title: Timing of antiviral treatment initiation is critical to reduce SARS-CoV-2 viral load

text: We modeled the viral dynamics of 13 untreated patients infected with SARS-CoV-2 to infer viral growth parameters and predict the effects of antiviral treatments. In order to reduce peak viral load by more than 2 logs, drug efficacy needs to be greater than 90% if treatment is administered after symptom onset; an efficacy of 60% could be sufficient if treatment is initiated before symptom onset. Given their pharmacokinetic/pharmacodynamic properties, current investigated drugs may be in a range of 6-87% efficacy. They may help control virus if administered very early, but may not have a major effect in severe patients.


title: Parkinson's disease case ascertainment in prospective cohort studies through combining multiple health information resources

text: Epidemiological evidence from prospective cohort studies on risk factors of Parkinson's disease (PD) is limited as case ascertainment is challenging due to a lack of registries and the disease course of PD. The objective of this study was to create a case ascertainment method for PD within two prospective Dutch cohorts based on multiple sources of PD information. This method was validated using clinical records from the general practitioners (GPs). Face validity of the case ascertainment was tested for three etiological factors (smoking, sex and family history of PD). In total 54825 participants were included from the cohorts AMIGO and EPIC-NL. Sources of PD information included self-reported PD, self-reported PD medication, a 9 item screening questionnaire (Tanner), electronical medical records, hospital discharge data and mortality records. Based on these sources we developed a likelihood score with 4 categories (no PD, unlikely PD, possible PD, likely PD). For the different sources of PD information and for the likelihood score we present the agreement with GP-validated cases. Risk of PD for established factors was studied by logistic regression as exact diagnose dates were not always available. Based on the algorithm, we assigned 346 participants to the likely PD category. GP validation confirmed 67% of these participants in EPIC-NL, but only 12% in AMIGO. PD was confirmed in only 3% of the participants with a possible PD classification. PD case ascertainment by mortality records (91%), EMR ICPC (82%) and self-reported information (62-69%) had the highest confirmation rates. The Tanner PD screening questionnaire had a lower agreement (18%). Risk estimates for smoking, family history and sex using all likely PD cases were comparable to the literature for EPIC-NL, but not for smoking in AMIGO. Using multiple sources of PD evidence in cohorts remains important but challenging as performance of sources varied in validity.


COVID-19-associated ophthalmoparesis and hypothalamic involvement


title: Early dynamics of transmission and control of COVID-19: a mathematical modelling study

text: BACKGROUND: An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to 95â333 confirmed cases as of March 5, 2020. Understanding the early transmission dynamics of the infection and evaluating the effectiveness of control measures is crucial for assessing the potential for sustained transmission to occur in new areas. Combining a mathematical model of severe SARS-CoV-2 transmission with four datasets from within and outside Wuhan, we estimated how transmission in Wuhan varied between December, 2019, and February, 2020. We used these estimates to assess the potential for sustained human-to-human transmission to occur in locations outside Wuhan if cases were introduced. METHODS: We combined a stochastic transmission model with data on cases of coronavirus disease 2019 (COVID-19) in Wuhan and international cases that originated in Wuhan to estimate how transmission had varied over time during January, 2020, and February, 2020. Based on these estimates, we then calculated the probability that newly introduced cases might generate outbreaks in other areas. To estimate the early dynamics of transmission in Wuhan, we fitted a stochastic transmission dynamic model to multiple publicly available datasets on cases in Wuhan and internationally exported cases from Wuhan. The four datasets we fitted to were: daily number of new internationally exported cases (or lack thereof), by date of onset, as of Jan 26, 2020; daily number of new cases in Wuhan with no market exposure, by date of onset, between Dec 1, 2019, and Jan 1, 2020; daily number of new cases in China, by date of onset, between Dec 29, 2019, and Jan 23, 2020; and proportion of infected passengers on evacuation flights between Jan 29, 2020, and Feb 4, 2020. We used an additional two datasets for comparison with model outputs: daily number of new exported cases from Wuhan (or lack thereof) in countries with high connectivity to Wuhan (ie, top 20 most at-risk countries), by date of confirmation, as of Feb 10, 2020; and data on new confirmed cases reported in Wuhan between Jan 16, 2020, and Feb 11, 2020. FINDINGS: We estimated that the median daily reproduction number (Rt) in Wuhan declined from 2·35 (95% CI 1·15-4·77) 1 week before travel restrictions were introduced on Jan 23, 2020, to 1·05 (0·41-2·39) 1 week after. Based on our estimates of Rt, assuming SARS-like variation, we calculated that in locations with similar transmission potential to Wuhan in early January, once there are at least four independently introduced cases, there is a more than 50% chance the infection will establish within that population. INTERPRETATION: Our results show that COVID-19 transmission probably declined in Wuhan during late January, 2020, coinciding with the introduction of travel control measures. As more cases arrive in international locations with similar transmission potential to Wuhan before these control measures, it is likely many chains of transmission will fail to establish initially, but might lead to new outbreaks eventually. FUNDING: Wellcome Trust, Health Data Research UK, Bill & Melinda Gates Foundation, and National Institute for Health Research.


title: Systematic review of registered trials of Hydroxychloroquine prophylaxis for COVID-19 health-care workers at the first third of 2020

text: In the absence of a vaccine the medical and scientific community is looking intensely at utilizing a pre or post exposure drug that could decrease viremia. The search for a medication that could reduce risk of serious disease, and ideally of any manifestation of disease from SARS-CoV2, and of asymptomatic shedding of SARS-CoV2 is of urgent interest. Repurposing existing pharmaceuticals is among the approaches to achieve these ends. We performed a systematic review of all interventional studies registered in ClinicalTrials.gov with a focus on one repurposed drug, Hydroxychloroquine (HCQ). The detailed analysis of these studies, some of them already recruiting, provide an overall picture of HCQ use as a COVID-19 prophylaxis around the world. Among the included studies, all but three were randomized and parallel and most of them (74%, 23/31) were double-blinded to quadruple-blinded studies. We found a great diversity in dosing and nearly all the possible scientifically reasonable regimens are under evaluation. This diversity offers benefits as well as challenges. Importantly, the final analysis of these trials should be done through an extensive reading of the results in regard to the clinical design, it will be crucial to carefully read and evaluate the results of each study in regards to the clinical design rather than quickly glancing a 140 characters-based social media message announcing the failure or success of a drug against a disease.


title: The Role of Emergency Radiology in COVID-19: From Preparedness to Diagnosis [Formula: see text]

text: Emergency trauma radiology, although a relatively new subspecialty of radiology, plays a critical role in both the diagnosis/triage of acutely ill patients, but even more important in providing leadership and taking the lead in the preparedness of imaging departments in dealing with novel highly infectious communicable diseases and mass casualties. This has become even more apparent in dealing with COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, first emerged in late 2019. We review the symptoms, epidemiology, and testing for this disease. We discuss characteristic imaging findings of COVID-19 in relation to other modern coronavirus diseases including SARS and MERS. We discuss roles that community radiology clinics, outpatient radiology departments, and emergency radiology departments can play in the diagnosis of this disease. We review practical methods to reduce spread of infections within radiology departments.


title: Immunological Implications of Physical Inactivity among Older Adults during the COVID-19 Pandemic

text: Social distancing has been adopted worldwide to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Social isolation is likely to lead to a decline in physical activity, which could result in immune system dysfunction, thereby increasing infection susceptibility and exacerbating the pathophysiology of conditions that are common among older adults, including cardiovascular disease, cancer, and inflammatory disorders. Older adults and people living with these comorbidities are at a greater risk for complications during coronavirus disease 2019 (COVID-19). In this review, we discuss the negative impact of physical inactivity on immune function and showcase evidence that regular physical activity may be an effective strategy to counter some of the deleterious effects of social isolation. Furthermore, we briefly highlight key research questions in exercise immunology, with a focus on older adults in the context of COVID-19. Although it is worth emphasizing that there is no direct evidence that physical activity can prevent or treat -COVID-19, promoting an active lifestyle is a key intervention to counteract the effects of social isolation, especially in older adults and other at-risk individuals, such as those living with chronic diseases associated with ageing and lifestyle.


title: Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been widely spread. We aim to investigate the clinical characteristic and allergy status of patients infected with SARS-CoV-2. METHODS: Electronic medical records including demographics, clinical manifestation, comorbidities, laboratory data, and radiological materials of 140 hospitalized COVID-19 patients, with confirmed result of SARS-CoV-2 viral infection, were extracted and analyzed. RESULTS: An approximately 1:1 ratio of male (50.7%) and female COVID-19 patients was found, with an overall median age of 57.0 years. All patients were community-acquired cases. Fever (91.7%), cough (75.0%), fatigue (75.0%), and gastrointestinal symptoms (39.6%) were the most common clinical manifestations, whereas hypertension (30.0%) and diabetes mellitus (12.1%) were the most common comorbidities. Drug hypersensitivity (11.4%) and urticaria (1.4%) were self-reported by several patients. Asthma or other allergic diseases were not reported by any of the patients. Chronic obstructive pulmonary disease (COPD, 1.4%) patients and current smokers (1.4%) were rare. Bilateral ground-glass or patchy opacity (89.6%) was the most common sign of radiological finding. Lymphopenia (75.4%) and eosinopenia (52.9%) were observed in most patients. Blood eosinophil counts correlate positively with lymphocyte counts in severe (r = .486, P < .001) and nonsevere (r = .469, P < .001) patients after hospital admission. Significantly higher levels of D-dimer, C-reactive protein, and procalcitonin were associated with severe patients compared to nonsevere patients (all P < .001). CONCLUSION: Detailed clinical investigation of 140 hospitalized COVID-19 cases suggests eosinopenia together with lymphopenia may be a potential indicator for diagnosis. Allergic diseases, asthma, and COPD are not risk factors for SARS-CoV-2 infection. Older age, high number of comorbidities, and more prominent laboratory abnormalities were associated with severe patients.


Disinfection threatens aquatic ecosystems


title: Tracheostomy guidelines developed at a large academic medical center during the COVID-19 pandemic

text: BACKGROUND: During the SARS-CoV-2 pandemic, tracheostomy may be required for COVID-19 patients requiring long-term ventilation in addition to other conditions such as airway compromise from head and neck cancer. As an aerosol-generating procedure, tracheostomy increases the exposure of health care workers to COVID-19 infection. Performing surgical tracheostomy and tracheostomy care requires a strategy that mitigates these risks and maintains the quality of patient care. METHODS: This study is a multidisciplinary review of institutional tracheostomy guidelines and clinical pathways. Modifications to support clinical decision making in the context of COVID-19 were derived by consensus and available evidence. RESULTS: Modified guidelines for all phases of tracheostomy care at an academic tertiary care center in the setting of COVID-19 are presented. DISCUSSION: During the various phases of the COVID-19 pandemic, clinicians must carefully consider the indications, procedural precautions, and postoperative care for tracheostomies. We present guidelines to mitigate risk to health care workers while preserving the quality of care.


title: Laparoscopic surgery for benign adnexal conditions under spinal anaesthesia: Towards a multidisciplinary minimally invasive approach

text: BACKGROUND: Laparoscopic gynaecological surgery is commonly performed under general anaesthesia with endotracheal intubation. In general surgery, locoregional anaesthesia was applied to laparoscopic procedures, increasing minimally invasive surgery advantages. AIMS: To assess and compare postoperative pain after laparoscopic adnexal procedures for benign conditions under spinal anaesthesia (SA) versus general anaesthesia (GA). Furthermore, anaesthesiologic, surgical and clinical data were evaluated in both groups. MATERIALS AND METHODS: This is a prospective cohort study performed in a tertiary level referral centre for minimally invasive gynaecological surgery (Gynaecology and Human Reproduction Physiopathology, University of Bologna). Women scheduled for adnexal laparoscopic surgery for benign conditions between February and May 2019 were assigned to receive either SA or GA with endotracheal intubation. A sample size of 13 women per group was needed to detect a 2-point difference in pain scores. MAIN FINDINGS: 13 women were enrolled in the SA arm, 15 in the GA arm. In the SA cohort, the most common intraoperative adverse event was shoulder pain, reported by 3/12 women. At 1, 8, 12, 24 and 48 h after surgery pain was significantly lower in the SA arm (p < .05). Patients submitted to SA experienced no need for opioid drugs administration, unlike those receiving GA. Patients' mobilization and return of bowel function were noted significantly earlier in the SA group (p < .05). CONCLUSIONS: SA is a feasible, safe and effective anaesthesiologic technique for laparoscopic gynaecological procedures for benign conditions, allowing a better control of postoperative pain. Women undergoing SA achieve earlier mobilization and bowel canalization. During the Covid-19 pandemics, SA could be useful in reducing the need for invasive procedures on respiratory tract.


title: Questionnaire on Perception of Threat from COVID-19

text: The ravages caused by the disease known as COVID-19 has led to a worldwide healthcare and social emergency requiring an effective combined effort from everyone to reduce contagion. Under these circumstances, the perception of the disease is going to have a relevant role in the individual's psychological adjustment. However, at the present time there is no validated instrument for evaluating adult perception of threat from COVID-19. Considering the importance of perception or representation of the disease in a state of social alert, our study intended to validate an instrument measuring the psychological process of the disease caused by the coronavirus (COVID-19). In view of the above, this study evaluated the factor structure and reliability of the version of the Illness Perception Questionnaire (IPQ) for COVID-19 in a sample of adults. The sample consisted of 1014 Spanish adults (67.2% women and 32.8% men). The exploratory and confirmatory factor analyses supported a unidimensional model of the scale, which was the one that showed the best fit and explained 43.87% of the variance. This brief version has adequate psychometric properties and may be used to evaluate the perception of threat from COVID-19 in an adult Spanish population. The validation of this instrument contributes to progress in representation of COVID-19 in our culture.


COVID-19 is catalyzing the adoption of teleneurology


title: The disaster worker resiliency training program: a randomized clinical trial

text: OBJECTIVES: Disaster workers are at elevated risk for mental health problems as a result of trauma exposures during response efforts. One possible way to prevent mental health problems is to build-up coping resources that promote resilience to the effects of disaster work. The primary aim of this study was to evaluate the efficacy of a resilience building workshop, the Disaster Worker Resiliency Training Program (DWRT), in disaster workers previously exposed to Hurricane Sandy. METHODS: Disaster workers (N = 167) were randomly assigned to the DWRT workshop (n = 78) or a waitlist (n = 89). Workers completed self-report measures on healthy lifestyle behaviors, perceived stress, depression, and Posttraumatic Stress Disorder (PTSD) symptoms at baseline and 3-month follow-up. They also completed a measure assessing subsequent trauma-exposure between the baseline and 3-month post-intervention. RESULTS: Participants in the workshop condition, as compared to those in a waitlist control, reported significantly greater improvements from pre-intervention (T1) to 3-month follow-up (T2) in healthy lifestyle behaviors (Î·2 = .03; p = .03), stress management (Î·2 = .03, p = .04), and spiritual growth (Î·2 = .03, p = .02). Among participants reporting subsequent trauma exposures between T1 and T2 (n = 101), participants in the waitlist condition, were more likely to report significant increases in perceived stress (Î·2 = .07, p < .01), PTSD (Î·2 = .05, p = .03), and depression (Î·2 = .07, p < .01) symptoms. CONCLUSIONS: Participation in the resilience workshop promoted engagement in positive health behaviors and reduced the incidence of mental health symptoms, especially when administered prior to a repeat trauma exposure. Further research is needed to evaluate the long-term health effects of participation in the program.


COVID-19 and economy


docid: zzljrkbf

title: The diagnostic value of joint detection of serum IgMand IgG antibodies to 2019-nCoV in 2019-nCoV infection/ 中华检验医学杂志

text: Objective@#To investigate the diagnostic value of immunoglobulin M (IgM) and immunoglobulin G(IgG) antibodies to 2019 Novel Coronavirus (2019-nCoV) in 2019-nCoV infection.@*Method@#This is a retrospective study. Serum samples were collected from 284 patients including outpatients and inpatients in the Renmin Hospital of Wuhan University from January 20, 2020 to February 17, 2020. Among them 205 cases were 2019-nCoV infected patients, including 186 cases confirmed with nucleic acid test and 19 cases diagnosed by clinical symptoms and CT characteristics according to "the New Coronavirus Pneumonia Control Protocol (5th edition)" . A total of 79 subjects with other diseases but negative to 2019-nCoV infection were recruited as control group. Serum IgM and IgG antibodies to 2019-nCoV were measured with fully automated immunoassay technology for all subjects. Statistical significance between 2019-nCoV antibodies test and 2019-nCoV nucleic acid test was determined using the χ2 tests.@*Result@#The sensitivity of serum IgM and IgG antibodies to 2019-nCoV were 70.24%(144/205) and 96.10%(197/205) respectively and the specificity were 96.20%(76/79) and 92.41%(73/79) respectively. The positive and negative predictive values of 2019-nCoV antibodies were 95.63%(197/206) and 91.03% (71/78) respectively, and the positive and negative predictive values of 2019-nCoV nucleic acid test were 100%(186/186) and 80.61%(79/98) respectively. The total coincidence rate of diagnosing 2019-nCoV infection between antibody tests and nucleic acid test for 2019-nCoV were 88.03%(250/284).@*Conclusion@#Joint detection of serum IgM and IgG antibodies to 2019-nCoV is an effective screening and diagnostic indicators for 2019-nCoV infection, and an effective complement to the false negative results to nucleic acid test.


title: Pregnancy affected by SARS-CoV-2 infection: a flash report from Michigan

text: The world is currently affected by the invasion of a human to human highly transmissible novel corona virus classified as SARS-CoV-2. It causes a severe acute lower respiratory tract syndrome named corona virus disease (CoVid-19). The virus is detected primarily by RT-PCR. The reproduction number (Ro) has been reported between 2.28 and 5.27]. It is beyond our objective to provide an in-depth discussion of the virus characteristics and its distinct viral clades and pathogenic behavior. On 30 January 2020 the World Health Organization (WHO) declared this outbreak a Public Health Emergency of International Concern, (PHEIC) and on 11 March 2020 WHO declared it a pandemic. There is limited information on the effect of CoVid-19 in pregnancy and the new born. We describe the details of the hospital course of the first 16 cases involving pregnant women, admitted to an urban-suburban community general hospital in Wayne County Michigan, from 26 March to 10 April 2020. At the time of this writing the Covid-19 pandemic has affected 35,291 persons in the state of Michigan (0.37%) making it the third most affected state in the USA (MDHHS). Pregnant women are believed to be at higher risk of Covid-19 infection in association with the known physiologic changes of the immune, cardiorespiratory and metabolic systems during pregnancy.


title: Challenges of Oral Medicine Specialistsat the time ofCOVID-19 Pandemic

text: The novel coronavirus disease 2019 (COVID-19) had caused major disruptions in medical and dental care across the world, affecting secondary care services that had to rapidly adapt to new circumstances. Postponed and delayed oral medicine (OM) care, deferring non-urgent follow-ups in case of patients because of COVID-19 crisis, and limited access to health care, may have lead serious consequences fororal and systemic health (Arduino et al, 2020; Jones et al, 2020). Deferred diagnosis of a malignant conditionwhen suspected or even dysplasia in oralleucoplakia cases vastly implies the clinical outcome, influencing treatment and prognosis, subsequently(Meng et al, 2020).Suspended routine care provision for patients with other, less severe conditions (hyposalivation, oral lichen planus,oral candidiasis, and recurrentaphthous stomatitis - RAS)could have a significant impact on the patients' well-being and quality of life, if oral medicine cases are not managed consistently and timely. Chronic autoimmune disorders with oral manifestations, such asmucous membrane pemphigoid orpemphigus vulgaris,can be exacerbated as a result of delayed OM follow-ups, dental care and self-management or even interruptionof long-term(pharmaco)therapy(Martins-Chaves et al, 2020; Kasperkiewicz et al, 2).


Remote digital monitoring in clinical trials in the time of COVID-19


title: Consecuencias maternas y neonatales de la infección por coronavirus COVID-19 durante el embarazo: una scoping review./ [Maternal and neonatal consequences of coronavirus COVID-19 infection during pregnancy: a scoping review]

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a new pathology, declared a public health emergency by the World Health Organization, which can have negative consequences for pregnant women and their newborns. The aim of this study was to explore the available knowledge on the consequences of developing COVI-19 in pregnant women and their neonates. METHODS: Scoping Review, in which the search for articles was conducted using DeCS ("pregnancy", "coronavirus", "health") and MeSH ("pregnan*", "pregnant women", "coronavirus"), linking the terms with the Boolean AND operator. Databases used were Web of Science, Scopus, BVS, Scielo and CUIDEN. In addition, the PRISMA methodology was applied. RESULTS: Ten studies were identified that assessed maternal and neonatal health after maternal COVID-19 infection. Pregnant women seem to had no serious symptoms. Neonates appeared to be affected to a greater extent. A death was reported in a premature newborn whose mother had COVID-19 pneumonia. There did not appear to be vertical transmission from mother to child. Nevertheless, this information was not conclusive. CONCLUSIONS: COVID-19 appears to be more benign with pregnant women than with their neonates.


COVID-19, wet markets, and planetary health


title: Guillain-Barré syndrome after SARS-CoV-2 infection

text: Since the first reports in December 2019 in Wuhan, China, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly developed into a pandemic associated with substantial morbidity and mortality. Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that may be triggered by various bacterial and viral infections. Reports on possible neurological manifestations of SARS-CoV-2 are still scarce. Hereby, we report a case of GBS after an infection with SARS-CoV-2.


Negative Nasopharyngeal and Oropharyngeal Swabs Do Not Rule Out COVID-19


title: Analysis of COVID-19 infection spread in Japan based on stochastic transition model

text: To assess the effectiveness of response strategies of avoiding large gatherings or crowded areas and to predict the spread of COVID-19 infections in Japan, we developed a stochastic transmission model by extending the Susceptible-Infected-Removed (SIR) epidemiological model with an additional modeling of the individual action on whether to stay away from the crowded areas. The population were divided into three compartments: Susceptible, Infected, Removed. Susceptible transitions to Infected every hour with a probability determined by the ratio of Infected and the congestion of area. The total area consists of three zones crowded zone, mid zone and uncrowded zone, with different infection probabilities characterized by the number of people gathered there. The time for each people to spend in the crowded zone is curtailed by 0, 2, 4, 6, 7, and 8 hours, and the time spent in mid zone is extended accordingly. This simulation showed that the number of Infected and Removed will increase rapidly if there is no reduction of the time spent in crowded zone. On the other hand, the stagnant growth of Infected can be observed when the time spent in the crowded zone is reduced to 4 hours, and the growth number of Infected will decrease and the spread of the infection will subside gradually if the time spent in the crowded zone is further cut to 2 hours. In conclusions The infection spread in Japan will be gradually contained by reducing the time spent in the crowded zone to less than 4 hours.


title: A practice of anesthesia scenario design for emergency cesarean section in patients with COVID-19 infection based on the role of standard patient

text: The new coronavirus (COVID-19) has been characterized as a world pandemic by WHO since March 11, 2020. Although it is likely that COVID-19 transmission is primarily via droplets and close contact, airborne transmission and fecal-oral route remains a possibility. The medical staff working in the operating room, such as anesthesiologists, surgeons and nurses, are at high risk of exposure to virus due to closely contacting patients. The perioperative management is under great challenge while performing surgeries for patients suffering COVID-19, including emergency cesarean section, which is one of the most common surgeries under such circumstances. How to prevent medical staff from cross-infection is an issue of great concern. In this article, we give a practice of anesthesia scenario design for emergency cesarean section in a supposed standard patient suffering COVID-19, aimed to optimize the work flow and implement the protective details through simulation of a real operation scenario, which may be useful for training and clinical practice of anesthesia management for patients suffering COVID-19 or other fulminating infectious diseases.


title: Acute Physiology and Chronic Health Evaluation II Score as a Predictor of Hospital Mortality in Patients of Coronavirus Disease 2019

text: OBJECTIVES: Coronavirus disease 2019 has emerged as a major global health threat with a great number of deaths in China. We aimed to assess the association between Acute Physiology and Chronic Health Evaluation II score and hospital mortality in patients with coronavirus disease 2019, and to compare the predictive ability of Acute Physiology and Chronic Health Evaluation II score, with Sequential Organ Failure Assessment score and Confusion, Urea, Respiratory rate, Blood pressure, Age 65 (CURB65) score. DESIGN: Retrospective observational cohort. SETTING: Tongji Hospital in Wuhan, China. SUBJECTS: Confirmed patients with coronavirus disease 2019 hospitalized in the ICU of Tongji hospital from January 10, 2020, to February 10, 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 178 potentially eligible patients with symptoms of coronavirus disease 2019, 23 patients (12.92%) were diagnosed as suspected cases, and one patient (0.56%) suffered from cardiac arrest immediately after admission. Ultimately, 154 patients were enrolled in the analysis and 52 patients (33.77%) died. Mean Acute Physiology and Chronic Health Evaluation II score (23.23 ± 6.05) was much higher in deaths compared with the mean Acute Physiology and Chronic Health Evaluation II score of 10.87 ± 4.40 in survivors (p < 0.001). Acute Physiology and Chronic Health Evaluation II score was independently associated with hospital mortality (adjusted hazard ratio, 1.07; 95% CI, 1.01-1.13). In predicting hospital mortality, Acute Physiology and Chronic Health Evaluation II score demonstrated better discriminative ability (area under the curve, 0.966; 95% CI, 0.942-0.990) than Sequential Organ Failure Assessment score (area under the curve, 0.867; 95% CI, 0.808-0.926) and CURB65 score (area under the curve, 0.844; 95% CI, 0.784-0.905). Based on the cut-off value of 17, Acute Physiology and Chronic Health Evaluation II score could predict the death of patients with coronavirus disease 2019 with a sensitivity of 96.15% and a specificity of 86.27%. Kaplan-Meier analysis showed that the survivor probability of patients with coronavirus disease 2019 with Acute Physiology and Chronic Health Evaluation II score less than 17 was notably higher than that of patients with Acute Physiology and Chronic Health Evaluation II score greater than or equal to 17 (p < 0.001). CONCLUSIONS: Acute Physiology and Chronic Health Evaluation II score was an effective clinical tool to predict hospital mortality in patients with coronavirus disease 2019 compared with Sequential Organ Failure Assessment score and CURB65 score. Acute Physiology and Chronic Health Evaluation II score greater than or equal to 17 serves as an early warning indicator of death and may provide guidance to make further clinical decisions.


title: Caring for Pregnant Patients with COVID-19: Practical Tips Getting from Policy to Practice

text: Novel coronavirus disease 2019 (COVID-19) is a pandemic with most American cases in New York. As an institution residing in a high-prevalence zip code, with over 8,000 births annually, we have cared for over 80 COVID-19-infected pregnant women, and have encountered many challenges in applying new national standards for care. In this article, we review how to change outpatient and inpatient practices, develop, and disseminate new hospital protocols, and we highlight the psychosocial challenges for pregnant patients and their providers. KEY POINTS: · Novel coronavirus disease 2019 (COVID-19) information rapidly changes.. · Multidisciplinary communication is key.. · This study addresses psychosocial challenges..


COVID-19: time for WHO to reconsider its stance towards Taiwan


title: Clinical and Chest Radiography Features Determine Patient Outcomes In Young and Middle Age Adults with COVID-19

text: Background Chest radiography (CXR) has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose The purpose of this study was to analyze the prognostic value of a CXR severity scoring system for younger (non-elderly) patients with COVID-19 upon initial presentation to the emergency department (ED). Outcomes of interest included hospitalization, intubation, prolonged stay, sepsis, and death. Materials & Methods In this retrospective study, patients between the ages of 21 and 50 years who presented to EDs of an urban multicenter health system from March 10 - 26, 2020 with COVID-19 confirmation on real-time reverse transcriptase polymerase chain reaction (RT-PCR) were identified. Each patient's ED CXR was divided into 6 zones and examined for opacities by two cardiothoracic radiologists with scores collated into a total concordant lung zone severity score. Clinical and laboratory variables were collected. Multivariable logistic regression was utilized to evaluate the relationship between clinical parameters, CXR scores, and patient outcomes. Results The study included 338 patients: 210 males (62%), median age 39 [31-45]. After adjustment for demographics and co-morbidities, independent predictors of hospital admission (n=145, 43%) were CXR severity score ≥ 2 (OR: 6.2, 95% CI 3.5-11, p<0.001) and obesity (OR 2.4 (1.1-5.4) or morbid obesity. Of patients who were admitted, a CXR score ≥3 was an independent predictor of intubation (n=28) (OR: 4.7, 95% CI 1.8-13, p=0.002) as was hospital site. We found no significant difference in primary outcomes across race/ethnicity, those with a history of tobacco use, asthma or diabetes mellitus type II. Conclusion For patients aged 21-50 with COVID-19 presenting to the emergency department, a chest x-ray severity score was predictive of risk for hospital admission and intubation.


title: Mathematical model of COVID-19 intervention scenarios for Sao Paulo- Brazil

text: An epidemiological compartmental model was used to simulate social distancing strategies to contain the COVID-19 pandemic and prevent a second wave in Sao Paulo, Brazil. Optimization using genetic algorithm was used to determine the optimal solutions. Our results suggest the best-case strategy for Sao Paulo is to maintain or increase the current magnitude of social distancing for at least 60 more days and increase the current levels of personal protection behaviors by a minimum of 10% (e.g., wearing facemasks, proper hand hygiene and avoid agglomeration). Followed by a long-term oscillatory level of social distancing with a stepping-down approach every 80 days over a period of two years with continued protective behavior.


title: Community Pharmacists: On the frontline of health service against COVID-19 in LMICs

text: The COVID-19 outbreak is a global public health crisis which has affected healthcare practice across professions. In the context of this pandemic, there is a need to highlight the roles and responsibilities of pharmacists. Community pharmacists are the most accessible healthcare professionals to the general public and have a lot to offer amid the COVID-19 response. This have led to significant changes in the health systems of many countries. This article seeks to highlight additional roles and activities relating to the public health response that can be undertaken by community pharmacists that could help to reduce pressure on general practice and other areas of the health service.


SARS-CoV-2-induced Acute Respiratory Distress Syndrome: Pulmonary Mechanics and Gas Exchange Abnormalities


docid: nczeiqmb

title: Disconnections between medical education and medical practice: A neglected dilemma

text: Medical practice has changed profoundly over the past 60 years. Many changes have also been made in medical education, often with a view to countering adverse aspects of highly specialised, commercialised and bureaucratised modern medical practice. Regardless of the state of the world today and of the variety of changes that may occur in the years ahead, excellence in the application of bedside skills and technological advances, accompanied by excellence in humanistic aspects of caring for patients as people, will remain preeminent goals at the heart of medical practice. Powerful social forces that negatively influence practice cannot be counteracted through changes in medical education alone and need to be addressed directly within health systems. Shifting healthcare towards a valued social service is arguably essential for improving both public and individual health through more widespread universal access to high quality and effectively integrated health care.


title: Telehealth Home Support During COVID-19 Confinement for Community-Dwelling Older Adults With Mild Cognitive Impairment or Mild Dementia: Survey Study

text: BACKGROUND: The public health emergency of coronavirus disease (COVID-19) is rapidly evolving worldwide; some countries, including Spain, have implemented restrictive measures. Populations that are vulnerable to this outbreak and its physical and mental health effects include community-dwelling older adults with mild cognitive impairment or mild dementia. Telehealth is a potential tool to deliver health care and decrease exposure risk. OBJECTIVE: The aims of this study were to explore the impact of confinement on the health and well-being of community-dwelling older adults with mild cognitive impairment or mild dementia, to provide television-based and telephone-based health and social support, and to study the effects of a television-based assistive integrated technology, TV-AssistDem (TeleVision-based ASSistive Integrated Service to supporT European adults living with mild DEMentia or mild cognitive impairment). METHODS: A telephone-based survey was administered in Spain to 93 participants in the TV-AssistDem clinical trial from March 25 to April 6, 2020. RESULTS: Of the respondents, 60/93 (65%) were women. The mean age was 73.34 (SD 6.07), and 69/93 (74%) lived accompanied. Lockdown measures forced 17/93 respondents (18%) to change their living arrangements. Health status was found to be optimal in 89/93 respondents (96%), with no COVID-19 symptoms. Grocery and pharmacy outings were performed by family members of 68/93 participants (73%); 57 (61%) reported overall well-being, and 65 (70%) maintained their sleep quality. However, participants living alone reported greater negative feelings and more sleeping problems. Regarding leisure activities, 53/93 respondents (57%) took walks, 32 (35%) played memory games, 55 (60%) watched television, and 91 (98%) telephoned relatives. 58/93 (64%) respondents reported accessing moderate or too much COVID-19 information, 89 (97%) received it from television, and 56 (62%) stated that their understanding of the information was extreme. 39/93 (39%) respondents had contacted health and social services, while 29 (31%) requested information regarding these services during the telephone call. There were no significant differences in health and well-being between the intervention and control groups. Respondents with TV-AssistDem performed more memory exercises (24/93, 52% vs 8/93, 17.4%; P<.001) than control respondents. CONCLUSIONS: Our findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population. However, those living alone reported greater negative psychological effects and sleeping problems. Measures adopted to address the negative experiences of confinement included keeping informed about the situation, accessing health and social services, having a support network that prevents risk of exposure to COVID-19 and guarantees food and medical supplies, a daily routine with maintained sleeping habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and ensuring social connectedness using technology. Television sets were preferred technological devices to access COVID-19 information, watch television as a recreational activity, and perform memory exercises as an intellectual activity. Television-based telehealth support using TV-AssistDem demonstrated potential for cognitive stimulation. TRIAL REGISTRATION: ClinicalTrials.gov NCT03653234; https://clinicaltrials.gov/ct2/show/NCT03653234.


Ritonavir/Lopinavir and Its Potential Interactions With Psychiatric Medications: A COVID-19 Perspective


title: Hamiltonian structure of compartmental epidemiological models

text: Any epidemiological compartmental model with constant population is shown to be a Hamiltonian dynamical system in which the total population plays the role of the Hamiltonian function. Moreover, some particular cases within this large class of models are shown to be bi-Hamiltonian. New interacting compartmental models among different populations, which are endowed with a Hamiltonian structure, are introduced. The Poisson structures underlying the Hamiltonian description of all these dynamical systems are explicitly presented, and their associated Casimir functions are shown to provide an efficient tool in order to find exact analytical solutions for epidemiological dynamics.


docid: dkhpglsb

title: COVID-19 STEMI 2020: It's Not What You Know, It's How You Think


SARS-CoV-2: What do we know so far?


title: Strongly-interacting massive particle and dark photon in the era of intensity frontier

text: A strongly interacting massive particle (SIMP) is an interesting candidate for dark matter (DM) because its self-interaction cross section can be naturally strong enough to address the astrophysical problem of small-scale structure formation. A simple model was proposed by assuming a monopole condensation, where composite SIMP comes from a"strongly interacting"U(1)$_{\rm d}$ gauge theory. In the original model, the DM relic abundance is determined by the $3\to2$ annihilation process via the Wess-Zumino-Witten term. In this letter, we discuss that the DM relic abundance is naturally determined also by a semi-annihilation process via a kinetic mixing between the hypercharge gauge boson and the dark U(1)$_{\rm d}$ gauge boson (dark photon). The dark photon can be discovered by LDMX-style missing momentum experiments in the near future.


title: Psychological Stress and Vocal Symptoms Among University Professors in Israel: Implications of the Shift to Online Synchronous Teaching During the COVID-19 Pandemic

text: OBJECTIVES: Psychological stress may have an adverse impact on the voice. The purpose of the present cross-sectional study was to investigate the relationship between the change in levels of perceived psychological stress and vocal symptoms among Israeli academic college professors required to shift to synchronous online teaching during the global COVID-19 pandemic. METHODS: An online questionnaire was completed by 313 professors (156 men and 157 women) from 14 academic colleges in Israel at the end of the first week of online synchronous teaching during the COVID-19 pandemic, which was assumed to be the most burdened and stressful week of the transition. Participants provided self-reports for the current levels of psychological stress and vocal symptoms during the transition to online synchronous teaching, as well as general psychological stress and general vocal symptoms during previous periods of teaching. RESULTS: The results revealed higher levels of psychological stress but not vocal symptoms during the transition to online synchronous teaching compared with previous periods of teaching. Psychological stress during the transition to online synchronous teaching was positively associated with vocal symptoms during this period but this association was moderated by general stress. Although there was a positive association between psychological stress and vocal symptoms for individuals who reported low levels of psychological stress during previous periods of teaching, this association was especially strong for individuals who reported high levels of psychological stress during previous periods of teaching. CONCLUSIONS: It is important to examine vocal symptoms of professors in specific contexts that are potentially stressful. The psychological stress surrounding the transition to online synchronous teaching was associated with elevated levels of vocal symptoms especially for those who reported high levels of psychological stress during previous periods of teaching. These results with professors accord with the notion that psychological stress may have a negative impact on the voice.


Psychiatry hospital management facing COVID-19: From medical staff to patients


title: Spectrum of Neurological Manifestations in Covid-19: A Review

text: COVID-19, in most patients, presents with mild flu-like illness. Elderly patients with comorbidities, like hypertension, diabetes, or lung and cardiac disease, are more likely to have severe disease and deaths. Neurological complications are frequently reported in severely or critically ill patients with comorbidities. In COVID-19, both central and peripheral nervous systems can be affected. The SARS-CoV-2 virus causes the disease COVID-19 and has the potential to invade the brain. The SARS-CoV-2 virus enters the brain either via a hematogenous route or olfactory system. Angiotensin-converting enzyme two receptors, present on endothelial cells of cerebral vessels, are a possible viral entry point. The most severe neurological manifestations, altered sensorium (agitation, delirium, and coma), are because of hypoxic and metabolic abnormalities. Characteristic cytokine storm incites severe metabolic changes and multiple organ failure. Profound coagulopathies may manifest with ischemic or hemorrhagic stroke. Rarely, SARS-CoV-2 virus encephalitis or pictures like acute disseminated encephalomyelitis or acute necrotizing encephalopathy have been reported. Nonspecific headache is a commonly experienced neurological symptom. A new type of headache "personal protection equipment-related headache" has been described. Complete or partial anosmia and ageusia are common peripheral nervous system manifestations. Recently, many cases of Guillain-Barré syndrome in COVID-19 patients have been observed, and a postinfectious immune-mediated inflammatory process was held responsible for this. Guillain-Barré syndrome does respond to intravenous immunoglobulin. Myalgia/fatigue is also common, and elevated creatine kinase levels indicate muscle injury. Most of the reports about neurological complications are currently from China. COVID-19 pandemic is spreading to other parts of the world; the spectrum of neurological complications is likely to widen further.


Throat and ear infections in children: URTI in the time of COVID-19


title: Thinking of treatment strategies for colorectal cancer patients in tumor hospitals under the background of coronavirus pneumonia/ 中华胃肠外科杂志

text: In December 2019, a new outbreak of coronavirus pneumonia began to occur. Its pathogen is 2019-nCoV, which has the characteristics of strong infectivity and general susceptibility. The current situation of prevention and control of new coronavirus pneumonia is severe. In this context, as front-line medical workers bearing important responsibilities and pressure, while through strict management strategy, we can minimize the risk of infection exposure. By summarizing the research progress and guidelines in recent years in the fields of colorectal cancer disease screening, treatment strategies(including early colorectal cancer, locally advanced colorectal cancer, obstructive colorectal cancer, metastatic colorectal cancer and the treatment of patients after neoadjuvant therapy), the choice of medication and time limit for adjuvant therapy, the protective measures for patients undergoing emergency surgery, the re-examination of postoperative patients and the protection of medical staff, etc., authors improve treatment strategies in order to provide more choices for patients to obtain the best treatment under the severe epidemic situation of new coronavirus pneumonia. Meanwhile we hope that it can also provide more timely treatment modeling schemes for colleagues.


title: Barrow holographic dark energy

text: We formulate Barrow holographic dark energy, by applying the usual holographic principle at a cosmological framework, but using the Barrow entropy instead of the standard Bekenstein-Hawking one. The former is an extended black-hole entropy that arises due to quantum-gravitational effects which deform the black-hole surface by giving it an intricate, fractal form. We extract a simple differential equation for the evolution of the dark energy density parameter, which possesses standard holographic dark energy as a limiting sub-case, and we show that the scenario can describe the universe thermal history, with the sequence of matter and dark energy eras. Additionally, the new Barrow exponent $\Delta$ significantly affects the dark energy equation of state, and according to its value it can lead it to lie in the quintessence regime, in the phantom regime, or experience the phantom-divide crossing during the evolution.


title: Following Data as it Crosses Borders During the COVID-19 Pandemic

text: Data changes the game in terms of how we respond to pandemics. Global data on disease trajectories and the effectiveness and economic impact of different social distancing measures are essential to facilitate effective local responses to pandemics. COVID-19 data flowing across geographic borders are extremely useful to public health professionals for many purposes such as accelerating the pharmaceutical development pipeline, and for making vital decisions about intensive care unit rooms, where to build temporary hospitals, or where to boost supplies of personal protection equipment, ventilators, or diagnostic tests. Sharing data enables quicker dissemination and validation of pharmaceutical innovations, as well as improved knowledge of what prevention and mitigation measures work. Even if physical borders around the globe are closed, it is crucial that data continues to transparently flow across borders to enable a data economy to thrive which will promote global public health through global cooperation and solidarity.


docid: mnzzsscb

title: Optimizing status epilepticus care during the COVID-19 pandemic


title: Epidemiologic and clinical characteristics of 10 children with coronavirus disease 2019 in Changsha, China

text: BACKGROUND: The outbreak of a new coronavirus, first reported in Wuhan, China, is spreading around the world. Information on the characteristics of children with Coronavirus Disease 2019 (COVID-19) is limited. METHODS: In this retrospective study, we recruited 10 children infected with SARS-COV-2 from January 27 to March 10, 2020, in Changsha, China. We report the epidemiological, clinical, laboratory, and high-resolution CT findings for these children. Qualitative descriptive analysis was used to describe the key results. RESULTS: Ten children were included. Three were male and seven were female. Three were from Wuhan, Hubei Province, and seven were from Changsha. All had a history of close contact with adults with COVID-19 before the onset of disease. Clinical manifestations included fever in four cases, respiratory symptoms in three cases, febrile convulsions in one case, vomiting in one case, abdominal pain in one case, and asymptomatic infection in two cases. All the children tested positive for nucleic acid in throat swabs at admission. Stool swabs of three cases were positive for nucleic acid after several days of fever. In nine children, blood routine results were normal, whereas in one case the white blood cell count was elevated. In four cases, CT findings of the lungs showed light ground-glass opacities, one case showed changes similar to bronchopneumonia, and the remaining cases were normal. All were treated with symptomatic support without complications. CONCLUSION: Our findings indicate that intrafamily transmission may be the main form of transmission of COVID-19 in children, and persistent intestinal excretion of virus is another characteristic among children. The results of stool swab tests should be considered for discharge and release from isolation.


title: Tratamiento inmunosupresor en pulsos en esclerosis múltiple durante el desescalado de la epidemia por SARS-CoV-2. Algoritmo de seguridad./ Tratamiento inmunosupresor en pulsos en esclerosis múltiple durante el desescalado de la epidemia por SARS-CoV-2. Algoritmo de seguridad./ Pulse immunosuppressive therapy for multiple sclerosis during the SARS-CoV-2 lockdown de-escalation plan: Safety algorithm

text: INTRODUCTION: The COVID-19 pandemic is changing approaches to diagnosis, treatment, and care provision in multiple sclerosis (MS). During both the initial and peak phases of the epidemic, the administration of disease-modifying drugs, typically immunosuppressants administered in pulses, was suspended due to the uncertainty about their impact on SARS-CoV-2 infection, mainly in contagious asymptomatic/presymptomatic patients. The purpose of this study is to present a safety algorithm enabling patients to resume pulse immunosuppressive therapy (PIT) during the easing of lockdown measures. METHODS: We developed a safety algorithm based on our clinical experience with MS and the available published evidence; the algorithm assists in the detection of contagious asymptomatic/presymptomatic cases and of patients with mild symptoms of SARS-CoV-2 infection with a view to withdrawing PIT in these patients and preventing new infections at day hospitals. RESULTS: We developed a clinical/microbiological screening algorithm consisting of a symptom checklist, applied during a teleconsultation 48hours before the scheduled session of PIT, and PCR testing for SARS-CoV-2 in nasopharyngeal exudate 24hours before the procedure. CONCLUSION: The application of our safety algorithm presents a favourable risk-benefit ratio despite the fact that the actual proportion of asymptomatic and presymptomatic individuals is unknown. Systematic PCR testing, which provides the highest sensitivity for detecting presymptomatic cases, combined with early detection of symptoms of SARS-CoV-2 infection may reduce infections and improve detection of high-risk patients before they receive PIT.


Out of the Darkness-Into the Light: Value of SARS-CoV-2 Antibody Testing in Populations to Benefit Public Health and in Individuals for Peace of Mind


Kontaktallergie auf FFP2-Maske in der COVID-19-Pandemie./ [Case report of contact allergy to filtering facepiece class 2 mask of a medical worker during Covid-19 pandemic]


title: Neurological associations of COVID-19

text: BACKGROUND: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is of a scale not seen since the 1918 influenza pandemic. Although the predominant clinical presentation is with respiratory disease, neurological manifestations are being recognised increasingly. On the basis of knowledge of other coronaviruses, especially those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome epidemics, cases of CNS and peripheral nervous system disease caused by SARS-CoV-2 might be expected to be rare. RECENT DEVELOPMENTS: A growing number of case reports and series describe a wide array of neurological manifestations in 901 patients, but many have insufficient detail, reflecting the challenge of studying such patients. Encephalopathy has been reported for 93 patients in total, including 16 (7%) of 214 hospitalised patients with COVID-19 in Wuhan, China, and 40 (69%) of 58 patients in intensive care with COVID-19 in France. Encephalitis has been described in eight patients to date, and Guillain-Barré syndrome in 19 patients. SARS-CoV-2 has been detected in the CSF of some patients. Anosmia and ageusia are common, and can occur in the absence of other clinical features. Unexpectedly, acute cerebrovascular disease is also emerging as an important complication, with cohort studies reporting stroke in 2-6% of patients hospitalised with COVID-19. So far, 96 patients with stroke have been described, who frequently had vascular events in the context of a pro-inflammatory hypercoagulable state with elevated C-reactive protein, D-dimer, and ferritin. WHERE NEXT?: Careful clinical, diagnostic, and epidemiological studies are needed to help define the manifestations and burden of neurological disease caused by SARS-CoV-2. Precise case definitions must be used to distinguish non-specific complications of severe disease (eg, hypoxic encephalopathy and critical care neuropathy) from those caused directly or indirectly by the virus, including infectious, para-infectious, and post-infectious encephalitis, hypercoagulable states leading to stroke, and acute neuropathies such as Guillain-Barré syndrome. Recognition of neurological disease associated with SARS-CoV-2 in patients whose respiratory infection is mild or asymptomatic might prove challenging, especially if the primary COVID-19 illness occurred weeks earlier. The proportion of infections leading to neurological disease will probably remain small. However, these patients might be left with severe neurological sequelae. With so many people infected, the overall number of neurological patients, and their associated health burden and social and economic costs might be large. Health-care planners and policy makers must prepare for this eventuality, while the many ongoing studies investigating neurological associations increase our knowledge base.


title: Olfactory and Oral Manifestations of COVID-19: Sex-Related Symptoms-A Potential Pathway to Early Diagnosis

text: OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic poses a threat to global health. Early diagnosis is an essential key to limit the outbreak of the virus. STUDY DESIGN: Case series, study conducted between March 25, 2020, and April 15, 2020. SETTING: Ambulatory, nonhospitalized patients who were quarantined in a designated hotel for COVID-19 patients and were recruited by an advertisement at the hotel. SUBJECTS AND METHODS: In total, 140 patients participated in a web-based questionnaire assessing initial symptoms of common viral diseases, olfactory and taste functions, xerostomia, and orofacial pain. RESULTS: A total of 58 men and 70 women participated. Initial symptoms were cough (59.4%), weakness (47.7%), myalgia (46.9%), fever (42.2%), headache (40.6%), impaired sense of smell (38.3%), impaired sense of taste (32.8%), sore throat (26.6%), runny nose (26.6%), and nasal congestion (22.7%). All symptoms were more frequent among women; however, only runny nose was statistically significant (P = .018). The most common combination of symptoms was cough and weakness (37.5%). A total of 25.8% reported olfactory and taste dysfunctions in the absence of other symptoms. In a comparison between the sexes, cough and runny nose were the most common combination in women (P = .018). A total of 38.3% of patients reported olfactory dysfunction as an initial symptom. Anosmia and facial pain were more common among women (P < .001 and P = .01, respectively), and 56% of patients reported xerostomia. CONCLUSION: A considerable number of patients presented with olfactory and oral disorders. Interestingly, women presented with a different cluster of symptoms than men, which may suggest a new clinical approach to diagnosing COVID-19 disease.


ASE Statement on Point-of-Care Ultrasound during the 2019 Novel Coronavirus Pandemic


docid: pgadzwau

title: Association of higher body mass index (BMI) with severe coronavirus disease 2019 (COVID-19) in younger patients


title: Interactions between antihyperglycemic drugs and the renin-angiotensin system: Putative roles in COVID-19. A mini-review

text: BACKGROUND: Diabetes mellitus is associated with a more severe course of coronavirus disease 2019 (COVID-19). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes angiotensin-converting enzyme II (ACE2) receptor for host cell entry. We aimed to assess the interactions between antihyperglycemic drugs and the renin-angiotensin system (RAS) and their putative roles in COVID-19. METHODS: A literature search was performed using Pubmed to review the interrelationships between hyperglycemia, RAS and COVID-19, and the effects of antihyperglycemic medications. RESULTS: The RAS has an essential role in glucose homeostasis and may have a role in COVID-19-induced lung injury. Some antihyperglycemic medications modulate RAS and might hypothetically alleviate the deleterious effect of angiotensin II on lung injury. Furthermore, most antihyperglycemic medications showed anti-inflammatory effects in animal models of lung injury. CONCLUSIONS: Some antihyperglycemic medications might have protective effects against COVID-19-induced lung injury. Early insulin therapy seems very promising in alleviating lung injury.


docid: gfuwowqj

title: Nonlinear dynamic analysis of an epidemiological model for COVID-19 including public behavior and government action

text: This paper is concerned with nonlinear modeling and analysis of the COVID-19 pandemic currently ravaging the planet. There are two objectives: to arrive at an appropriate model that captures the collected data faithfully, and to use that as a basis to explore the nonlinear behavior. We use a nonlinear SEIR (Susceptible, Exposed, Infectious&Removed) transmission model with added behavioral and government policy dynamics. We develop a genetic algorithm technique to identify key model parameters employing COVID19 data from South Korea. Stability, bifurcations and dynamic behavior are analyzed. Parametric analysis reveals conditions for sustained epidemic equilibria to occur. This work points to the value of nonlinear dynamic analysis in pandemic modeling and demonstrates the dramatic influence of social and government behavior on disease dynamics.


COVID-19 effects on tuberculosis care in Sierra Leone


Not yet time for a public inquiry into UK's response to covid-19


Remdesivir - A giant step, or a tiptoe?


Experiences from the SARS-CoV-2 Pandemic: How One Orthopaedic Practice Pivoted to Serve Their Community


title: Emerging Challenges and Threats for Dental Health Care Sector Attributable to COVID-19: Tale of a Developing Country

text: Prevention and control of infection in dentistry is an essential matter that has gained immense attention in recent years. There exist a lack of scientific data about the cross-transmission and its associated risk, especially in the dental health care setting of Pakistan. This article will evaluate the emerging challenges and threats for the dental community in Pakistan attributable to the COVID-19 outbreak. Moreover, there exists a significant knowledge gap regarding the state- and institutional-level infection prevention and control (IPC) policies and practices and not much is known about the development, implementation, and monitoring of IPC policies and its challenges.


docid: iqupfcsq

title: Association between viral infection and increased mucosal eosinophils and CD8+ CD103+ T cells in chronic rhinosinusitis


docid: hhnvarbp

title: The COVID-19 pandemic and perinatal mental health


title: First case of drug-induced liver injury associated with the use of tocilizumab in a patient with COVID-19

text: BACKGROUND AND AIMS: Tocilizumab (TCZ; interleukine-6 receptor antagonist) has been proposed to treat severe forms of Coronavirus disease-19 (COVID-19) because interleukine-6 plays an important role in COVID-19-induced cytokine storm. Several clinical studies have shown very good effects of TCZ in patients with COVID-19, with a few minor side effects reported. Only eight serious liver injuries caused by TCZ were reported before being used in the treatment of patients with COVID-19. Considering the significantly increased use of TCZ for the treatment of COVID-19, we would like to warn of its rare but possible serious hepatotoxicity, especially when used together with other hepatotoxic drugs. METHODS: We describe a patient with COVID-19-induced cytokine storm who developed drug-induced liver injury associated with the use of TCZ. RESULTS: One day after TCZ administration, serum transaminase levels increased 40-fold. Nevertheless, TCZ had a positive effect on clinical and laboratory parameters in cytokine storm, with transaminases values normalizing in 10 days. CONCLUSIONS: This is the first reported case of DILI caused by TCZ in a COVID-19 patient. Intensive liver function monitoring is imperative in COVID-19 patients, because of frequent polypharmacy with potentially hepatotoxic drugs.


Preserve Global South's research capacity


title: One-step fluorescence photoacoustic tomography with the optical radiative transfer model

text: We present adjoint-based Jacobian as well as gradient evaluations and corresponding reconstruction schemes to solve the fully nonlinear, optical radiative transfer modeled one-step fluorescence photoacoustic tomographic (FPAT) problem, which aims to reconstruct the map of absorption coefficient of the exogenous fluorophore from boundary photoacoustic data. The radiative transport equation (RTE) and frequency-domain photoacoustic equation have been employed to model light and photoacoustic wave propagation, respectively. Levenberg-Marquardt and Broyden-Fletcher-Goldfarb-Shanno reconstruction schemes have been used corresponding to the evaluated Jacobians and gradients, respectively. Numerical reconstructions obtained from the two schemes have been validated for scattering-dominant as well as nonscattering-dominant media in 2D. To the best of our knowledge, these are the first one-step FPAT reconstruction results in literature based on the optical RTE model.


title: Neuroanesthesia Practice During the COVID-19 Pandemic: Recommendations From Society for Neuroscience in Anesthesiology and Critical Care (SNACC)

text: The pandemic of coronavirus disease 2019 (COVID-19) has several implications relevant to neuroanesthesiologists, including neurological manifestations of the disease, impact of anesthesia provision for specific neurosurgical procedures and electroconvulsive therapy, and health care provider wellness. The Society for Neuroscience in Anesthesiology and Critical Care appointed a task force to provide timely, consensus-based expert guidance for neuroanesthesiologists during the COVID-19 pandemic. The aim of this document is to provide a focused overview of COVID-19 disease relevant to neuroanesthesia practice. This consensus statement provides information on the neurological manifestations of COVID-19, advice for neuroanesthesia clinical practice during emergent neurosurgery, interventional radiology (excluding endovascular treatment of acute ischemic stroke), transnasal neurosurgery, awake craniotomy and electroconvulsive therapy, as well as information about health care provider wellness. Institutions and health care providers are encouraged to adapt these recommendations to best suit local needs, considering existing practice standards and resource availability to ensure safety of patients and providers.


China coronavirus: WHO declares international emergency as death toll exceeds 200


title: COVID-19 Fear in Eastern Europe: Validation of the Fear of COVID-19 Scale

text: COVID-19 is a major source of fear, stress, and anxiety as well as a major factor impacting the health and wellbeing of people worldwide. The present study builds on the recently developed "Fear of COVID-19 Scale" (Ahorsu et al., In International Journal of Mental Health and Addiction, 10.1007/s11469-020-00270-8, 2020). The sample comprised of 850 participants, male and female young adults from Russia and Belarus. The majority of survey participants are university students and graduates. Females, students, and others from Russia report higher levels of COVID-19-related fear than those from Belarus. Respondents from Russia and Belarus report less fear than people from Iran who were surveyed earlier. The scale used for the present survey evidenced a good Cronbach's Alpha measure of internal consistency or reliability (0.809). Clearly, further research is needed across locations and over time about the nature and extent of fear caused by COVID 19. Overall, the FCV-19S appears to be a valuable and brief instrument that may provide useful information for intervention and policy purposes to migrate fear and problem behavior linked to infectious disease outbreaks.


title: Death and contagious infectious diseases: Impact of the COVID-19 virus on stock market returns

text: This study investigates whether contagious infectious diseases affect stock market outcomes. As a natural experiment, we use panel data regression analysis to measure the effect of the COVID-19 virus, which is a contagious infectious disease, on the Chinese stock market. The findings indicate that both the daily growth in total confirmed cases and in total cases of death caused by COVID-19 have significant negative effects on stock returns across all companies.


Clinical characteristics of COVID-19 and active tuberculosis co-infection in an Italian reference hospital


docid: ypelbams

title: COVID-19, Risk, Fear, and Fall-out


title: COVID-19 and human spermatozoa - potential risks for infertility and sexual transmission

text: The COVID-19 (SARS-CoV-2) virus has created a global pandemic responsible for over 500,000 deaths and untold human and economic suffering. Attention has rightly focused on the respiratory system, because this is where a life-and-death battle is waged between the viral horde and the host's immune system. However, other tissues are also susceptible to viral attack including the kidney, heart and brain. The purpose of this communication is to highlight the evidence that the male reproductive system, particularly spermatozoa, constitute another vulnerable target, raising the possibility that COVID-19 might ultimately induce male infertility and/or facilitate the sexual transmission of this virus, depending on the level of infection.


Demystifying BCG Vaccine and COVID-19 Relationship


title: A Universal Design of Betacoronavirus Vaccines against COVID-19, MERS, and SARS

text: Vaccines are urgently needed to control the ongoing pandemic COVID-19 and previously emerging MERS/SARS caused by coronavirus (CoV) infections. The CoV spike receptor-binding domain (RBD) is an attractive vaccine target but is undermined by limited immunogenicity. We describe a dimeric form of MERS-CoV RBD that overcomes this limitation. The RBD-dimer significantly increased neutralizing antibody (NAb) titers compared to conventional monomeric form and protected mice against MERS-CoV infection. Crystal structure showed RBD-dimer fully exposed dual receptor-binding motifs, the major target for NAbs. Structure-guided design further yielded a stable version of RBD-dimer as a tandem repeat single-chain (RBD-sc-dimer) which retained the vaccine potency. We generalized this strategy to design vaccines against COVID-19 and SARS, achieving 10- to 100-fold enhancement of NAb titers. RBD-sc-dimers in pilot scale production yielded high yields, supporting their scalability for further clinical development. The framework of immunogen design can be universally applied to other beta-CoV vaccines to counter emerging threats.


Drug-induced vasculitis in a patient with COVID-19


The second worldwide wave of interest in coronavirus since the COVID-19 outbreaks in South Korea, Italy and Iran: A Google Trends study


Home ventilators for invasive ventilation of patients with COVID-19


Comparison of the Clinical Features of SARS-CoV-2, Other Coronavirus and Influenza Infections in Infants Less Than 1-Year-Old


title: Implementation and strategies to ensure adequate coordination within a Urology Department during the COVID-19 pandemic

text: PURPOSE: to provide an update on the management of a Urology Department during the COVID-19 outbreak, suggesting strategies to optimize assistance to the patients, to implement telemedicine and triage protocols, to define pathways for hospital access, to reduce risk of contagious inside the hospital and to determine the role of residents during the pandemic. MATERIALS AND METHODS: In May the 6th 2020 we performed a review of the literature through online search engines (PubMed, Web of Science and Science Direct). We looked at recommendations provided by the EAU and ERUS regarding the management of urological patients during the COVID-19 pandemic. The main aspects of interest were: the definition of deferrable and non-deferrable procedures, Personal Protective Equipment (PPE) and hospital protocols for health care providers, triage, hospitalization and surgery, post-operative care training and residents' activity. A narrative summary of guidelines and current literature for each point of interest was performed. CONCLUSION: In the actual Covid-19 scenario, while the number of positive patients globally keep on rising, it is fundamental to embrace a new way to deliver healthcare and to overcome challenges of physical distancing and self-isolation. The use of appropriate PPE, definite pathways to access the hospital, the implementation of telemedicine protocols can represent effective strategies to carry on delivering healthcare.


Time Kinetics of Viral Clearance and Resolution of Symptoms in Novel Coronavirus Infection


Proposed algorithm for return to sports in competitive athletes who have suffered COVID-19


docid: xgumukwb

title: The COVID-19 pandemic: a moment for exposure science


[Consideration and suggestions on development of blood transfusion department under the epidemic situation of novel coronavirus pneumonia]


Triage decision-making at the time of COVID-19 infection: the Piacenza strategy


title: Connecting clusters of COVID-19: an epidemiological and serological investigation

text: BACKGROUND: Elucidation of the chain of disease transmission and identification of the source of coronavirus disease 2019 (COVID-19) infections are crucial for effective disease containment. We describe an epidemiological investigation that, with use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays, established links between three clusters of COVID-19. METHODS: In Singapore, active case-finding and contact tracing were undertaken for all COVID-19 cases. Diagnosis for acute disease was confirmed with RT-PCR testing. When epidemiological information suggested that people might have been nodes of disease transmission but had recovered from illness, SARS-CoV-2 IgG serology testing was used to establish past infection. FINDINGS: Three clusters of COVID-19, comprising 28 locally transmitted cases, were identified in Singapore; these clusters were from two churches (Church A and Church B) and a family gathering. The clusters in Church A and Church B were linked by an individual from Church A (A2), who transmitted SARS-CoV-2 infection to the primary case from Church B (F1) at a family gathering they both attended on Jan 25, 2020. All cases were confirmed by RT-PCR testing because they had active disease, except for A2, who at the time of testing had recovered from their illness and tested negative. This individual was eventually diagnosed with past infection by serological testing. ELISA assays showed an optical density of more than 1·4 for SARS-CoV-2 nucleoprotein and receptor binding domain antigens in titres up to 1/400, and viral neutralisation was noted in titres up to 1/320. INTERPRETATION: Development and application of a serological assay has helped to establish connections between COVID-19 clusters in Singapore. Serological testing can have a crucial role in identifying convalescent cases or people with milder disease who might have been missed by other surveillance methods. FUNDING: National Research Foundation (Singapore), National Natural Science Foundation (China), and National Medical Research Council (Singapore).


title: Penn Medicine Head and Neck Cancer Service Line COVID-19 management guidelines

text: INTRODUCTION: The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has altered the health care environment for the management of head and neck cancers. The purpose of these guidelines is to provide direction during the pandemic for rational Head and Neck Cancer management in order to achieve a medically and ethically appropriate balance of risks and benefits. METHODS: Creation of consensus document. RESULTS: The process yielded a consensus statement among a wide range of practitioners involved in the management of patients with head and neck cancer in a multihospital tertiary care health system. CONCLUSIONS: These guidelines support an ethical approach for the management of head and neck cancers during the COVID-19 epidemic consistent with both the local standard of care as well as the head and neck oncological literature.


Seven days in medicine: 4-10 March 2020


Is biologic treatment of hidradenitis suppurativa during the COVID-19 pandemic different from psoriasis biologic treatment?


Computational studies of drug repurposing and synergism of lopinavir, oseltamivir and ritonavir binding with SARS-CoV-2 protease against COVID-19


Findings of lung ultrasonography of novel corona virus pneumonia during the 2019-2020 epidemic


Prisons: Amplifiers of the COVID-19 Pandemic Hiding in Plain Sight


COVID-19 global pandemic: options for management of gynecologic cancers. The experience in surgical management of ovarian cancer in the second highest affected Italian region


Telehealth in pregnancy


Letter: Neurological Implications of COVID-19 and Lessons Learned From Prior Epidemics and Pandemics


An evolving problem-Mental health symptoms among health care workers during COVID-19 pandemic


Bayesian phylodynamic inference on the temporal evolution and global transmission of SARS-CoV-2


Covid-19: Keep essential malaria services going during pandemic, urges WHO


title: Preparing a young palliative care unit for the COVID-19 pandemic in a teaching hospital in Ghana

text: The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic has necessitated an interim restructuring of the healthcare system in accordance with public health preventive measures to mitigate spread of the virus while providing essential healthcare services to the public. This article discusses how the Palliative Care Team of the Komfo Anokye Teaching Hospital in Ghana has modified its services in accordance with public health guidelines. It also suggests a strategy to deal with palliative care needs of critically ill patients with COVID-19 and their families.


docid: kwcyprgl

title: Possible causes for decreased susceptibility of children to coronavirus


Critically ill pregnant patient with COVID-19 and neonatal death within two hours of birth


title: COVID-19 and the Rohingya Refugees in Bangladesh: The Challenges and Recommendations

text: The current situation of global pandemic COVID-19 can put the 1.1 million Rohingya refugees, living in Bangladesh, in a substantially vulnerable position. A poor, overcrowded living condition, limited access to safe drinking water and health services, and a restricted communication system have substantially increased the risk of rapid spread of COVID-19 in these refugee camps. As COVID-19 infection has already been reported in Bangladesh, this infection will inevitably proliferate among this segregated and neglected community. Thus, in this short report, we describe the current challenges Rohingya refugee camps are facing and suggest possible prevention measures to avoid COVID-19 in these vulnerable areas.


Covid-19: Call for a rapid forward looking review of the UK's preparedness for a second wave-an open letter to the leaders of all UK political parties


docid: gzchaome

title: Features of liver injury in patients with coronavirus disease 2019 in Bozhou, China

text: ObjectiveTo investigate the condition of liver injury in different populations of patients with coronavirus disease 2019 (COVID-2019), and to further understand the pathogenic characteristics of COVID-2019 MethodsA total of 28 patients with COVID-2019 and liver injury who were admitted to the designated hospitals for COVID-2019 in Bozhou, China from February 1 to 12, 2020 were enrolled, and they were divided into male group（n=15）and female group（n=13）according to sex or young group（n=10）and middle-aged and elderly group（n=17）according to age The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) were measured on admission The Wilcoxon rank-sum test was used for comparison of continuous data between two groups, the Fisher exact test was used for comparison of categorical data between two groups ResultsVarying degrees of liver injury were observed in the 28 patients There were no significant differences in the levels of ALT, AST, GGT, ALP, and LDH between the male group and the female group and between the young group and the middle-aged and elderly group (all P＞0 05) There was no significant difference in abnormal rate of ALT, AST, GGT and LDH between male group and female group (all P＞0 05);There was no significant difference in abnormal rate of ALT, AST, GGT between the young group and the middle-aged and elderly group (all P＞0 05);there was a significant difference in abnormal rate of LDH between the young group and the middle-aged and elderly group(P＜0 05) ConclusionPatients with COVID-2019 may experience different degrees of liver injury with the development of the disease, middle-aged and elderly patients tend to develop liver injury There was no significant correlation with gender and age in mild and general patients Therefore, liver function should be monitored in patients with COVID-2019, and the treatment method should be selected carefully to prevent liver injury


title: Typical radiological progression and clinical features of patients with coronavirus disease 2019

text: We aimed to describe typical radiological features and progression of Coronavirus disease 2019 (COVID-19) patients. We reviewed the chest CT scans, laboratory findings, and clinical records of 66 COVID-19 patients who were admitted to affiliated hospitals of Nanchang university, Nanchang, China, from Jan 21 to Feb 2, 2020. CT was used to evaluate the radiological characteristics of COVID-19 patients. Only 4 patients (4/66, 6%) claimed their exposure to COVID-19 pneumonia patients. The major symptoms were fever (60/66, 91%) and cough (37/66, 56%). The predominant features of lesion were scattered (43/66, 65%), bilateral (50/66, 76%), ground-glass opacity (64/66, 97%), and air bronchogram sign (47/66, 71%). Forty-eight patients (48/66, 73%) had more than two lobes involved. Right lower lobe (58/66, 88%) and left lower lobe (49/66, 74%) were most likely invaded. Twelve patients (12/66, 18%) had at least one comorbid condition. Pleural traction (29/66, 44%), crazy paving (15/66, 23%), interlobular septal thickening (11/66, 17%), and consolidation (7/66, 11%) were also observed. The typical radiology features of COVID-19 patients are scattered ground-glass opacity in the bilateral lobes. Fever and cough are the major symptoms. Evaluating chest CT, clinical symptoms, and laboratory results could facilitate the early diagnosis of COVID-19, and judge disease progression.


title: Detection of COVID-19 Infection from Routine Blood Exams with Machine Learning: A Feasibility Study

text: The COVID-19 pandemia due to the SARS-CoV-2 coronavirus, in its first 4 months since its outbreak, has to date reached more than 200 countries worldwide with more than 2 million confirmed cases (probably a much higher number of infected), and almost 200,000 deaths. Amplification of viral RNA by (real time) reverse transcription polymerase chain reaction (rRT-PCR) is the current gold standard test for confirmation of infection, although it presents known shortcomings: long turnaround times (3-4 hours to generate results), potential shortage of reagents, false-negative rates as large as 15-20%, the need for certified laboratories, expensive equipment and trained personnel. Thus there is a need for alternative, faster, less expensive and more accessible tests. We developed two machine learning classification models using hematochemical values from routine blood exams (namely: white blood cells counts, and the platelets, CRP, AST, ALT, GGT, ALP, LDH plasma levels) drawn from 279 patients who, after being admitted to the San Raffaele Hospital (Milan, Italy) emergency-room with COVID-19 symptoms, were screened with the rRT-PCR test performed on respiratory tract specimens. Of these patients, 177 resulted positive, whereas 102 received a negative response. We have developed two machine learning models, to discriminate between patients who are either positive or negative to the SARS-CoV-2: their accuracy ranges between 82% and 86%, and sensitivity between 92% e 95%, so comparably well with respect to the gold standard. We also developed an interpretable Decision Tree model as a simple decision aid for clinician interpreting blood tests (even off-line) for COVID-19 suspect cases. This study demonstrated the feasibility and clinical soundness of using blood tests analysis and machine learning as an alternative to rRT-PCR for identifying COVID-19 positive patients. This is especially useful in those countries, like developing ones, suffering from shortages of rRT-PCR reagents and specialized laboratories. We made available a Web-based tool for clinical reference and evaluation (This tool is available at https://covid19-blood-ml.herokuapp.com/ ).


title: COVID-19  mehr Lungen-PoCUS und sparsam mit Stethoskop, Thoraxröntgen und Lungen-CT umgehen./ [COVID-19 - More Lung Pocus and Sparing Use of Stethoscope, Chest X-Ray and Lung CT]

text: COVID-19 - More Lung Pocus and Sparing Use of Stethoscope, Chest X-Ray and Lung CT Abstract. For an optimal management of COVID-19 (Coronary Virus Disease) we depend on a fast and reliable diagnosis and severity assessment. The gold standard so far is RT-PCR (reverse transcriptase polmerase chain reaction) from the nasopharyngeal smear. Current tests have a sensitivity of 60-90 %. As a consequence, we must expect 10-40 % false negative results. In addition to oxygen saturation for severity classification, stethoscope, chest X-ray and lung computer tomography are routinely used. However, the standard methods stethoscope and chest X-ray are unreliable. Moreover, all three diagnostic examination techniques expose physicians, support staff and subsequent patients to an additional risk of exposure. In view of the contagiousness of SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus), lung point-of-care ultrasound (Lu-PoCUS) is a still underutilized valuable alternative, especially when using pocket devices. In this review the current value and role of stethoscope, pulsoxymetry, chest x ray, lung computer tomography and lung point-of-care ultrasound will be determined based on the available literature.


Ensuring Uptake of Vaccines against SARS-CoV-2


title: Data Analysis for the COVID-19 early dynamics in Northern Italy. The effect of first restrictive measures

text: In a recent report we have collected some data about the COVID-19 epidemics in Northern Italy; in this follow-up we analyze how these changed after the mild restrictive measures taken by the Government two weeks ago and the large campaign of public awareness developed in the meanwhile.


title: Data analysis for the COVID-19 early dynamics in Northern Italy

text: The COVID-19 epidemics, started in China in January 2020, was recognized to have reached Italy around February 20; recent estimates show that most probably the virus circulated in the country already in January, but was not recognized. Data for the early dynamics of COVID-19 in Northern Italy are analyzed.


title: Children and the COVID-19 pandemic

text: As a result of the COVID-19 pandemic, many school districts have closed for the remainder of the academic year. These closures are unfortunate because, for many students, schools are their only source of trauma-informed care and supports. When schools reopen, they must develop a comprehensive plan to address the potential mental health needs of their students. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


What can be said about lifestyle and psychosocial issues during the coronavirus disease pandemic? first impressions


Coronavirus and dermatology: a resident's perspective


La pandemia de la COVID-19 desde la SEAP./ [The Spanish Society of Pathologists on the COVID-19 pandemic]


Prioritizing Physician Mental Health as COVID-19 Marches On


COVID-19 in nursing homes


title: Recurrent pneumonia in a patient with new coronavirus infection after discharge from hospital for insufficient antibody production: a case report

text: BACKGROUND: The rapid spread of coronavirus disease 2019 (COVID-19) was declared as an emerging public health threat by the World Health Organization. As various measures have been taken successfully to combat the epidemic caused by SARS-CoV-2, a growing number of fully recovered patients have been discharged from hospitals. However, some of them have relapsed. Little is known about the causes that triggered the relapse. CASE PRESENTATION: We report a case of a 40 years old man who suffered from recurrent pulmonary infection with progression of lesions on chest computed tomography (CT), elevated levels of ferritin and IL2R, reduced lymphocyte count and positive oropharyngeal swab test for SARS-CoV-2 again after 5 days discharge from hospital. The anti-SARS-CoV-2 antibody level of this patient was very low at the time of relapse, suggesting a weak humoral immune response to the virus. Total exon sequencing revealed mutations in TRNT1 gene, which may be responsible for B cell immunodeficiency. Therefore, uncleared SARS-CoV-2 at his first discharge was likely to lead to his recurrence. However, viral superinfection and non-infectious organizing pneumonia could not be completely excluded. CONCLUSION: COVID-19 relapse may occur in a part of discharged patients with low titers of anti-SARS-CoV-2 antibodies. These patients should be maintained in isolation for longer time even after discharge. A more sensitive method to detect SARS-CoV-2 needs to be established and serological testing for specific antibodies may be used as a reference to determine the duration of isolation.


Code Blue During the COVID-19 Pandemic


Covid-19 and perioperative mortality; where do we stand?


Letter to the Editor Defensive Medicine and the Neurosurgeon: Rules for Success in Pandemics (COVID-19)


Reply to: 'Interaction between RAAS inhibitors and ACE2 in the context of COVID-19'


title: [Benign prostatic hyperplasia management during COVID-19 pandemia.]

text: OBJECTIVES: The pandemic caused by the new SARS / Cov-2 Coronavirus represents an unprecedented scenario in modern medicine that affects many aspects of daily healthcare Lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) has a high prevalence and is related to high consumption of health resources For this reason, we performed a revision of the management of LUTS and HBP during and after COVID-19 pandemic MATERIAL AND METHODS: A group of experts in benign prostatic hyperplasia from different regions of Spain were selected to design a strategy to reorganize the management of benign prostatic hyperplasia and lower urinary tract symptoms during the pandemic A comprehensive review of the literature was undertaken and a set of recommendations are generated RESULTS: Recommendations for the management of LUTS-BPH during and after the SARS/CoV2 coronavirus pandemic outbreak consist of promoting telemedicine and developing joint protocols with Primary Care Attention Clear diagnostic and treatment criteria and referral criteria must be established Referral of patients for risk complications such as kidney failure, recurrent hematuria and obstructive uropathy are a priority Surgeries due to BPH are generally potentially delayed until phases I and II of the pandemic, in which the percentage of hospitalized patients with COVID-19 does not exceed 25%, and it is necessary to determine COVID19 negativity The surgical technique that associates the least complications and the shortest stay should be selected CONCLUSIONS: The diagnosis and prescription of treatment for BPH during the COVID-19 pandemic should be based on telemedicine and joint protocols for primary care attention and urology Elective surgical treatment can be delayed until we are in phases I or II, individualizing the surgical and anaesthetic technique of choice to minimize risks


Turning to Faith and Technology During the Coronavirus Disease 2019 Crisis


Retrospective Analysis of Dermatological Adverse Events Associated with Hydroxychloroquine Reported to the United States Food and Drug Administration


title: Time Course of COVID-19 Cases in Austria

text: COVID-19 is an infectious disease caused by a novel coronavirus, which first appeared in China in late 2019, and reached pandemic distribution in early 2020. The first major outbreak in Europe occurred in Northern Italy where it spread to neighboring countries, notably to Austria, where skiing resorts served as a main transmission hub. Soon, the Austrian government introduced strict measures to curb the spread of the virus. Using publicly available data, we assessed the efficiency of the governmental measures. We assumed an average incubation period of one week and an average duration of infectivity of 10 days. One week after the introduction of strict measures, the increase in daily new cases was reversed, and the reproduction number dropped. The crude estimates tended to overestimate the reproduction rate in the early phase. Publicly available data provide a first estimate about the effectiveness of public health measures. However, more data are needed for an unbiased assessment.


Endothelin receptor antagonists for pulmonary arterial hypertension and COVID-19: Friend or foe?


Social Media: A Pandemic of Misinformation


title: COVID-19 and HIV co-infection an emerging consensus

text: Toombs et al provide an important contribution to the emerging literature which seeks to establish if those People Living with Human Immunodeficiency Virus (PLWH) are disproportionately affected by the COVID-19 pandemic (1). Evidence from their case series have been consistent with the hypothesis that PLWH do not experience disproportionately greater hospital admission, morbidity, or mortality. This article is protected by copyright. All rights reserved.


Nasopharyngeal swab or clinical-radiological evidence: the dark side of the moon for cancer patients in the COVID-19 era


title: 70 years of machine learning in geoscience in review

text: This review gives an overview of the development of machine learning in geoscience. A thorough analysis of the co-developments of machine learning applications throughout the last 70 years relates the recent enthusiasm for machine learning to developments in geoscience. I explore the shift of kriging towards a mainstream machine learning method and the historic application of neural networks in geoscience, following the general trend of machine learning enthusiasm through the decades. Furthermore, this chapter explores the shift from mathematical fundamentals and knowledge in software development towards skills in model validation, applied statistics, and integrated subject matter expertise. The review is interspersed with code examples to complement the theoretical foundations and illustrate model validation and machine learning explainability for science. The scope of this review includes various shallow machine learning methods, e.g. Decision Trees, Random Forests, Support-Vector Machines, and Gaussian Processes, as well as, deep neural networks, including feed-forward neural networks, convolutional neural networks, recurrent neural networks and generative adversarial networks. Regarding geoscience, the review has a bias towards geophysics but aims to strike a balance with geochemistry, geostatistics, and geology, however excludes remote sensing, as this would exceed the scope. In general, I aim to provide context for the recent enthusiasm surrounding deep learning with respect to research, hardware, and software developments that enable successful application of shallow and deep machine learning in all disciplines of Earth science.


title: Insomnia during the COVID-19 pandemic in a Greek population

text: Insomnia is a major health issue associated with great psychological burden. Research of insomnia during a pandemic crisis is limited. The aim of the present study was to explore sleep difficulties during the COVID-19 pandemic in a Greek population. The three-day online survey included questions about sociodemographic characteristics, contact with COVID-19 and COVID-19-related negative attitudes, as well as the Athens Insomnia Scale (AIS), the Intolerance to Uncertainty scale (IUS), the De Jong Gierveld Loneliness scale (JGLS) and the Patient Health Questionnaire-2 (PHQ-2) Depression Scale. Altogether, 2,427 individuals participated in the study (with 2,363 of them providing all basic demographic data). Sleep problems were detected in 37.6% of the participants. Women and people in urban areas were more vulnerable to sleep problems, while younger age showed a non-significant trend. Those uncertain about having themselves, or someone close to them contracted the virus, also demonstrated elevated insomnia scores. Lastly, according to the regression analysis, higher levels of intolerance to uncertainty, COVID-19-related worry, loneliness, as well as more severe depressive symptoms, were all predictive of insomnia. Results may be used for the development of therapeutic strategies and implementation of social policies to support people with sleep difficulties.