title: Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019

text: OBJECTIVES: Severe cases of coronavirus disease 2019 develop the acute respiratory distress syndrome, requiring admission to the ICU. This study aimed to describe specific pathophysiological characteristics of acute respiratory distress syndrome from coronavirus disease 2019. DESIGN: Prospective crossover physiologic study. SETTING: ICU of a university-affiliated hospital from northern Italy dedicated to care of patients with confirmed diagnosis of coronavirus disease 2019. PATIENTS: Ten intubated patients with acute respiratory distress syndrome and confirmed diagnosis of coronavirus disease 2019. INTERVENTIONS: We performed a two-step positive end-expiratory pressure trial with change of 10 cm H2O in random order. MEASUREMENTS AND MAIN RESULTS: At each positive end-expiratory pressure level, we assessed arterial blood gases, respiratory mechanics, ventilation inhomogeneity, and potential for lung recruitment by electrical impedance tomography. Potential for lung recruitment was assessed by the recently described recruitment to inflation ratio. In a subgroup of seven paralyzed patients, we also measured ventilation-perfusion mismatch at lower positive end-expiratory pressure by electrical impedance tomography. At higher positive end-expiratory pressure, respiratory mechanics did not change significantly: compliance remained relatively high with low driving pressure. Oxygenation and ventilation inhomogeneity improved but arterial CO2 increased despite unchanged respiratory rate and tidal volume. The recruitment to inflation ratio presented median value higher than previously reported in acute respiratory distress syndrome patients but with large variability (median, 0.79 [0.53-1.08]; range, 0.16-1.40). The FIO2 needed to obtain viable oxygenation at lower positive end-expiratory pressure was significantly correlated with the recruitment to inflation ratio (r = 0.603; p = 0.05). The ventilation-perfusion mismatch was elevated (median, 34% [32-45%] of lung units) and, in six out of seven patients, ventilated nonperfused units represented a much larger proportion than perfused nonventilated ones. CONCLUSIONS: In patients with acute respiratory distress syndrome from coronavirus disease 2019, potential for lung recruitment presents large variability, while elevated dead space fraction may be a specific pathophysiological trait. These findings may guide selection of personalized mechanical ventilation settings.


The aftermath of coronavirus disease 2019: devastation or a new dawn for nephrology?


Could DIZE be the answer to COVID-19?


Risk factors for acute respiratory distress syndrome in COVID-19


docid: uxsyewab

title: Heparanase, cell signaling, and viral infections

text: Heparanase (HPSE) is a multifunctional protein endowed with many non-enzymatic functions and a unique enzymatic activity as an endo-ß-D-glucuronidase. The latter allows it to serve as a key modulator of extracellular matrix (ECM) via a well-regulated cleavage of heparan sulfate side chains of proteoglycans at cell surfaces. The cleavage and associated changes at the ECM cause release of multiple signaling molecules with important cellular and pathological functions. New and emerging data suggest that both enzymatic as well as non-enzymatic functions of HPSE are important for health and illnesses including viral infections and virally induced cancers. This review summarizes recent findings on the roles of HPSE in activation, inhibition, or bioavailability of key signaling molecules such as AKT, VEGF, MAPK-ERK, and EGFR, which are known regulators of common viral infections in immune and non-immune cell types. Altogether, our review provides a unique overview of HPSE in cell-survival signaling pathways and how they relate to viral infections.


title: Operating during the COVID-19 pandemic: How to reduce medical error

text: Our professional and private lives changed on March 11 2020 when the coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO. By March 16, surgical training was suspended, MRCS and FRCS examinations cancelled and all courses postponed. In theory, essential cancer surgery, emergency and trauma operating will continue. All elective, non-essential cases are currently cancelled. While we adapt to our new ways of working, we remind ourselves that surgeons are flexible, resilient and, ultimately, we are doctors in the first instance. We present a short article on operating during the COVID-19 pandemic.


title: Coronavirus Disease 2019 (COVID-19) in Kenya: Preparedness, response and transmissibility

text: The world and Kenya face a potential pandemic as the respiratory virus Coronavirus Disease 2019 (COVID-19) affects world populations. Nations have been forced to intervene and issue directions under executive orders to ensure the pandemic is contained. Kenya has reported 110 confirmed COVID-19 cases (as at 2nd April, 2020), three persons have succumbed and 2 people have fully recovered. Most of the affected people had entered/returned to Kenya from different parts of the world. Most of the people who have contracted COVID 19 are between the 16-74 years of age. As a result, since February 2020, Kenya put in place several precautionary measures to mitigate the pandemic in its early stages. However, the economic status of the population of country won't be simple to control COVID 19, if government won't integrate the realistic feasible timely plans. This article highlights the preparedness, response, transmissibility of Covid-19 and proposes intuitions to manage COVID-19 in Kenya. Currently it is clear that since first confirmation to current, the transmission of the COVID-19 is exponentially increasing in Kenya.


title: Persistent viral RNA shedding after COVID-19 symptom resolution in older convalescent plasma donors

text: INTRODUCTION: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for a worldwide pandemic. While the medical community understands the mode of viral transmission, less is known about how long viral shedding occurs once viral symptoms have resolved. Our objective was to determine how long the SARS-CoV-2 remains detectable following self-reporting of viral symptom resolution. METHODS: This study was approved by the University of Wisconsin Institutional Review Board. A cohort of patients who were previously SARS-CoV-2 positive less than 28 days after self-reported symptom resolution were retested for proof of viral recovery by nasal swab reverse transcriptase polymerase chain reaction for SARS-CoV-2 RNA. RESULTS: A total of 152 potential participants were screened, of which 5 declined, 54 were ineligible, and 93 were recruited; 86 of 93 completed testing. Eleven of 86 (13%) were still positive at a median of 19 days (range, 12-24 days) after symptom resolution. Positive participants were significantly older than negative participants (mean, 54 years; 95% confidence interval [CI], 44-63 vs 42 years; 95% CI, 38-46; P = .024). CT values were significantly, inversely associated with age (ß = -.04; r2 = 0.389; P = .04). The number of days since symptom recovery was not apparently different between positive and negative participants. CONCLUSION: We found evidence of persistent viral shedding in nasopharyngeal secretions more than 2 weeks after resolution of symptoms from confirmed COVID-19 infection. Persistent shedding was more common in older participants, and viral load was higher among older positive participants. These results underscore the necessity of testing COVID-19 convalescent plasma donors less than 28 days after symptom resolution.


title: Otorinolaringologicheskie aspekty techeniya zabolevaniya u detei, infitsirovannykh virusom SARS-CoV-2./ [Otorhinolaryngological aspects of the disease course in children infected with SARS-CoV-2 virus]

text: Recently, almost all over the world attention of doctors and scientists is focused on a new coronavirus infection, the source of which was the causative agent SARS-CoV-2. In this regard, early diagnosis, including on the basis of symptoms from ENT organs, is crucial. A brief analysis of the available literature on the peculiarities of ENT organs manifestations in patients with SARS-CoV-2 is given. It was found out that to date there is very little data on the state of loro organs in patients with SARS-CoV-2 and no data on anosmia in the pediatric population. However, it is in children in the epidemic aspect that early diagnosis of infection and understanding of its key symptoms is of utmost importance.


Different patterns of Influenza A and B detected during early stages of COVID-19 in a university hospital in São Paulo, Brazil


Management of orthodontic emergencies during 2019-NCOV


title: Severe COVID-19 in a renal transplant recipient: A focus on pharmacokinetics

text: The current coronavirus disease 2019 (COVID-19) pandemic requires extra attention for immunocompromised patients, including solid organ transplant recipients. We report on a case of a 35-year-old renal transplant recipient who suffered from a severe COVID-19 pneumonia. The clinical course was complicated by extreme overexposure to the mammalian target of rapamycin inhibitor everolimus, following coadministration of chloroquine and lopinavir/ritonavir therapy. The case is illustrative for dilemmas that transplant professionals may face in the absence of evidence-based COVID-19 therapy and concurrent pressure for exploration of experimental pharmacological treatment options. However, the risk-benefit balance of experimental or off-label therapy may be weighed differently in organ transplant recipients than in otherwise healthy COVID-19 patients, owing to their immunocompromised status and potential drug interactions with immunosuppressive therapy. With this case report, we aimed to achieve increased awareness and improved management of drug-drug interactions associated with the various treatment options for COVID-19 in renal transplant patients.


title: CTæ£æ¥å¨2019å ç¶ç æ¯ç çæ¥ãè¯æåæ²»çä¸çåºç¨ä»·å¼./ CTæ£æ¥å¨2019å ç¶ç æ¯ç çæ¥ãè¯æåæ²»çä¸çåºç¨ä»·å¼./ Value of CT application in the screening,diagnosis,and treatment of COVID-19

text: The coronavirus disease 2019 (COVID-19) has attracted extensive attention all around the world recently. Early screening, early diagnosis, early isolation, and early treatment remain the most effective prevention and control measures. Computed tomography (CT) plays a vital role in the screening, diagnosis, treatment, and follow-up of COVID-19, especially in the early screening, with a higher sensitivity than that of real-time fluorescence RT-PCR. The combination of CT and artificial intelligence has the potential to help clinicians in improving the diagnostic accuracy and working efficiency.


title: Position Paper for the State-of-the-Art Application of Respiratory Support in Patients with COVID-19

text: Against the background of the pandemic caused by infection with the SARS-CoV-2 virus, the German Respiratory Society has appointed experts to develop therapy strategies for COVID-19 patients with acute respiratory failure (ARF). Here we present key position statements including observations about the pathophysiology of (ARF). In terms of the pathophysiology of pulmonary infection with SARS-CoV-2, COVID-19 can be divided into 3 phases. Pulmonary damage in advanced COVID-19 often differs from the known changes in acute respiratory distress syndrome (ARDS). Two types (type L and type H) are differentiated, corresponding to early- and late-stage lung damage. This differentiation should be taken into consideration in the respiratory support of ARF. The assessment of the extent of ARF should be based on arterial or capillary blood gas analysis under room air conditions, and it needs to include the calculation of oxygen supply (measured from the variables of oxygen saturation, hemoglobin level, the corrected values of Hüfner's factor, and cardiac output). Aerosols can cause transmission of infectious, virus-laden particles. Open systems or vented systems can increase the release of respirable particles. Procedures in which the invasive ventilation system must be opened and endotracheal intubation carried out are associated with an increased risk of infection. Personal protective equipment (PPE) should have top priority because fear of contagion should not be a primary reason for intubation. Based on the current knowledge, inhalation therapy, nasal high-flow therapy (NHF), continuous positive airway pressure (CPAP), or noninvasive ventilation (NIV) can be performed without an increased risk of infection to staff if PPE is provided. A significant proportion of patients with ARF present with relevant hypoxemia, which often cannot be fully corrected, even with a high inspired oxygen fraction (FiO2) under NHF. In this situation, the oxygen therapy can be escalated to CPAP or NIV when the criteria for endotracheal intubation are not met. In ARF, NIV should be carried out in an intensive care unit or a comparable setting by experienced staff. Under CPAP/NIV, a patient can deteriorate rapidly. For this reason, continuous monitoring and readiness for intubation are to be ensured at all times. If the ARF progresses under CPAP/NIV, intubation should be implemented without delay in patients who do not have a "do not intubate" order.


title: Permeability measures predict haemorrhagic transformation after ischemic stroke

text: OBJECTIVE: We sought to examine the diagnostic utility of existing predictors of any haemorrhagic transformation (HT) and compare them to novel perfusion imaging permeability measures in ischemic stroke patients receiving alteplase only. METHODS: A pixel-based analysis of pre-treatment CT perfusion (CTP) was undertaken to define the optimum CTP permeability thresholds to predict the likelihood of HT. We then compared previously proposed predictors of HT using regression analyses and receiver operator characteristic curve analysis to produce an Area Under the Cure (AUC), and compared AUCs using Chi Square analysis. RESULTS: From 5 centres, 1407 patients were included in this study, 282 had HT. The cohort was split into a derivation (1025, 70% patients) and validation cohort (382 patients or 30%). The E permeability map at a threshold of 30% relative to contralateral had the highest AUC at predicting any HT (derivation AUC 0.85, 95% CI, 0.79-0.91, validation AUC 0.84, 95% CI, 0.77-0.91). The AUC improved when permeability was assessed within the acute perfusion lesion for the E maps at a threshold of 30% (derivation AUC 0.91, 95% CI, 0.86-0.95, validation AUC 0.89, 95% CI, 0.86-0.95). Previously proposed associations with HT and PH showed lower AUC values than the permeability measure. INTERPRETATION: In this large multi-centre study, we have validated a highly accurate measure of HT prediction. This measure may be useful in clinical practice to predict haemorrhagic transformation in ischemic stroke patients before receiving alteplase alone. This article is protected by copyright. All rights reserved.


docid: azohssro

title: COVID-19 and Home Positive Airway Pressure (PAP) Therapy


title: CareCall: a Call-Based Active Monitoring Dialog Agent for Managing COVID-19 Pandemic

text: Tracking suspected cases of COVID-19 is crucial to suppressing the spread of COVID-19 pandemic. Active monitoring and proactive inspection are indispensable to mitigate COVID-19 spread, though these require considerable social and economic expense. To address this issue, we introduce CareCall, a call-based dialog agent which is deployed for active monitoring in Korea and Japan. We describe our system with a case study with statistics to show how the system works. Finally, we discuss a simple idea which uses CareCall to support proactive inspection.


Covid-19: GPs call for same personal protective equipment as hospital doctors


title: Case Report: Rapid Development of Visualization Dashboards to Enhance Situation Awareness of COVID-19 Telehealth Initiatives at a Multi-Hospital Healthcare System

text: The COVID-19 pandemic has led to the rapid expansion of telehealth services as healthcare organizations aim to mitigate community transmission while providing safe patient care. As technology adoption rapidly increases, operational telehealth teams must maintain awareness of critical information such as patient volumes and wait times, patient and provider experience, and telehealth platform performance. Using a model of situation awareness as a conceptual foundation and a user-centered design approach we describe our process for rapidly developing and disseminating dashboard visualizations to support telehealth operations. We used a five-step process to gain domain knowledge, identify user-needs, identify data sources, design and develop visualizations, and iteratively refine these visualizations. Through this process we identified three distinct stakeholder groups and designed and developed visualization dashboards to meet their needs. Feedback from users demonstrated the dashboards support situation awareness and informed important operational decisions. Lessons learned are shared to provide other organizations with insights from our process.


title: Overcoming Barriers: The Endothelium As a Linchpin of Coronavirus Disease 2019 Pathogenesis?

text: OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a global pandemic involving >5 500 000 cases worldwide as of May 26, 2020. The culprit is the severe acute respiratory syndrome coronavirus-2, which invades cells by binding to angiotensin-converting enzyme 2. While the majority of patients mount an appropriate antiviral response and recover at home, others progress to respiratory distress requiring hospital admission for supplemental oxygen. In severe cases, deterioration to acute respiratory distress syndrome necessitating mechanical ventilation, development of severe thrombotic events, or cardiac injury and dysfunction occurs. In this review, we highlight what is known to date about coronavirus disease 2019 and cardiovascular risk, focusing in on the putative role of the endothelium in disease susceptibility and pathogenesis. Approach and Results: Cytokine-driven vascular leak in the lung alveolar-endothelial interface facilitates acute lung injury in the setting of viral infection. Given that the virus affects multiple organs, including the heart, it likely gains access into systemic circulation by infecting or passing from the respiratory epithelium to the endothelium for viral dissemination. Indeed, cardiovascular complications of coronavirus disease 2019 are highly prevalent and include acute cardiac injury, myocarditis, and a hypercoagulable state, all of which may be influenced by altered endothelial function. Notably, the disease course is worse in individuals with preexisting comorbidities that involve endothelial dysfunction and may be linked to elevated ACE2 (angiotensin-converting enzyme 2) expression, such as diabetes mellitus, hypertension, and cardiovascular disease. CONCLUSIONS: Rapidly emerging data on coronavirus disease 2019, together with results from studies on severe acute respiratory syndrome coronavirus-1, are providing insight into how endothelial dysfunction may contribute to the pandemic that is paralyzing the globe. This may, in turn, inform the design of biomarkers predictive of disease course, as well as therapeutics targeting pathogenic endothelial responses.


title: Early transmission patterns of coronavirus disease 2019 (COVID-19) in travellers from Wuhan to Thailand, January 2020

text: We report two cases of coronavirus disease 2019 (COVID-19) in travellers from Wuhan, China to Thailand. Both were independent introductions on separate flights, discovered with thermoscanners and confirmed with RT-PCR and genome sequencing. Both cases do not seem directly linked to the Huanan Seafood Market in Hubei but the viral genomes are identical to four other sequences from Wuhan, suggesting early spread within the city already in the first week of January.


title: Bedeutung der Hornhautorgankultur bei Spendern mit möglicher SARS-CoV-2-Infektion./ [Importance of corneal organ culture in donors with possible SARS-CoV-2 infections]

text: The appearance of the novel severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2) poses challenges in ophthalmology particularly for eye banks. A valid risk assessment for the removal and processing of donor corneas is difficult due to the lack of data. The risk to infect transplant recipients with SARS-CoV2 still appears very unlikely due to the experience with severe acute respiratory syndrome -coronavirus(1) (SARS-CoV(1)) and Middle East respiratory syndrome-coronavirus (MERS-CoV); however, due to the occurrence of angiotensin-converting enzyme 2 (ACE2) receptors in the cornea an infection of this tissue with SARS-CoV2 cannot be completely excluded. Therefore, routine testing of the organ culture medium used for donor corneas for SARS-CoV2 prior to transplantation during the coronavirus disease 2019 (COVID19) pandemic should be considered.


title: Change of the diagnostic distribution in applicants to dermatology after COVID-19 pandemic: What it whispers to us?

text: We aim to evaluate the change in the diagnostic spectrum in dermatology outpatient applications compared to before COVID-19. All patients were enrolled from the Department of Dermatology between February 12 and May 8, 2020, the duration of 4 weeks before COVID-19 and 8 weeks after were analyzed in three parts consisting of 4 weeks. Data obtained from the database such as age, gender, diagnoses were anonymized. Repeated applications with the same diagnosis in 10 days after the first presentation were ignored. Compared to the pre-outbreak, there was a 3.5-fold decrease in dermatology applications in the first month after COVID-19 and an 8.8-fold in the second month. We found a significant increase in the frequency of diagnoses such as generalized pruritus, pityriasis rosea, alopecia areata, bacterial skin/mucosa diseases, and zona zoster after COVID-19. The frequency declined in diseases such as verruca vulgaris, hyperpigmentation, skin tag, melanocytic nevus, and seborrheic keratosis/solar lentigo. It has been found that the frequencies of most diseases, including acne (â25% of patients), did not change. We think that many factors, such as affecting the quality of life, risk perception, increased stress burden may cause a change in the diagnostic distribution of the dermatology applications.


docid: ihdppmpb

text: We aim to evaluate the change in the diagnostic spectrum in dermatology outpatient applications compared to before COVID-19. All patients were enrolled from the Department of Dermatology between February 12 and May 8, 2020, the duration of 4 weeks before COVID-19 and eight weeks after were analyzed in 3 parts consisting of 4 weeks. Data obtained from the database such as age, gender, diagnoses were anonymized. Repeated applications with the same diagnosis in ten days after the first presentation were ignored. Compared to the pre-outbreak, there was a 3.5-fold decrease in dermatology applications in the first month after COVID-19 and an 8.8-fold in the second month. We found a significant increase in the frequency of diagnoses such as generalized pruritus, pityriasis rosea, alopecia areata, bacterial skin/mucosa diseases, and zona zoster after COVID-19. The frequency declined in diseases such as verruca vulgaris, hyperpigmentation, skin tag, melanocytic nevus, seborrheic keratosis/solar lentigo. It has been found that the frequencies of most diseases, including acne (â25% of patients), did not change. We think that many factors, such as affecting the quality of life, risk perception, increased stress burden may cause a change in the diagnostic distribution of the dermatology applications. This article is protected by copyright. All rights reserved.


Apremilast as a potential treatment option for COVID-19: No symptoms of infection in a psoriatic patient


An epidemiological study exploring a possible impact of treatment with ACE inhibitors or angiotensin receptor blockers on ACE2 plasma concentrations


title: O uso intensivo da internet por crianças e adolescentes no contexto da COVID-19 e os riscos para violências autoinflingidas./ O uso intensivo da internet por crianças e adolescentes no contexto da COVID-19 e os riscos para violências autoinflingidas./ The intensive use of the internet by children and adolescents in the context of COVID-19 and the risks for self-inflicted violence

text: This essay aimed to discuss the implications of social isolation due to the COVID-19 pandemic for the intensive use of the internet among children and adolescents and its possible consequences for the practice of self-inflicted violence. We briefly discussed the anxiogenic potential and the reproduction of a "global fear" that are consolidated with the massive and unmediated exposure of the content consumed, which can increase the vulnerabilities to stress and suicidal ideas. We centered our debate on "recreational" practices, called "challenges" with self-harm power, carried out by teenagers on the YouTube website. This practice has been shown to increase with the social isolation measures. Our reflection on these risks builds on the theoretical perspective of digital sociability, and its implications for the internet-mediated interactions of adolescents.


Atypical presentation of COVID-19 in young infants


Impact of COVID-19 epidemic on coronary care unit accesses for acute coronary syndrome in Veneto region, Italy


title: Change points in the spread of COVID-19 question the effectiveness of nonpharmaceutical interventions in Germany

text: Aims: Nonpharmaceutical interventions against the spread of SARS-CoV-2 in Germany included the cancellation of mass events (from March 8), closures of schools and child day care facilities (from March 16) as well as a"lockdown"(from March 23). This study attempts to assess the effectiveness of these interventions in terms of revealing their impact on infections over time. Methods: Dates of infections were estimated from official German case data by incorporating the incubation period and an empirical reporting delay. Exponential growth models for infections and reproduction numbers were estimated and investigated with respect to change points in the time series. Results: A significant decline of daily and cumulative infections as well as reproduction numbers is found at March 8 (CI [7, 9]), March 10 (CI [9, 11] and March 3 (CI [2, 4]), respectively. Further declines and stabilizations are found in the end of March. There is also a change point in new infections at April 19 (CI [18, 20]), but daily infections still show a negative growth. From March 19 (CI [18, 20]), the reproduction numbers fluctuate on a level below one. Conclusions: The decline of infections in early March 2020 can be attributed to relatively small interventions and voluntary behavioural changes. Additional effects of later interventions cannot be detected clearly. Liberalizations of measures did not induce a re-increase of infections. Thus, the effectiveness of most German interventions remains questionable. Moreover, assessing of interventions is impeded by the estimation of true infection dates and the influence of test volume.


title: Recomendaciones de consenso SEPAR-AEER sobre la utilidad de la ecografía torácica en el manejo del paciente con sospecha o infección confirmada con COVID-19./ Recomendaciones de consenso SEPAR-AEER sobre la utilidad de la ecografía torácica en el manejo del paciente con sospecha o infección confirmada con COVID-19./ SEPAR-AEER Consensus Recommendations on the Usefulness of the Thoracic Ultrasound in the Management of the Patient with Suspected or Confirmed Infection with COVID-19

text: The great pulmonary affectation produced by the COVID-19 infection, requires a fast diagnostic tool that complements the diagnostic test by PCR and which is also useful in evaluating the progression of lung lesions. Since most of these are peripheral, in this consensus document we propose the use of thoracic ultrasound for early diagnosis and for the daily evaluation of the progression of lung lesions by a single explorer without the need to use the chest CT. In this consensus, it is proposed to carry out a systematic ultrasound examination of the thorax dividing it by quadrants and therefore identifying the ultrasound signs that are related to the type of parenchymal or pleural affectation that the patient has: A lines, B lines, parenchymal condensation, pleural line and pleural effusion. These findings will facilitate the decision making regarding the patient management, both when deciding the place of admission of the patient and the type of treatment to be prescribed.


Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors


Re: 'Rapid point-of-care testing for SARS-CoV-2 in a community screening setting shows low sensitivity'


title: Chinese expert consensus on diagnosis and treatment of coagulation dysfunction in COVID-19

text: Since December 2019, a novel type of coronavirus disease (COVID-19) in Wuhan led to an outbreak throughout China and the rest of the world. To date, there have been more than 1,260,000 COVID-19 patients, with a mortality rate of approximately 5.44%. Studies have shown that coagulation dysfunction is a major cause of death in patients with severe COVID-19. Therefore, the People's Liberation Army Professional Committee of Critical Care Medicine and Chinese Society on Thrombosis and Hemostasis grouped experts from the frontline of the Wuhan epidemic to come together and develop an expert consensus on diagnosis and treatment of coagulation dysfunction associated with a severe COVID-19 infection. This consensus includes an overview of COVID-19-related coagulation dysfunction, tests for coagulation, anticoagulation therapy, replacement therapy, supportive therapy and prevention. The consensus produced 18 recommendations which are being used to guide clinical work.


Setting the clock back: new hope for dialysis patients. Sodium thiosulphate and the regression of vascular calcifications


title: Comparison and analysis of the detection performance of six new coronavirus nucleic acid detection reagents/ 重庆医学

text: Objective To compare and analyse the detection performance of different 2019-new coronavirus (2019-nCoV) nucleic acid detection kits, in order to provide references for laboratory. Methods Six kinds of domestic reagents (A—F reagent) were selected for parallel detection of a series of samples from one patient in this hospital whose 2019-nCoV nucleic acid result was confirmed weakly positive. The samples were taken at three different times, the RNAs were extracted and amplified, and two parallel tests were performed each time by use of these six kits. The detection performance was compared according to the results of each kit. Results The three parallel test results (ORF1ab and N gene) of C and F reagents were positive, the results of D reagent showed the N gene was not detected, and the results of A, B, E reagents showed the ORF1ab gene was not detected sometimes. The reproducibility of in-batch detections by C reagent was the best, and the CT values of F reagents (N and ORF1ab), E reagents (ORF1ab) and A reagents (ORF1ab) showed changes in trend. Conclusion There are differences in the detection ability of six 2019-nCoV nucleic acid detection reagents for weakly positive samples, and the accuracy, sensitivity and reproducibility of some reagents are not good. There is an urgent need to further optimize and improve their performance in order to better meet the needs of large-scale screening.


title: Blame the signaling: Role of cAMP for the resolution of inflammation

text: A complex intracellular signaling governs different cellular responses in inflammation. Extracellular stimuli are sensed, amplified, and transduced through a dynamic cellular network of messengers converting the first signal into a proper response: production of specific mediators, cell activation, survival, or death. Several overlapping pathways are coordinated to ensure specific and timely induction of inflammation to neutralize potential harms to the tissue. Ideally, the inflammatory response must be controlled and self-limited. Resolution of inflammation is an active process that culminates with termination of inflammation and restoration of tissue homeostasis. Comparably to the onset of inflammation, resolution responses are triggered by coordinated intracellular signaling pathways that transduce the message to the nucleus. However, the key messengers and pathways involved in signaling transduction for resolution are still poorly understood in comparison to the inflammatory network. cAMP has long been recognized as an inducer of anti-inflammatory responses and cAMP-dependent pathways have been extensively exploited pharmacologically to treat inflammatory diseases. Recently, cAMP has been pointed out as coordinator of key steps of resolution of inflammation. Here, we summarize the evidence for the role of cAMP at inducing important features of resolution of inflammation.


COVID-19: protect great apes during human pandemics


Lessons Learned From the Coronavirus Health Crisis in Madrid, Spain: How COVID-19 Has Changed Our Lives in the Last 2 Weeks


title: [Prevention and control of novel coronavirus infection in department of stomatology]

text: During a short period of time, the COVID-19, a respiratory disease caused by a novel coronavirus and first reported by the end of the year 2019 in China, has spread rapidly to many countries and regions outside China. The number of confirmed cases and deaths continued to rise. World Health Organization announced that the outbreaks of the novel coronavirus infection have constituted a Public Health Emergency of International Concern. Efficient infection control can prevent the virus from further spreading, which may make the pandemic situation under control. Due to the specialty of oral healthcare settings, the risk of cross infection is severe among patients and oral healthcare workers. It's urgent to implement more strict and efficient infection control protocols. This article, based on existing guidelines and published researches pertinent to dental infection-control principles and practices, mainly discusses epidemiological characteristics of COVID-19 and the features of nosocomial infection in oral healthcare settings, and furthermore provides recommendations on patient's evaluation, and infection control protocols in departments of stomatology under current circumstance.


Self-screening to reduce medical resource consumption facing the COVID-19 pandemic


Leadership Lessons From Prior Pandemics: Turning the Coronavirus Disease 2019 (COVID-19) Pandemic Into an Opportunity


title: "Clinical Characteristics, Outcomes and Prognosticators in Adult Patients Hospitalized with COVID-19"

text: BACKGROUND: COVID-19 is a novel disease caused by SARS-CoV-2. METHODS: We conducted a retrospective evaluation of patients admitted with COVID-19 to one site in March 2020. Patients were stratified into three groups: survivors who did not receive mechanical ventilation (MV), survivors who received MV and those who received MV and died during hospitalization. RESULTS: There were 140 hospitalizations; 22 deaths (mortality rate 15.7%), 83 (59%) survived and did not receive MV, 35 (25%) received MV and survived; 18 (12.9%) received MV and died. Thee mean age of each group was 57.8, 55.8 and 72.7 years respectively (p=.0001). Of those who received MV and died, 61% were male (p=.01). More than half the patients (n=90, 64%) were African American. First measured d-dimer >575.5 ng/mL, procalcitonin > 0.24 ng/mL, LDH > 445.6 units/L and BNP > 104.75 pg/mL had odds ratios of 10.5, 5, 4.5 and 2.9 respectively for MV (p < .05 for all). Peak BNP > 167.5 pg/mL had an odds ratio of 6.7 for inpatient mortality when mechanically ventilated (p= .02). CONCLUSIONS: Age and gender may impact outcomes in COVID-19. D-dimer, procalcitonin, LDH and BNP may serve as early indicators of disease trajectory.


title: COVID-19 dentistry-related aspects: a literature overview

text: A new coronavirus (Sars-CoV-2) was detected in China at the end of 2019 and has since caused a worldwide pandemic. This virus is responsible for an acute respiratory syndrome (COVID-19), distinguished by a potentially lethal interstitial bilateral pneumonia. Because Sars-CoV-2 is highly infective through airborne contamination, the high infection risk in the dental environment is a serious problem for both professional practitioners and patients. This literature overview provides a description of the clinical aspects of COVID-19 and its transmission, while supplying valuable information regarding protection and prevention measures.


title: No evidence of secondary transmission of COVID-19 from children attending school in Ireland, 2020

text: As many countries begin to lift some of the restrictions to contain COVID-19 spread, lack of evidence of transmission in the school setting remains. We examined Irish notifications of SARS-CoV2 in the school setting before school closures on 12 March 2020 and identified no paediatric transmission. This adds to current evidence that children do not appear to be drivers of transmission, and we argue that reopening schools should be considered safe accompanied by certain measures.


Drinking no-links to the severity of COVID-19: a systematic review and meta-analysis


title: The international EAN survey on neurological symptoms in patients with COVID-19 infection

text: BACKGROUND AND PURPOSE: Although the main clinical features of COVID-19 infection are pulmonary, several associated neurological signs, symptoms and diseases are emerging. Incidence and characteristics of neurological complications are unclear. For this reason, the European Academy of Neurology (EAN) core COVID-19 Task Force initiated a survey on neurological symptoms observed in patients with COVID-19 infection. METHODS: A 17-question on-line survey was made available on the EAN website and distributed to EAN members and other worldwide physicians starting on April 9th , 2020. RESULTS: By April 27th, 2020, proper data were collected from 2,343 responders (out of 4,199), of whom 82.0% were neurologists, mostly from Europe. Most responders (74.7%) consulted patients with COVID-19 mainly in emergency rooms and in COVID-19 units. The majority (67.0%) had evaluated fewer than 10 patients with neurological manifestations of COVID-19 (neuro COVID-19). The most frequently reported neurological findings were headache (61.9%), myalgia (50.4%), anosmia (49.2%), ageusia (39.8%), impaired consciousness (29.3%), and psychomotor agitation (26.7%). Encephalopathy and acute cerebrovascular disorders were reported at 21.0%. Neurological manifestations were generally interpreted as being possibly related to COVID-19, they were most commonly recognized in patients with multiple general symptoms, and occurred at any time during infection. CONCLUSION: Neurologists are currently and actively involved in the management of neurological issues related to the COVID-19 pandemic. This survey justifies setting up a prospective registry to better capture the prevalence of patients with neuro COVID-19, neurological disease characteristics and the contribution of neurological manifestations to outcome.


title: The possibility of using Lopinave/Litonawe (LPV/r) as treatment for novel coronavirus 2019-nCov pneumonia: a quick systematic review based on earlier coronavirus clinical studies/ 中华急诊医学杂志

text: Objective@#To explore the possibility of using Lopinave/Litonawe (LPV/r) as treatment for novel coronavirus 2019-nCov pneumonia by systematically review earlier coronavirus studies.@*Methods@#Systematically retrieve relevant clinical studies from Chinese and English databases such as CNKI,VIP, Wangfang Data,CBM,PubMed, Web of Science,EMBASE. In addition, information from Chinese bio-medical journals, WHO, US CDC, Chinese CDC websites and the references from published relevant articles were retrieved. The inclusion period is from January 2003 to January 24, 2020. The criteria for inclusion are: (1) studies that aim to compare LPV/r and placebo/standard for SARS, MERS; (2) studies that include at least one clinical outcome; (3) studies with diagnosis criteria meeting WHO requirement on SARS or MERS; (4) data from multiple reports but originated from one study, where we extract information from all reports; (5) guidelines, includes: national or academic guidelines/experts 'consensus. The exclude criteria are: 1) only have abstracts but no full information; 2) in vitro studies. Two reviewers independently review articles and extract data on study design, patients, diagnosis criteria, regimen, and clinical outcomes (mortality, morbidity, quality of life, steroids dosage, chest image and adverse responses).@*Results@#Two hundred and thirty potential article were found by screening, and narrow down to forty-four articles for evaluation and finally four studies were included. The results of included studies indicate the early use of LPV/r regimen can reduce the mortality of SARS and MERS, and reduce steroids dosing.@*Conclusions@#ILPV/r can be used as a component of experimental regimen for treat 2019-nCoV pneumonia. It strongly suggests that initiating real world studies to explore the true clinical effects of LPV/r on 2019-nCoV patients.


Surgeons, Surgical Research, and the COVID-19 Pandemic


Venous thromboembolism and COVID-19


Healing the Healer: Protecting Emergency Health Care Workers' Mental Health During COVID-19


We Can Choose NOT to Fail


Spotlight for healthy adolescents and adolescents with preexisting chronic diseases during the COVID-19 pandemic


Rigorous Randomized Controlled Trial Implementation in the Era of COVID-19


title: COVID-19-related complications and decompression illness share main features.: Could the SARS-CoV2-related complications rely on blood foaming?

text: A study by Saraiva et al. (2011) demonstrated the presence of Angiotensin II receptors on the erythrocyte membrane. This little-known information should be deemed as crucial as the SARS-CoV-2 relationships with oxygen saturation and the Renine Angiotensin System but it currently remains unexploited. The pulmonary and cardiovascular systems are involved in any typical complications of COVID-19 but numerous other unrelated symptoms may occur. To fill the gap, we shall first emphasize some similarities between the complications of this infectious disease and Decompression Illness (DCI), which involves bubble formation. We theorized that the Angiotensin II clearance by the red blood cells could trigger the release of its oxygen content in the bloodstream. The resulting foam would worsen the widespread endotheliitis, worsen the gas exchange, trigger the coagulation process, the inflammation process and the complement pathway as typically occurs in DCI. At the end, we propose a plausible mechanism.


COVID-19 and non-communicable diseases


title: High frequency of rheumatic regional pain syndromes in first-degree relatives of patients with rheumatoid arthritis

text: First-degree relatives (FDR) of patients with rheumatoid arthritis (RA) have a higher risk for the development of RA. In the stages prior to the development of arthritis, nonspecific musculoskeletal (MSK) manifestations may occur. The aim of the study is to describe the frequency of rheumatic regional pain syndromes (RRPS) in FDR of RA patients. A cross-sectional study was carried out from July 2016 to September 2018. Parents, offspring, and siblings of RA patients completed the Community Oriented Program in the Rheumatic Diseases (COPCORD) questionnaire. Rheumatoid factor (RF) IgG, IgM, and IgA; anticitrullinated peptide antibodies (ACPAs); C-reactive protein (CRP); and erythrocyte sedimentation rate (ESR) were determined. All subjects with a positive COPCORD (defined by the presence of musculoskeletal pain) were evaluated and classified. Three hundred thirty-five FDRs participated, 75.8% were female, mean age of 44.15 years; 138 (41.2%) were diagnosed with at least one RRPS; 72 (21.5%) had rotator cuff tendinitis, 51 (15.2%) pes anserine bursitis, and 39 (11.6) lateral epicondylitis; RA was diagnosed in 24 (7.16%) subjects, undifferentiated arthritis (UA) in 30 (8.9%) and inflammatory arthralgia (AI) in 104 (31%). We found anti-CCP positivity in 6.8%, RF IgA in 22.3%, RF IgM in 48.6%, and RF IgG in 8.9%. The presence of RRPS was higher in this RA-FDR group compared to general population. Clinical evaluation of this risk group should include screening for RRPS.


title: Moroccan Medicinal plants as inhibitors against SARS-CoV-2 main protease: Computational investigations

text: The new Corona-virus, recently called the severe acute respiratory syndrome Coronavirus (SARS-CoV-2) appears for the first time in China and more precisely in Wuhan (December 2019). This disease can be fatal. Seniors, and people with other medical conditions (diabetes, heart disease ), may be more vulnerable and become seriously ill. This is why research into drugs to treat this infection remains essential in several research laboratories. Natural herbal remedies have long been the main, if not the only, remedy in the oral tradition for treating illnesses. Modern medicine has known its success thanks to traditional medicine, the effectiveness of which derives from medicinal plants. The objective of this study is to determine if the components of natural origin have an anti-viral effect and which can prevent humans from infection by this coronavirus using the most reliable method is molecular docking, which used to find the interaction between studied molecules and the protein, in our case we based on the inhibitor of Coronavirus (nCoV-2019) main protease. The results of molecular docking showed that among 67 molecules of natural origin, three molecules (Crocin, Digitoxigenin, and ß-Eudesmol) are proposed as inhibitors against the coronavirus based on the energy types of interaction between these molecules and studied protein. [Formula: see text]Communicated by Ramaswamy H. SarmaHighlightsDetermine natural compounds that can have an anti-viral effect and which can prevent humans from infection by this coronavirus;Molecular docking to find interaction between the molecules studied and the receptor of COVID-19;The synthesis of these molecules and the evaluation of their in vitro activity against SARS-Cov-2 could be interesting.


What we can learn from COVID-19 outbreak in Iran about the importance of alcohol use education


COVID 19 a challenge for emergency medicine and every health care professional


Clinical course and outcome of COVID-19 in patients with rheumatic diseases: are all biological disease-modifying antirheumatic drugs alike? Response to: 'Increased risk for severe COVID-19 in patients with inflammatory rheumatic diseases treated with rituximab' by Schulze-Koops et al


Protecting Ourselves During the COVID-19 Pandemic


title: Pituitary surgery during Covid-19: a first hand experience and evaluation

text: PURPOSE: During the Covid-19 pandemic every hospital has had to change its internal organization. Different institutions have highlighted the risks connected with endoscopic endonasal surgery. The goal of this paper is to illustrate the feasibility of pituitary region surgery during the SARS-CoV-2 pandemic. METHODS: After two negative Covid tests were obtained, three patients with macro GH-secreting tumors, and two patients with micro ACTH-secreting tumors resistant to medical treatment underwent surgery during the pandemic. During the surgery, every patient was treated as if they were positive. RESULTS: Neither operator, nor patient have developed Covid symptoms. The two neurosurgeons performing the operations underwent two Covid swab, which resulted negative. CONCLUSIONS: Pituitary surgery is a high risk non-urgent surgery. However, the method described has so far been effective and is safe for both patients and healthcare providers.


Providing care for pediatric cancer patients in the COVID-19 era: Rapid response recommendations from a developing country


title: Rapid Detection of COVID-19 Causative Virus (SARS-CoV-2) in Human Nasopharyngeal Swab Specimens Using Field-Effect Transistor-Based Biosensor

text: Coronavirus disease 2019 (COVID-19) is a newly emerging human infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, previously called 2019-nCoV). Based on the rapid increase in the rate of human infection, the World Health Organization (WHO) has classified the COVID-19 outbreak as a pandemic. Because no specific drugs or vaccines for COVID-19 are yet available, early diagnosis and management are crucial for containing the outbreak. Here, we report a field-effect transistor (FET)-based biosensing device for detecting SARS-CoV-2 in clinical samples. The sensor was produced by coating graphene sheets of the FET with a specific antibody against SARS-CoV-2 spike protein. The performance of the sensor was determined using antigen protein, cultured virus, and nasopharyngeal swab specimens from COVID-19 patients. Our FET device could detect the SARS-CoV-2 spike protein at concentrations of 1 fg/mL in phosphate-buffered saline and 100 fg/mL clinical transport medium. In addition, the FET sensor successfully detected SARS-CoV-2 in culture medium (limit of detection [LOD]: 1.6 × 101 pfu/mL) and clinical samples (LOD: 2.42 × 102 copies/mL). Thus, we have successfully fabricated a promising FET biosensor for SARS-CoV-2; our device is a highly sensitive immunological diagnostic method for COVID-19 that requires no sample pretreatment or labeling.


title: Using public health law to contain the spread of COVID-19

text: Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers what powers are available to ministers, health and local authorities to minimise the spread of the novel coronavirus and the disease it causes.


Cutaneous manifestations in COVID-19: a new contribution


title: Indication for radioiodine remnant ablation in differentiated thyroid cancer patients: does 2018 Italian consensus change anything?

text: PURPOSE: We speculated that radioiodine remnant ablation (RRA) could be performed less frequently in differentiated thyroid cancer (DTC) patients, if the recommendations of the 2018 Italian Consensus (ITA) were applied in clinical practice. Therefore, we compared the ITA indications for RRA with the recommendations by the 2015 American Thyroid Association guidelines (ATA). METHODS: We retrospectively evaluated 380 consecutive DTC patients treated with surgery and RRA, followed at the Section of Endocrinology, University of Siena, Italy from January 2006 to December 2019. RESULTS: Using ITA a significant increase of DTC patients classified as low or high risk and a significant decrease of patients defined at intermediate risk were observed (p < 0.0001). Consequently, the percentage of patients without routinary indication for RRA (47.4%, versus 38.2%, p < 0.0001) and those with a definite indication for RRA (8.2 versus 1.8%, p < 0.0001) was significantly higher compared to ATA. Moreover, using ITA the percentage of patients with a selective use of RRA was lower in comparison to ATA (44.7% versus 60%, p < 0.0001). Nevertheless, the prevalence of distant metastases, at post-ablative whole body scan, in patients without indication for RRA, was not different using either ATA or ITA (2.1% and 1.1% respectively, p = 0.37). CONCLUSION: The use of ITA Consensus, in clinical practice, increases significantly the number of patients for whom RRA is not routinely indicated in comparison to ATA guidelines but without differences in delaying the diagnosis of distant metastatic disease.


title: Plasmonic and Superhydrophobic Self-Decontaminating N95 Respirators

text: The COVID-19 pandemic is endangering the world due to the spread of respiration droplets with viruses. Medical workers and frontline staff need to wear respirators to protect themselves from breathing in the virus-containing respiration droplets. The most frequently used state-of-the-art respirators are of N95 standard; however, they lack self-decontamination capabilities. In addition, the viruses and bacteria can accumulate on the respirator surfaces, possessing high risks to the wearers over long-term usage. Photothermal decontamination is a contactless, fast, low-cost, and widely available method, capable of decontaminating the respirators. Herein, we report a plasmonic photothermal and superhydrophobic coating on N95 respirators, possessing significantly better protection than existing personal protection equipment. The plasmonic heating can raise the surface temperature to over 80 °C for this type of respirator within 1 min of sunlight illumination. The superhydrophobic features prohibit respiration droplets from accumulating on the respirator surfaces. The presence of the silver nanoparticles can provide additional protection via the silver ion's disinfection toward microbes. These synergistic features of the composite coatings provide the N95 respirator with better protection and can inspire experts from interdisciplinary fields to develop better personal protection equipment to fight the COVID-19 pandemic.


Does SARS-CoV-2 cause viral myocarditis in COVID-19 patients?


docid: ecglnkon

title: Pharmacological inhibition of lysine-specific demethylase 1 (LSD1) induces global transcriptional deregulation and ultrastructural alterations that impair viability in Schistosoma mansoni

text: Treatment and control of schistosomiasis still rely on only one effective drug, praziquantel (PZQ) and, due to mass treatment, the increasing risk of selecting for schistosome strains that are resistant to PZQ has alerted investigators to the urgent need to develop novel therapeutic strategies. The histone-modifying enzymes (HMEs) represent promising targets for the development of epigenetic drugs against Schistosoma mansoni. In the present study, we targeted the S. mansoni lysine-specific demethylase 1 (SmLSD1), a transcriptional corepressor, using a novel and selective synthetic inhibitor, MC3935, which was used to treat schistosomula and adult worms in vitro. By using cell viability assays and optical and electron microscopy, we showed that treatment with MC3935 affected parasite motility, egg-laying, tegument, and cellular organelle structures, culminating in the death of schistosomula and adult worms. In silico molecular modeling and docking analysis suggested that MC3935 binds to the catalytic pocket of SmLSD1. Western blot analysis revealed that MC3935 inhibited SmLSD1 demethylation activity of H3K4me1/2. Knockdown of SmLSD1 by RNAi recapitulated MC3935 phenotypes in adult worms. RNA-Seq analysis of MC3935-treated parasites revealed significant differences in gene expression related to critical biological processes. Collectively, our findings show that SmLSD1 is a promising drug target for the treatment of schistosomiasis and strongly support the further development and in vivo testing of selective schistosome LSD1 inhibitors.


We have to write and share valid and reliable information on COVID-19


Hypertension, renin-angiotensin-aldosterone system inhibition, and COVID-19


title: Correlation between environmental pollution indicators and COVID-19 pandemic: A brief study in Californian context

text: In December 2019, the novel coronavirus COVID-19 outbreak was first detected in Wuhan Hubei province, China. The April 24, 2020, the Centers for Disease Control and Preventions (CDC) has confirmed more than 39,000 cases, including >1800 deaths. California's Governor Gavin Newsom ordered mandatory stay at home after World Health Organization (WHO) declared COVID-19 as a global pandemic in early March. We have evaluated the correlation between environmental pollution determinants and the COVID-19 outbreak in California by using the secondary published data from the Centers for Disease Control and the Environmental Pollution Agency (EPA). We employed Spearman and Kendall correlation tests to analyze the association of PM 2.5, PM 10, SO2, NO2, Pb, VOC, and CO with COVID-19 cases in California. Our findings indicate that environmental pollutants such as PM10, PM2.5, SO2, NO2, and CO have a significant correlation with the COVID-19 epidemic in California. Overall, our study is a useful supplement to encourage regulatory bodies to promote changes in environmental policies as pollution source control can reduce the harmful effects of environmental pollutants.


Covid-19 infection and mortality: a physiologist's perspective enlightening clinical features and plausible interventional strategies


title: Learning Memory-Efficient Stable Linear Dynamical Systems for Prediction and Control

text: Learning a stable Linear Dynamical System (LDS) from data involves creating models that both minimize reconstruction error and enforce stability of the learned representation. We propose a novel algorithm for learning stable LDSs. Using a recent characterization of stable matrices, we present an optimization method that ensures stability at every step and iteratively improves the reconstruction error using gradient directions derived in this paper. When applied to LDSs with inputs, our approach---in contrast to current methods for learning stable LDSs---updates both the state and control matrices, expanding the solution space and allowing for models with lower reconstruction error. We apply our algorithm in simulations and experiments to a variety of problems, including learning dynamic textures from image sequences and controlling a robotic manipulator. Compared to existing approaches, our proposed method achieves an orders-of-magnitude improvement in reconstruction error and superior results in terms of control performance. In addition, it is provably more memory-efficient, with an O(n^2) space complexity compared to O(n^4) of competing alternatives, thus scaling to higher-dimensional systems when the other methods fail.


title: Coronavirus pandemic and tourism: Dynamic stochastic general equilibrium modeling of infectious disease outbreak

text: â¢We propose a DSGE model to examine the impact of the coronavirus outbreak on tourism.â¢The model is generalizable to any epidemic.â¢The model supports the policy of providing tourism consumption vouchers for residents.


title: POCOVID-Net: Automatic Detection of COVID-19 From a New Lung Ultrasound Imaging Dataset (POCUS)

text: With the rapid development of COVID-19 into a global pandemic, there is an ever more urgent need for cheap, fast and reliable tools that can assist physicians in diagnosing COVID-19. Medical imaging such as CT can take a key role in complementing conventional diagnostic tools from molecular biology, and, using deep learning techniques, several automatic systems were demonstrated promising performances using CT or X-ray data. Here, we advocate a more prominent role of point-of-care ultrasound imaging to guide COVID-19 detection. Ultrasound is non-invasive and ubiquitous in medical facilities around the globe. Our contribution is threefold. First, we gather a lung ultrasound (POCUS) dataset consisting of (currently) 1103 images (654 COVID-19, 277 bacterial pneumonia and 172 healthy controls), sampled from 64 videos. While this dataset was assembled from various online sources and is by no means exhaustive, it was processed specifically to feed deep learning models and is intended to serve as a starting point for an open-access initiative. Second, we train a deep convolutional neural network (POCOVID-Net) on this 3-class dataset and achieve an accuracy of 89% and, by a majority vote, a video accuracy of 92% . For detecting COVID-19 in particular, the model performs with a sensitivity of 0.96, a specificity of 0.79 and F1-score of 0.92 in a 5-fold cross validation. Third, we provide an open-access web service (POCOVIDScreen) that is available at: https://pocovidscreen.org. The website deploys the predictive model, allowing to perform predictions on ultrasound lung images. In addition, it grants medical staff the option to (bulk) upload their own screenings in order to contribute to the growing public database of pathological lung ultrasound images. Dataset and code are available from: https://github.com/jannisborn/covid19_pocus_ultrasound


title: Molecular Diagnosis of a Novel Coronavirus (2019-nCoV) Causing an Outbreak of Pneumonia

text: BACKGROUND: A novel coronavirus of zoonotic origin (2019-nCoV) has recently been identified in patients with acute respiratory disease. This virus is genetically similar to SARS coronavirus and bat SARS-like coronaviruses. The outbreak was initially detected in Wuhan, a major city of China, but has subsequently been detected in other provinces of China. Travel-associated cases have also been reported in a few other countries. Outbreaks in health care workers indicate human-to-human transmission. Molecular tests for rapid detection of this virus are urgently needed for early identification of infected patients. METHODS: We developed two 1-step quantitative real-time reverse-transcription PCR assays to detect two different regions (ORF1b and N) of the viral genome. The primer and probe sets were designed to react with this novel coronavirus and its closely related viruses, such as SARS coronavirus. These assays were evaluated using a panel of positive and negative controls. In addition, respiratory specimens from two 2019-nCoV-infected patients were tested. RESULTS: Using RNA extracted from cells infected by SARS coronavirus as a positive control, these assays were shown to have a dynamic range of at least seven orders of magnitude (2x10-4-2000 TCID50/reaction). Using DNA plasmids as positive standards, the detection limits of these assays were found to be below 10 copies per reaction. All negative control samples were negative in the assays. Samples from two 2019-nCoV-infected patients were positive in the tests. CONCLUSIONS: The established assays can achieve a rapid detection of 2019n-CoV in human samples, thereby allowing early identification of patients.


title: Medical education engagement during the COVID-19 era - A student parents perspective

text: The COVID-19 pandemic has affected the delivery of medical education and has limited the ability of student parents to fully engage with their studies. Student parents have been faced with additional challenges such as increased childcare roles and home-schooling responsibilities, splitting their focus. Identifying the issues student parents face and adopting workable solutions at all levels, will ensure the best outcomes for these students and better preparedness for the future.


docid: exonzbyx

title: Toll of acute methanol poisoning for preventing COVID-19


docid: pnphigls

title: Mesenchymal stem cells as a potential treatment for critically ill patients with coronavirus disease 2019


title: Is the kidney a target of SARS-CoV-2?

text: The new disease produced by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) represents a major pandemic event nowadays. Since its origin in China in December 2019, there is compelling evidence that novel SARS-CoV-2 is a highly transmissible virus, and it is associated to a broad clinical spectrum going from subclinical presentation to severe respiratory distress and multiorgan failure. Like other coronaviruses, SARS-CoV-2 recognizes human angiotensin-converting enzyme 2 as a cellular receptor that allows it to infect different host cells and likely disrupts renin-angiotensin-aldosterone system homeostasis. Particularly, a considerable incidence of many renal abnormalities associated to COVID-19 has been reported, including proteinuria, hematuria, and acute kidney injury. Moreover, it has been recently demonstrated that SARS-CoV-2 can infect podocytes and tubular epithelial cells, which could contribute to the development of the aforementioned renal abnormalities. In this review, we discuss the biological aspects of SARS-CoV-2 infection, how understanding current knowledge about SARS-CoV-2 infection may partly explain the involvement of the kidneys in the pathophysiology of COVID-19, and what questions have arisen and remain to be explored.


title: Enabling and Emerging Technologies for Social Distancing: A Comprehensive Survey

text: Social distancing is crucial for preventing the spread of viral diseases illnesses such as COVID-19. By minimizing the closely physical contact between people, we can reduce chances of catching the virus and spreading it to the community. This paper aims to provide a comprehensive survey on how emerging technologies, e.g., wireless and networking, AI can enable, encourage, and even enforce social distancing. To that end, we provide a fundamental background of social distancing including basic concepts, measurements, models and propose practical scenarios. We then discuss enabling wireless technologies which are especially effective and can be widely adopted in practice to keep distance and monitor people. After that, emerging technologies such as machine learning, computer vision, thermal, ultrasound, etc., are introduced. These technologies open many new solutions and directions to deal with problems in social distancing, e.g., symptom prediction, detection and monitoring quarantined people, and contact tracing. Finally, we provide important open issues and challenges (e.g., privacy-preserving, cybersecurity) in implementing social distancing in practice.


title: Gravitational Microlensing Time Delays at High Optical Depth: Image Parities and the Temporal Properties of Fast Radio Bursts

text: Due to differing gravitational potentials and path lengths, gravitational lensing induces time delays between multiple images of a source which, for solar mass objects, is of order $\sim10^{-5}$ seconds. If an astrophysically compact source, such as a Fast Radio Burst (FRB), is observed through a region with a high optical depth of such microlensing masses, this gravitational lensing time delay can be imprinted on short timescale transient signals. In this paper, we consider the impact of the parity of the macroimage on the resultant microlensing time delays. It is found that this parity is directly imprinted on the microlensing signal, with macroimages formed at minima of the time arrival surface beginning with the most highly magnified microimages and then progressing to the fainter microimages. At macroimages at the maxima of the time arrival surface, this situation is reversed, with fainter images observed first and finishing with the brightest microimages. For macroimages at saddle-points, the signal again begins with fainter images, followed by brighter images before again fading through the fainter microimages. The growing populations of cosmologically distant bursty transient sources will undoubtedly result in the discovery of strong lensed, multiply imaged FRBs, which will be susceptible to microlensing by compact masses. With the temporal resolution being offered my modern and future facilities, the detection of microlensing induced time delays will reveal the parities of the gravitational lens macroimages, providing additional constraints on macrolensing mass models and improving the efficacy of these transient sources as a cosmological probes.


NHS Test and Trace: it didn't have to be this way


Public Health : "How Coronaviruses Cause Infection"


Caregiving at a Physical Distance: Initial Thoughts for COVID-19 and Beyond


Risks to Bangladeshi children and young people during covid-19 outbreak


title: Early Report on the Impact of COVID-19 Outbreak in Neurosurgical Practice Among Members of the Latin American Federation of Neurosurgical Societies

text: BACKGROUND: The COVID-19 pandemic has caused severe economic consequences by local governmental measures to contain the outbreak. We provide insight on the impact that health care restriction has made on neurosurgical activity in Latin Iberoamerica. METHODS: We performed an internet-based survey among presidents and members of the societies of the Latin American Federation of Neurosurgical Societies (FLANC). We blindly analyzed information regarding local conditions and their impact on neurosurgical praxis using SPSS software. RESULTS: Information came from 21 countries. Sixteen society presidents reported having suspended regular activities and deferring local scheduled congresses, 14 reported mandatory isolation by government, and 4 instituted a telemedicine project. Four-hundred eighty-six colleagues, mean age 49 years, reported a mean 79% reduction in their neurosurgical praxis. Seventy-six percent of neurosurgeons have savings to self-support for 3-6 months if restrictions are long lasting. CONCLUSIONS: Stopping activities among societies of the FLANC, together with a drop of 79% of neurosurgical praxis, adds to deficits in provider's protection equipment and increasing demand for attention in the health care systems, representing a huge financial risk to their sustainability. Neurosurgeons should be involved in local policies to protect health and economy. Telemedicine represents an excellent solution, avoiding another pandemic of severe diseases across all-specialties as nonessential care can turn essential if left untreated. Financial support and ethics code review is needed to battle this new disease, designated the occupational disease of the decade, that continues to scrag the health care system. Times of crisis are times of great opportunities for humanity to evolve.


title: Potential short-term outcome of an uncontrolled COVID-19 epidemic in Lombardy, Italy, February to March 2020

text: Sustained coronavirus disease (COVID-19) transmission is ongoing in Italy, with 7,375 reported cases and 366 deaths by 8 March 2020. We provide a model-based evaluation of patient records from Lombardy, predicting the impact of an uncontrolled epidemic on the healthcare system. It has the potential to cause more than 250,039 (95% credible interval (CrI): 147,717-459,890) cases within 3 weeks, including 37,194 (95% CrI: 22,250-67,632) patients requiring intensive care. Aggressive containment strategies are required.


Low frequency of COVID-19 in inflammatory bowel diseases


title: Prognosis of COVID-19: Changes in laboratory parameters

text: INTRODUCTION: Since December 2019, an outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome - Coronavirus 2 (SARS-CoV-2) emerged in China and has become a global threat Comparison of hematological parameters between mild and severe cases of SARS-CoV 2 is so far limited, but significant differences in parameters such as interleukin-6, d-dimers, glucose, fibrinogen and C-reactive protein have been already reported PURPOSE: In this study we analyzed the changes observed in easily measured blood biomarkers in the patients and provided evidence of how these markers can be used as prognostic factors of the disease METHODS: Demographic characteristics, detailed medical history, and laboratory findings of all enrolled SARS-CoV 2 infection positive patients who were referred to Patras University Hospital from the period of March 4th 2020 (when first confirmed case in Greece appeared in our hospital) until April 4th 2020 were extracted from electronic medical records and analyzed RESULTS: We provided evidence that some very common laboratory values can be used as independent predictive factors in SARS-CoV 2 infection Despite the retrospective nature of this study and the small number of subjects analyzed, we showed that NLR, LDH, d-dimers, CRP, fibrinogen and ferritin can be used early at the patient's first visit for SARS-CoV 2 infection symptoms and can predict the severity of infection CONCLUSION: More studies are warranted to further objectively confirm the clinical value of prognostic factors related to SARS-CoV 2 and establish an easy-to-get panel of laboratory findings for evaluating the disease severity


A dialogue between the editor-in-chief and a deputy editor of a cardiology journal during the coronavirus outbreak: Take-home messages from the Italian experience


Coronavirus Disease 2019 (COVID-19), Videoconferencing, and Gender


title: Potential fecal transmission of SARS-CoV-2: Current evidence and implications for public health

text: Coronavirus disease 2019 (COVID-19) emerged in Hubei Province, China in December 2019 and has since become a global pandemic, with hundreds of thousands of cases and over 165 countries affected. Primary routes of transmission of the causative virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are through respiratory droplets and close person-to-person contact. While information about other potential modes of transmission are relatively sparse, evidence supporting the possibility of a fecally mediated mode of transmission has been accumulating. Here, current knowledge on the potential for fecal transmission is briefly reviewed and the possible implications are discussed from a public health perspective.


Préconisations cardiologiques lors de l'utilisation d'un traitement pouvant entraîner des troubles conductifs ou un allongement de l'intervalle QT dans le COVID-19


docid: etpmevun

title: Coalition: Advocacy for prospective clinical trials to test the post-exposure potential of hydroxychloroquine against COVID-19

text: Our coalition of public health experts, doctors, and scientists worldwide want to draw attention to the need for high-quality evaluation protocols of the potential beneficial effect of hydroxychloroquine (HCQ) as a post-exposure drug for exposed people, meaning people with close contact with positive tested patients, including home and medical caregivers. We have reviewed the mechanisms of antiviral effect of HCQ, the risk-benefit ratio taking into consideration the PK/PD of HCQ and the thresholds of efficacy. We have studied its use as an antimalarial, an antiviral, and an immunomodulating drug and concluded that the use of HCQ at does matching that of the standard treatment of Systemic Lupus erythematous, which has proven safety and efficacy in terms of HCQ blood and tissue concentration adapted to bodyweight (2,3), at 6â¯mg/kg/day 1 (loading dose) followed by 5â¯mg/kg/day, with a maximum limit of 600â¯mg/day in all cases should swiftly be clinically evaluated as a post-exposure drug for exposed people.


title: Italian survey on managing immune checkpoint inhibitors in oncology during COVID-19 outbreak

text: BACKGROUND: During COVID-19 outbreak, oncological care has been reorganized. Patients with cancer have been reported to experience a more severe COVID-19 syndrome; moreover, there are concerns of a potential interference between immune checkpoint inhibitors (ICIs) and SARS-CoV-2 pathogenesis. MATERIALS AND METHODS: Between 6 and 16 May 2020, a 22-item survey was sent to Italian physicians involved in administering ICIs. It aimed at exploring the perception about SARS-CoV-2-related risks in cancer patients receiving ICIs, and the attitudes towards their management. RESULTS: The 104 respondents had a median age of 35.5 years, 58.7% were females and 71.2% worked in Northern Italy. 47.1% of respondents argued a synergism between ICIs and SARS-CoV-2 pathogenesis leading to worse outcomes, but 97.1% would not deny an ICI only for the risk of infection. During COVID-19 outbreak, to reduce hospital visits, 55.8% and 30.8% opted for the highest labelled dose of each ICI and/or, among different ICIs for the same indication, for the one with the longer interval between cycles, respectively. 53.8% of respondents suggested testing for SARS-CoV-2 every cancer patient candidate to ICIs. 71.2% declared to manage patients with onset of dyspnoea and cough as infected by SARS-CoV-2 until otherwise proven; however, 96.2% did not reduce the use of steroids to manage immune-related toxicities. The administration of ICIs in specific situations for different cancer types has not been drastically conditioned. CONCLUSIONS: These results highlight the uncertainties around the perception of a potential interference between ICIs and COVID-19, supporting the need of focused studies on this topic.


title: Expression of the COVID-19 receptor ACE2 in the human conjunctiva

text: SARS-CoV-2 is assumed to use angiotensin-converting enzyme 2 (ACE2) and other auxiliary proteins for cell entry. Recent studies have described conjunctival congestion in 0.8% of patients with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and there has been speculation that SARS-CoV-2 can be transmitted through the conjunctiva. However, it is currently unclear whether conjunctival epithelial cells express ACE2 and its cofactors. In this study, a total of 38 conjunctival samples from 38 patients, including 12 healthy conjunctivas, 12 melanomas, seven squamous cell carcinomas, and seven papilloma samples, were analyzed using high-throughput RNA sequencing to assess messenger RNA (mRNA) expression of the SARS-CoV-2 receptor ACE2 and its cofactors including TMPRSS2, ANPEP, DPP4, and ENPEP. ACE2 protein expression was assessed in eight healthy conjunctival samples using immunohistochemistry. Our results show that the SARS-CoV-2 receptor ACE2 is not substantially expressed in conjunctival samples on the mRNA (median: 0.0 transcripts per million [TPM], min: 0.0 TPM, max: 1.7 TPM) and protein levels. Similar results were obtained for the transcription of other auxiliary molecules. In conclusion, this study finds no evidence for a significant expression of ACE2 and its auxiliary mediators for cell entry in conjunctival samples, making conjunctival infection with SARS-CoV-2 via these mediators unlikely.


title: Large-Scale, Precision Xenon Doping of Liquid Argon

text: The detection of scintillation light from liquid argon is an experimental technique key to a number of current and future nuclear/particle physics experiments, such as neutrino physics, neutrinoless double beta decay and dark matter searches. Although the idea of adding small quantities of xenon (doping) to enhance the light yield has attracted considerable interest, this technique has never been demonstrated at the necessary scale. Here we report on xenon doping in a 100~l crogenic vessel. We observed an increase in light yield by a factor of 1.81$\pm$0.04 at a dopant concentration of 10~ppm, consistent with a Geant4 prediction of 1.83$\pm$0.02. We determine a lower limit on the attenuation length of $3$~m at a concentration of 10~ppm


Reply: Use of statins in patients with COVID-19


Webinars in plastic and reconstructive surgery training - a review of the current landscape during the COVID-19 pandemic


title: Application of Biosafety Principles in Laboratory Analysis of Clinical Samples from Patients with COVID-19

text: COVID-19 poses a great challenge to clinical and diagnostic services around the world. The need of biosafety practices can never be emphasised more than under current circumstances. The four pillars of biosafety namely, leadership, standard operating procedures, personal protective equipment (PPE) and engineering controls must be employed for effective and safe practices in the clinical setting in general and laboratory settings in particular. Risk assessment must be carried out before meeting up the diagnostic challenge for COVID-19 and essential biorisk management measures are required to be taken. In our resource-poor settings, we need to adapt safe but cost-effective and improvised solutions to ensure safe handling of clinical samples from COVID-19 patients in the laboratories. The correct use of PPE and their suitable alternatives are available for selection and use. Disinfection of the lab areas and safe disposal of the clinical samples from such patients is also of paramount importance.


docid: dvgigmdq

title: Loneliness, isolation, and social support factors in post-COVID-19 mental health

text: Social support plays a key role in well-being, yet one of the major preventative efforts for reducing the spread of COVID-19 involves social distancing. During times of crisis, social support is emphasized as a coping mechanism. This requires many people to change their typical ways of connectedness and assumes that people have existing healthy relationships or access to technology. The purpose of this article was to explore the potential impact of COVID-19 on loneliness and well-being. Social support is an important consideration for understanding the impact of COVID-19 Psychological First Aid and Skills for Psychological Recovery, which are tools used to inform response methods to help people connect during isolation and are interventions that could be adapted to COVID-specific needs for what may be a prolonged isolation and postisolation. Given the many unknowns of COVID-19, studies are needed to understand the larger behavioral health impact to ensure resources are available, current, and evidence informed. Future studies are also needed to understand how access to technology may help buffer loneliness and isolation and thus improve the social outcomes of the current pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Mobile phone data analytics against the COVID-19 epidemics in Italy: flow diversity and local job markets during the national lockdown

text: Understanding collective mobility patterns is crucial to plan the restart of production and economic activities, which are currently put in stand-by to fight the diffusion of the epidemics. In this report, we use mobile phone data to infer the movements of people between Italian provinces and municipalities, and we analyze the incoming, outcoming and internal mobility flows before and during the national lockdown (March 9th, 2020) and after the closure of non-necessary productive and economic activities (March 23th, 2020). The population flow across provinces and municipalities enable for the modelling of a risk index tailored for the mobility of each municipality or province. Such an index would be a useful indicator to drive counter-measures in reaction to a sudden reactivation of the epidemics. Mobile phone data, even when aggregated to preserve the privacy of individuals, are a useful data source to track the evolution in time of human mobility, hence allowing for monitoring the effectiveness of control measures such as physical distancing. We address the following analytical questions: How does the mobility structure of a territory change? Do incoming and outcoming flows become more predictable during the lockdown, and what are the differences between weekdays and weekends? Can we detect proper local job markets based on human mobility flows, to eventually shape the borders of a local outbreak?


title: COVID-19 Treatment: Close to a Cure? - A Rapid Review of Pharmacotherapies for the Novel Coronavirus

text: Currently, there is no approved therapy for COVID-19. The World Health Organization therefore endorse supportive care only. However, frontline clinicians and researchers have been experimenting with several virus-based and host-based therapeutics since the outbreak in China. China's National Health Commission has issued the first COVID-19 Treatment Guideline with therapy suggestions (7th edition attached) which inspired following clinical studies worldwide. Major therapeutics are evaluated in this review. Key evidence from in vitro researches, animal models and clinical researches in emerging coronaviruses are examined. Antiviral therapies remdesivir, lopinavir/ritonavir and umifenovir, if considered, could be initiated before the peak of viral replication for optimal outcomes. Ribavirin may be beneficial as an add-on therapy and is ineffective as a monotherapy. Corticosteroids use should be limited to indicating comorbidities. IVIG is not recommended due to lack of data in COVID-19. Xuebijing may benefit patients with complications of bacterial pneumonia or sepsis. The efficacy of interferon is unclear due to conflicting outcomes in coronavirus studies. Chloroquine and hydroxychloroquine have shown in vitro inhibition of SARS-CoV-2, and the studies on clinical efficacy and whether the benefits outweigh the risk of dysrhythmias remain inconclusive. For patients who developed cytokine release syndrome, interleukin-6 inhibitors may be beneficial.


Some reflections on organizational profiles in Italy in the time of COVID-19


docid: orqktgdo

title: COVID-19 therapeutic options for patients with kidney disease


COVID-19 in Italy - Passing through bitter waters


title: Neuroendovascular clinical trials disruptions due to COVID-19. Potential future challenges and opportunities

text: To assess the impact of COVID-19 on neurovascular research and deal with the challenges imposed by the pandemic. METHODS: A survey-based study focused on randomized controlled trials (RCTs) and single-arm studies for acute ischemic stroke and cerebral aneurysms was developed by a group of senior neurointerventionalists and sent to sites identified through the clinical trials website (https://clinicaltrials.gov/), study sponsors, and physician investigators. RESULTS: The survey was sent to 101 institutions, with 65 responding (64%). Stroke RCTs were being conducted at 40 (62%) sites, aneurysm RCTs at 22 (34%) sites, stroke single-arm studies at 37 (57%) sites, and aneurysm single-arm studies at 43 (66%) sites. Following COVID-19, enrollment was suspended at 51 (78%) sites-completely at 21 (32%) and partially at 30 (46%) sites. Missed trial-related clinics and imaging follow-ups and protocol deviations were reported by 27 (42%), 24 (37%), and 27 (42%) sites, respectively. Negative reimbursements were reported at 17 (26%) sites. The majority of sites, 49 (75%), had put new trials on hold. Of the coordinators, 41 (63%) worked from home and 20 (31%) reported a personal financial impact. Remote consent was possible for some studies at 34 (52%) sites and for all studies at 5 (8%) sites. At sites with suspended trials (n=51), endovascular treatment without enrollment occurred at 31 (61%) sites for stroke and 23 (45%) sites for aneurysms. A total of 277 patients with acute ischemic stroke and 184 with cerebral aneurysms were treated without consideration for trial enrollment. CONCLUSION: Widespread disruption of neuroendovascular trials occurred because of COVID-19. As sites resume clinical research, steps to mitigate similar challenges in the future should be considered.


COVID-19 pandemic and its impact on cardiology and its subspecialty training


title: Etiology and genetic evolution of canine coronavirus circulating in five provinces of China, during 2018-2019

text: As the outbreaks of COVID-19 in worldwide, coronavirus has once again caught the attention of people. Canine coronavirus is widespread among dog population, and sometimes causes even fatal cases. Here, to characterize the prevalence and evolution of current circulating canine coronavirus (CCoV) strains in China, we collected 213 fecal samples from diarrheic pet dogs between 2018 and 2019. Of the 213 samples, we found 51 (23.94%) were positive for CCoV. Co-infection with canine parvovirus (CPV), canine astrovirus (CaAstV), canine kobuvirus (CaKV), Torque teno canis virus (TTCaV) were ubiquitous existed. Mixed infection of different CCoV subtypes exists extensively. Considering the limited sequences data in recent years, we sequenced 7 nearly complete genomes and 10 complete spike gene. Phylogenetic analysis of spike gene revealed a new subtype CCoV-II Variant and CCoV-IIa was the most prevalent subtype currently circulating. Moreover, we identified strain B906_ZJ_2019 shared 93.24% nucleotide identifies with previous strain A76, and both of them clustered with CCoV-II Variant, which were not well clustered with the known subtypes. Recombination analysis of B906_ZJ_2019 indicated that strain B906_ZJ_2019 may a recombinant variant between CCoV-I and CCoV-II, which is consistent with strain A76. Furthermore, amino acid variations widely existed among current CCoV-IIa strains circulating in China and the classic CCoV-IIa strains, in spite of the unknown functions. In a word, we report a useful information as to the etiology and evolution of canine coronavirus in China based on the available sequences, which is urgent for the devise of future effective disease prevention and control strategies.


title: Old Drugs for Newly Emerging Viral Disease, COVID-19: Bioinformatic Prospective

text: Coronavirus (COVID-19) outbreak in late 2019 and 2020 comprises a serious and more likely a pandemic threat worldwide. Given that the disease has not approved vaccines or drugs up to now, any efforts for drug design and or clinical trails of old drugs based on their mechanism of action are worthy and creditable in such circumstances. Experienced docking experiments using the newly released coordinate structure for COVID-19 protease as a receptor and thoughtfully selected chemicals among antiviral and antibiotics drugs as ligands may be leading in this context. We selected nine drugs from HIV-1 protease inhibitors and twenty-one candidates from anti bronchitis drugs based on their chemical structures and enrolled them in blind and active site-directed dockings in different modes and in native-like conditions of interactions. Our findings suggest the binding capacity and the inhibitory potency of candidates are as follows Tipranavir>Indinavir>Atazanavir>Darunavir>Ritonavir>Amprenavir for HIV-1 protease inhibitors and Cefditoren>Cefixime>Erythromycin>Clarithromycin for anti bronchitis medicines. The drugs bioavailability, their hydrophobicity and the hydrophobic properties of their binding sites and also the rates of their metabolisms and deactivations in the human body are the next determinants for their overall effects on viral infections, the net results that should survey by clinical trials to assess their therapeutic usefulness for coronavirus infections.


title: EEG Findings in Coronavirus Disease

text: PURPOSE: Neurologic manifestations of coronavirus disease (COVID-19) such as encephalopathy and seizures have been described. To our knowledge, detailed EEG findings in COVID-19 have not yet been reported. This report adds to the scarce body of evidence. METHODS: We identified eight COVID-19 positive patients who underwent EEG monitoring in our hospital system. RESULTS: EEGs were most commonly ordered for an altered level of consciousness, a nonspecific neurologic manifestation. We observed generalized background slowing in all patients and generalized epileptiform discharges with triphasic morphology in three patients. Focal electrographic seizures were observed in one patient with a history of focal epilepsy and in another patient with no such history. Five of eight patients had a previous diagnosis of epilepsy, suggesting that pre-existing epilepsy can be a potential risk factor for COVID-19-associated neurological manifestations. Five of eight patients who underwent EEG experienced a fatal outcome of infection. CONCLUSIONS: Our findings underscore previous observations that neurologic manifestations are common in severe cases. COVID-19 patients with epilepsy may have an increased risk of neurological manifestations and abnormal EEG.


COVID-19-immunity from prosecution for physicians forced to allocate scarce resources: the Italian perspective


Diagnosing and Treating Systemic Racism


Coronavirus: online GP bookings should be stopped because of safety risks, warns BMA


The Role of Spine Surgeons in the Era of COVID-19 Outbreak


title: Indirect effects of COVID-19 on the environment

text: This research aims to show the positive and negative indirect effects of COVID-19 on the environment, particularly in the most affected countries such as China, USA, Italy, and Spain. Our research shows that there is a significant association between contingency measures and improvement in air quality, clean beaches and environmental noise reduction. On the other hand, there are also negative secondary aspects such as the reduction in recycling and the increase in waste, further endangering the contamination of physical spaces (water and land), in addition to air. Global economic activity is expected to return in the coming months in most countries (even if slowly), so decreasing GHG concentrations during a short period is not a sustainable way to clean up our environment.


title: Can Zn Be a Critical Element in COVID-19 Treatment?

text: The current COVID-19 pandemic caused by SARS-CoV-2 has prompted investigators worldwide to search for an effective anti-viral treatment. A number of anti-viral drugs such as ribavirin, remdesivir, lopinavir/ritonavir, antibiotics such as azithromycin and doxycycline, and anti-parasite such as ivermectin have been recommended for COVID-19 treatment. In addition, sufficient pre-clinical rationale and evidence have been presented to use chloroquine for the treatment of COVID-19. Furthermore, Zn has the ability to enhance innate and adaptive immunity in the course of a viral infection. Besides, Zn supplement can favour COVID-19 treatment using those suggested and/or recommended drugs. Again, the effectiveness of Zn can be enhanced by using chloroquine as an ionophore while Zn inside the infected cell can stop SARS-CoV-2 replication. Given those benefits, this perspective paper describes how and why Zn could be given due consideration as a complement to the prescribed treatment of COVID-19.


title: Diacerein: A potential multi-target therapeutic drug for COVID-19

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 19 (COVID-19), was declared pandemic by the World Health Organization in March 2020. SARS-CoV-2 binds its host cell receptor, angiotensin-converting enzyme 2 (ACE2), through the viral spike (S) protein. The mortality related to severe acute respiratory distress syndrome (ARDS) and multi-organ failure in COVID-19 patients has been suggested to be connected with cytokine storm syndrome (CSS), an excessive immune response that severely damages healthy lung tissue. In addition, cardiac symptoms, including fulminant myocarditis, are frequent in patients in a severe state of illness. Diacerein (DAR) is an anthraquinone derivative drug whose active metabolite is rhein. Different studies have shown that this compound inhibits the IL-1, IL-2, IL-6, IL-8, IL-12, IL-18, TNF-α, NF-κB and NALP3 inflammasome pathways. The antiviral activity of rhein has also been documented. This metabolite prevents hepatitis B virus (HBV) replication and influenza A virus (IAV) adsorption and replication through mechanisms involving regulation of oxidative stress and alterations of the TLR4, Akt, MAPK, and NF-κB signalling pathways. Importantly, rhein inhibits the interaction between the SARS-CoV S protein and ACE2 in a dose-dependent manner, suggesting rhein as a potential therapeutic agent for the treatment of SARS-CoV infection. Based on these findings, we hypothesize that DAR is a multi-target drug useful for COVID-19 treatment. This anthraquinone may control hyperinflammatory conditions by multi-faceted cytokine inhibition and by reducing viral infection.


title: Four-step approach to efficiently develop capillary gel electrophoresis methods for viral vaccine protein analysis

text: Vaccines against infectious diseases are urgently needed. Therefore, modern analytical method development should be as efficient as possible to speed up vaccine development. The objectives of the study were to identify critical method parameters (CMPs) and to establish a set of steps to efficiently develop and validate a CE-SDS method for vaccine protein analysis based on a commercially available gel buffer. The CMPs were obtained from reviewing the literature and testing the effects of gel buffer dilution. A four-step approach, including two multivariate DoE (design of experiments) steps, was proposed, based on CMPs and was verified by CE-SDS method development for: (i) the determination of influenza group 1 mini-haemagglutinin glycoprotein; and (ii) the determination of polio virus particle proteins from an inactivated polio vaccine (IPV). The CMPs for sample preparation were incubation temperature(s) and time(s), pH, and reagent(s) concentration(s) and the detection wavelength. The effects of gel buffer dilution revealed the CMPs for CE-SDS separation to be the effective length, the gel buffer concentration, and the capillary temperature. The four-step approach based on the CMPs was efficient for the development of the two CE methods. A four-step approach to efficiently develop capillary gel electrophoresis methods for viral vaccine protein analysis was successfully established. This article is protected by copyright. All rights reserved.


The impact of hydroxychloroquine shortages on patients with dermatological conditions during COVID-19 pandemic


docid: amqpupxr

title: Chilblain y lesiones purpúricas acrales en COVID-19./ Chilblain y lesiones purpúricas acrales en COVID-19./ Chilblain and Acral Purpuric Lesions in COVID-19


Et COVID-19 nous frappa de plein fouet ./ [COVID-19, a brutal blow ]


Humanity tested


The alarming burden of non-communicable diseases in COVID-19 new normal: Implications on oral health


title: The Alarming Burden of Non-Communicable Diseases in COVID-19 New Normal: Implications on Oral Health

text: The coronavirus disease (COVID-19) outbreak has triggered massive debates within dental professional organizations about prioritization of offered services, served groups, and required protective measures.(Volgenant et al., 2020) While navigating through the post-outbreak era, we aim to demonstrate the importance of continuous global focus on the burden of non-communicable diseases (NCDs) such as oral diseases. Oral diseases are the most prevalent NCDs worldwide consuming one-fifth of out-of-pocket health expenditure and being recognized as the third most expensive condition to treat in Europe.(Peres et al., 2019) The World Health Organization (WHO) recommends prioritizing common risk factor approaches in all interventions targeting NCDs in order to draw attention to the multifaceted relationship between oral diseases and chronic conditions like diabetes, cardiovascular disease, and cancers.(Sheiham & Watt, 2000).


Facetime to reduce behavioral problems in a nursing home resident with Alzheimer's dementia during COVID-19


COVID-19: the gendered impacts of the outbreak


We should err on side of caution with Covid-19 advice