docid: jocwiafy

title: Knowledge, Awareness and Practice of Health care Professionals amid SARS-CoV-2, Corona Virus Disease Outbreak

text: OBJECTIVE: To assess the knowledge, awareness and practice level of health care workers towards Corona Virus disease - 2019 (COVID-19). METHODS: A cross sectional study was conducted by administering a well-structured questionnaire comprising of three sections including knowledge, attitude and practice amongst health care professionals in various hospitals and clinics, over a duration of two months ‘Feb-March’ 2020. The data from 810 participants were collected manually as well as through online survey registered on www.surveys.google.com, using a validated questionnaire. The questionnaire comprised of three sections assessing knowledge, awareness and practice of participants. The descriptive analysis was carried out for demographics and dependent variables with statistical program for social sciences. Spearman test was used to detect any relationship between the health care professional response with respect to their gender and level of education. A p value of < 0.05 was considered statistically significant. RESULTS: More than half (57.2%) of the health care professionals were working in a hospital setting. Fifty two percent of health care professionals had awareness and 72% were practicing adequate measures to combat COVID-19. The majority (81.9%) believed that the sign and symptoms are similar to a common flu and the main strata of population that could be affected by COVID-19 are elderly (79%). Seventy three percent of participants did not attend any lecture, workshop or seminar on COVID-19 for awareness purpose. Sixty seven percent of health care professionals were practicing universal precaution for infection control and 57.4% were using sodium hypochlorite as a surface disinfectant in dental surgeries. There was no significant relationship (p > 0.05) between the health care professionals’ responses with gender and their education level. CONCLUSION: The study suggests that the vast majority of the health care professionals have adequate knowledge and awareness related to COVID-19. However some aspects of practice of health care professionals were found to be deficient including, following CDC guidelines during patient care, acquiring verified knowledge related to COVID-19, disinfection protocol and the use of N-95 mask. Mandatory Continued professional development programs including lectures and workshops on COVID-19 for all health care professionals are the need of the hour, to manage the pandemic and limiting the morbidity and mortality related to it.


title: GraphDTA: Predicting drug–target binding affinity with graph neural networks

text: The development of new drugs is costly, time consuming, and often accompanied with safety issues. Drug repurposing can avoid the expensive and lengthy process of drug development by finding new uses for already approved drugs. In order to repurpose drugs effectively, it is useful to know which proteins are targeted by which drugs. Computational models that estimate the interaction strength of new drug–target pairs have the potential to expedite drug repurposing. Several models have been proposed for this task. However, these models represent the drugs as strings, which is not a natural way to represent molecules. We propose a new model called GraphDTA that represents drugs as graphs and uses graph neural networks to predict drug–target affinity. We show that graph neural networks not only predict drug–target affinity better than non-deep learning models, but also outperform competing deep learning methods. Our results confirm that deep learning models are appropriate for drug–target binding affinity prediction, and that representing drugs as graphs can lead to further improvements. Availability of data and materials The proposed models are implemented in Python. Related data, pre-trained models, and source code are publicly available at https://github.com/thinng/GraphDTA. All scripts and data needed to reproduce the post-hoc statistical analysis are available from https://doi.org/10.5281/zenodo.3603523.


docid: dumtvxcl

title: Indicators of low-carbon management in the leisure industry: Research using examples in Taiwan and China

text: This study aimed to establish indicators of low-carbon management in the leisure industries in Taiwan and China to meet the demands of saving energy, reducing carbon emissions and slowing global warming. The Pushin Ranch in Taiwan and Lishan Farm in China were targeted as examples. Quantitative indicators were identified through interviews and questionnaire surveys with experts from the industrial, governmental and academic sectors, as well as data integration and statistical analysis using the Delphi method and a paired-samples t test. On the basis of 11 major sustainable tourism indicators proposed by the United NationsWorld Tourism Organization and the relevant literature, three dimensions were selected for investigation, namely organizational management and operation, ecotourism and social collaboration, along with five operational indicators and 42 assessment indicators. After the expert questionnaire and t test, a set of selection criteria was constructed based on the approval of more than 80% of the experts; 36 indicators were retained for Taiwan (Pushin Ranch met 17) and 29 were retained for China (Lishan Farm met 13). This allows industrial, governmental and academic units to establish management models and assessment indicators for the leisure industry to meet the demands of energy conservation and carbon reduction.


title: Plasma concentration and safety of lopinavir/ritonavir in patients with Covid-19: a retrospective cohort study

text: Background: There is an urgent need of active treatment for coronavirus disease 2019 (Covid-19). Although efficacy have not been proven, lopinavir/ritonavir 400 mg/100 mg twice daily has been proposed as a treatment of moderate to severe Covid-19. Previously published cohorts showed Covid-19 is associated with major inflammation. To date, no data are available regarding lopinavir/ritonavir plasma concentration and its safety in Covid-19 patients. Methods: Real-world Covid-19 experience based on a retrospective cohort study Results: On the cohort of 31 patients treated by lopinavir/ritonavir for Covid-19, we observed very high lopinavir plasma concentrations, increased of 4.6-fold (IQR 2.9-6.4), with regards to average plasma concentrations in HIV treatment. All except two patients were above the upper limit of the concentration ranges of HIV treatment. In this cohort, about one over four to five patients prematurely stopped lopinavir/ritonavir therapy due to a moderate adverse drug reaction, mainly hepatic and gastrointestinal disorders. Conclusion: Patients with Covid-19 pneumonitis treated with lopinavir/ritonavir have plasma concentrations dramatically higher than expected. Owing to that high plasma concentration may be required for antiviral activity against SARS-CoV-2, it appears that lopinavir dosage should not be reduced in the absence of adverse effect. About 80% of the patients well tolerated lopinavir/ritonavir therapy under these plasma concentrations. However, cautious is necessary as drug repurposing can be associated with a new drug safety profile.


title: Effects of Government Mandated Social Distancing Measures on Cumulative Incidence of COVID-19 in the United States and its Most Populated Cities

text: COVID-19, caused by the SARS-CoV-2 virus, has quickly spread throughout the world, necessitating assessment of the most effective containment methods. Very little research exists on the effects of social distancing measures on this pandemic. The purpose of this study was to examine the effects of government implemented social distancing measures on the cumulative incidence rates of COVID-19 in the United States on a state level, and in the 25 most populated cities, while adjusting for socio-demographic risk factors. The social distancing variables assessed in this study were: days to closing of non-essential business; days to stay home orders; days to restrictions on gathering, days to restaurant closings and days to school closing. Using negative binomial regression, adjusted rate ratios and 95% confidence intervals were calculated comparing two levels of a binary variable: above median value, and median value and below for days to implementing a social distancing measure. For city level data, the effects of these social distancing variables were also assessed in high (above median value) vs low (median value and below) population density cities. For the state level analysis, days to school closing was associated with cumulative incidence, with an adjusted rate ratio of 1.59 (95% CI:1.03,2.44), p=0.04 at 35 days. Some results were counterintuitive, including inverse associations between cumulative incidence and days to closure of non-essential business and restrictions on gatherings. This finding is likely due to reverse causality, where locations with slower growth rates initially chose not to implement measures, and later implemented measures when they absolutely needed to respond to increasing rates of infection. Effects of social distancing measures seemed to vary by population density in cities. Our results suggest that the effect of social distancing measures may differ between states and cities and between locations with different population densities. States and cities need individual approaches to containment of an epidemic, with an awareness of their own structure in terms of crowding and socio-economic variables. In an effort to reduce infection rates, cities may want to implement social distancing in advance of state mandates.


title: Integrated Tool Condition Monitoring Systems and Their Applications: A Comprehensive Review

text: Abstract In conventional metal cutting, different tool wear modes, and their individual deterioration rates play vital roles in overall production performance. For a given tool (i.e., geometry or materials), many shop floors still follow a standard rule by pre-setting a tool life, which is conservative but not realistic. Premature failure of a tool can cause unexpected machine downtime and material losses, while another tool could serve beyond that pre-set life. As a result, optimized tool life and productivity cannot be achieved. Moreover, nowadays, there is an increased demand of process monitoring and optimization on the unmanned and the semi-automated shop floors. Tool condition monitoring (TCM) systems for process improvement and optimization have been in research for several decades. Both offline and online TCM systems are invented and discussed. A wide range of original publications are reported focusing on different sub-topics, e.g., specific machining process-based TCM methods, measurement or signal acquisition methods, processing methods, and classifiers. With the recent evolution of smart sensors in the era of Industry 4.0, development of online TCM systems received much attention to the researchers. Accordingly, research on some sub-topics also gets motivated into different directions, such as, feasibility of power or current sensors, machine vision technique, and combination of multi-sensors. Thus, from the industrial viewpoint, the current state of implementation of the proposed TCM systems for (near) real-time process monitoring and control needs to be clear. This paper presents the state-of-the-art of the TCM systems covering three major machining operations, discusses their application feasibility in industry environments, and states some current TCMS implementations. Challenges being faced by the industry are concluded, along with direction and suggestions for future researches.


title: Optimal control of an SIR epidemic through finite-time non-pharmaceutical intervention

text: We consider the problem of controlling an SIR-model epidemic by temporarily reducing the rate of contact within a population. The control takes the form of a multiplicative reduction in the contact rate of infectious individuals. The control is allowed to be applied only over a finite time interval, while the objective is to minimize the total number of individuals infected in the long-time limit, subject to some cost function for the control. We first consider the no-cost scenario and analytically determine the optimal control and solution. We then study solutions when a cost of intervention is included, as well as a cost associated with overwhelming the available medical resources. Examples are studied through the numerical solution of the associated Hamilton-Jacobi-Bellman equation. Finally, we provide some examples related directly to the current pandemic.


title: Ultrametric model for covid-19 dynamics: an attempt to explain slow approaching herd immunity in Sweden

text: We present a mathematical model of infection dynamics that might explain slower approaching the herd immunity during the covid-19 epidemy in Sweden than it was predicted by a variety of other models; see graphs Fig. 2. The new model takes into account the hierarchic structure of social clusters in the human society. We apply the well developed theory of random walk on the energy landscapes represented mathematically with ultrametric spaces. This theory was created for applications to spin glasses and protein dynamics. To move from one social cluster (valley) to another, the virus (its carrier) should cross a social barrier between them. The magnitude of a barrier depends on the number of social hierarchy's levels composing this barrier. As the most appropriate for the recent situation in Sweden, we consider linearly increasing (with respect to hierarchy's levels) barriers. This structure of barriers matches with a rather soft regulations imposed in Sweden in March 2020. In this model, the infection spreads rather easily inside a social cluster (say working collective), but jumps to other clusters are constrained by social barriers. This model's feature matches with the real situation during the covid-19 epidemy, with its cluster spreading structure. Clusters need not be determined solely geographically, they are based on a number of hierarchically ordered social coordinates. The model differs crucially from the standard mathematical models of spread of disease, such as the SIR-model. In particular, our model describes such a specialty of spread of covid-19 virus as the presence of "super-spreaders" who by performing a kind of random walk on a hierarchic landscape of social clusters spreads infection. In future, this model will be completed by adding the SIR-type counterpart. But, the latter is not a specialty of covid-19 spreading.


docid: znrvkmee

title: A systematic review on the levels of antibodies in COVID-19 virus exposed but negative newborns: a possible vertical transmission of IgG/ IgM

text: Background Currently, there is no doubt on human-to-human transmission of Coronavirus Disease 2019 (COVID-19). Now, the debates remain on whether, vertical transmission of Severe Respiratory Syndrome Virus 2 (SARS-CoV-2) and antibodies against the virus do exist. We therefore, conducted a systematic review to determine the immunoglobulin G and M (IgG/IgM) levels among infants born to mothers with COVID-19. Methods The systematic search was done using PubMed/MEDLINE and Google Scholar database. The research included studies on IgG/ IgM against SARS-CoV-2 among infants born to mother with COVID-19 published in English from December 1, 2019 onwards. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) guidelines. We synthesized a narrative from eligible studies and performed two tailed non-parametric Mann-Whitney test to determine and compare the median IgG/IgM levels. Results In total, 486 abstracts were screened and 63 full-text articles were assessed. Of 63 articles, 6 met the inclusion criteria for qualitative analysis. Two articles were included in quantitative analysis of anti-SARS-CoV-2 IgG/ IgM levels. The median antibody levels was 75.49AU/mL (range: 7.25AU/mL- 140.32AU/mL ) and for 3.79AU/mL (range: 0.16AU/mL-45.83AU/mL) (P = 0.0041) for anti-SARS-CoV-2 IgG and IgM, respectively. Conclusion There were high levels of IgG but low IgM against SARS-CoV-2 (using <10 AU/mL as a reference range) among COVID-19 virus exposed but negative newborns. This review suggest a possible natural passive immunity (IgG/ IgM) against COVID-19 virus.


Biovacc-19: A Candidate Vaccine for Covid-19 (SARS-CoV-2) Developed from Analysis of its General Method of Action for Infectivity


title: Estimation of COVID-19 transmission rates in California and the U.S. with reporting delays

text: We estimated time-varying reproduction numbers of COVID-19 transmission in counties and regions of California and in states of the United States, using the Wallinga-Teunis method of estimations applied to publicly available data. The serial interval distribution assumed incorporates wide uncertainty in delays from symptom onset to case reporting. This assumption contributes smoothing and a small but meaningful increase in numerical estimates of reproduction numbers due to the likely existence of secondary cases not yet reported. Transmission in many areas of the U.S. may not yet be controlled, including areas in which case counts appear to be stable or slowly declining.


title: Energy Density Comparison via Highspeed, In-situ Imaging of Directed Energy Deposition

text: Abstract Metal additive manufacturing has become an increasingly popular technology and receives interest from multiple business sectors that require optimally lightweight components and mass customization (aerospace, automotive, and medical device). Directed energy deposition (DED) is one of the main laser-based additive manufacturing processes, but a fundamental understanding of the process is lacking partly because it has not been the focus of highspeed, in-situ x-ray imaging studies like laser powder bed fusion has. A novel in-situ DED system is presented here, and an experimental study is performed to show that the small-scale system recovers processing parameter trends of a full-scale build. Observed meltpool lengths range from about 200 μm to 900 μm, while meltpool depths range from about 50 μm to 500 μm and can support high-fidelity modelling. Additionally, an investigation on the relationship between meltpool dimensions and global energy density GED' is performed. It was found that GED' is not a good predictor of meltpool dimensions due to the discrepancy in linear and exponential trends in laser powder and powder mass flowrate. Further studies and analysis using the presented novel DED system are needed to develop an appropriate energy density term to predict of meltpool dimension and clad height.


title: Synchronized travel restrictions across cities can be effective in COVID-19 control

text: Mobility control measures are of crucial importance for public health planning in combating the COVID-19 pandemic. Previous studies established the impact of population outflow from Wuhan on the spatial spread of coronavirus in China and hinted the impact of the other three mobility patterns, i.e., population outflow from Hubei province excluding Wuhan, population inflow from cities outside Hubei, and intra-city population movement. However, the overall impact of all mobility patterns, or the impact of the different timing of mobility restriction intervention, are not systematically analyzed. Here we apply the cumulative confirmed cases and mobility data of 350 Chinese cities outside Hubei to explore the relationships between all mobility patterns and epidemic spread, and estimate the impact of local travel restrictions, both in terms of level and timing, on the epidemic control based on mobility change. The relationships were identified by using Pearson correlation analysis and stepwise multivariable linear regression, while scenario simulation was used to estimate the mobility change caused by local travel restrictions. Our analysis shows that: (1) all mobility patterns correlated with the spread of the coronavirus in Chinese cities outside Hubei, while the corrleations droppd with the implemetation of travel restrictions; (2) the cumulative confirmed cases in two weeks after the Wuhan lockdown was mainly brought by three patterns of inter-city population movement, while those in the third and fourth weeks after was significantly influenced by the number of intra-city population movement; (3) the local travel restrictions imposed by cities outside Hubei have averted 1,960 (95%PI: 1,474-2,447) more infections, taking 22.4% (95%PI: 16.8%-27.9%) of confirmed ones, in two weeks after the Wuhan lockdown, while more synchronized implementation would further decrease the number of confirmed cases in the same period by 15.7% (95%PI:15.4%-16.0%) or 1,378 (95%PI: 1,353-1,402) cases; and (4) local travel restrictions on different mobility patterns have different degrees of protection on cities with or without initial confirmed cases until the Wuhan lockdown. Our results prove the effectiveness of local travel restrictions and highlight the importance of synchronized implementation of mobility control across cities in mitigating the COVID-19 transmission.


title: COVID-19 and homelessness in England: a modelling study of theCOVID-19 pandemic among people experiencing homelessness, and theimpact of a residential intervention to isolate vulnerable people andcare for people with symptoms

text: Background: There is an ongoing pandemic of the viral respiratory disease COVID-19. People experiencing homelessness are vulnerable to infection and severe disease. Health and housing authorities in England have developed a residential intervention that aims to isolate those vulnerable to severe disease (COVID-PROTECT) and care for people with symptoms (COVID CARE). Methods: We used a discrete-time Markov chain model to forecast COVID-19 infections among people experiencing homelessness, given strong containment measures in the general population and some transmission among 35,817 people living in 1,065 hostels, and 11,748 people sleeping rough (the 'do nothing' scenario). We then estimated demand for beds if those eligible are offered COVID-PROTECT and COVID-CARE. We estimated the reduction in the number of COVID-19 cases, deaths, and hospital admissions that could be achieved by these interventions. We also conducted sensitivity and scenario analyses to identify programme success factors. Results: In a 'do nothing' scenario, we estimate that 34% of the homeless population could get COVID-19 between March and August 2020, with 364 deaths, 4,074 hospital admissions and 572 critical care admissions. In our 'base intervention' scenario, demand for COVID-PROTECT peaks at 9,934 beds, and demand for COVID-CARE peaks at 1,366 beds. The intervention could reduce transmission by removing symptomatic individuals from the community, and preventing vulnerable individuals from being infected. This could lead to a reduction of 164 deaths, 2,624 hospital admissions, and 248 critical care admissions over this period. Sensitivity analyses showed that the number of deaths is sensitive to transmission of COVID-19 in COVID-PROTECT. If COVID-PROTECT capacity is limited, scenario analyses show the benefit of prioritising people who are vulnerable to severe disease. Conclusion: Supportive accommodation can mitigate the impact of the COVID-19 pandemic on the homeless population of England, and reduce the burden on acute hospitals.


title: Can we use these masks? Rapid Assessment of the Inhalation Resistance Performance of Uncertified Medical Face Masks in the Context of Restricted Resources Imposed during a Public Health Emergency

text: In the case of a public health emergency such as the COVID-19 pandemic, access to large quantities of appropriate personal protection equipment (PPE) has presented a significant problem. A shortage of face masks and respirators has been widely reported across the world. A concerted effort to manufacture high volumes has not unsurprisingly put pressure on the supply chain and the important certification processes. PPE procured or donated as uncertified stock requires rigorous, expedient and scientifically informed evidence before decisions can be made regarding suitable deployment, expensive certification, return or possible destruction of stock. This paper reports a series of experiments devised in reaction to this situation. In this study, an experimental methodology for the assessment of the filtration performance of samples of real-world, uncertified, fluid resistant surgical masks (FRSM type IIR) was evaluated in the resource limited (lockdown) environment of the COVID-19 pandemic. A steady-state flow rig was adapted to incorporate a bespoke filter flow chamber for mounting face masks in order to evaluate the resistance to air flow as an indicator of mask inhalation performance. Pure air was drawn through a specified control surface area at known flow rate conditions; the resistance to the air flow through the masks was measured as the resulting pressure drop. Over 60 tests were performed from 4 different, randomly sampled batches and compared to a control sample of EN Type IIR certified FRSM masks. Steady-state volumetric airflow rates of 30 and 95 lmin-1 were chosen to represent deep breathing and vigorous exercise conditions respectively. The results showed that the sample masks produced a pressure drop of between 26% to 58% compared to the control batch at the lower flow rate and 22% to 55% at the higher rate. The results for each sample were consistent across both flow rates. Within the group of masks tested, two sets (between 48% and 58% of the reference set) showed the potential to be professionally assessed for appropriate deployment in a suitable setting. Although the absolute values of pressure drop measured by this method are unlikely to correlate with other testing approaches, the observed, indicative trends and relative performance of the masks is key to this approach. Critically, this method does not replace certification but it has enabled a public body to quickly make decisions; certify, re-assign, refund, thus saving time and resources. The total time spent conducting the tests was less than 8 hours and the low cost method proposed can be repurposed for low resource regions.


title: Associations between wearing masks, washing hands, and social distancing practices, and risk of COVID-19 infection in public: a cohort-based case-control study in Thailand

text: Objective. To investigate whether wearing masks, washing hands and social distancing practices are associated with lower risk of COVID-19 infection. Design. A retrospective cohort-based case-control study. All participants were retrospectively interviewed by phone about their preventive measures against COVID-19 infection. Setting. Thailand, using the data from contact tracing of COVID-19 patients associated with nightclub, boxing stadium and state enterprise office clusters from the Surveillance Rapid Response Team, Department of Disease Control, Ministry of Public Health. Contacts were tested for COVID-19 using PCR assays per national contact tracing guidelines. Participants. A cohort of 1,050 asymptomatic contacts of COVID-19 patients between 1 and 31 March 2020. Main outcome measures. Diagnosis of COVID-19 by 21 April 2020. Odds ratios for COVID-19 infection and population attributable fraction were calculated. Exposure. The study team retrospectively asked about wearing masks, washing hands, and social distancing practices during the contact period through telephone interviews. Results. Overall, 211 (20%) were diagnosed with COVID-19 by 21 Apr 2020 (case group) while 839 (80%) were not (control group). Fourteen percent of cases (29/210) and 24% of controls (198/823) reported wearing either non-medical or medical masks all the time during the contact period. Wearing masks all the time (adjusted odds ratio [aOR] 0.23; 95%CI 0.09-0.60) was associated with lower risk of COVID-19 infections compared to not wearing masks, while wearing masks sometimes (aOR 0.87; 95%CI 0.41-1.84) was not. Shortest distance of contact >1 meter (aOR 0.15; 95%CI 0.04-0.63), duration of close contact [≤]15 minutes (aOR 0.24; 95%CI 0.07-0.90) and washing hands often (aOR 0.33; 95%CI 0.13-0.87) were significantly associated with lower risk of infection. Sharing a cigarette (aOR 3.47; 95%CI 1.09-11.02) was associated with higher risk of infection. Type of mask was not independently associated with risk of infection. Those who wore masks all the time were more likely to wash hands and practice social distancing. We estimated that if everyone wore a mask all the time, washed hands often, did not share a dish, cup or cigarette, had shortest distance of contact >1 meter and had duration of close contact [≤]15 minutes, cases would have been reduced by 84%. Conclusions. Our findings support consistently wearing non-medical masks, washing hands, and social distancing in public to prevent COVID-19 infections.


title: Coronavirus and birth in Italy: results of a national population-based cohort study

text: Introduction The study was implemented to provide guidance to decision makers and clinicians by describing hospital care offered to women who gave birth with confirmed COVID 19 infection. Materials and methods National population based prospective cohort study involving all women with confirmed COVID 19 who gave birth between February 25 and April 22, 2020 in any Italian hospital. Results The incidence rate of confirmed SARS-CoV-2 infection in women who gave birth was 2.1 per 1000 maternities at a national level and 6.9/1000 in the Lombardy Region. Overall one third of the women developed a pneumonia and 49.7% assumed at least one drug. Caesarean section rate was 32.9%, no mothers nor newborns died. Six percent of the infants tested positive for SARS CoV 2 at birth. Conclusions Clinical features and outcomes of COVID 19 in women who gave birth are similar to those described for the general population, most women developing mild to moderate illness.


title: Higher Education Institutions in Ukraine during the Coronavirus, or COVID-19, Outbreak: New Challenges vs New Opportunities

text: In a matter of weeks the coronavirus (COVID-19) pandemic has changed students' way of learning across the globe These changes let us envisage how education can modify for better or otherwise for worse over the long term COVID-19 2019/2020 has encouraged Higher Education Institutions in Ukraine to make innovative decisions in a relatively short period of time To provide distance education in Ukrainian universities during the quarantine there have been introduced offline and online courses through various web servers, platforms, resources, and social media: Moodle, Zoom, Skype, Viber, Telegram, Messenger, Google-class etc The summarized results of the questionnaire among Ukrainian students provided an opportunity to identify difficulties and benefits of introduced distance-learning The sources to provide the information for this work included regulations issued by public authorities in Ukraine (Head of State, executive and legislative bodies) as well as directives to administrations of Ukrainian higher education institutions


title: SARS-CoV-2 IgG Antibody Responses in New York City

text: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a strain of coronavirus that causes coronavirus disease 2019 (Covid-19) and has been declared a global pandemic by the World Health Organization. Total cases of SARS-CoV-2 worldwide exceed 4.8 million, with over 320,000 deaths recorded. Little is known about the body's immune response to SARS-CoV-2 infection. In this paper, we describe SARS-CoV-2 IgG antibody responses in 11,092 patients from the New York City metropolitan area and report a SARS-CoV-2 IgG positivity rate of nearly 50%, indicating the widespread nature of the pandemic in the city and state of New York. Additionally, we report on the correlation between SARS-CoV-2 patient symptom severity and level of SARS-CoV-2 IgG antibody found in the patient sample.


title: Expanding Covid-19 Testing: Mathematical Guidelines for the Optimal Sample Pool Size Given Positive Test Rate

text: Widespread testing is essential to the mitigation of the spread of any virus, and is particularly central to the discussion on transitioning out of national quarantine. Sample pooling is a method that aims to multiply testing capability by using one testing kit for multiple samples, but will only be successful under certain conditions. This paper gives precise guidelines on those conditions for success: for any proposed sample pool size, explicit bounds on the positive infection rate are given that are informed by both discrete and statistical modeling.


title: The impact of COVID-19 on fieldwork efforts and planning in pairfam and FReDA-GGS

text: The worldwide spread of the COVID-19 pandemic has disrupted the fieldwork of surveys. The data collection efforts via the face-to-face mode have been affected especially, including the ongoing surveys that were in the field during the COVID-19 outbreak and the planned surveys scheduled for fieldwork later in 2020. We provide an account of how COVID-19 has impacted two family studies in Germany: “The German Family Panel” (pairfam) and the “Generations and Gender Survey” (GGS) both of which will be part of the “Family Research and Demographic Analysis” (FReDA) infrastructure. Based on pairfam, we illustrate the effects of the pandemic on ongoing data collection and the measures taken to proceed with fieldwork, and we report on a special COVID-19 survey. Based on FReDA-GGS, we outline how COVID-19 has affected our planned survey schedules, what future challenges are expected when fieldwork becomes possible again, and how we have adapted our plans accordingly.


title: COVID-19 In Shang Hai: It is Worth Learning from the Successful Experience in Preventing and Controlling the Overseas Epidemic Situation

text: COVID-19 first appeared in Wuhan, Hubei Province,China in late December 2019 and spread rapidly in China. Currently, the spread of local epidemics has been basically blocked. The import of overseas epidemics has become the main form of growth in China's new epidemic. As an important international transportation hub in China, Shanghai is one of the regions with the highest risk of imported cases abroad. Due to imported of overseas cases are affected by the international epidemic trend. The traditional infectious disease model is difficult to accurately predict the cumulative trend of cumulative cases in the Shanghai areas. It is also difficult to accurately evaluate the effectiveness of the international traffic blockade. In this situation, this study takes Shanghai as an example to propose a new type of infectious disease prediction model. The model first uses the sparse graph model to analyze the international epidemic spread network to find countries and regions related to Shanghai. Next, multiple regression models were used to fit the existing COV-19 growth data in Shanghai. Finally, the model can predict the growth curve of Shanghai's epidemic without blocking traffic. The results show that the control measures taken by Shanghai are very effective. At present, more and more countries and regions will face the current situation in Shanghai. We recommend that other countries and regions learn from Shanghai's successful experience in preventing overseas imports in order to fully prepare for epidemic prevention and control.


title: Regulating wildlife conservation and food safety to prevent human exposure to novel virus

text: Epidemiological investigation suggested that the current outbreak of COVID-19 virus was associated with a seafood market, and COVID-19 has been identified a probable bat origin. Similar to SARS event in 2003, such a zoonotic disease showed an animal-to-person and even more serious person-to-person spread, and posed a significant threat to the global health and socio-economic development. We analyzed the association of both outbreaks with wildlife diet in China and proposed suggestions for regulating wildlife conservation and food safety to prevent human exposure to the novel virus, including increasing social awareness of hazards in eating wild animals, strengthening legislation on eating and trading of wild animals, improving the standards for food safety, and establishing market supervision mechanism. Regulatory intervention is not only critical for China but also for other countries where wildlife hunting is prevalent to prevent from novel virus exposures.


title: Exploring the spread dynamics of COVID-19 inMorocco

text: Despite some similarities of the dynamic of COVID-19 spread in Morocco and other countries, the infection, recovery and death rates remain very variable. In this paper, we analyze the spread dynamics of COVID-19 in Morocco within a standard susceptible-exposed-infected-recovered-death (SEIRD) model. We have combined SEIRD model with a time-dependent infection rate function, to fit the real data of i) infection counts and ii) death rates due to COVID-19, for the period between March 2nd and Mai 15th 2020. By fitting the infection rate, SEIRD model placed the infection peak on 04/24/2020 and could reproduce it to a large extent on the expense of recovery and death rates. Fitting the SEIRD model to death rates gives rather satisfactory predictions with a maximum of infections on 04/06/2020. Regardless of the low peak position, the peak position, confirmed cases and transmission rate were well reproduced.


title: Evolution of COVID-19 Pandemic in India

text: A mathematical analysis of patterns for the evolution of COVID-19 cases is key to the development of reliable and robust predictive models potentially leading to efficient and effective governance against COVID-19. Towards this objective, we study and analyze the temporal growth pattern of COVID-19 infection and death counts in various states of India. Our analysis up to June 16, 2020 shows that several states (namely Maharashtra, Tamil Nadu, Delhi, Uttar Pradesh) have reached t-squared power-law growth, while some others like Gujarat, Rajasthan, and Madhya Pradesh have reached linear growth. Karnataka and Kerala are exhibiting a second wave. In addition, we report that the death counts exhibit similar behavior as the infection counts. These observations indicate that Indian states are far from flattening their epidemic curves.


title: Canadian banks’ responses to COVID-19: a strategic positioning analysis

text: The Canadian banking system is among the best in the world. Amid the COVID-19 pandemic, the world is challenged and banks are expected to rescue society. Businesses are revising, repurposing, and reinventing their products and services to address people’s needs. In this context, this article seeks to understand how Canada’s banks are supporting their clients and communities, during the current health crisis. Content analysis was conducted to analyse Canada’s ten largest banks’ supporting actions towards the pandemic, leading to 125 documents and 19 different actions consulted. Based on the data, a combination of hierarchical clustering and multidimensional scaling was conducted. Following a CSR approach, three clusters of banks are identified: sweeping actions, cautious actions, and wait & see, highlighting that while most banks are doing little to help their stakeholders, three of them have a proactive and strong commitment to their clients and communities in these times of need.


title: Measure what matters: counts of hospitalized patients are a better metric for health system capacity planning for a reopening

text: Responding to the COVID-19 pandemic requires accurate forecasting of health system capacity requirements using readily available inputs. We examined whether testing and hospitalization data could help quantify the anticipated burden on the health system given shelter-in-place (SIP) order. We find a marked slowdown in the hospitalization rate within ten days of SIP even as cases continued to rise. We also find a shift towards younger patients in the age distribution of those testing positive for COVID-19 over the four weeks of SIP. The impact of this shift is a divergence between increasing positive case confirmations and slowing new hospitalizations, both of which affects the demand on health systems. Without using local hospitalization rates and the age distribution of positive patients, current models are likely to overestimate the resource burden of COVID-19. It is imperative that health systems start using these data to quantify effects of SIP and aid reopening planning.


title: Severe Acute Respiratory Syndrome Coronavirus Induces Differential Host Gene Expression Responses Associated with Pathogenesis

text: Abstract The newly emerging severe acute respiratory syndrome coronavirus (SARS-CoV) exhibits unique characteristics with respect to its molecular biology, replication, transcription and assembly Several cell types including Vero E6 cells are permissive for SARS-CoV replication with resultant cytopathic effects Microarray analyses have elucidated the cellular expression patterns of human genes in response to SARS-CoV infection These studies have revealed alterations in the transcription and translation of genes belonging to various functional groups including cell cycle, apoptosis, signal transduction, transcriptional regulation, host translation, protein modulators, protein trafficking, cytoskeletal network, cellular metabolism, and antiviral resistance There is significant induction of heat shock proteins that are crucial to the immune response mechanism Specific immune-related genes are upregulated, coinciding with the high cytokine profiles in SARS patients which incite proinflammatory responses Modified levels of transcripts mediating proinflammatory and anti-inflammatory processes illustrate the balance between opposing forces during SARS pathogenesis Another interesting phenomenon is the differential expression of genes that support both anti-apoptotic and proapoptotic processes Thus, anti-apoptotic mechanisms facilitate the initial viral multiplication, whereas at later infection phase, apoptosis results in cell lysis to release viral progeny Transcriptomic and proteomic analyses provide new insights into the host-pathogen interactions and pathophysiology of SARS-CoV infection These critical interactions involve an elaborate interplay between various mechanisms to favor virus propagation before frank apoptosis and the triggering of specific pathways in host cells that attempt to eliminate the pathogen


title: Regaining perspective on SARS-CoV-2 molecular tracing and its implications

text: During the past three months, a new coronavirus (SARS-CoV-2) epidemic has been growing exponentially, affecting over 100 thousand people worldwide, and causing enormous distress to economies and societies of affected countries. A plethora of analyses based on viral sequences has already been published, in scientific journals as well as through non-peer reviewed channels, to investigate SARS-CoV-2 genetic heterogeneity and spatiotemporal dissemination. We examined all full genome sequences currently available to assess the presence of sufficient information for reliable phylogenetic and phylogeographic studies. Our analysis clearly shows severe limitations in the present data, in light of which any finding should be considered, at the very best, preliminary and hypothesis-generating. Hence the need for avoiding stigmatization based on partial information, and for continuing concerted efforts to increase number and quality of the sequences required for robust tracing of the epidemic.


docid: bxzprauu

title: COVID-19 in Wuhan: Immediate Psychological Impact on 5062 Health Workers

text: BACKGROUND: The outbreak of COVID-19 has laid unprecedented psychological stress on health workers (HWs). We aimed to assess the immediate psychological impact on HWs at Tongji Hospital in Wuhan, China. METHODS: We conducted a single-center, cross-sectional survey of HWs via online questionnaires between February 8th and 10th, 2020. We evaluated stress, depression and anxiety by Impact of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder 7-item (GAD-7), respectively. We also designed a questionnaire to assess the effect of psychological protective measures taken by Tongji Hospital. Multivariate logistic regression was used to identify predictors of acute stress, depression, and anxiety. RESULTS: We received 5062 completed questionnaires (response rate, 77.1 percent). 1509 (29.8 percent), 681 (13.5 percent) and 1218 (24.1 percent) HWs reported stress, depression and anxiety symptoms. Women (hazard ratio[HR], 1.31; P=0.032), years of working> 10 years (HR, 2.02; P<0.001), concomitant chronic diseases (HR, 1.51; P<0.001), history of mental disorders (HR, 3.27; P<0.001), and family members or relatives confirmed or suspected (HR, 1.23; P=0.030) were risk factors for stress, whereas care provided by hospital and department administrators(odds ratio [OR], 0.76; P=0.024) and full coverage of all departments with protective measures (OR, 0.69; P=0.004) were protective factors. CONCLUSIONS: Women and those who have more than 10 years of working, concomitant chronic diseases, history of mental disorders, and family members or relatives confirmed or suspected are susceptible to stress, depression and anxiety among HWs during the COVID-19 pandemic. Psychological protective measures implemented by the hospital could be helpful.


title: Lack of Antiviral Activity of Darunavir against SARS-CoV-2

text: Given the high need and the absence of specific antivirals for treatment of COVID-19 (the disease caused by severe acute respiratory syndrome-associated coronavirus-2 [SARS-CoV-2]), human immunodeficiency virus (HIV) protease inhibitors are being considered as therapeutic alternatives. Prezcobix/Rezolsta is a fixed-dose combination of 800 mg of the HIV protease inhibitor darunavir (DRV) and 150 mg cobicistat, a CYP3A4 inhibitor, which is indicated in combination with other antiretroviral agents for the treatment of HIV infection. There are currently no definitive data on the safety and efficacy of DRV/cobicistat for treatment of COVID-19. The in vitro antiviral activity of darunavir against a clinical isolate from a patient infected with SARS-CoV-2 was assessed. DRV showed no activity against SARS-CoV-2 at clinically relevant concentrations (EC50 >100 μM). Remdesivir, used as a positive control, showed potent antiviral activity (EC50 = 0.38 μM). Overall, the data do not support the use of DRV for treatment of COVID-19.


title: An SEIARD epidemic model for COVID-19 in Mexico: mathematical analysis and state-level forecast

text: We propose an SEIARD mathematical model to investigate the current outbreak of coronavirus disease (COVID-19) in Mexico. Our model incorporates the asymptomatic infected individuals, who represent the majority of the infected population (with symptoms or not) and could play an important role in spreading the virus without any knowledge. We calculate the basic reproduction number (R0) via the next-generation matrix method and estimate the per day infection, death and recovery rates. The local stability of the disease free equilibrium is established in terms of R0. A sensibility analysis is performed to determine the relative importance of the model parameters to the disease transmission. We calibrate the parameters of the SEIARD model to the reported number of infected cases and fatalities for several states in Mexico by minimizing the sum of squared errors and attempt to forecast the evolution of the outbreak until August 2020.


title: Characterization of a novel, low-cost, scalable ozone gas system for sterilization of N95 respirators and other COVID-19 related use cases.

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an elusive and highly pathogenic agent, has resulted in the ongoing COVID-19 pandemic affecting numerous populations worldwide. New studies investigating the tenacity of SARS-CoV-2 have highlighted its ability to persist on a myriad of surfaces for several days, including gowns and shoes. As a result, there is a global need for sterilization of a variety of potentially-contaminated items, ranging from clothing to personal protective equipment like face coverings. To this end, we have designed and constructed a cost-effective, scalable, and sustainable sterilization system that uses ozone gas to inactivate viral particles. We sought to determine the efficacy of the system in the sterilization of viral particles as well as its ability to sterilize N95 respirators for reuse. N95 respirators inoculated with P22 bacteriophage and sterilized in the ozone system showed a 6-log10 reduction in viral load when treated at 25 ppm for 150 minutes. Further, N95 respirators treated with five 150-minute cycles at 35 ppm for a total concentration-time product (CT) of 26,250 ppm*min in the ozone system showed comparable filtration efficiency to untreated N95 respirators in a 50 to 200 nmr particulate challenge filtration test. Interestingly, the surgical N95 respirators tested showed complete inactivation of fluid resistance and degradation of the elasticity of polyisoprene straps after five cycles in the sterilization system. Taken together, these data suggest that while our ozone system may negatively affect certain protective aspects of surgical N95 respirators, it does effectively sterilize viral particles and can be utilized for a multitude of other use cases, including sterilizing polypropylene face coverings after potential SARS-CoV-2 contamination. In addition to providing long-term environmental benefits, deployment of this system during the ongoing pandemic reduces the risk of COVID-19 community transmission while conserving monetary resources otherwise spent on the continuous purchase of disposable face coverings.


title: A prediction model based on machine learning for diagnosing the early COVID-19 patients

text: With the dramatically fast spread of COVID-9, real-time reverse transcription polymerase chain reaction (RT-PCR) test has become the gold standard method for confirmation of COVID-19 infection. However, RT-PCR tests are complicated in operation andIt usually takes 5-6 hours or even longer to get the result. Additionally, due to the low virus loads in early COVID-19 patients, RT-PCR tests display false negative results in a number of cases. Analyzing complex medical datasets based on machine learning provides health care workers excellent opportunities for developing a simple and efficient COVID-19 diagnostic system. This paper aims at extracting risk factors from clinical data of early COVID-19 infected patients and utilizing four types of traditional machine learning approaches including logistic regression(LR), support vector machine(SVM), decision tree(DT), random forest(RF) and a deep learning-based method for diagnosis of early COVID-19. The results show that the LR predictive model presents a higher specificity rate of 0.95, an area under the receiver operating curve (AUC) of 0.971 and an improved sensitivity rate of 0.82, which makes it optimal for the screening of early COVID-19 infection. We also perform the verification for generality of the best model (LR predictive model) among Zhejiang population, and analyze the contribution of the factors to the predictive models. Our manuscript describes and highlights the ability of machine learning methods for improving the accuracy and timeliness of early COVID-19 infection diagnosis. The higher AUC of our LR-base predictive model makes it a more conducive method for assisting COVID-19 diagnosis. The optimal model has been encapsulated as a mobile application (APP) and implemented in some hospitals in Zhejiang Province.


title: Comparison of the COVID-19 infection risks by close contact and aerosol transmission

text: A comprehensive understanding of the transmission routes of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of great importance for the effective control of the spread of Corona Virus Disease 2019 (COVID-19). Human-to-human transmission by close contact where large respiratory droplets play a significant role has been established as the main transmission route. At the same time the transmission by small aerosol is getting increasing attention. There is no distinct boundary between droplets and aerosol in nature so it is natural to investigate the infection risk due to aerosol. Here, we utilized a newly developed dose-response relation, combined with a box model for the exposure estimation, to quantitatively evaluate the infection risk of SARS-CoV-2 through aerosol transmission and compared with the risk due to close contact. The results indicated that the median infection risk via aerosol transmission was about 3.7x10-5 (95% confidence interval: 3.5x10-6 to 4.4x10-4) for one hour of exposure in a room with the size of 10 m (width)x10 m (length)x3 m (height) with one infected individual in it. The risk was more than three orders of magnitude lower than the risk at short distance, about 12.8% within 1 m, based on a meta-analysis. A simple exponential regression model Risk=10-0.90xD+0.10 (D<=5 m) could be utilized to characterize the magnitude of infection risk in the considered scenario based on the distance D from the infected individual. With prolonged exposure duration and large exposed population, the infection caused by aerosol transmission could be considerable, thus it is necessary to be cautious for the potential aerosol transmission risk in such situations.


docid: ahpkmffy

title: SARS-CoV-2 launches a unique transcriptional signature from in vitro, ex vivo, and in vivo systems

text: One of the greatest threats to humanity is the emergence of a pandemic virus. Among those with the greatest potential for such an event include influenza viruses and coronaviruses. In the last century alone, we have observed four major influenza A virus pandemics as well as the emergence of three highly pathogenic coronaviruses including SARS-CoV-2, the causative agent of the ongoing COVID-19 pandemic. As no effective antiviral treatments or vaccines are presently available against SARS-CoV-2, it is important to understand the host response to this virus as this may guide the efforts in development towards novel therapeutics. Here, we offer the first in-depth characterization of the host transcriptional response to SARS-CoV-2 and other respiratory infections through in vitro, ex vivo, and in vivo model systems. Our data demonstrate the each virus elicits both core antiviral components as well as unique transcriptional footprints. Compared to the response to influenza A virus and respiratory syncytial virus, SARS-CoV-2 elicits a muted response that lacks robust induction of a subset of cytokines including the Type I and Type III interferons as well as a numerous chemokines. Taken together, these data suggest that the unique transcriptional signature of this virus may be responsible for the development of COVID-19.


title: Global and local mobility as a barometer for COVID-19 dynamics

text: The spreading of infectious diseases including COVID-19 depends on human interactions. In an environment where behavioral patterns and physical contacts are constantly evolving according to new governmental regulations, measuring these interactions is a major challenge. Mobility has emerged as an indicator for human activity and, implicitly, for human interactions. Here we study the coupling between mobility and COVID-19 dynamics and show that variations in global air traffic and local car traffic mobility can be used to stratify different disease phases. Our study shows that, for 26 European countries, maximal correlation between driving mobility and disease dynamics follows a normal distribution with a 17-day mean and two-day standard deviation. Our findings suggests that local mobility can serve as a quantitative metric to forecast future reproduction numbers and identify the final stages of the pandemic when mobility and reproduction become decorrelated.


title: A path towards SARS-CoV-2 attenuation: metabolic pressure on CTP synthesis rules the virus evolution

text: Fighting the COVID-19 epidemic summons deep understanding of the way SARS-CoV-2 taps into its host cell metabolic resources. We describe here the singular metabolic background that creates a bottleneck constraining coronaviruses to evolve towards likely attenuation in the long term. Cytidine triphosphate (CTP) is at the crossroad of the biosynthetic processes that allow the virus to multiply. This is because CTP is in demand for three essential steps. It is a building block of the virus genome, it is required for synthesis of the cytosine-based liponucleotide precursors of the viral envelope and, finally, it is a critical building block of the host transfer RNAs synthesis. The CCA 3’-end of all the transfer RNAs required to translate the RNA genome and further transcripts into the proteins used to build active virus copies is not coded in the human genome. It must be synthesized de novo from CTP and ATP. Furthermore, intermediary metabolism is built on compulsory steps of synthesis and salvage of cytosine-based metabolites via uridine triphosphate (UTP) that keep limiting CTP availability. As a consequence, accidental replication errors tend to replace cytosine by uracil in the genome, unless recombination events allow the sequence to return to its ancestral sequences. We document some of the consequences of this situation in the function of viral proteins. We also highlight and provide a raison d’être to viperin, an enzyme of innate antiviral immunity, which synthesizes 3’-deoxy-3′,4’-didehydro-CTP (ddhCTP) as an extremely efficient antiviral nucleotide.


title: Considerations about Non-Metastatic Bladder Cancer Management during the COVID-19 Pandemic

text: Bladder cancer is the sixth most common malignancy in the United States and is associated with high morbidity and mortality rates To date, no guidelines have been published that clearly establish bladder cancer management recommendations during the COVID-19 pandemic In this short commentary, we strive to outline recommendations for treatment of both muscle invasive and non-muscle invasive disease based on data from various trials and prior studies while taking into account the potential lack of hospital resources available to physicians depending on their practice location Copyright © 2020 - IOS Press and the authors All rights reserved


title: Epidemiological model with anomalous kinetics - The Covid-19 pandemics

text: We generalize the phenomenological, law of mass action-like, SIR and SEIR epidemiological models to situations with anomalous kinetics. Specifically, the contagion and removal terms, normally linear in the fraction $I$ of infecteds, are taken to depend on $I^{,q_{up}}$ and $I^{,q_{down}}$, respectively. These dependencies can be understood as highly reduced effective descriptions of contagion via anomalous diffusion of susceptibles and infecteds in fractal geometries, and removal (i.e., recovery or death) via complex mechanisms leading to slowly decaying removal-time distributions. We obtain rather convincing fits to time series for both active cases and mortality with the same values of $(q_{up},q_{down})$ for a given country, suggesting that such aspects may in fact be present in the evolution of the Covid-19 pandemic. We also obtain approximate values for the effective population $N_{eff}$, which turns out to be a small percentage of the entire population $N$ for each country.


title: Pharmacovigilance and protective medication for drug-induced liver injury in treatment of COVID-19/ 注重新型冠状病毒肺炎（COVID-19）治疗中药物性肝损伤的预警与保护

text: The outbreak of COVID-19 coronavirus pneumonia in December 2019 has aroused great concern worldwide. At present, the COVID-19 coronavirus pneumonia is highly contagious, rapid and widespread. It has been reported that COVID-19 virus is spread by respiratory droplets and direct contact transmission, and it has various clinical manifestations and recurrent is common. Some patients do not even appear obvious fever and have negative results for throat swab virus culture at the onset of the disease, but the rapid deterioration in their clinical condition usually occurred, which bring difficulties to scientific diagnosis and treatment. At present, western medicine treats most patients with anti-viral drugs, hormones and other drugs, or treats critically ill patients with ECMO oxygenation, important organ function support and other emergency treatments. Traditional Chinese medicine (TCM) based on syndrome differentiation and treatment has obtained curative effects in this outbreak. In order to improve the effects and safety of Chinese and western drug therapy, we applied literature-mining method and network pharmacology, summarized the potential liver injury during the application of western medicine and discussed hepatotoxicity networks and potential pathway targets of ingredients in Chinese patent medicine and Chinese herbal compound. This study not only summarizes essential information regarding potential drug-induced liver injury and biomarkers for pharmacovigilance, but also provides insights for liver protection by TCM or TCM in combination with western medicine in the treatment of novel coronavirus.


title: Role of the Eye in Transmitting Human Coronavirus: What We Know and What We Do Not Know

text: The outbreak of the current 2019 novel coronavirus (2019-nCoV, now named SARS-CoV-2) infection has become a worldwide health threat. Currently, more information is needed so as to further understand the transmission and clinical characteristics of 2019-nCoV infection and the infection control procedures required. Recently, the role of the eye in transmitting 2019-nCoV has been intensively discussed. Previous investigations of other highly infectious human CoVs, that is, severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), may provide useful information. In this review, we describe the genomics and morphology of human CoVs, the epidemiology, systemic and ophthalmic manifestations, and mechanisms of human CoV infection, and recommendations for infection control procedures. The role of the eye in the transmission of 2019-nCoV is discussed in detail. Although the conjunctiva is directly exposed to extraocular pathogens, and the mucosa of the ocular surface and upper respiratory tract are connected by the nasolacrimal duct and share the same entry receptors for some respiratory viruses, the eye is rarely involved in human CoV infection, conjunctivitis is quite rare in patients with 2019-nCoV infection, and the CoV RNA positive rate by RT-PCR test in tears and conjunctival secretions from patients with 2019-nCoV and SARS-CoV infection is also extremely low. This suggests that the eye is neither a preferred organ of human CoV infection nor a preferred gateway of entry for human CoVs for infecting the respiratory tract. However, pathogens that the ocular surface is exposed to might be transported to nasal and nasopharyngeal mucosa by constant tear rinsing through the lacrimal duct system and then cause respiratory tract infection. Considering that close doctor-patient contact is quite common in ophthalmic practice and is apt to transmit human CoVs by droplets and fomites, strict hand hygiene and proper personal protection are highly recommended for health care workers to avoid hospital-related viral transmission during ophthalmic practice.


docid: pxcjiqlm

title: Modeling quantitative traits for COVID-19 case reports

text: Medical practitioners record the condition status of a patient through qualitative and quantitative observations. The measurement of vital signs and molecular parameters in the clinics gives a complementary description of abnormal phenotypes associated with the progression of a disease. The Clinical Measurement Ontology (CMO) is used to standardize annotations of these measurable traits. However, researchers have no way to describe how these quantitative traits relate to phenotype concepts in a machine-readable manner. Using the WHO clinical case report form standard for the COVID-19 pandemic, we modeled quantitative traits and developed OWL axioms to formally relate clinical measurement terms with anatomical, biomolecular entities and phenotypes annotated with the Uber-anatomy ontology (Uberon), Chemical Entities of Biological Interest (ChEBI) and the Phenotype and Trait Ontology (PATO) biomedical ontologies. The formal description of these relations allows interoperability between clinical and biological descriptions, and facilitates automated reasoning for analysis of patterns over quantitative and qualitative biomedical observations.


title: A geospatial infodemic: Mapping Twitter conspiracy theories of COVID-19

text: Conspiracy theories have proliferated during the COVID-19 pandemic to provide an explanation for uncontrollable circumstances. Most conspiratorial explanations often ascribe disease to foreigners or as a result of deliberate actions. Through mapping retweets that attribute COVID-19 to a bioweapon or a lab in China, I examine the geography behind a metonymic conspiracy theory.


docid: nudnjnkw

title: Comparison of Mental Health Symptoms Prior to and During COVID-19 among Patients with Systemic Sclerosis from Four Countries: A Scleroderma Patient-centered Intervention Network (SPIN) Cohort Study

text: Background: No studies have reported comparisons of mental health symptoms prior to and during COVID-19 in vulnerable populations. Objectives were to compare anxiety and depression symptoms among people with a pre-existing medical condition, the autoimmune disease systemic sclerosis (SSc; scleroderma), including continuous change scores, proportion with change [≥] 1 minimal clinically important difference (MCID), and factors associated with changes, including country. Methods: Pre-COVID-19 Scleroderma Patient-centered Intervention Network Cohort data were linked to COVID-19 data collected April 9 to April 27, 2020. Anxiety symptoms were assessed with the PROMIS Anxiety 4a v1.0 scale (MCID = 4 points) and depression symptoms with the Patient Health Questionnaire-8 (MCID = 3 points). Multiple linear and logistic regression were used to assess factors associated with continuous change and change [≥] 1 MCID. Findings: Among 435 participants (Canada = 98; France = 159; United Kingdom = 50; United States = 128), mean anxiety symptoms increased 4.9 points (95% confidence interval [CI] 4.0 to 5.7). Depression symptom change was negligible (0.3 points; 95% CI -0.7 to 0.2). Compared to France, adjusted scores from the United States and United Kingdom were 3.8 points (95% CI 1.7 to 5.9) and 2.9 points higher (95% CI 0.0 to 5.7); scores for Canada were not significantly different. Odds of increasing by [≥] 1 MCID were twice as high for the United Kingdom (2.0, 95% CI 1.0 to 4.2) and United States (1.9, 95% CI 1.1 to 3.2). Participants who used mental health services pre-COVID had adjusted increases 3.7 points (95% CI 1.7 to 5.7) less than other participants. Interpretation: Anxiety symptoms, but not depression symptoms, increased dramatically during COVID-19 among people with a pre-existing medical condition. Increase was larger in the United Kingdom and United States than in Canada and France but substantially less for people with pre-COVID-19 mental health treatment.


title: Will the coronavirus help mRNA and DNA vaccines prove their worth?

text: Biotech companies, pharma firms, universities, and government agencies are all rushing to start clinical trials of newly created gene-based vaccines for COVID-19 Developer;Technology;Phase I clinical trial Moderna and National Institutes of Health;mRNA vaccine;Began in March 2020 CanSino Biologics;Adenoviral vector vaccine;Began in March 2020 BioNTech, Shanghai Fosun Pharmaceutical, and Pfizer;mRNA vaccine;April 2020 Inovio Pharmaceuticals and Wistar Institute;DNA vaccine;April 2020 University of Oxford;Adenoviral vector vaccine;April 2020 CureVac;mRNA vaccine;By early summer Imperial College London;mRNA vaccine;Early summer Arcturus Therapeutics and Duke-NUS Medical School;mRNA vaccine;Second half of 2020 Johnson & Johnson and Biomedical Advanced Research and Development Authority;Adenoviral vector vaccine;By September Altimmune;Adenoviral vector vaccine;Q3 2020 Translate Bio and Sanofi Pasteur;mRNA vaccine;By end of 2020 eTheRNA Immunotherapies;mRNA vaccine;2021 Karolinska Institute;DNA vaccine;2021 University of Pennsylvania and Duke Human Vaccine Institute;mRNA vaccine;Unknown


title: Anaesthesia and infection control in cesarean section of pregnant women with coronavirus disease 2019 (COVID-19)

text: Background The coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China, and soon caused an ongoing pandemic globally. In this study we conducted a retrospective study to evaluate the safety and efficacy of combined spinal-epidural anaesthesia (CSEA) and infection control measures on perinatal care quality of 30 pregnant women with confirmed and suspected COVID-19. Methods Individual demographic data, clinical outcomes, laboratory investigations of pregnant women and their newborns were collected from electronic medical records of the Maternal and Children Health Hospital of Hubei Province, during January 24 to February 29, 2020. Anaesthesia and surgery results were compared between pregnant women with confirmed and suspected COVID-19 infection. Results Using CSEA in cesarean section was effective and safe for pregnant women with confirmed and suspected COVID-19 infection. Administration of dezocine and morphine was effective as postoperative analgesia, and well tolerated in COVID-19 patients. The assessment of surgery outcomes also showed similar results in both confirmed and suspected cases. No respiratory failure nor distress were found in the mothers with confirmed COVID-19 infection and their neonates. None of these patients experienced severe obstetric complications related to anaesthesia and surgeries. No COVID-19 infection was reported in the neonates born to the mothers with confirmed COVID-19 infection and healthcare workers in these operations. Conclusions In cesarean section for pregnant women with COVID-19 infection, CSEA was safe and efficient in achieving satisfactory obstetrical anaesthesia and postoperative analgesia. No cross-infection occurred in the HCWs working in these operations.


title: How did SARS-CoV-19 spread in India from Italy, Iran and China? Genetic surveillance of early cases and virus demography

text: SARS-CoV-19 after emerging from Wuhan, drastically devastated all sectors of human life by crushing down the global economy and increased psychological burden on public, government, and healthcare professionals. We manifested by analyzing 35 early coronavirus cases of India, that virus introduction in India, occurred from Italy, Iran and China and population demography apparently revealed a rapid population expansion after the outbreak with a present steady growth. We depicted nucleotide substitutions in structural genes, drove for the adaptive selection and plead for sequencing more genomes to facilitate identification of new emerged mutants, genetic evolution and disease transmission caused by coronavirus.


title: Treatment of ARDS and hyperinflammation in COVID-19 with IL-6 antagonist Tocilizumab: a tertiary care experience from Pakistan

text: Cytokine release syndrome in COVID-19 is characterized by hyperinflammation which manifests as ARDS, multi-organ failure, and high inflammatory parameters. Tocilizumab, an IL-6 antagonist has been used in COVID-19 acute respiratory distress syndrome (ARDS) with conflicting results from different parts of the world. We conducted a retrospective descriptive study from Feb 2020 to May 2020 on COVID-19 patients with ARDS and hyperinflammation characterized by raised CRP and/or ferritin. A total of 244 patients with COVID-19 were admitted out of which 107 had ARDS. Thirty patients had both ARDS and hyperinflammation and received tocilizumab. The mean age was 62.5 years (SD: 13.5) and the majority were male (83%). The mean CRP pre-treatment was 217.5 mg/L and post 48 to 72 hours of tocilizumab treatment was 98.5 mg/L. Twenty-one patients (70%) also received concomitant intravenous methylprednisolone. Of the 30 patients, 7 died and 20 recovered. Ten patients required intensive care unit admission and nine developed nosocomial infections. COVID-19 associated aspergillosis was diagnosed in three patients post tocilizumab treatment. Mortality was significantly higher in patients who developed a nosocomial infection and who required intermittent positive pressure ventilation (IPPV). Our study is the first to describe the treatment outcomes with tocilizumab from a low-middle income country. The availability and cost of tocilizumab in our region which makes it imperative to understand its potential for use in our setting. Our study supports the use of tocilizumab in a select patient population with COVID-19 and recommends monitoring of nosocomial infections and opportunistic infections.


title: Prevalence and Factors Associated with Depression and Anxiety of Hospitalized Patients with COVID-19

text: Objective: The 2019 coronavirus disease (COVID-19) epidemic has raised international concern. Mental health is becoming an issue that cannot be ignored in our fight against it. This study aimed to explore the prevalence and factors linked to anxiety and depression in hospitalized patients with COVID-19. Methods: A total of 144 patients diagnosed with COVID-19 were included in this study. We assessed depression and anxiety symptoms using the Hospital Anxiety and Depression Scale (HADS), and social support using the Perceived Social Support Scale (PSSS) among patients at admission. Multivariate linear regression analyses were performed to identify factors associated with symptoms of anxiety and depression. Results: Of the 144 participants, 34.72% and 28.47% patients with COVID-19 had symptoms of anxiety or depression, respectively. The bivariate correlations showed that less social support was correlated with more anxious (r=-0.196, p<0.05) and depressive (r=-0.360，p<0.05) symptoms among patients with COVID-19. The multiple linear regression analysis showed that gender (β=1.446, p=0.034), age (β=0.074, p=0.003), oxygen saturation (β =-2.140, p=0.049), and social support (β =-1.545, p=0.017) were associated with anxiety for COVID-19 patients. Moreover, age (β=0.084, p=0.001), family infection with SARS-CoV-2 (β =1.515, p=0.027) and social support (β =-2.236, p＜0.001) were the factors associated with depression. Conclusion: Hospitalized patients with COVID-19 presented features of anxiety and depression. Mental concern and appropriate intervention are essential parts of clinical care for those who are at risk.


title: Biochemical evidence of furin specificity and potential for phospho-regulation at Spike protein S1/S2 cleavage site in SARS-CoV2 but not in SARS-CoV1 or MERS-CoV

text: The Spike protein of the novel coronavirus SARS-CoV2 contains an insertion 680SPRRAR↓SV687 forming a cleavage motif RxxR for furin-like enzymes at the boundary of S1/S2 subunits. Cleavage at S1/S2 is important for efficient viral entry into target cells. The insertion is absent in other CoV-s of the same clade, including SARS-CoV1 that caused the 2003 outbreak. However, an analogous insertion was present in the Spike protein of the more distant Middle East Respiratory Syndrome coronavirus MERS-CoV. We show that a crucial third arginine at the left middle position, comprising a motif RRxR is required for furin recognition in vitro, while the general motif RxxR in common with MERS-CoV is not sufficient for cleavage. Further, we describe a surprising finding that the two serines at the edges of the insert SPRRAR↓SV can be efficiently phosphorylated by proline-directed and basophilic protein kinases. Both phosphorylations switch off furin’s ability to cleave the site. Although phosphoregulation of secreted proteins is still poorly understood, further studies, supported by a recent report of ten in vivo phosphorylated sites in the Spike protein of SARS-CoV2, could potentially uncover important novel regulatory mechanisms for SARS-CoV2.


title: State-by-State estimates of R0 at the start of COVID-19 outbreaks in the USA

text: We estimated the initial basic reproduction number (R0) for States in the USA experiencing COVID-19 epidemics by analyzing death data time series using a time-varying autoregressive state-space model. The initial R0 varied greatly among States, with the highest R0 = 8.3 in New York State. The variation in initial R0 was strongly correlated with the peak daily death count among States, showing that the initial R0 anticipates subsequent challenges in controlling epidemics. Furthermore, the variation in initial R0 implies different needs for public health measures. Finally, the States that relaxed public health measures early were not those with the lowest risks of resurgence, highlighting the need for science to guide public health policies.


News: Hospitalist Teams Provide Backup, Especially during Surges Like COVID-19


title: Shut it down: a cross country panel analysis on the efficacy of lockdown measures

text: Coronavirus pandemic outbreak from China in the December 2019 and since then has quickly spread all over the world. National governments introduced policies aimed to reduce the probability to contract the virus, such as lockdown measures, in order to limit the outbreak. Lockdown fostered a debate about the effective need and the optimal duration of such measures. Indeed, these policies have a high price, being characterized by the alt of many productive activities. The aim of this note is to provide preliminary evidences about the efficacy of lockdown measures all over the world, by the means of a panel data quantitative analysis. Our results confirm the efficacy of such measures, and that the average time to have effects in terms of a reduction of cases is of about ten days. Furthermore the beneficial effects of a lockdown keep reducing the new cases with a linear trend for at least the ten successive days.


docid: ekaqbruo

title: The COVID-19 mortality effects of underlying health conditions in India: a modelling study

text: Objective: To model how known COVID-19 comorbidities will affect mortality rates and the age distribution of mortality in a large lower middle income country (India), as compared with a high income country (England), and to identify which health conditions drive any differences. Design: Modelling study. Setting: England and India. Participants: 1,375,548 respondents aged 18 to 99 to the District Level Household Survey-4 and Annual Health Survey in India. Additional information on health condition prevalence on individuals aged 18 to 99 was obtained from the Health Survey for England and the Global Burden of Diseases, Risk Factors, and Injuries Studies (GBD). Main outcome measures: The primary outcome was the proportional increase in age-specific mortality in each country due to the prevalence of each COVID-19 mortality risk factor (diabetes, hypertension, obesity, chronic heart disease, respiratory illness, kidney disease, liver disease, and cancer, among others). The combined change in overall mortality and the share of deaths under 60 from the combination of risk factors was estimated in each country. Results: Relative to England, Indians have higher rates of diabetes (10.6% vs. 8.5%), chronic respiratory disease (4.8% vs. 2.5%), and kidney disease (9.7% vs. 5.6%), and lower rates of obesity (4.4% vs. 27.9%), chronic heart disease (4.4% vs. 5.9%), and cancer (0.3% vs. 2.8%). Population COVID-19 mortality in India relative to England is most increased by diabetes (+5.4%) and chronic respiratory disease (+2.3%), and most reduced by obesity (-9.7%), cancer (-3.2%), and chronic heart disease (-1.9%). Overall, comorbidities lower mortality in India relative to England by 9.7%. Accounting for demographics and population health explains a third of the difference in share of deaths under age 60 between the two countries. Conclusions: Known COVID-19 health risk factors are not expected to have a large effect on aggregate mortality or its age distribution in India relative to England. The high share of COVID-19 deaths from people under 60 in low- and middle-income countries (LMICs) remains unexplained. Understanding mortality risk associated with health conditions prevalent in LMICs, such as malnutrition and HIV/AIDS, is essential for understanding differential mortality. Keywords: COVID-19, India, low- and middle-income countries, comorbidity


title: Evolution and epidemic spread of SARS-CoV-2 in Brazil

text: Brazil currently has one of the fastest growing SARS-CoV-2 epidemics in the world. Due to limited available data, assessments of the impact of non-pharmaceutical interventions (NPIs) on virus transmission and epidemic spread remain challenging. We investigate the impact of NPIs in Brazil using epidemiological, mobility and genomic data. Mobility-driven transmission models for Sao Paulo and Rio de Janeiro cities show that the reproduction number (Rt) reached below 1 following NPIs but slowly increased to values between 1 to 1.3 (1.0 - -1.6). Genome sequencing of 427 new genomes and analysis of a geographically representative genomic dataset from 21 of the 27 Brazilian states identified >100 international introductions of SARS-CoV-2 in Brazil. We estimate that three clades introduced from Europe emerged between 22 and 27 February 2020, and were already well-established before the implementation of NPIs and travel bans. During this first phase of the epidemic establishment of SARS-CoV-2 in Brazil, we find that the virus spread mostly locally and within-state borders. Despite sharp decreases in national air travel during this period, we detected a 25% increase in the average distance travelled by air passengers during this time period. This coincided with the spread of SARS-CoV-2 from large urban centers to the rest of the country. In conclusion, our results shed light on the role of large and highly connected populated centres in the rapid ignition and establishment of SARS-CoV-2, and provide evidence that current interventions remain insufficient to keep virus transmission under control in Brazil.


title: VENTILATORY SUPPORT IN SARS-VOC-2 DURING INTENSIVE THERAPY

text: Introduction: The SARS-CoV-2 disease outbreak has now become a pandemic. Critical patients with COVID-19 require basic and advanced respiratory support. Therefore, the objective was to describe the ventilatory support strategies in SARS-CoV-2 during intensive therapy. Materials and methods: A systematic review of observational studies of the available scientific literature was performed in accordance with the recommendations of the Cochrane collaboration and the criteria of the PRISMA Declaration. Results: Fifteen observational studies were included that gave a study population of 4,081 patients. Mechanical ventilation is the main respiratory support treatment for critically ill patients, which should be administered as soon as normal oxygenation cannot be maintained, and despite the fact that there is no current consensus on the parameters of mechanical ventilation, the evidence collected suggests the use of Fio2 on average 50%, PEEP of 14 cmH2O, lung compliance of 29-37 ml per cm of water, driving pressure between 12-14 cm of water and a plateau pressure of 22-25 cm of water. Conclusions: IL-6 is shown as a possible marker of respiratory failure and a worse prognosis as well as obesity. In addition, the use of prone position, neuromuscular blockade, pulmonary vasodilators, ECMO, and mechanical ventilation based on the clinical conditions and needs of the patient with COVID-19 are strategies that could benefit patients entering intensive therapy for SARS-CoV- 2.


In Greece, COVID-19 Numbers Are Very Low. Neurologists Explain Why


title: South Korea’s fast response to coronavirus disease: implications on public policy and public management theory

text: The first case of coronavirus disease 2019 (COVID-19) in South Korea was identified on 20 January 2020. South Korea’s blended response of quick action and technological innovations has proven effective in containing the COVID-19 outbreak and can offer lessons for other countries. This paper presents a review of the administrative and legal measures taken by the Korean government, a discussion on the lessons learned from previous epidemics and disasters, and an overview of the government’s agile testing and containment strategies. The paper ends with a discussion on the implications of Korea’s responses to public policy and public management theory.


Statistical Issues and Recommendations for Clinical Trials Conducted During the COVID-19 Pandemic


title: COVID-19 in Spain: age, Interleukin-6, C Reactive Protein and lymphocytes as key clues from a multicentre retrospective study

text: SARS-CoV-2 infection has widely spread to the hugest public health challenge to date, COVID-19 pandemic. Different fatality rates among countries are probably due to unstandardized records being carried out by local health authorities. Spanish case-fatality rate is 11.86%, far higher to those reported in Asia or by other European countries. A multicenter retrospective study of demographic, clinical, laboratory and immunological features of 574 Spanish COVID-19 inpatients (59.4% males) and their outcomes was performed. 27.7% cases presented a mild curse, 42% a moderate one and 30.3%, severe. Ages ranged from 18 to 98 (average 63.2). Interleukin 6 was higher as increasing severity. On the other hand, CD8 lymphocyte count was significantly lower as severity grew and subpopulations CD4, CD8, CD19 and NK showed concordant lowering trends. Severity-related natural killer percent descents were evidenced just within aged cases. A significant severity-related decrease of CD4 lymphocytes was found in males. The use of renin-angiotensin system blockers was associated with moderate or mild disease courses. Clinical course of the disease is more severe in this study than in previous literature cohorts. Age and age-related comorbidities, such as dyslipidemia, hypertension or diabetes, were also higher. Immunosenescence might be therefore a suitable explanation for immune system effectors severity-related hampering. Adaptive immunity would go exhausted and a huge ineffective and almost deleterious innate response would account for COVID-19 severity. Hypertensive patients treated with renin-angiotensin system blockers developed milder forms of the disease.


title: Coronaviruses and COVID-19-Complications and Lessons Learned for the Future

text: Despite the earlier two Coronavirus outbreaks, this appearance of the third Coronavirus outbreak has brought several complications and now emerged as a human-health related pandemic issue The wide geographical spread and transmissibility of newly emerged novel-Coronavirus (2019-nCoV) and severity of coronavirus disease 2019 (COVID-19) raised serious concerns about the future trajectory of the 2019-nCoV/COVID-19 outbreak Herein, we have briefly covered some important aspects of the 2019-nCoV/COVID-19 outbreak to highlight the need to learn lessons for a safer future First, an epidemiological comparison of respiratory viral infections with particular reference to 2019-nCoV is given with relevant examples Following that, considering the earlier two Coronavirus outbreaks, the emergence of another new 2019-nCoV is given Finally, the lesson learned, so far, and key concerns for pandemic impact assessment at large and COVID-19, in particular, are discussed for future considerations


title: Conseils d’experts du sommeil pour bien dormer et garder le rythme chez les adultes et les enfants en cette période de confinement liée au CoVid-19

text: Résumé A la fois le confinement lié au virus Covid-19 et le stress induit par la pandémie peuvent entraîner des perturbations importantes des rythmes et du sommeil. Des experts du sommeil de la section Sommeil et rythmes biologiques en Psychiatrie (SoPsy) de l’Association Française de Psychiatrie Biologique et de Neuropsychopharmacologie (AFPBN) et de la Société Française de Recherche et Médecine du Sommeil (SFRMS), en partenariat avec le Réseau Morphée et l’Institut National du Sommeil et de la Vigilance (INSV), proposent ici des conseils pour bien dormir et garder ses rythmes. Des recommandations spécifiques sont adressées d’une part aux adultes et d’autre part aux parents pour leurs enfants. Les personnes avec un trouble de l’humeur (dépression, trouble bipolaire, etc) doivent particulièrement prêter attention et conserver des routines durant cette période afin de maintenir une humeur stable. Il est proposé des stratégies d’autogestion pour renforcer l’horloge biologique, tous les jours ! Les recommandations comportent des astuces simples et pratiques pour le jour et la nuit, mais aussi des conseils spécifiques à ce contexte pour limiter l’exposition au stress et mieux le gérer. Enfin, quelques sources et liens utiles sont proposés. Abstract Both, the confinement itself and the stress induces by the Covid-19 virus pandemic can lead to significant disruptions in habitual rhythms and sleep. Sleep experts from the Sleep and Biological Rhythms in Psychiatry section (SoPsy) of the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) and the French Society of Sleep Research and Medicine (SFRMS), in partnership with the Morphée network and the National Institute of Sleep and Vigilance (INSV), offer recommendations on how to sleep well and to keep your rhythms. Specific recommendations are addressed on the one hand to adults and on the other hand to parents for their children. People affected by mood disorders (depression, bipolar disorder, etc.) should particularly pay attention to maintaining routines during this period in order to maintain a stable mood. Self-management strategies are suggested to strengthen the biological clock, every day! The recommendations include tips for day and night, but also some specific advices for this context, to limit stress exposure and to improve its management. Finally, useful online ressources and links are suggested.


title: Key Points of Clinical and CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV) Imported Pneumonia Based On 21 Cases Analysis

text: Background and Objective: WHO Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern,and the outbreak is still on-going.Chest CT had been a key component of the diagnostic workup for patients with suspected infection. In this retrospective study, we attempt to summarize and analyze the chest CT features of 2019-nCov infections, and to identify the typical features to improved the diagnostic accuracy of new coronavirus pneumonia (NCP). Methods:Chest CT scans and Clinical data of 21 patients confirmed NCP in our hospital were enrolled.These patients were divided into mild and sever group according to clinical manifestations described by the 6th clinical practice guideline of NCP in China. Main clinical and chest CT features were analyzed and identify. Results: Fever (85.7%) and cough (80.9%) were the two main symptoms of NCP patients.More significantly higher incidence (85.7%) of shortness of breath in the severe cases. Multiple lesions in both lungs and with incidence of GGO(100%),vascular enlargement (76.5%) and cobblestone/reticular pattern(70.6%) were the major feature.The incidence of consolidation, mixed pattern and vascular enlargement features were up to 100% in the severe group, significantly higher than that of patients in mild group. In addition, the incidence of air-bronchogram, dilated bronchi with thickened wall and fibrosis in the severe group was significantly higher than that in the mild group. Conclusions: Fever and cough are the typical clinical features of NCP patients, and chest CT mainly manifested as multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern.Changes in these main CT features can indicate development of the disease.


title: Mechanistic Transmission Modeling of COVID-19 on the Diamond Princess Cruise Ship Demonstrates the Importance of Aerosol Transmission

text: Background The current prevailing position is that coronavirus disease 2019 (COVID-19) is transmitted primarily through large respiratory droplets within close proximity (i.e., 1-2 m) of infected individuals. However, quantitative information on the relative importance of specific transmission pathways of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (i.e., droplets, aerosols, and fomites across short- and long-range distances) remains limited. Methods To evaluate the relative importance of multiple transmission routes for SARS-CoV-2, we leveraged detailed information available from the Diamond Princess Cruise Ship outbreak that occurred in early 2020. We developed a framework that combines stochastic Markov chain and negative exponential dose-response modeling with available empirical data on mechanisms of SARS-CoV-2 dynamics and human behaviors, which informs a modified version of the Reed-Frost epidemic model to predict daily and cumulative daily case counts on the ship. We modeled 21,600 scenarios to generate a matrix of solutions across a full range of assumptions for eight unknown or uncertain epidemic and mechanistic transmission factors, including the magnitude of droplet and aerosol emissions from infected individuals, the infectious dose for deposition of droplets and aerosols to the upper and lower respiratory tracts, and others. Findings A total of 132 model iterations met acceptability criteria (R2 > 0.95 for modeled vs. reported cumulative daily cases and R2 > 0 for daily cases). Analyzing only these successful model iterations yields insights into the likely values for uncertain parameters and quantifies the likely contributions of each defined mode of transmission. Mean estimates of the contributions of short-range, long-range, and fomite transmission modes to infected cases aboard the ship across the entire simulation time period were 35%, 35%, and 30%, respectively. Mean estimates of the contributions of large respiratory droplets and small respiratory aerosols were 41% and 59%. Short-range transmission was the dominant mode after passenger quarantine began, albeit due primarily to aerosol transmission, not droplets. Interpretation Our results demonstrate that aerosol inhalation was likely the dominant contributor to COVID-19 transmission among passengers aboard the Diamond Princess Cruise Ship. Moreover, close-range and long-range transmission likely contributed similarly to disease progression aboard the ship, with fomite transmission playing a smaller role. The passenger quarantine also affected the importance of each mode, demonstrating the impacts of the interventions. Although cruise ships represent unique built environments with high ventilation rates and no air recirculation, these findings underscore the importance of implementing public health measures that target the control of inhalation of aerosols in addition to ongoing measures targeting control of large droplet and fomite transmission, not only aboard cruise ships but in other indoor environments as well.


title: COVID- 19 Infection in Children: Estimating Pediatric Morbidity and Mortality

text: BACKGROUND: Estimates of pediatric morbidity and mortality from COVID-19 are vital for planning optimal use of human and material resources throughout this pandemic. METHODS: Government websites from countries with minimum 1000 cases in adults and children on April 13, 2020 were searched to find the number of cases confirmed in children, the age range, and the number leading to hospitalization, intensive care unit (ICU) admission or death. A systematic literature search was performed April 13, 2020 to find additional data from cases series. RESULTS: Data on pediatric cases were available from government websites for 23 of the 70 countries with minimum 1000 cases by April 13, 2020. Of 424 978 cases in these 23 countries, 8113 (1.9%) occurred in children. Nine publications provided data from 4251 cases in 4 additional countries. Combining data from the websites and the publications, 330 of 2361 cases required admission (14%). The ICU admission rate was 2.2 % of confirmed cases (44 of 2031) and 7.2% of admitted children (23 of 318). Death was reported for 15 cases. CONCLUSION: Children accounted for 1.9% of confirmed cases. The true incidence of pediatric infection and disease will only be known once testing is expanded to individuals with less severe or no symptoms. Admission rates vary from 0.3 to 10% of confirmed cases (presumably varying with the threshold for testing) with about 7% of admitted children requiring ICU care. Death is rare in middle and high income countries.