from War Zones-Personal Experiences During the COVID-19 Pandemic


title: SARS-CoV-2 infection in children - Understanding the immune responses and controlling the pandemic

text: In December 2019, a cluster of patients with severe pneumonia caused by a novel coronavirus (SARS-CoV-2) emerged in the city of Wuhan, China. The disease is now termed coronavirus disease 2019 (COVID-19). In the early reports, the patients were mainly middle-aged and elderly men, and children appeared to be less susceptible to this infection. With modern and efficient transportation, the disease quickly spread to almost all corners of the world and the mortality far exceeds that caused by severe acute respiratory syndrome (SARS) coronavirus or Middle East respiratory syndrome (MERS) coronavirus. As the number of children with COVID-19 gradually increases, the disease has been documented in premature babies, infants, children, and adolescents. Severe and fatal cases in children are relatively rare. The burden of disease in children has been relatively low, but the high proportions of asymptomatic or mildly symptomatic infections in children deserve careful attention. A clear understanding of the immune responses to the virus in children and the transmission potential of asymptomatic children is of paramount importance for the development of specific treatments and vaccine in order to effectively control the ongoing pandemic.


Accessibility of Virtual Visits for Urgent Care Among US Hospitals: a Descriptive Analysis


docid: isupwxcd

title: Asymptomatic SARS-CoV-2 Transmission from Community Contacts in Healthcare Workers


docid: wiijnzmh

title: Impact of the Burden of COVID-19 in Italy: Results of Disability-Adjusted Life Years (DALYs) and Productivity Loss

text: The WHO declared the novel coronavirus disease a pandemic, with severe consequences for health and global economic activity and Italy is one of the hardest hit countries. This study aims to assess the socio-economic burden of COVID-19 pandemic in Italy through the estimation of Disability-Adjusted Life Years (DALYs) and productivity loss. The observational study was based on data from official governmental sources collected since the inception of epidemic until 28 April 2020. DALYs for a disease combines the years of life lost due to premature mortality in the population and the years lost due to disability of the disease. In addition to DALYs, temporary productivity loss due to absenteeism from work and permanent productivity loss due to premature mortality were estimated using the Human Capital Approach. The total DALYs amount to 2.01 per 1000 persons. The total permanent productivity loss was around EUR 300 million while the temporary productivity loss was around EUR 100 million. This evaluation does not consider other economic aspects related to lockdown, quarantine of contacts, healthcare direct costs etc. The burden of disease methodology is functional metric for steering choices of health policy and allowing the government to be accountable for the utilization of resources.


title: Living with PTSD amid a global pandemic

text: The COVID-19 pandemic has demonstrated itself to be a considerable stressor, especially for those individuals coping with a preexisting mental health disorder. This article contains clinical observations and reflections from two practicing psychologists regarding the impact of the COVID-19 pandemic and associated social conditions on clients with posttraumatic stress disorder. Observations include changes in trauma-related symptom manifestations and therapeutic process issues, particularly in response to social isolation. The authors encourage specific therapeutic considerations and offer suggestions for adapting treatment with regard to these early observations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Forecasting Covid-19 dynamics in Brazil: a data driven approach

text: This paper has a twofold contribution. The first is a data driven approach for predicting the Covid 19 pandemic dynamics, based on data from more advanced countries. The second is to report and discuss the results obtained with this approach for Brazilian states, as of May 4th, 2020. We start by presenting preliminary results obtained by training an LSTM SAE network, which are somewhat disappointing. Then, our main approach consists in an initial clustering of the world regions for which data is available and where the pandemic is at an advanced stage, based on a set of manually engineered features representing a country response to the early spread of the pandemic. A Modified Auto-Encoder network is then trained from these clusters and learns to predict future data for Brazilian states. These predictions are used to estimate important statistics about the disease, such as peaks. Finally, curve fitting is carried out on the predictions in order to find the distribution that best fits the outputs of the MAE, and to refine the estimates of the peaks of the pandemic. Results indicate that the pandemic is still growing in Brazil, with most states peaks of infection estimated between the 25th of April and the 19th of May 2020. Predicted numbers reach a total of 240 thousand infected Brazilians, distributed among the different states, with S\~ao Paulo leading with almost 65 thousands estimated, confirmed cases. The estimated end of the pandemics (with 97 percent of cases reaching an outcome) starts as of May 28th for some states and rests through August 14th, 2020.


title: Analysis and Review of Automated Risk Calculators Used to Predict Postoperative Complications After Orthopedic Surgery

text: PURPOSE OF REVIEW: To discuss the automated risk calculators that have been developed and evaluated in orthopedic surgery. RECENT FINDINGS: Identifying predictors of adverse outcomes following orthopedic surgery is vital in the decision-making process for surgeons and patients. Recently, automated risk calculators have been developed to quantify patient-specific preoperative risk associated with certain orthopedic procedures. Automated risk calculators may provide the orthopedic surgeon with a valuable tool for clinical decision-making, informed consent, and the shared decision-making process with the patient. Understanding how an automated risk calculator was developed is arguably as important as the performance of the calculator. Additionally, conveying and interpreting the results of these risk calculators with the patient and its influence on surgical decision-making are paramount. The most abundant research on automated risk calculators has been conducted in the spine, total hip and knee arthroplasty, and trauma literature. Currently, many risk calculators show promise, but much research is still needed to improve them. We recommend they be used only as adjuncts to clinical decision-making. Understanding how a calculator was developed, and accurate communication of results to the patient, is paramount.


Mortality in COVID-19 patients treated with ACEIs/ARBs: Re-estimated meta-analysis results following the Mehra et al. retraction


title: Epidemiological and initial clinical characteristics of patients with family aggregation of COVID-19

text: BACKGROUND: Since December 2019, a new outbreak of the coronavirus disease 2019 (COVID-19) in Wuhan (Hubei, China) and rapidly spread throughout China, however, confirmed cases are still increasing worldwide. OBJECTIVES: To investigate the epidemiological history and initial clinical characteristics of 10 patients with family aggregation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Western Chongqing, China. STUDY DESIGN: Ten patients positive for SARS-CoV-2 nucleic acid detection by real time Reverse Transcription-Polymerase Chain Reaction (RT-PCR), were collected from The People's Hospital of Dazu District, Chongqing. Epidemiological data and laboratory and imaging results were collected on the first day of admission, and analyzed based on the Diagnosis and Treatment Guideline for COVID-19 (5th edition, China). RESULTS: Of the 10 cases, case A had a history of a temporary stay in Wuhan and transmitted the virus to the others through family gathering, living together, and sharing vehicles. The average age was 56.5 years (± 11.16), six patients were males, and the incubation period was 2-14 days. Dry cough was the main symptom, followed by fever and fatigue. Most patients were clinically classified as ordinary-type, with three cases being severe-type. Chest computed tomography results were nonspecific, mainly with ground-glass attenuation and/or shadow images. Extensive lesion distribution was seen in severe cases. CD4+ lymphocyte counts were 61, 180, and 348 cells/uL in severe-type patients, respectively. Notably, viral nucleic acid values in nasopharyngeal swabs were lower (19, 25, and 26) than those of ordinary-type patients, suggesting a higher viral load. Neutrophil-lymphocyte ratio (NLR) was also higher in severe-type patients CONCLUSIONS: Initial examination results of lower CD4+ lymphocyte counts and RT-PCR-CT values coupled with higher NLR may indicate the severity of COVID-19 infection for these family clusters.


COVID-19 infection in children


title: Cardiovascular disease due to novel coronavirus and the search for investigational therapies

text: OBJECTIVE: The primary purpose of the study was to investigate and to summarize the registered trials that listed COVID-19 as the primary condition. METHODS: We performed a search on ClinicalTrials.gov using the independent search terms COVID-19, SARS, and SARS-CoV-2 and then downloaded the data file on March 23, 2020. All trials were downloaded to a csv file and searched for appropriateness. RESULTS: Of 124 registered trials, 56 (45.2%) were listed as recruiting. The majority (85 [68.5%]) were classified as interventional, 37 (29.8%) as observational, and one (0.8%) each as either expanded access: individual patients|treatment investigational new drug/protocol or expanded access: intermediate-size population|treatment investigational new drug/protocol. There were 67 (54.0%) trials that listed drug as the type of study. Immunologic and antiviral trials were the most common, representing approximately 30% and 21%, respectively. When immunologic and antiviral drugs were used alone or in combination, they represented 41.9% and 34.4%, respectively. Antimalarial agents are represented in 7.5% of trials. Approximately 14% of trials involved traditional Chinese medicine. The study agents used solely or in combination represented approximately 80% of therapeutic approaches to COVID-19. CONCLUSIONS: There was a large and quick response on ClinicalTrials.gov to the COVID-19 outbreak. Many of the registered trials are currently recruiting new patients, whereas some will begin in the near future. Specific potential experimental therapies, including dosing and monitoring, might be found by reviewing content. Within ClinicalTrials.gov, patients, family members, health care professionals, and researchers can search and find ongoing and future trials for COVID-19.


COVID-19: Common Critical and Practical Questions


Intra-hospital preventive principles to protect frontline healthcare workers to overcome pandemic COVID-19 in Taiwan


Older patients with cancer and febrile neutropenia in the COVID-19 era: A new concern


title: [Experts recommendation on the diagnosis and treatment of oral mucosal diseases during prevention and control stage of the novel coronavirus infection]

text: The announcement of National Health Commission on January 20, 2020 (No 1 of 2020) has included Novel Coronavirus Pneumonia(NCP) into the B class infectious diseases according to the law of the People's Republic of China on the prevention and control of infectious diseases, and has been managed as A class infectious diseases People's governments at all levels and health administration departments have been paying high attention to it, and medical and health institutions have taken a series of prevention and control measures according to the law to prevent and control the spread of NCP In the process of combating the outbreak of NCP, how to protect the oral mucosal disease physicians normatively, how to ensure hand and environmental cleaning and disinfection;how to carry out triage of the patients with oral mucosal disease accompanied by fever reasonably;how to carry out oral mucosal disease patients'self-care and self-management during this stage, are the practical problems that all levels of medical institutions and medical workers and patients will meet For these three problems, we invited the experts from the Society of Oral Medicine, Shanghai Stomatological Association and the Oral Mucosal Disease Specialist Alliance Organization of Shanghai Ninth People's Hospital Group to write the recommendation on the diagnosis and treatment of oral mucosal disease during prevention and control stage of novel coronavirus infection, in order to provide references for oral mucosal disease medical physicians and patients in this special period This recommendation will be updated according to the situation of epidemic prevention and control in China and the new relevant diagnosis and treatment plans


Hypoxia inducible factor-1 protects against COVID-19: A hypothesis


The complement inhibitors in COVID-19: future expectations


COVID-19 in Latin America: The implications of the first confirmed case in Brazil


title: Health service psychology education and training in the time of COVID-19: Challenges and opportunities

text: The COVID-19 pandemic has posed unprecedented challenges to health service psychology (HSP) education and training but also presents tremendous opportunities for growth that will persist well past the resolution of this public health crisis. The present article addresses three aims in understanding the challenges and opportunities faced by the HSP education and training community. First, it describes challenges to HSP education and training created by the COVID-19 pandemic, including the need to maintain the integrity of training; facilitate trainee progress; continue clinical service delivery; manage the safety and wellbeing of trainees, faculty, staff, and clients/patients; and adhere to national and local emergency orders. Second, the article summarizes guidance from training organization leadership regarding training program and clinical site responses to these challenges. Several principle-based recommendations called upon training programs to prioritize trainees and their training needs, while urging balance and flexibility in meeting the multiple demands of training programs, institutions, and the public. Third, the article discusses key opportunities for improvement in HSP education and training, including more effective use of competency evaluations; distance technologies in therapy, supervision, and admissions; and reconsideration of internship and degree timing and HSP's identity as a health care profession; and the potential for comprehensive review and redesign of HSP education and training. Embracing these opportunities may help ensure that HSP education and training is preparing its graduates to meet the psychological health care needs of the future. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


docid: ojqofqeh

title: Eyes on New Product Development


Spontaneous pneumomediastinum in COVID-19


Correction to Lancet Infect Dis 2020; Published online March 23. https://doi.org/10.1016/S1473-3099(20)30226-7


Impact of severe acute respiratory syndrome on blood services and blood in Hong Kong in 2003


title: Miller Fisher syndrome diagnosis and treatment in a patient with SARS-CoV-2

text: This case report describes the clinical characteristics of a 50-year-old woman that developed SARS-CoV-2 pneumonia and was admitted at the COVID-19 dedicated unit where she developed neurological symptoms 10 days after admission. After neurological examination, including a panel of blood cerebrospinal fluid biomarkers, a diagnosis of Miller Fisher syndrome (MFS) was hypothesized and intravenous immunoglobulin therapy (IVIG) was initiated. Fourteen days after the start of IVIG treatment, the patient has been discharged at home with the resolution of respiratory symptoms and only minor hyporeflexia at the lower limbs, without any side effect.


title: The Twitter Social Mobility Index: Measuring Social Distancing Practices from Geolocated Tweets

text: Social distancing is an important component of the response to the novel Coronavirus (COVID-19) pandemic. Minimizing social interactions and travel reduces the rate at which the infection spreads, and"flattens the curve"such that the medical system can better treat infected individuals. However, it remains unclear how the public will respond to these policies. This paper presents the Twitter Social Mobility Index, a measure of social distancing and travel derived from Twitter data. We use public geolocated Twitter data to measure how much a user travels in a given week. We find a large reduction in travel in the United States after the implementation of social distancing policies, with larger reductions in states that were early adopters and smaller changes in states without policies. Our findings are presented on http://socialmobility.covid19dataresources.org and we will continue to update our analysis during the pandemic.


Public Health: Our Time of Challenge


title: COVID-19 Mitigation Steps Provide a Blueprint for Malaria Control and Elimination

text: Most countries around the world have responded promptly to the novel coronavirus disease (COVID-19) challenge by adopting considered and scientifically guided strategies for its containment. However, the situation is more complex for nations where malaria is endemic, as they now have the additional burden of COVID-19. In such nations, the healthcare systems are either in the preparatory or containment phase of the current pandemic. This enforced, sudden, and sharp public health refocus is likely to result in the disruption of annual malaria control activities such as distribution of insecticide-impregnated bed nets, indoor residual spraying of insecticide, maintenance of malaria surveillance, and mass provision of antimalarial drugs. Nonetheless, we feel that the best facets of COVID-19 public health management can become new guiding principles in malaria-endemic countries to improve malaria control and hasten malaria elimination. Redirection against malaria of the best public health initiatives used in COVID-19 containment could fast-track the global goal of a malaria-free world. Such public health advancement could be one positive outcome from the scourge of COVID-19.


title: Correction to: New clinical manifestation of COVID-19 related Guillain-Barrè syndrome highly responsive to intravenous immunoglobulins: two Italian cases

text: The above article was published online with inverted given and family names. The correct presentation has been corrected above.


Kreftbehandling og covid-19


title: Functional urology during COVID-19: Recommendations during de-escalation./ La urologia funcional en la era COVID-19. Consejos para la desescalada

text: OBJECTIVES: Due to the COVID-19 Pandemic, all surgical activity that was not life threatening was cancelled , as well as most face-to-face consultations Currently the beginning of the de-escalation phases that will led us to a new normal, forces us to establish some degree of priority in the interventions as well as in the medical consultations Our objective is to establish some recommendation on Functional Urology office visits and surgical interventions that serve as a tool to facilitate decision-making MATERIAL AND METHODS: Experts in Functional Urology from different autonomous communities of Spain were contacted to design a strategy to reorganize the activity of both, diagnosis and treatment A modified nominal group technique has been used due to the extraordinary restrictions of assembly and mobility during the COVID pandemic The first signer (EMC) made the first draft with the measures adopted and the strategy to be followed during the evolution of the COVID-19 pandemic The proposal was sent to the rest of the authors, in order to unify criteria and experiences to reach a quick consensus on the relative priority of the different activities, problems and solutions A final version was approved by all authors May 27, 2020 RESULTS:Tables of recommendation have been prepared for outpatient consultation, surgical and technical interventions, according to de-escalation phases proposed by the Spanish Associations of Surgeons CONCLUSIONS: The change that COVID-19 Pandemich as involved in our clinical practice force us to seek alternative methods to treat our patients, some of which may already be established Mean while, a consensusin decision making is necessary Documents such as the current one, are intended to guide the management of patients with urological functional pathology in exceptional situations Logically, it should be adapted to material and human availability, and to the idiosyncrasy of each Urology service OBJETIVOS: Debido a la Pandemia COVID-19 se suspendio toda actividad quirurgica que no fuera una urgencia vital, asi como la mayoria de consultas presenciales Actualmente el inicio de las fases dedesescalada que nos llevaran a una nueva normalidad nos obliga a establecer unos grados de prioridad en las intervenciones asi como en las consultas medicas Nuestro objetivo es establecer una serie de recomendaciones sobre las consultas de Urologia Funcional y las intervenciones quirurgicas que sirva como herramientade ayuda en la toma de decisiones MATERIAL Y METODOS: Expertos en Urologia Funcionalde distintas comunidades autonomas de Espana fueron contactados para disenar una estrategia parareorganizar la actividad tanto de diagnostico como de tratamiento Se ha utilizado una tecnica de grupo nominal modificada debido a las restricciones extraordinarias de reunion y movilidad durante la pandemia COVID El primer firmante (EMC) realizo el primer borrado rcon las medidas adoptadas y la estrategia a seguir durante la evolucion de la pandemia COVID19 Se remitio la propuesta al resto de autores, con el fin de unificar criterios y experiencias para llegar a un rapido consenso sobre la importancia relativa de las distintas actividades, problemas y soluciones Se realizo una version definitiva, aprobada por todos los autores, el dia 27 de mayo de 2020 RESULTADOS: Se han elaborado tablas de recomendaciones tanto para consultas externas, como para intervenciones quirurgicas y tecnicas, de acuerdo con las fases de desescalada propuestas por la Asociacion Espanola de Cirujanos (AEC) CONCLUSIONES: El cambio que ha supuesto la Pandemia COVID-19 en nuestra practica clinica nos obliga a buscar metodos alternativos para seguir y tratar a nuestros pacientes, algunos de los cuales pueden ya quedar instaurados Mientras, es necesario un consenso en la toma de decisiones Documentos como el actual, pretenden orientar en el manejo de los pacientes con patologia funcional urologica en situaciones excepcionales Logicamente, debera adaptarse alas disponibilidades materiales y humanas, y a la idiosincrasia de cada ser icio de Urologia


docid: nqiwzpmj

title: [Functional urology during COVID-19: Recommendations during de-escalation.]

text: OBJECTIVES: Due to the COVID-19 Pandemic, all surgical activity that was not life threatening was cancelled , as well as most face-to-face consultations Currently the beginning of the de-escalation phases that will led us to a new normal, forces us to establish some degree of priority in the interventions as well as in the medical consultations Our objective is to establish some recommendation on Functional Urology office visits and surgical interventions that serve as a tool to facilitate decision-making MATERIAL AND METHODS: Experts in Functional Urology from different autonomous communities of Spain were contacted to design a strategy to reorganize the activity of both, diagnosis and treatment A modified nominal group technique has been used due to the extraordinary restrictions of assembly and mobility during the COVID pandemic The first signer (EMC) made the first draft with the measures adopted and the strategy to be followed during the evolution of the COVID-19 pandemic The proposal was sent to the rest of the authors, in order to unify criteria and experiences to reach a quick consensus on the relative priority of the different activities, problems and solutions A final version was approved by all authors May 27, 2020 RESULTS: Tables of recommendation have been prepared for outpatient consultation, surgical and technical interventions, according to de-escalation phases proposed by the Spanish Associations of Surgeons CONCLUSIONS: The change that COVID-19 Pandemich as involved in our clinical practice force us to seek alternative methods to treat our patients, some of which may already be established Mean while, a consensusin decision making is necessary Documents such as the current one, are intended to guide the management of patients with urological functional pathology in exceptional situations Logically, it should be adapted to material and human availability, and to the idiosyncrasy of each Urology service


title: Duty, indemnity and immunity during the COVID-19 pandemic

text: Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers arrangements for indemnifying nurses returning to practice in the pandemic, and whether nurses might be given immunity from negligence claims.


docid: mgvtykfe

title: Immunosuppression drug-related and clinical manifestation of Coronavirus disease 2019: A therapeutical hypothesis


title: Robust Conditional Independence maps of single-voxel Magnetic Resonance Spectra to elucidate associations between brain tumours and metabolites

text: The aim of the paper is two-fold. First, we show that structure finding with the PC algorithm can be inherently unstable and requires further operational constraints in order to consistently obtain models that are faithful to the data. We propose a methodology to stabilise the structure finding process, minimising both false positive and false negative error rates. This is demonstrated with synthetic data. Second, to apply the proposed structure finding methodology to a data set comprising single-voxel Magnetic Resonance Spectra of normal brain and three classes of brain tumours, to elucidate the associations between brain tumour types and a range of observed metabolites that are known to be relevant for their characterisation. The data set is bootstrapped in order to maximise the robustness of feature selection for nominated target variables. Specifically, Conditional Independence maps (CI-maps) built from the data and their derived Bayesian networks have been used. A Directed Acyclic Graph (DAG) is built from CI-maps, being a major challenge the minimization of errors in the graph structure. This work presents empirical evidence on how to reduce false positive errors via the False Discovery Rate, and how to identify appropriate parameter settings to improve the False Negative Reduction. In addition, several node ordering policies are investigated that transform the graph into a DAG. The obtained results show that ordering nodes by strength of mutual information can recover a representative DAG in a reasonable time, although a more accurate graph can be recovered using a random order of samples at the expense of increasing the computation time.


title: Neurosensory dysfunction: a diagnostic marker of early COVID-19

text: OBJECTIVES: To detailly described the neurosensory dysfunction, including hyposmia, hypogeusia and tinnitus, in patients with COVID-19. METHODS: Clinical characteristics and oropharyngeal swabs were obtained from 86 patients with COVID-19 hospitalized in Guangzhou Eighth People's Hospital. Chronological analysis method was used to detailly clarify the neurosensory dysfunction. The cycle threshold (Ct) values were used to approximately indicate viral load. RESULTS: Forth-four (51.2%) patients had neurosensory dysfunction: hyposmia (34, 39.5%), hypogeusia (33, 38.4%), and tinnitus (3, 3.5%). Neurosensory dysfunction was significantly more common in patients under 40 years old (p = 0.001) or women (p = 0.006). Hyposmia and hypogeusia coexisted in 23 (26.7%) patients. The interval between onset of hyposmia and hypogeusia was 0.7 ± 1.46 days. The interval from onset of hyposmia and hypogeusia to typical symptoms was 0.22 ± 4.57 and 0.75 ± 6.77 days; the interval from onset of hyposmia and hypogeusia to admission was 6.06 ± 6.68 and 5.76 ± 7.68 days; and the duration of hyposmia and hypogeusia was 9.09 ± 5.74 and 7.12 ± 4.66 days, respectively. The viral load was high since symptoms onset, peaked within the first week, and then gradually declined. CONCLUSIONS: The neurosensory dysfunction tends to occur in the early stage of COVID-19, and it could be used as a marker for early diagnosis of COVID-19.


Prolonged grief disorder following the Coronavirus (COVID-19) pandemic


Multidisciplinary: research priorities for the COVID-19 pandemic


title: Guidelines for the management of diabetes in care homes during the Covid-19 pandemic

text: The National Diabetes Stakeholders Covid-19 Response Group was formed in early April 2020 as a rapid action by the Joint British Diabetes Societies for Inpatient Care, Diabetes UK, the Association of British Clinical Diabetologists, and Diabetes Frail to address and support the special needs of residents with diabetes in UK care homes during Covid-19. It was obvious that the care home sector was becoming a second wave of Covid-19 infection and that those with diabetes residing in care homes were at increased risk not only of susceptibility to infection but also to poorer outcomes. Its key purposes included minimising the morbidity and mortality associated with Covid-19 and assisting care staff to identify those residents with diabetes at highest risk of Covid-19 infection. The guidance was particularly created for care home managers, other care home staff, and specialist and non-specialist community nursing teams. The guidance covers the management of hyperglycaemia by discussion of various clinical scenarios that could arise, the management of hypoglycaemia, foot care and end of life care. In addition, it outlines the conditions where hospital admission is required. The guidance should be regarded as interim and will be updated as further medical and scientific evidence becomes available.


title: Update on neurological manifestations of COVID-19

text: Novel coronavirus (severe acute respiratory syndrome coronavirus-2: SARS-CoV-2) has a high homology with other cousin of coronaviruses such as SARS and Middle East respiratory syndrome-related coronavirus (MERS). After outbreak of the SARS-CoV-2 in China, it has spread so fast around the world. The main complication of coronavirus disease 2019 (COVID-19) is respiratory failure, but several patients have also been admitted to the hospital with neurological symptoms. Direct invasion, hematogenic rout, retrograde and anterograde transport along peripheral nerves are considered as main neuroinvasion mechanisms of SARS-CoV-2. In the present study, we describe the possible routes for entering of SARS-CoV-2 into the nervous system. Then, neurological manifestations of the SARS-CoV-2 infection in the central nervous system (CNS) and peripheral nervous system (PNS) are reviewed. Furthermore, the neuropathology of the virus and its impacts on other neurological disorders are discussed.


title: Reorganisation of faecal microbiota transplant services during the COVID-19 pandemic

text: The COVID-19 pandemic has led to an exponential increase in SARS-CoV-2 infections and associated deaths, and represents a significant challenge to healthcare professionals and facilities. Individual countries have taken several prevention and containment actions to control the spread of infection, including measures to guarantee safety of both healthcare professionals and patients who are at increased risk of infection from COVID-19. Faecal microbiota transplantation (FMT) has a well-established role in the treatment of Clostridioides difficile infection. In the time of the pandemic, FMT centres and stool banks are required to adopt a workflow that continues to ensure reliable patient access to FMT while maintaining safety and quality of procedures. In this position paper, based on the best available evidence, worldwide FMT experts provide guidance on issues relating to the impact of COVID-19 on FMT, including patient selection, donor recruitment and selection, stool manufacturing, FMT procedures, patient follow-up and research activities.


title: Racial disparities in knowledge, attitudes and practices related to COVID-19 in the USA

text: BACKGROUND: Recent reports indicate racial disparities in the rates of infection and mortality from the 2019 novel coronavirus (coronavirus disease 2019 [COVID-19]). The aim of this study was to determine whether disparities exist in the levels of knowledge, attitudes and practices (KAPs) related to COVID-19. METHODS: We analyzed data from 1216 adults in the March 2020 Kaiser Family Foundation 'Coronavirus Poll', to determine levels of KAPs across different groups. Univariate and multivariate regression analysis was used to identify predictors of KAPs. RESULTS: In contrast to White respondents, Non-White respondents were more likely to have low knowledge (58% versus 30%; P < 0.001) and low attitude scores (52% versus 27%; P < 0.001), but high practice scores (81% versus 59%; P < 0.001). By multivariate regression, White race (odds ratio [OR] 3.06; 95% confidence interval [CI]: 1.70-5.50), higher level of education (OR 1.80; 95% CI: 1.46-2.23) and higher income (OR 2.06; 95% CI: 1.58-2.70) were associated with high knowledge of COVID-19. Race, sex, education, income, health insurance status and political views were all associated with KAPs. CONCLUSIONS: Racial and socioeconomic disparity exists in the levels of KAPs related to COVID-19. More work is needed to identify educational tools that tailor to specific racial and socioeconomic groups.


title: Fatal arrhythmias: Another reason why doctors remain cautious about chloroquine/hydroxychloroquine for treating COVID-19

text: BACKGROUND: Early during the current coronavirus disease 19 (COVID-19) pandemic, hydroxychloroquine (HCQ) received a significant amount of attention as a potential antiviral treatment, such that it became one of the most commonly prescribed medications for COVID-19 patients. However, not only has the effectiveness of HCQ remained questionable, but mainly based on preclinical and a few small clinical studies, HCQ is known to be potentially arrhythmogenic, especially as a result of QT prolongation. OBJECTIVE: The purpose of this study was to investigate the arrhythmic effects of HCQ, as the heightened risk is especially relevant to COVID-19 patients, who are at higher risk for cardiac complications and arrhythmias at baseline. METHODS: An optical mapping technique utilizing voltage-sensitive fluorescent dyes was used to determine the arrhythmic effects of HCQ in ex vivo guinea pig and rabbit hearts perfused with the upper therapeutic serum dose of HCQ (1000 ng/mL). RESULTS: HCQ markedly increased action potential dispersion, resulted in development of repolarization alternans, and initiated polymorphic ventricular tachycardia. CONCLUSION: The study results further highlight the proarrhythmic effects of HCQ.


title: COVID-19 in solid organ transplant recipients: a single-center experience

text: Solid organ transplant (SOT) recipients may be at risk for severe COVID-19. Data on the clinical course of COVID-19 in immunosuppressed patients are limited, and the effective treatment strategy for these patients is unknown. We describe our institutional experience with COVID-19 in SOT. Demographic, clinical, and treatment data were extracted from the electronic patient files. A total of 23 SOT transplant recipients suffering from COVID-19 were identified (n = 3 heart; n = 15 kidney; n = 1 kidney-after-heart; n = 3 lung, and n = 1 liver transplant recipient). The presenting symptoms were similar to nonimmunocompromised patients. Eighty-three percent (19/23) of the patients required hospitalization, but only two of these were transferred to the intensive care unit. Five patients died from COVID-19; all had high Clinical Frailty Scores. In four of these patients, mechanical ventilation was deemed futile. In 57% of patients, the immunosuppressive therapy was not changed and only three patients were treated with chloroquine. Most patients recovered without experimental antiviral therapy. Modification of the immunosuppressive regimen alone could be a therapeutic option for SOT recipients suffering from moderate to severe COVID-19. Pre-existent frailty is associated with death from COVID-19.


title: The Shared Epitope Phenomenon - A potential impediment to virtual crossmatch accuracy

text: With the implementation of the new Kidney Allocation System (KAS), there is increased reliance on a virtual crossmatch/histocompatibility risk assessment (vXM) for evaluating potential presence, as well as strength, of HLA antibodies against a potential donor. The accuracy of such an assessment depends on the precision in the identification of the recipient's antibody profile and the potential donor's HLA typing. While the development of the single antigen bead (SAB) multiplex assay has improved the sensitivity and specificity of HLA-antibody detection, several limitations of the assay (specific to certain sensitized patients) can complicate accurate interpretation of results. In this report, we focus on the "shared-epitope" phenomenon, a condition in which antibody strength can be underrepresented, or its presence completely missed, due to binding of the antibody to competing targets on multiple antigens (beads), effectively "diluting" the resulting MFI-readout. Here, we provide a relevant background to understand this phenomenon and present a couple of case studies illustrating how it can be investigated, leading to a more accurate histocompatibility consultation.


title: Viral exanthem with "Spins and needles sensation" on extremities of a COVID-19 patient: A self-reported case from an Indonesian medical frontliner

text: Cutaneous manifestation is a newly reported clinical manifestation of COVID-19 infection. The clinical description of cutaneous manifestation is still not fully described. Our patient, a medical person, had viral exanthem distributed in the extremities along with a "Spins and needles sensation," which differs from a previously published paper on cutaneous manifestations. The differential diagnosis of drug-induced skin rash and hand-foot-mouth disease was ruled out based on the patient's previous history and course of the disease.


docid: jqgipnto

title: A potential inhibitory role for integrin in the receptor targeting of SARS-CoV-2


title: Mental Health and Behavior of College Students During the Early Phases of the COVID-19 Pandemic: Longitudinal Smartphone and Ecological Momentary Assessment Study

text: BACKGROUND: The vast majority of people worldwide have been impacted by coronavirus disease (COVID-19). In addition to the millions of individuals who have been infected with the disease, billions of individuals have been asked or required by local and national governments to change their behavioral patterns. Previous research on epidemics or traumatic events suggests that this can lead to profound behavioral and mental health changes; however, researchers are rarely able to track these changes with frequent, near-real-time sampling or compare their findings to previous years of data for the same individuals. OBJECTIVE: By combining mobile phone sensing and self-reported mental health data among college students who have been participating in a longitudinal study for the past 2 years, we sought to answer two overarching questions. First, have the behaviors and mental health of the participants changed in response to the COVID-19 pandemic compared to previous time periods? Second, are these behavior and mental health changes associated with the relative news coverage of COVID-19 in the US media? METHODS: Behaviors such as the number of locations visited, distance traveled, duration of phone usage, number of phone unlocks, sleep duration, and sedentary time were measured using the StudentLife smartphone sensing app. Depression and anxiety were assessed using weekly self-reported ecological momentary assessments of the Patient Health Questionnaire-4. The participants were 217 undergraduate students, with 178 (82.0%) students providing data during the Winter 2020 term. Differences in behaviors and self-reported mental health collected during the Winter 2020 term compared to previous terms in the same cohort were modeled using mixed linear models. RESULTS: During the first academic term impacted by COVID-19 (Winter 2020), individuals were more sedentary and reported increased anxiety and depression symptoms (P<.001) relative to previous academic terms and subsequent academic breaks. Interactions between the Winter 2020 term and the week of the academic term (linear and quadratic) were significant. In a mixed linear model, phone usage, number of locations visited, and week of the term were strongly associated with increased amount of COVID-19-related news. When mental health metrics (eg, depression and anxiety) were added to the previous measures (week of term, number of locations visited, and phone usage), both anxiety (P<.001) and depression (P=.03) were significantly associated with COVID-19-related news. CONCLUSIONS: Compared with prior academic terms, individuals in the Winter 2020 term were more sedentary, anxious, and depressed. A wide variety of behaviors, including increased phone usage, decreased physical activity, and fewer locations visited, were associated with fluctuations in COVID-19 news reporting. While this large-scale shift in mental health and behavior is unsurprising, its characterization is particularly important to help guide the development of methods to reduce the impact of future catastrophic events on the mental health of the population.


title: Laboratory Diagnosis of COVID-19: Current Issues and Challenges

text: The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past several months. This commentary covers current issues and challenges for the laboratory diagnosis of infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is essential for a prompt and accurate molecular diagnosis of COVID-19. Appropriate measures are required to keep laboratory staff safe while producing reliable test results. In the analytic stage, real-time reverse transcription-PCR (RT-PCR) assays remain the molecular test of choice for the etiologic diagnosis of SARS-CoV-2 infection while antibody-based techniques are being introduced as supplemental tools. In the postanalytical stage, testing results should be carefully interpreted using both molecular and serological findings. Finally, random-access, integrated devices available at the point of care with scalable capacities will facilitate the rapid and accurate diagnosis and monitoring of SARS-CoV-2 infections and greatly assist in the control of this outbreak.