title: CT appearance of new coronavirus pneumonia in subclinical period and short-term changes/ 中华放射学杂志

text: Objective@#To explore the characteristics and short-term changes of high resolutionCT (HRCT) in subclinical stage of new coronavirus pneumonia (NCP).@*Methods@#TheHRCT images of 17 NCP patients in subclinical stage were analyzed retrospectively in Union Hospital of Tongji Medical College, Huazhong University of science and technology and Wuhan JinyintanHospital from January 15 to January 31, 2020. There were 4 males and 13 females, aged from 25.0 to 51.0 (39.8±7.5) years, who were closely contacted with NCP patients. The follow-up CT examination was performed 3 to 6 days after the initial CT examination in all patients. Six patients were treated using anti-virus, anti-inflammation andsymptomatic therapy, while the orther 11 patients were untreated. The CT imaging signs of subclinical and short-term follow-up were analyzed, and the CT image changes of short-term follow-up was summarized.@*Results@#Thelesions of 17 NCP patients were mainly located at the lower lobes of both lungs (9 cases at the left lower lobe and 10 cases at the right lower lobe in the subclinical stage, 9 casesat the left lower lobe and 11casesat the right lower lobe in the short-term follow-up). The number of lung segments involved increased from 46 in the subclinical stage to 90 in the short-term follow-up. In the subclinical stage, most of the lesions were multiple (13 cases), while in the short-term follow-up, the number of multiple cases decreased (7 cases), focal (6 cases) and diffuse distribution(4 cases) increased. The lesions were mainly distributed under the pleura (13 cases) or along the bronchovascular bundle (10 cases). In the short-term follow-up, 1 case progressed from subpleural to subpleural and along the bronchovascular bundle. There were 3 main types of lesions, including ground glass nodule, ground glass opacity and crazy-paving pattern. In the subclinical stage and short-term follow-up, ground glass nodules were seen in all the 17 cases. In the short-termfollow-up, ground glass nodules decreased in 4 cases and crazy-paving pattern increased in 4 cases. In 6 patients after treatment, 3 cases were changed from multiple to single ground glass nodule, 3 cases showed multiple ground glass opacity reduced. Therange of lesions in 11 patients without treatment enlarged.@*Conclusion@#TheHRCT features of the NCP patients in subcilincal stagehave some charicteristics, such as small ground glass nodule, ground glass opacity along the subpleural or along the bronchovascular bundle, and the great changescan be seen in the short-term follow-up.


Maternal death in pregnancy due to COVID-19


Extremely High Incidence of Lower Extremity Deep Venous Thrombosis in 48 Patients with Severe COVID-19 in Wuhan


docid: ckuocehv

title: Practical Guidance for Outpatient Spasticity Management During the Coronavirus (COVID-19) Pandemic: Canadian Spasticity COVID-19 Task Force


title: Cerebrovascular disease is associated with an increased disease severity in patients with Coronavirus Disease 2019 (COVID-19): A pooled analysis of published literature

text: INTRODUCTION: There is an urgent need to identify patients at high risk during the ongoing coronavirus disease (COVID-19) pandemic. Whether a history of stroke is associated with increased severity of disease or mortality is unknown. METHOD: We pooled studies from published literature to assess the association of a history of stroke with outcomes in patients with COVID-19. RESULTS: A pooled analysis of 4 studies showed a â¼2.5-fold increase in odds of severe COVID-19. While a trend was observed, there was no statistically significant association of stroke with mortality in patients with COVID-19 infection. DISCUSSION: Our findings are limited by a small number of studies and sample size. CONCLUSION: There is a â¼2.5-fold increase in odds of severe COVID-19 illness with a history of cerebrovascular disease.


Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission


title: An evidence-based framework for priority clinical research questions for COVID-19

text: Background: On 31 December, 2019, the World Health Organization China Country Office was informed of cases of pneumonia of unknown aetiology. Since then, there have been over 75 000 cases globally of the 2019 novel coronavirus (COVID-19), 2000 deaths, and over 14 000 cases recovered. Outbreaks of novel agents represent opportunities for clinical research to inform real-time public health action. In 2018, we conducted a systematic review to identify priority research questions for Severe Acute Respiratory Syndrome-related coronavirus (SARS-CoV) and Middle East Respiratory Syndrome-related coronavirus (MERS-CoV). Here, we review information available on COVID-19 and provide an evidenced-based framework for priority clinical research in the current outbreak. Methods: Three bibliographic databases were searched to identify clinical studies published on SARS-CoV and MERS-CoV in the outbreak setting. Studies were grouped thematically according to clinical research questions addressed. In February 2020, available information on COVID19 was reviewed and compared to the results of the SARS-CoV and MERS-CoV systematic review. Results: From the research objectives for SARS-CoV and MERS-CoV, ten themes in the literature were identified: Clinical characterisation, prognosis, diagnosis, clinical management, viral pathogenesis, epidemiological characterisation, infection prevention and control/transmission, susceptibility, psychosocial, and aetiology. For COVID19, some information on clinical presentation, diagnostic testing, and aetiology is available but many clinical research gaps have yet to be filled. Conclusions: Based on a systematic review of other severe coronaviruses, we summarise the state of clinical research for COVID-19, highlight the research gaps, and provide recommendations for the implementation of standardised protocols. Data based on internationally standardised protocols will inform clinical practice real-time.


docid: lncsfohg

title: Disposable masks: Disinfection and sterilization for reuse, and non-certified manufacturing, in the face of shortages during the COVID-19 pandemic

text: The COVID-19 pandemic is posing a huge global health threat. To deal with this problem, in addition to research and work in the medical field, the main health measures being taken in the workplace and at home involve the establishment of safety protocols, which include distance measures, hygiene and the use of personal protective equipment, such as masks, etc. The WHO still does not recommend the use of masks for the general population. However, their successful use in China, South Korea and the Czech Republic has encouraged their widespread use, and the shortage that already existed. This has caused that companies and individuals are looking at the best way to reuse them, and to manufacture, homemade or not, of non-certified masks. This paper is based on two objectives: to consult the scientific literature to identify the main strategies for disinfecting them, and to determine the effectiveness of non-certified disposable masks. A rapid review has been conducted in which the main publications and other information available online have been analyzed. Results showed that the most promising methods are those that use hydrogen peroxide vapor, ultraviolet radiation, moist heat, dry heat and ozone gas. Soapy water, alcohol, bleach immersion, ethylene oxide, ionizing radiation, microwave, high temperature, autoclave or steam are not fully recommended. Regarding the effectiveness of surgical masks compared to PPE, the former have been seen to be slightly less effective than PPE. As for other types of masks the effectiveness of homemade or non-certified masks is very low.


title: Pylons ablaze: Examining the role of 5G COVID-19 conspiracy beliefs and support for violence

text: Amid increased acts of violence against telecommunication engineers and property, this pre-registered study (N = 601 Britons) investigated the association between beliefs in 5G COVID-19 conspiracy theories and the justification and willingness to use violence. Findings revealed that belief in 5G COVID-19 conspiracy theories was positively correlated with state anger, which in turn, was associated with a greater justification of real-life and hypothetical violence in response to an alleged link between 5G mobile technology and COVID-19, alongside a greater intent to engage in similar behaviours in the future. Moreover, these associations were strongest for those highest in paranoia. Furthermore, we show that these patterns are not specific to 5G conspiratorial beliefs: General conspiracy mentality was positively associated with justification and willingness for general violence, an effect mediated by heightened state anger, especially for those most paranoid in the case of justification of violence. Such research provides novel evidence on why and when conspiracy beliefs may justify the use of violence.


title: Ocular manifestations of coronavirus disease 2019

text: PURPOSE: Coronavirus disease 2019 (COVID-19) is an ongoing global public health problem, and most of the COVID-19 research is focused mainly on the respiratory system because of life-threatening results. However, manifestations in other organs should not be ignored since they can also be a mode of transmission. We sought to describe the ocular manifestations of COVID-19 and investigate the association between ocular involvement and clinical presentation and laboratory outcomes. METHODS: This cross-sectional study was conducted between March 1, 2020, and April 30, 2020. Ninety-three sequentially hospitalized and clinically confirmed COVID-19 patients were included in the study. The systemic and ocular symptoms, clinical findings, and laboratory outcomes were recorded. RESULTS: Of the 93 COVID-19 patients, 54 (58.1%) were male, and 39 (41.9%) were female. Mean age of the patients was 39.4 ± 21.9 (min 7, max 88) years. Twenty patients (n 21.5%) had at least one ocular abnormality. Most common findings included hyperemia (n = 20), epiphora (n = 9), increased secretion (n = 6), chemosis (n = 3), follicular conjunctivitis (n = 2), and episcleritis (n = 2). The most common symptom was photophobia (n 15). Patients with ocular involvement were more likely to have higher neutrophil counts (p = 0.001), and increased CRP (p < 0.001), PCT (p = 0.001), and ESR levels (p < 0.001). Mean lymphocyte count was statistically lower in patients with ocular manifestations (p = 0.001). Mean age and number of patients with fever over 37.3 °C in the ocular involvement group was found to be higher (p < 0.001, p = 0.006, respectively). CONCLUSION: Older age, high fever, increased neutrophil/lymphocyte ratio, and high levels of acute phase reactants seemed to be risk factors for ocular involvement.


COVID-19 preparedness for portable x-rays in an Indian hospital - Safety of the radiographers, the frontline warriors


Dimensões do cuidado na perspectiva da espiritualidade durante a pandemia pelo novo coronavírus (COVID-19)


title: Rapid Review: Nonsteroidal Anti-inflammatory Agents and Aminosalicylates in COVID-19 Infections

text: In the current COVID-19 pandemic, there has been concern regarding the use of ibuprofen and other nonsteroidal anti-inflammatory agents by COVID-19 infected patients. Aminosalicylates (5-ASAs) are structurally similar and have anti-inflammatory functions that resemble those of nonsteroidal anti-inflammatory agents. Since 5-ASAs are a mainstay treatment for inflammatory bowel disease, the authors review the pharmacology of both classes of drugs and discuss the potential relevance of 5-ASAs in the ongoing discussion of medication use in patients infected with COVID-19.


title: Challenges and Priorities in Responding to COVID-19 in Inpatient Psychiatry

text: This Open Forum focuses on specific challenges, contingency planning considerations, and downstream impacts of COVID-19 on inpatient psychiatric care. COVID-19 is a novel coronavirus that has been declared a pandemic. Challenges for inpatient psychiatry include risky close contact among staff and patients, space constraints, and structural barriers in care delivery. Nuanced considerations of five contingency planning strategies in response to COVID-19 are described, including COVID-19-specific precautions, visitor restrictions, physician workforce considerations, operational adjustments, and group therapy changes. Organized leadership and clear communication are identified as early priorities in pandemic response to minimize misinformation and address immediate challenges.


title: Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection

text: OBJECTIVE: To provide clinical management guidelines for novel coronavirus (COVID-19) in pregnancy. METHODS: On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID-19 infection in pregnancy were discussed. RESULTS: Ten key recommendations were provided for the management of COVID-19 infections in pregnancy. CONCLUSION: Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal-fetal status.


title: The Italian USL Toscana Centro model of a vascular hub responding to the COVID-19 emergency

text: BACKGROUND: Spreading of the COVID-19 pandemic in Italy forced health facilities to drastically change their organization to face the overwhelming number of infected patients needing hospitalization. The aim of this paper is to share with all the vascular community the protocol developed by the USL (Unità Sanitaria Locale) Toscana Centro for the reorganization of the Vascular Surgery Unit during the COVID-19 emergency, hoping to help other institutions to face the emergency during the hard weeks coming. METHODS: The USL Toscana Centro is a public Italian health care institution including four districts (Empoli, Florence, Pistoia, Prato) with 13 different hospitals, serving more than 1,500,000 people in a 5000 km2 area. The USL adopted a protocol of reorganization of the Vascular Surgery Unit during the first difficult weeks of the epidemic, consisting in the creation of a Vascular Hub for urgent cases, with a profound reorganization of activities, wards, surgical operators, operating blocks, and intensive care unit (ICU) beds. RESULTS: All 13 hospitals are now COVID-19 as the first days of April passed. The San Giovanni di Dio Hospital (Florence) has more than 80 COVID-19 patients in different settings (ICU, medical and surgical ward), which at the time of writing is almost one-third of the total hospital capacity (80/260 beds). It has been identified as the Surgical Hub for urgent vascular COVID-19 cases. Therefore, the elective surgical and office activities were reduced by 30% and 80%, respectively, and reserved to priority cases. A corner of the whole operating block, well separate from the remaining operating rooms, was rapidly converted into one operating room and six ICU beds dedicated to COVID patients. The COVID-19 surgical path now includes an emergency room for suspected COVID-19 patients directly connected to an elevator for the transfer of COVID patients in the COVID operating block and dedicated COVID-19 ward and ICU beds. CONCLUSIONS: Rapid modification of hospital settings, a certain "flexibility" of the medical personnel, a stepwise shutdown of vascular surgical and office activity, and the necessity of a strong leadership are mandatory to cope with the tsunami of the COVID-19 outbreak.


docid: xwnrugou

title: Radiologist Reporting and Operational Management for Patients With Suspected COVID-19

text: PURPOSE: The aim of this study was to evaluate the adoption and outcomes of locally designed reporting guidelines for patients with possible coronavirus disease 2019 (COVID-19). METHODS: A departmental guideline was developed for radiologists that specified reporting terminology and required communication for patients with imaging findings suggestive of COVID-19, on the basis of patient test status and imaging indication. In this retrospective study, radiology reports completed from March 1, 2020, to May 3, 2020, that mentioned COVID-19 were reviewed. Reports were divided into patients with known COVID-19, patients with "suspected" COVID-19 (having an order indication of respiratory or infectious signs or symptoms), and "unsuspected patients" (other order indications, eg, trauma or non-chest pain). The primary outcome was the percentage of COVID-19 reports using recommended terminology; the secondary outcome was percentages of suspected and unsuspected patients diagnosed with COVID-19. Relationships between categorical variables were assessed using the Fisher exact test. RESULTS: Among 77,400 total reports, 1,083 suggested COVID-19 on the basis of imaging findings; 774 of COVID-19 reports (71%) used recommended terminology. Of 574 patients without known COVID-19 at the time of interpretation, 345 (60%) were eventually diagnosed with COVID-19, including 61% (315 of 516) of suspected and 52% (30 of 58) of unsuspected patients. Nearly all unsuspected patients (46 of 58) were identified on CT. CONCLUSIONS: Radiologists rapidly adopted recommended reporting terminology for patients with suspected COVID-19. The majority of patients for whom radiologists raised concern for COVID-19 were subsequently diagnosed with the disease, including the majority of clinically unsuspected patients. Using unambiguous terminology and timely notification about previously unsuspected patients will become increasingly critical to facilitate COVID-19 testing and contact tracing as states begin to lift restrictions.


docid: zgeczzev

title: Cuidados intensivos durante la epidemia de coronavirus 2019./ Cuidados intensivos durante la epidemia de coronavirus 2019./ Intensive care during the 2019-coronavirus epidemic

text: On 31 December 2019, the Health Commission of Hubei Province of China first unveiled a group of unexplained cases of pneumonia, which WHO subsequently defined as the new coronavirus of 2019 (SARS-CoV-2). SARS-CoV-2 has presented rapid person-to-person transmission and is currently a global pandemic. In the largest number of cases described to date of hospitalized patients with SARS-CoV-2 disease (2019-nCoViD), 26% required care in an intensive care unit (ICU). This pandemic is causing an unprecedented mobilization of the scientific community, which has been associated with an exponentially growing number of publications in relation to it. This narrative literature review aims to gather the main contributions in the area of intensive care to date in relation to the epidemiology, clinic, diagnosis and management of 2019-nCoViD.


Pulmonology (is) on the air


We Asked the Experts: Virtual Learning in Surgical Education During the COVID-19 Pandemic-Shaping the Future of Surgical Education and Training


title: Chest CT features of the novel coronavirus disease (COVID-19)

text: A new type of coronavirus (2019-nCoV) is rapidly spreading worldwide and causes pneumonia, respiratory distress, thromboembolic events, and death. Chest computed tomography (CT) plays an essential role in the diagnosis of viral pneumonia, monitoring disease progression, determination of disease severity, and evaluating therapeutic efficacy. Chest CT can show important clues of 2019-nCoV disease (also known as COVID-19) in patients with an appropriate clinic. Prompt diagnosis of COVID-19 is essential to prevent disease transmission and provide close clinical observation of patients with clinically severe disease. Therefore, radiologists and clinicians should be familiar with the CT imaging findings of COVID-19 pneumonia. Herein we aimed to review the imaging findings of COVID-19 pneumonia and to examine the critical points to be considered for imaging in cases with COVID-19 suspicion.


title: A single-center, retrospective study of COVID-19 features in children: a descriptive investigation

text: BACKGROUND: Compared to adults, there are relatively few studies on COVID-19 infection in children, and even less focusing on the unique features of COVID-19 in children in terms of laboratory findings, locations of computerized tomography (CT) lesions, and the role of CT in evaluating clinical recovery. The objective of this study is to report the results from patients at Wuhan Children's Hospital, located within the initial center of the outbreak. METHODS: Clinical, imaging, and laboratory data of 76 children were collected retrospectively and analyzed with the Fisher exact test and Cox regression statistical methods. RESULTS: Among 50 children with a positive COVID-19 real-time reverse-transcriptase polymerase chain reaction (PCR), five had negative PCR results initially but showed positive results in subsequent tests. Eight (16%) patients had lymphopenia, seven (14%) with thrombocytopenia, four (8%) with lymphocytosis, two (4%) with thrombocytosis, ten (20%) with elevated C-reactive protein, four (8%) with hemoglobin above, and six (12%) with below standard reference values. Seven (14%) of the 50 had no radiologic evidence of disease on chest CT. For the 43 patients who had abnormal CT findings, in addition to previously reported patterns of ground-glass opacity (67%), local patchy shadowing (37%), local bilateral patchy shadowing (21%), and lesion location of lower lobes (65%), other CT features include that an overwhelming number of pediatric patients had lesions in the subpleural area (95%) and 22 of the 28 lower lobe lesions were in the posterior segment (78%). Lesions in most of the 15 patients (67%) who received chest CT at discharge were not completely absorbed, and 26% of these pediatric patients had CT lesions that were either unchanged or worse. CONCLUSIONS: There were a few differences between COVID-19 children and COVID-19 adults in terms of laboratory findings and CT characteristics. CT is a powerful tool to detect and characterize COVID-19 pneumonia but has little utility in evaluating clinical recovery for children. These results oppose current COVID-19 hospital discharge criteria in China, as one requirement is that pulmonary imaging must show significant lesion absorption prior to discharge. These differences between pediatric and adult cases of COVID-19 may necessitate pediatric-specific discharge criteria.


title: Drape to Prevent Disease Transmission During Endotracheal Intubation

text: Endotracheal intubation poses high risk of transmission of SARS-CoV-2 and other respiratory pathogens. We designed and here describe a protective drape that we believe will greatly reduce this risk. Unlike the intubation box that has been described prior, it is portable, disposable, and does not restrict operator dexterity. We have used it extensively and successfully during the height of the COVID-19 outbreak.


docid: kjmllmud

title: Security Apps under the Looking Glass: An Empirical Analysis of Android Security Apps

text: Third-party security apps are an integral part of the Android app ecosystem. Many users install them as an extra layer of protection for their devices. There are hundreds of such security apps, both free and paid in Google Play Store and some of them are downloaded millions of times. By installing security apps, the smartphone users place a significant amount of trust towards the security companies who developed these apps, because a fully functional mobile security app requires access to many smartphone resources such as the storage, text messages and email, browser history, and information about other installed applications. Often these resources contain highly sensitive personal information. As such, it is essential to understand the mobile security apps ecosystem to assess whether is it indeed beneficial to install them. To this end, in this paper, we present the first empirical study of Android security apps. We analyse 100 Android security apps from multiple aspects such as metadata, static analysis, and dynamic analysis and presents insights to their operations and behaviours. Our results show that 20% of the security apps we studied potentially resell the data they collect from smartphones to third parties; in some cases, even without the user consent. Also, our experiments show that around 50% of the security apps fail to identify malware installed on a smartphone.


Food in a time of COVID-19


title: The identification of spatially constrained homogeneous clusters of Covid-19 transmission

text: The paper introduces an approach to identify a set of spatially constrained homogeneous areas maximally homogeneous in terms of epidemic trends. The proposed hierarchical algorithm is based on the Dynamic TimeWarping distances between epidemic time trends where units are constrained by a spatial proximity graph. The paper includes two different applications of this approach to Italy, based on different data (number of positive test and number of differential deaths, with respect to the previous years) and on different observational units (provinces and Labour Market Areas). Both applications, above all the one related to Labour Market Areas, show the existence of well-defined areas, where the dynamics of growth of the infection have been strongly differentiated. The adoption of the same lock-down policy throughout the entire national territory has been therefore sub-optimal, showing once again the urgent need for local data-driven policies.


Sexually Transmitted COVID19


title: Covid-19 med negative nasofarynksprøver tidlig i forløpet./ Covid-19 med negative nasofarynksprøver tidlig i forløpet./ Negative nasopharyngeal swabs early in the course of COVID-19

text: BACKGROUND: The diagnosis of COVID-19 is made by detection of SARS-CoV-2 RNA by reverse transcription polymerase chain reaction (RT-PCR). Studies have shown a percentage of up to 30 % false negative results. CASE PRESENTATION: A previously healthy man in his late thirties was admitted to the hospital after 3-5 days of suffering chest pain, dyspnoea and abdominal discomfort. He had hypoxic respiratory failure and required oxygen therapy. The routine nasopharyngeal swab for PCR was negative at days 5 and 7 after onset of symptoms. A specimen obtained from bronchoalveolar lavage on day 8 was positive. INTERPRETATION: This case report shows us that even in the early course of SARS-Cov-2 infection, when the viral load in the upper respiratory tract has been shown to be at its highest, there might be false negative tests. It also emphasises the importance of including other clinical measures before discontinuation of isolation.


docid: kcwphzmc

title: Going with the flow: COVID-19 pathway and experience in Galway University Hospital


title: Dose optimized chest CT for diagnosis of COVID-19 - Evaluation of the image quality and diagnostic impact

text: OBJECTIVES: The detection of COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) has varying sensitivity. CT of the chest can verify the infection in patients with clinical symptoms and a negative test result accelerating treatment and actions to prevent further contagion. However, CT employs ionizing radiation. The purpose of this study was to evaluate protocol settings, associated radiation exposure, image quality and diagnostic performance of a low-dose CT protocol in a university hospital setting. MATERIALS AND METHODS: Chest-CT examinations were performed on a single scanner (Somatom Definition Edge, Siemens Healthineers, Germany) in 105 symptomatic patients (60 male, 45 female). Images were evaluated with regard to protocol parameters, image quality, radiation exposure and diagnostic accuracy. Serial RT-PCR served as the standard of reference. Based on this reference standard sensitivity, specificity, positive and negative predictive values of CT with 95% confidence interval were calculated. RESULTS: The mean effective dose was 1.3 ± 0.4 mSv (0.7 - 2.9 mSv) for the patient cohort (mean age 66.6 ± 16.7 years (19-94 years), mean BMI 26.6 ± 5.3 kg/m² (16-46 kg/m²)). A sensitivity of 100 [95% CI: 82-100]%, a specificity of 78 [95% CI: 68-86]%, a positive predictive value of 50 [95% CI: 33-67]% and a negative predictive value of 100 [95% CI: 95-100]% were obtained. No COVID-19 diagnoses were missed by CT. Image noise did not strongly correlate with BMI or patient diameter and was rated as average. CONCLUSIONS: We presented a robust imaging procedure with a chest CT protocol for confident diagnosis of COVID-19. Even for an overweight patient cohort, an associated radiation exposure of only 1.3 ± 0.4 mSv was achieved with sufficient diagnostic quality to exclude COVID-19.


title: Emergency trauma care during the outbreak of corona virus disease 2019 (COVID-19) in China

text: BACKGROUND: A novel coronavirus pneumonia outbreak began in Wuhan, Hubei Province, in December 2019; the outbreak was caused by a novel coronavirus previously never observed in humans. China has imposed the strictest quarantine and closed management measures in history to control the spread of the disease. However, a high level of evidence to support the surgical management of potential trauma patients during the novel coronavirus outbreak is still lacking. To regulate the emergency treatment of trauma patients during the outbreak, we drafted this paper from a trauma surgeon perspective according to practical experience in Wuhan. MAIN BODY: The article illustrates the general principles for the triage and evaluation of trauma patients during the outbreak of COVID-19, indications for emergency surgery, and infection prevention and control for medical personnel, providing a practical algorithm for trauma care providers during the outbreak period. CONCLUSIONS: The measures of emergency trauma care that we have provided can protect the medical personnel involved in emergency care and ensure the timeliness of effective interventions during the outbreak of COVID-19.


The COVID-19 testing debacle


title: Enhancing immunity in viral infections, with special emphasis on COVID-19: A review

text: BACKGROUND AND AIMS: Balanced nutrition which can help in maintaining immunity is essential for prevention and management of viral infections. While data regarding nutrition in coronavirus infection (COVID-19) are not available, in this review, we aimed to evaluate evidence from previous clinical trials that studied nutrition-based interventions for viral diseases (with special emphasis on respiratory infections), and summarise our observations. METHODS: A systematic search strategy was employed using keywords to search the literature in 3 key medical databases: PubMed®, Web of Science® and SciVerse Scopus®. Studies were considered eligible if they were controlled trials in humans, measuring immunological parameters, on viral and respiratory infections. Clinical trials on vitamins, minerals, nutraceuticals and probiotics were included. RESULTS: A total of 640 records were identified initially and 22 studies were included from other sources. After excluding duplicates and articles that did not meet the inclusion criteria, 43 studies were obtained (vitamins: 13; minerals: 8; nutraceuticals: 18 and probiotics: 4). Among vitamins, A and D showed a potential benefit, especially in deficient populations. Among trace elements, selenium and zinc have also shown favourable immune-modulatory effects in viral respiratory infections. Several nutraceuticals and probiotics may also have some role in enhancing immune functions. Micronutrients may be beneficial in nutritionally depleted elderly population. CONCLUSIONS: We summaries possible benefits of some vitamins, trace elements, nutraceuticals and probiotics in viral infections. Nutrition principles based on these data could be useful in possible prevention and management of COVID-19.


title: Meeting the Transitional Care Needs of Older Adults with COVID-19

text: Older adults with COVID-19 who survive hospitalizations and return to their homes confront substantial health challenges and an unpredictable future. While understanding of the unique needs of COVID-19 survivors is developing, components of the evidence-based Transitional Care Model provide a framework for taking a more immediate, holistic response to caring for these individuals as they moved back into the community. These components include: increasing screening, building trusting relationships, improving patient engagement, promoting collaboration across care teams, undertaking symptom management, increasing family caregiver care/education, coordinating health and social services, and improving care continuity. Evidence generated from rigorous testing of these components reveal the need for federal and state policy solutions to support the following: employment/redeployment of nurses, social workers, and community health workers; training and reimbursement of family caregivers; widespread access to research-based transitional care tools; and coordinated local efforts to address structural barriers to effective transitions. Immediate action on these policy options is necessary to more effectively address the complex issues facing these older adults and their family caregivers who are counting on our care system for essential support.


title: Guillain-Barré syndrome following COVID-19: a newly emerging post-infectious complication

text: A 57-year-old man presented with a progressive flaccid symmetrical motor and sensory neuropathy following a 1-week history of cough and malaise. He was diagnosed with Guillain-Barré syndrome secondary to COVID-19 and started on intravenous immunoglobulin. He proceeded to have worsening respiratory function and needed intubation and mechanical ventilation. This is the first reported case of this rare neurological complication of COVID-19 in the UK, but it adds to a small but growing body of international evidence to suggest a significant association between these two conditions. Increasing appreciation of this by clinicians will ensure earlier diagnosis, monitoring and treatment of patients presenting with this.


title: A Case of Pediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19 in South Dakota

text: Coronavirus infectious disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was deemed a worldwide pandemic by the World Health Organization in February 2020 The U S began seeing epidemic levels of cases in early March 2020 South Dakota case numbers dramatically increased in late March/early April, 2020 due to a large meat processing facility outbreak Although COVID-19 infections in adults more severely involve the lungs and heart with multiple organ-system dysfunction, pediatric patients have largely been spared In May 2020, a syndrome resembling severe Kawasaki disease with shock in children was reported from European groups We report a case that presented to and was managed in our Sioux Falls pediatric intensive care unit in April 2020 that fits the description, course, and successful treatment described by our European colleagues Our case fulfils the case definition of paediatric multisystem inflammatory syndrome temporally associated with COVID-19 described by the Royal College of Paediatrics and Child Health on April 27, 2020 We will review and discuss the European and US case definitions of this syndrome and similarities, and differences with Kawasaki disease and treatment options


Boosting the arsenal against COVID-19 through computational drug repurposing


title: COVID-19 and Management of Orthopedic Emergencies. Producing a Consensus of Experts

text: OBJECTIVE: Report the results of a participatory approach in Tunisian orthopedic surgery, for the development of a consensus of experts, on the identification of the list of pathologies to always be considered as non-postponable emergencies, during the COVID-19 pandemic. MATERIAL AND METHODS: This descriptive study of the opinions of Tunisian experts covered all orthopedic morbidities classified into three homogeneous groups: trauma, infections and tumors of the musculoskeletal system. The attitudes of the interviewees were collected using the "Delphi" method, using a "Google-Form" questionnaire, sent by email to all of the Tunisian university orthopedic surgeons in practice, and registered at the SOTCOT. Consensus has been established for an item, if validated by at least 80% of the experts. The analysis of the results focused on the first 30 responses to this "online" form. RESULTS: Tunisian experts agreed on the continuity of the urgency of taking in charge all the items of orthopedic morbidity during the COVID-19 pandemic, apart from the following affections: aseptic nonunions in the upper and lower limbs, aggressive giant cell tumors, and hyperalgesic disc herniations, where agreement rates were only at 8%, 12%, 58% and 77%. CONCLUSION: Relative to its disciplinary and professional specificities, the majority the of orthopedic conditions were still considered as emergencies, during the COVID-19 pandemic, which did not lend to postponement of the surgery. However, their management should obey to the recommendations of "Sorting" and the " COVID-19 Patient Pathway ", established by national authorities.


Manifestations in Neonates Born to COVID-19 Positive Mothers


title: Clinical characteristics and outcomes of the first 63 adult patients hospitalized with COVID-19: An experience from Oman

text: INTRODUCTION: To identify the clinical characteristics and outcomes of hospitalized patients with COVID-19 in Oman. METHODS: A case series of hospitalized COVID-19 laboratory-confirmed patients between February 24th through April 24th, 2020, from two hospitals in Oman. Analyses were performed using univariate statistics. RESULTS: The cohort included 63 patients with an overall mean age of 48±16 years and 84% (n=53) were males. A total of 38% (n=24) of the hospitalized patients were admitted to intensive care unit (ICU). Fifty one percent (n=32) of patients had at least one co-morbidity with diabetes mellitus (DM) (32%; n=20) and hypertension (32%; n=20) as the most common co-morbidities followed by chronic heart and renal diseases (12.8%; n=8). The most common presenting symptoms at onset of illness were fever (84%; n=53), cough (75%; n=47) and shortness of breaths (59%; n=37). All except two patients (97%; n=61) were treated with either chloroquine or hydroxychloroquine, while the three most prescribed antibiotics were ceftriaxone (79%; n=50), azithromycin (71%; n=45), and the piperacillin/tazobactam combination (49%; n=31). A total of 59% (n=37), 49% (n=31) and 24% (n=15) of the patients were on lopinavir/ritonavir, interferons, or steroids, respectively. Mortality was documented in (8%; n=5) of the patients while 68% (n=43) of the study cohort recovered. Mortality was associated with those that were admitted to ICU (19% vs 0; p=0.009), mechanically ventilated (31% vs 0; p=0.001), had DM (20% vs 2.3%; p=0.032), older (62 vs 47 years; p=0.045), had high total bilirubin (43% vs 2.3%; p=0.007) and those with high C-reactive protein (186 vs 90mg/dL; p=0.009) and low corrected calcium (15% vs 0%; p=0.047). CONCLUSIONS: ICU admission, those on mechanical ventilation, the elderly, those with high total bilirubin and low corrected calcium were associated with high mortality in hospitalized COVID-19 patients.


title: Update on asthma prevalence in severe COVID-19 patients

text: We carefully read the recently published research letter "Is asthma protective of COVID-19?" by Carli et al.1 with great interest. Important topics for asthma patients during the coronavirus disease 2019 (COVID-19) pandemic were discussed, including that until recently there was limited evidence that patients with chronic respiratory disorders are at lower risk of being infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or becoming severely ill.


title: Optimisation of non-pharmaceutical measures in COVID-19 growth via neural networks

text: On 19th March, the World Health Organisation declared a pandemic. Through this global spread, many nations have witnessed exponential growth of confirmed cases brought under control by severe mass quarantine or lockdown measures. However, some have, through a different timeline of actions, prevented this exponential growth. Currently as some continue to tackle growth, others attempt to safely lift restrictions whilst avoiding a resurgence. This study seeks to quantify the impact of government actions in mitigating viral transmission of SARS-CoV-2 by means of training neural network models to predict the daily slope increase of cumulative infected and by using such models in an optimisation study aimed at understanding the best set of mitigating actions. Data for two nations, Italy and Taiwan, have been gathered to model government restrictions in traveling, testing and enforcement of social distance measures as well as people connectivity and adherence to government actions. It is found that a larger and earlier testing campaign with tighter entry restrictions benefit both nations, resulting in significantly less confirmed cases. Interestingly, this scenario couples with an earlier but milder implementation of nationwide restrictions for Italy, thus supporting Taiwan's lack of nationwide lockdown. The results, found with a purely data-driven approach, are in line with the main findings of mathematical epidemiological models, proving that the proposed approach has value and that the data alone contains valuable knowledge to inform decision makers.


title: Accelerating Antimicrobial Discovery with Controllable Deep Generative Models and Molecular Dynamics

text: De novo therapeutic design is challenged by a vast chemical repertoire and multiple constraints such as high broad-spectrum potency and low toxicity. We propose CLaSS (Controlled Latent attribute Space Sampling) - a novel and efficient computational method for attribute-controlled generation of molecules, which leverages guidance from classifiers trained on an informative latent space of molecules modeled using a deep generative autoencoder. We further screen the generated molecules by using a set of deep learning classifiers in conjunction with novel physicochemical features derived from high-throughput molecular simulations. The proposed approach is employed for designing non-toxic antimicrobial peptides (AMPs) with strong broad-spectrum potency, which are emerging drug candidates for tackling antibiotic resistance. Synthesis and wet lab testing of only twenty designed sequences identified two novel and minimalist AMPs with high potency against diverse Gram-positive and Gram-negative pathogens, including the hard-to-treat multidrug-resistant K. pneumoniae, as well as low in vitro and in vivo toxicity. The proposed approach thus presents a viable path for faster discovery of potent and selective broad-spectrum antimicrobials with a higher success rate than state-of-the-art methods.


Hydroxychloroquine prophylaxis for high-risk COVID-19 contacts in India: a prudent approach


Outcomes of COVID-19: disparities in obesity and by ethnicity/race


docid: tmrcgdal

title: The importance of hypertension as a risk factor for severe illness and mortality in COVID-19


title: Coronavirus disease 2019: A new severe acute respiratory syndrome from Wuhan in China

text: An outbreak of new severe acute respiratory syndrome coronavirus disease, coronavirus disease 2019 (COVID-19), has emerged during December 2019. The ongoing outbreak in Wuhan City spread rapidly throughout China, where the fatality rate ranged from 2.1 to 4.9%. Due to its high transmissibility, the World Health Organization (WHO) declared a public health emergency of international concern on 30 January 2020. The current outbreak has the potential to become the first pandemic of the new millennium. Most patients who were first diagnosed with COVID-19 worked at or lived in the vicinity of the local Huanan Seafood Wholesale Market, where live animals were also on sale. The concerted efforts of Chinese scientists led to the independent isolation from patients and identification of a novel coronavirus, SARS coronavirus 2 (SARS-CoV-2), on 6 January 2020; this has been an important step in the development of treatment. The purpose of this article is to overview the history, epidemiology, clinical characteristics, diagnosis, and treatment of COVID 2019 reported in recently published studies. Based on the results of virus genome sequencing and a model of the interaction between host cells and the virus, we propose several possible targets for antiviral drugs, which may provide new ideas for epidemic control and vaccine development. Keywords: 2019 novel coronavirus; pneumonia; SARS-CoV-2; Coronaviridae; COVID-19.


Parents on the front lines of COVID-19 face tough choices


Drinking alone: COVID-19, lockdown, and alcohol-related harm


title: Hospital pharmacists' pharmaceutical care for hospitalized patients with COVID-19: Recommendations and guidance from clinical experience

text: OBJECTIVE: To discuss hospital pharmacists' role in providing pharmaceutical care for hospitalized patients with COVID-19 to promote patient care and management during the pandemic. METHOD: Based on the method of evidence-based pharmacy, clinical evidence of therapeutical drugs for COVID-19 were retrieved and summarized. Based on clinical experience Chinese hospital pharmacists gained from providing pharmaceutical care services during COVID-19 pandemic, taking COVID-19 hospitalized patients' needs into consideration, the methods and strategies hospital pharmacists shall use to provide pharmaceutical care were analyzed and summarized. RESULTS: Hospital pharmacists shall support pharmaceutical care services by participating in making evidence-based decisions for medication, monitoring and evaluation of medication safety and efficacy, providing strengthened care for special population and patients with combined underlying diseases, monitoring and management of convalescent plasma therapy, providing emotional counselling and psychological support, and providing scientific information about COVID-19 vaccines. CONCLUSION: The need of pharmaceutical care services in COVID-19 hospitalized patients during this pandemic was quite distinguished from the past. Hospital pharmacists shall join the collaborative multidisciplinary team to improve COVID-19 patients' outcome and reduce mortality, and to facilitate the pandemic control.


A confirmed case of COVID-19 among the first three from Kerala, India


title: Analysis of an improved workflow of endoscope reprocessing for bedside endoscopic diagnosis and treatment on COVID-19 patients

text: Severe cases infected with the coronavirus disease 2019 (COVID-19), named by the World Health Organization (WHO) on Feb. 11, 2020, tend to present a hypercatabolic state because of severe systemic consumption, and are susceptible to stress ulcers and even life-threatening gastrointestinal bleeding. Endoscopic diagnosis and treatment constitute an irreplaceable part in the handling of severe COVID-19 cases. Endoscopes, as reusable precision instruments with complicated structures, require more techniques than other medical devices in cleaning, disinfection, sterilization, and other reprocessing procedures. From 2016 to 2019, health care-acquired infection caused by improper endoscope reprocessing has always been among the top 5 on the list of top 10 health technology hazards issued by the Emergency Care Research Institute. Considering the highly infective nature of COVID-19 and the potential aerosol contamination therefrom, it is of pivotal significance to ensure that endoscopes are strictly reprocessed between uses. In accordance with the national standard "Regulation for Cleaning and Disinfection Technique of Flexible Endoscope (WS507-2016)," we improved the workflow of endoscope reprocessing including the selection of chemicals in an effort to ensure quality control throughout the clinical management towards COVID-19 patients. Based on the experience we attained from the 12 severe COVID-19 cases in our hospital who underwent endoscopy 23 times in total, the article provides an improved version of endoscopic reprocessing guidelines for bedside endoscopic diagnosis and treatment on COVID-19 patients for reference.


Covid-19: US sees record rise in cases


title: Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study

text: BACKGROUND: A range of public health measures have been implemented to suppress local transmission of coronavirus disease 2019 (COVID-19) in Hong Kong. We examined the effect of these interventions and behavioural changes of the public on the incidence of COVID-19, as well as on influenza virus infections, which might share some aspects of transmission dynamics with COVID-19. METHODS: We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (Rt) for COVID-19 and influenza A H1N1 to estimate changes in transmissibility over time. Attitudes towards COVID-19 and changes in population behaviours were reviewed through three telephone surveys done on Jan 20-23, Feb 11-14, and March 10-13, 2020. FINDINGS: COVID-19 transmissibility measured by Rt has remained at approximately 1 for 8 weeks in Hong Kong. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% CI 34-53%) reduction in transmissibility in the community, from an estimated Rt of 1·28 (95% CI 1·26-1·30) before the start of the school closures to 0·72 (0·70-0·74) during the closure weeks. Similarly, a 33% (24-43%) reduction in transmissibility was seen based on paediatric hospitalisation rates, from an Rt of 1·10 (1·06-1·12) before the start of the school closures to 0·73 (0·68-0·77) after school closures. Among respondents to the surveys, 74·5%, 97·5%, and 98·8% reported wearing masks when going out, and 61·3%, 90·2%, and 85·1% reported avoiding crowded places in surveys 1 (n=1008), 2 (n=1000), and 3 (n=1005), respectively. INTERPRETATION: Our study shows that non-pharmaceutical interventions (including border restrictions, quarantine and isolation, distancing, and changes in population behaviour) were associated with reduced transmission of COVID-19 in Hong Kong, and are also likely to have substantially reduced influenza transmission in early February, 2020. FUNDING: Health and Medical Research Fund, Hong Kong.


title: Impact of COVID-19 on mental health in a Low and Middle-Income Country

text: Mental disorders (MD) are commonly comorbid with cardiovascular, metabolic, and some infectious diseases. Since the current SARS-CoV-2 epidemic is affecting the most multimorbid individuals, we might expect that the epidemic will be particularly problematic for people with MD. Understanding the burden of an outbreak on mental health is fundamental to effective action towards containing the spread of the disease, as psychopathology might reduce endurance during the lockdown. This can potentially reduce adhesion to ongoing treatment resulting in avoidable recurrence of a disorder. Additionally, there is the stress caused by the eminent risk of infection or economic uncertainty, especially in low-middle income settings. This is an overview on the expected influence of the COVID-19 on mental health from a research group that has not long ago been involved in the Zika epidemic. It aims to discuss the effects of the pandemic on a Low and Middle-Income country (LMIC), Brazil.


title: Imaging manifestations and diagnostic value of chest CT of coronavirus disease 2019 (COVID-19) in the Xiaogan area

text: AIM: To report the epidemiological, clinical, and radiological characteristics of patients with COVID-19 in Xiaogan, Hubei, China. MATERIALS AND METHODS: The complete clinical and imaging data of 114 confirmed COVID-19 patients treated in Xiaogan Hospital were analysed retrospectively. Data were gathered regarding the presence of chest computed tomography (CT) abnormalities; the distribution, morphology, density, location, and stage of abnormal shadows on chest CT; and observing the correlation between the severity of chest infection and lymphocyte ratio and blood oxygen saturation (SPO2) in patients. RESULTS: Chest CT revealed abnormal lung shadows in 110 patients. Regarding lesion distribution, multi-lobe lesions in both lungs were present in most patients (80 cases; 72.7%). Lesions most frequently involved both the peripheral zone and the central zone (62 cases; 56.4%). Regarding lesion morphology, 56 cases (50.1%) demonstrated patchy shadows that were partially fused into large areas. Thirty cases showed ground-glass opacity (27.3%), 30 cases showed the consolidation change (27.3%), and the remaining 50 cases showed both types of changes (45.4%). The progressing stage was the most common stage (54 cases; 49.1%). CT results showed a negative correlation with SPO2 and lymphocyte numbers (p<0.05), with r-values of -0.446 and -0.780, respectively. CONCLUSION: Spiral CT is a sensitive examination method, which can be applied to make an early diagnosis and for evaluation of progression, with a diagnostic sensitivity and accuracy better than that of nucleic acid detection.


An editorial perspective on the infamous COVID-19 studies retracted by Lancet and NEJM


The Roles and Challenges of Facial Plastic Surgeons in Pandemics


title: Emergency endoscopic variceal band ligation in a COVID-19 patient presented with hematemesis while on mechanical ventilation

text: COVID-19, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), is now a global pandemic with serious health consequences. Currently, many strict control measures are applied in health care settings, including endoscopy units, in order to limit virus spread. Several recommendations called to limit endoscopic procedures to emergent endoscopies; however, several uncertainties still exist concerning patient safety, protective measures, and infection control methods in emergency endoscopic settings. In this case report, we present a case of successful endoscopic band ligation for bleeding esophageal varices in man with COVID-19 disease who presented with an acute attack of hematemesis while on mechanical ventilation (MV). Esophago-gastroduodenoscopy was performed in the ICU room after preparing the setting, and revealed large, risky esophageal varices. Endoscopic band ligation was done with successful control of bleeding. Third-level measures of medical protection were applied for the participating medical personnel, and patient monitoring was maintained all through the procedure. After the procedure, the bleeding stopped, and the patient was vitally stable and conscious. We conclude that emergency endoscopic interventions could be performed safely with appropriate arrangements in patients with confirmed COVID-19 on MV.


title: AGA Clinical Practice Update on Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: Expert Commentary

text: The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update was to rapidly review the emerging evidence and provide timely expert recommendations regarding the management of patients with inflammatory bowel disease during the coronavirus disease 2019 pandemic. This expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely perspective on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Gastroenterology.


title: An Analytical Perspective on Pandemic Recovery

text: After implementing restrictions to curb the spread of coronavirus, governments in the United States and around the world are trying to identify the path to social and economic recovery. The White House and the Centers for Disease Control and Prevention have published guidelines to assist US states, counties, and territories in planning these efforts. As the impact of the coronavirus pandemic has not been uniform, these central guidelines need to be translated into practice in ways that recognize variation among jurisdictions. We present a core methodology to assist governments in this task, presenting a case for appropriate actions at each stage of recovery based on scientific data and analysis. Specifically, 3 types of data are needed: data on the spread of disease should be analyzed alongside data on the overall health of the population and data on infrastructure-for example, the capacity of health systems. Local circumstances will produce different needs and present different setbacks, and governments may need to reinstate as well as relax restrictions. Transparent, defensible analysis can assist in making these decisions and communicating them to the public. In the absence of a widely administered vaccine, analysis remains one of our most important tools in addressing the coronavirus pandemic.


title: Structural elucidation of SARS-CoV-2 vital proteins: Computational methods reveal potential drug candidates against main protease, Nsp12 polymerase and Nsp13 helicase

text: The recently emerged SARS-CoV-2 caused a major outbreak of coronavirus disease 2019 (COVID-19) and instigated a widespread fear, threatening global health security. To date, no licensed antiviral drugs or vaccines are available against COVID-19 although several clinical trials are underway to test possible therapies. During this urgency situation, computational drug discovery methods provide an alternative to tiresome high-throughput screening, particularly in the hit-to-lead-optimization stage. Identification of small molecules that specifically target viral replication apparatus has indicated highest potential towards antiviral drug discovery. In this work, we present potential compounds that specifically target SARS-CoV-2 vital proteins, including the main protease, Nsp12 RNA polymerase and Nsp13 helicase. An integrative virtual screening and molecular dynamics simulations approach led to the identification of potential binding modes and favourable molecular interaction profile of corresponding compounds. Moreover, the identification of structurally important binding site residues in conserved motifs located inside the active site highlights relative importance of ligand binding based on residual energy decomposition analysis. Although the current study lacks experimental validation, the structural information obtained from this computational study has paved way for the design of targeted inhibitors to combat COVID-19 outbreak.


Author's correction for Euro Surveill. 2020;25(10)


title: Implementation of Clinical Diagnostic Criteria and Universal Symptom Survey Contributed to Lower Magnitude and Faster Resolution of the COVID-19 Epidemic in Wuhan

text: The majority of cases infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China centered in the city of Wuhan. Despite a rapid increase in the number of cases and deaths due to the coronavirus disease 2019 (COVID-19), the epidemic was stemmed via a combination of epidemic mitigation and control measures. This study evaluates how the implementation of clinical diagnostics and universal symptom surveys contributed to epidemic control in Wuhan. We extended the susceptibles-exposed-infectious-removed (SEIR) transmission dynamics model by considering three quarantined compartments (SEIR+Q). The SEIR+Q dynamics model was fitted using the daily reported number of confirmed infections and unconfirmed cases by clinical diagnostic criteria up to February 14, 2020 in Wuhan. Applying the model to carry forward the pre-February 14 trend in Wuhan, the number of daily new diagnosed cases would be expected to drop below 100 by March 25, below 10 by April 29, and reach 0 by May 31, 2020. The observed case counts after February 14 demonstrated that the daily new cases fell below 100 by March 6, below 10 by March 11, and reached 0 by March 18, or, respectively, 19, 49, and 74 d earlier than model predictions. By March 30, the observed number of cumulative confirmed cases was 50 006, which was 19 951 cases fewer than the predicted count. Effective reproductive number R(t) analysis using observed frequencies showed a remarkable decline after the implementation of clinical diagnostic criteria and universal symptom surveys, which was significantly below the R(t) curve estimated by the model assuming that the pre-February 14 trend was carried forward. In conclusion, the proposed SEIR+Q dynamics model was a good fit for the epidemic data in Wuhan and explained the large increase in the number of infections during February 12-14, 2020. The implementation of clinical diagnostic criteria and universal symptom surveys contributed to a contraction in both the magnitude and the duration of the epidemic in Wuhan.


title: WHO statement - "Older people are at highest risk from COVID-19": Should the hypothesis be corroborated or rejected?

text: Coronavirus COVID 19 has become a threat to mankind affecting millions of people worldwide. United States, Italy and Spain has the highest number of Coronavirus cases as of April 30, 2020. According to World Health Organization (WHO) statement - "Older people are at highest risk from COVID-19". However, in contrast to the statement, some new studies and findings have come to light. And this has created confusion in our mind as to whether the hypothesis should be corroborated or rejected.


title: Comparison of broad-spectrum antiviral activities of the synthetic rocaglate CR-31-B (-) and the eIF4A-inhibitor Silvestrol

text: Rocaglates, a class of natural compounds isolated from plants of the genus Aglaia, are potent inhibitors of translation initiation. They are proposed to form stacking interactions with polypurine sequences in the 5'-untranslated region (UTR) of selected mRNAs, thereby clamping the RNA substrate onto eIF4A and causing inhibition of the translation initiation complex. Since virus replication relies on the host translation machinery, it is not surprising that the rocaglate Silvestrol has broad-spectrum antiviral activity. Unfortunately, synthesis of Silvestrol is sophisticated and time-consuming, thus hampering the prospects for further antiviral drug development. Here, we present the less complex structured synthetic rocaglate CR-31-B (-) as a novel compound with potent broad-spectrum antiviral activity in primary cells and in an ex vivo bronchial epithelial cell system. CR-31-B (-) inhibited the replication of corona-, Zika-, Lassa-, Crimean Congo hemorrhagic fever viruses and, to a lesser extent, hepatitis E virus (HEV) at non-cytotoxic low nanomolar concentrations. Since HEV has a polypurine-free 5'-UTR that folds into a stable hairpin structure, we hypothesized that RNA clamping by Silvestrol and its derivatives may also occur in a polypurine-independent but structure-dependent manner. Interestingly, the HEV 5'-UTR conferred sensitivity towards Silvestrol but not to CR-31-B (-). However, if an exposed polypurine stretch was introduced into the HEV 5'-UTR, CR-31-B (-) became an active inhibitor comparable to Silvestrol. Moreover, thermodynamic destabilization of the HEV 5'-UTR led to reduced translational inhibition by Silvestrol, suggesting differences between rocaglates in their mode of action, most probably by engaging Silvestrol's additional dioxane moiety.


title: Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China

text: BACKGROUND: Cancer patients are regarded as a highly vulnerable group in the current Coronavirus Disease 2019 (COVID-19) pandemic. To date, the clinical characteristics of COVID-19-infected cancer patients remain largely unknown. PATIENTS AND METHODS: In this retrospective cohort study, we included cancer patients with laboratory-confirmed COVID-19 from three designated hospitals in Wuhan, China. Clinical data were collected from medical records from 13 January 2020 to 26 February 2020. Univariate and multivariate analyses were carried out to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death. RESULTS: A total of 28 COVID-19-infected cancer patients were included; 17 (60.7%) patients were male. Median (interquartile range) age was 65.0 (56.0-70.0) years. Lung cancer was the most frequent cancer type (n = 7; 25.0%). Eight (28.6%) patients were suspected to have hospital-associated transmission. The following clinical features were shown in our cohort: fever (n = 23, 82.1%), dry cough (n = 22, 81%), and dyspnoea (n = 14, 50.0%), along with lymphopaenia (n = 23, 82.1%), high level of high-sensitivity C-reactive protein (n = 23, 82.1%), anaemia (n = 21, 75.0%), and hypoproteinaemia (n = 25, 89.3%). The common chest computed tomography (CT) findings were ground-glass opacity (n = 21, 75.0%) and patchy consolidation (n = 13, 46.3%). A total of 15 (53.6%) patients had severe events and the mortality rate was 28.6%. If the last antitumour treatment was within 14 days, it significantly increased the risk of developing severe events [hazard ratio (HR) = 4.079, 95% confidence interval (CI) 1.086-15.322, P = 0.037]. Furthermore, patchy consolidation on CT on admission was associated with a higher risk of developing severe events (HR = 5.438, 95% CI 1.498-19.748, P = 0.010). CONCLUSIONS: Cancer patients show deteriorating conditions and poor outcomes from the COVID-19 infection. It is recommended that cancer patients receiving antitumour treatments should have vigorous screening for COVID-19 infection and should avoid treatments causing immunosuppression or have their dosages decreased in case of COVID-19 coinfection.


title: Prevalence and predictors of general psychiatric disorders and loneliness during COVID-19 in the United Kingdom

text: Despite ample research on the prevalence of specific psychiatric disorders during COVID-19, we know little about the broader psychological impact of the pandemic on a wider population. The study investigates the prevalence and predictors of general psychiatric disorders measured by the 12-item General Health Questionnaire (GHQ-12) and frequency of loneliness during COVID-19 in the United Kingdom, a country heavily hit by the pandemic. We analyzed 15,530 respondents of the first large-scale, nationally representative survey of COVID-19 in a developed country, the first wave of Understanding Society COVID-19 Study. Results show that 29.2% of the respondents score 4 or more, the caseness threshold, on the general psychiatric disorder measure, and 35.86% of the respondents sometimes or often feel lonely. Regression analyses show that those who have or had COVID-19-related symptoms are more likely to develop general psychiatric disorders and are lonelier. Women and young people have higher risks of general psychiatric disorders and loneliness, while having a job and living with a partner are protective factors. This study showcases the psychological impact, including general psychiatric disorders and loneliness, of broader members of the society during COVID-19 and the underlying social inequalities.


SGLT-2 inhibitors for COVID-19 - A miracle waiting to happen or just another beat around the bush?


Strategies for qualified triage stations and fever clinics during the outbreak of COVID-2019 in the county hospitals of Western Chongqing


title: SARS-CoV-2: origen, estructura, replicación y patogénesis

text: La enfermedad por coronavirus 2019, es una enfermedad respiratoria aguda con una amplia gama de manifestaciones: desde un simple resfriado, pasando por una neumonía leve, moderada o grave, hasta sepsis, shock séptico o la muerte Inició presuntamente en un mercado de animales vivos en la ciudad de Wuhan, provincia de Hubei, China, en diciembre de 2019 Su agente etiológico es el coronavirus 2 del síndrome respiratorio agudo grave, cuyo origen específico aún no se ha determinado Estudios filogenéticos orientan a, pero no confirman, que el virus pudo haberse originado en murciélagos En lo que va del siglo XXI, esta es la tercera enfermedad en el ser humano provocada por un coronavirus altamente patógeno Las primeras dos fueron el Síndrome Respiratorio Agudo Grave y el Síndrome Respiratorio del Medio Oriente Este artículo describe el conocimiento actual del origen, la estructura y la patogénesis del coronavirus 2 del síndrome respiratorio agudo grave, así como el daño tisular que provoca en los pacientes infectados (AU)Coronavirus disease 2019 is an acute respiratory illness with multiple clinical manifestations, ranging from a simple cold to mild, moderate or severe pneumonia, or even sepsis, septic shock and death It allegedly started in a live animal market in Wuhan City, Hubei Province, China, in December 2019 Its etiological agent is the severe acute respiratory syndrome coronavirus 2, its specific origin has not yet been determined Phylogenetic studies guide, but do not confirm, that the virus may have originated in bats This is the third disease in humans caused by a highly pathogenic coronavirus during the 21st century The first two were Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome This essay describes current knowledge about the origin, structure and pathogenesis of severe acute respiratory syndrome coronavirus 2, as well as the tissue damage it causes in infected patients (AU)


The New Coronavirus, the Current King of China


Lack of COVID-19 transmission on an international flight


Evolving Neuroimaging Findings during COVID-19


title: Coexistence of DIPNECH and carotid body paraganglioma: is it just a coincidence?

text: Summary: We describe the case of a 56 year-old woman with the almost simultaneous appearance of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) and a carotid body paraganglioma. Of interest, 6 years earlier, the patient underwent total thyroidectomy due to papillary thyroid carcinoma and, in the meantime, she was submitted to mastectomy to treat an invasive ductal carcinoma of the breast. In order to explain these lesions, an extensive genetic study was performed. Results showed positivity for the presence of the tumor suppressor gene PALB2, whose presence had already been detected in a niece with breast cancer. The patient underwent different procedures to treat the lesions and currently she is symptom-free over 2 years of follow-up. Learning points: The presence of two rare neoplasms in a single person should raise the suspicion of a common etiology. To the best of our knowledge, this is the first case that shows the coexistence of DIPNECH and paraganglioma. The contribution of the PALB2 gene in the etiology of these rare neoplasms is a possibility.


docid: jksgcaba

title: COVID-19 in a severe eosinophilic asthmatic receiving benralizumab - a case study

text: Introduction: Only little is known about COVID-19 in patients with asthma. There is no data on COVID-19 in patients with severe asthma or patients with asthma who are treated with monoclonal antibodies.Case Study: Here, we present the case of a severe eosinophilic asthmatic in whom benralizumab treatment, an anti-IL-5R monoclonal antibody, was initiated 2 years ago. Prior to benralizumab treatment, every viral infection had resulted in a prolonged course of oral corticosteroids (OCS). Since initiation of benralizumab, the patient has had good asthma control. Mid-March 2020, the patient developed high fever.Results: A SARS-CoV-2-PCR (nasopharyngeal swab) was positive. The patient's symptoms subsided after few days. No OCS was needed. The asthma control questionnaire 6-item scale worsened moderately in the week of the infection and returned to normal levels thereafter. The asthma control test, measuring longer term asthma control, showed no decline.Conclusion: The course of COVID-19 was very mild in this particular patient with severe eosinophilic asthma. So far, there is no evidence that would suggest a more severe course of COVID-19 in patients with asthma. It is worth noting, that prior to the initiation of benralizumab this patient had multiple exacerbations per year triggered by viral infections (4/year), which all required OCS. Whilst only anecdotal, this case study provides the first evidence to support the current recommendation of continuing monoclonal antibodies in patients with severe asthma during the COVID-19 pandemic.


title: Radiology department strategies to protect radiologic technologists against COVID19: Experience from Wuhan

text: The outbreak of Coronavirus Disease 2019 (COVID-19) is a huge threat to global public health security. In the absence of specific antiviral medicines to prevent or treat COVID-19, it is essential to detect the infected patients at an early stage and immediately isolate them from the healthy population. In view of the advantages of sensitivity and high spatial resolution, CT imaging has played an important role in screening and diagnosing of COVID-19 in China. The radiologic technologists performing CT scans for the infected patients become high-risk medical care personnel. It is critical for the radiology department to ensure the personal safety of radiologic technologists and avoid cross-infection. In this review article, we describe the systematic strategies to combat COVID-19 from the radiology department in Tongji hospital in Wuhan, P.R. China, including personnel arrangements, environmental modification, protection levels and configurations, radiological imaging (CT and radiography), and disinfection methods. It can provide guidance to other radiology departments faced with COVID-19 to reduce infection risk for radiologic technologists.


title: Art therapy in the time of COVID-19

text: We are fighting two invisible enemies: COVID-19 and mental health challenges due to unmitigated stress and trauma as we follow directions to avoid the spread of the virus. To address the mental health challenges, art therapy is offered as a tool to support individuals during periods of isolation. Art therapy is a wonderful self-care activity that can benefit individuals throughout the life span. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Efferocytosis and Its Associated Cytokines: A Light on Non-tumor and Tumor Diseases?

text: Billions of cells undergo turnover and die via apoptosis throughout our lifetime. A prompt clearance of these apoptotic cells and debris by phagocytic cells, a process known as efferocytosis, is important in maintaining tissue homeostasis. Accordingly, impaired efferocytosis due to the defective clearance and disrupted stages can lead to a growing number of inflammation- and immune-related diseases. Although numerous studies have shown the mechanisms of efferocytosis, its role in disorders, such as non-tumor and tumor diseases, remains poorly understood. This review summarizes the processes and signal molecules in efferocytosis, and efferocytosis-related functions in non-tumor (atherosclerosis, lung diseases, etc.) and tumor diseases (breast cancer, prostate cancer, etc.), as well as describes the role of involved cytokines. Of note, there is a dual role of efferocytosis in the abovementioned disorders, and a paradoxical effect among non-tumor and tumor diseases in terms of inflammation resolution, immune response, and disease progression. Briefly, intact efferocytosis and cytokines promote tissue repair, while they contribute to tumor progression via tumor microenvironment and macrophage politzerization. Additionally, this review provides potential targets associated with TAM receptors and cytokines, such as tumor necrosis factor α - and CXCL5, suggesting potential novel therapeutic ways in treating diseases.


title: Collateral Damage of the COVID-19 Pandemic on Nutritional Quality and Physical Activity: Perspective from South Korea

text: A novel coronavirus (SARS-CoV-2), that emerged in the city of Wuhan, China in December 2019, has now spread worldwide.


docid: gywizkkq

title: Noncontact endoscopy for infection-free gastric examination during the COVID-19 pandemic


title: Adaptation and evaluation of Turkish version of the fear of COVID-19 Scale

text: We investigated the psychometric properties of the Fear of COVID-19 Scale in Turkish among a diverse group with a focus on the prevalence of coronavirus related fear across gender, age intervals, SES, chronic illness situation, and educational level. Based on a confirmatory factor analysis, the Fear of COVID-19 Scale had appropriate psychometric properties for utilization, including excellent goodness-of-fit indices, a Cronbach's alpha value of .86, and discriminant validity, as shown by a significant negative correlation with resilience. Furthermore, group comparison analyses revealed that women reported significantly higher fear of coronavirus. Additionally, individuals from middle SES reported significantly higher fear of coronavirus while the fear of coronavirus did not differ based on participants' educational level, socioeconomic status, and age level. Implications for mental health providers are discussed.


title: Renin-angiotensin system inhibition in COVID-19 patients

text: Angiotensin-converting enzyme (ACE) inhibitors (ACEIs) and angiotensin II type1 receptor blockers (ARBs) are among the most widely prescribed drugs for the treatment of arterial hypertension, heart failure and chronic kidney disease. A number of studies, mainly in animals and not involving the lungs, have indicated that these drugs can increase expression of angiotensin-converting enzyme 2 (ACE2). ACE2 is the cell entry receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19) that is currently battering the globe. This has led to the hypothesis that use of ACEIs and ARBs may increase the risk of developing severe COVID-19. In this point of view paper, possible scenarios regarding the impact of ACEI/ARB pharmacotherapy on COVID-19 are discussed in relation to the currently available evidence. Although further research on the influence of blood-pressure-lowering drugs, including those not targeting the renin-angiotensin system, is warranted, there are presently no compelling clinical data showing that ACEIs and ARBs increase the likelihood of contracting COVID-19 or worsen the outcome of SARS-CoV2 infections. Thus, unless contraindicated, use of ACEIs/ARBs in COVID-19 patients should be continued in line with the recent recommendations of medical societies.


title: Rapid viral diagnosis and ambulatory management of suspected COVID-19 cases presenting at the infectious diseases referral hospital in Marseille, France, - January 31st to March 1st, 2020: A respiratory virus snapshot

text: BACKGROUND: Rapid virological diagnosis is needed to limit the length of isolation for suspected COVID-19 cases. METHOD: We managed the first 280 patients suspected to have COVID-19 through a rapid care circuit and virological diagnosis in our infectious disease reference hospital in Marseille, France. Rapid viral detection was performed on sputum and nasopharyngeal samples. RESULTS: Over our study period, no SARS-CoV-2 was detected. Results were obtained within approximately 3 h of the arrival of patient samples at the laboratory. Other viral infections were identified in 49% of the patients, with most common pathogens being influenza A and B viruses, rhinovirus, metapneumovirus and common coronaviruses, notably HKU1 and NL63. CONCLUSION: Early recognition of COVID-19 is critical to isolate confirmed cases and prevent further transmission. Early rule-out of COVID-19 allows public health containment measures to be adjusted by reducing the time spent in isolation.


Reactive Psychosis in a Health Care Worker During the COVID-19 Pandemic


title: Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva

text: BACKGROUND: Patients with coronavirus disease 2019 (COVID-19) can unknowingly spread the virus to several people during the early subclinical period. METHODS: We evaluated the viral dynamics in various body fluid specimens, such as nasopharyngeal swab, oropharyngeal swab, saliva, sputum, and urine specimens, of two patients with COVID-19 from hospital day 1 to 9. Additional samples of the saliva were taken at 1 hour, 2 hours, and 4 hours after using a chlorhexidine mouthwash. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load was determined by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). RESULTS: SARS-CoV-2 was detected from all the five specimens of both patients by rRT-PCR. The viral load was the highest in the nasopharynx (patient 1 = 8.41 log10 copies/mL; patient 2 = 7.49 log10 copies/mL), but it was also remarkably high in the saliva (patient 1 = 6.63 log10 copies/mL; patient 2 = 7.10 log10 copies/mL). SARS-CoV-2 was detected up to hospital day 6 (illness day 9 for patient 2) from the saliva of both patients. The viral load in the saliva decreased transiently for 2 hours after using the chlorhexidine mouthwash. CONCLUSION: SARS-CoV-2 viral load was consistently high in the saliva; it was relatively higher than that in the oropharynx during the early stage of COVID-19. Chlorhexidine mouthwash was effective in reducing the SARS-CoV-2 viral load in the saliva for a short-term period.


title: COVID-19, Chloroquine Repurposing, and Cardiac Safety Concern: Chirality Might Help

text: The desperate need to find drugs for COVID-19 has indicated repurposing strategies as our quickest way to obtain efficacious medicines. One of the options under investigation is the old antimalarial drug, chloroquine, and its analog, hydroxychloroquine. Developed as synthetic succedanea of cinchona alkaloids, these chiral antimalarials are currently in use as the racemate. Besides the ethical concern related to accelerated large-scale clinical trials of drugs with unproven efficacy, the known potential detrimental cardiac effects of these drugs should also be considered. In principle, the safety profile might be ameliorated by using chloroquine/hydroxychloroquine single enantiomers in place of the racemate.


Providing Steroid/Corticosteroid Injections Safely in the Covid-19 Environment


Medicaid and COVID-19: At the Center of Both Health and Economic Crises


Polypill for Population-Level Primary Cardiovascular Prevention in Underserved Populations-A Social Epidemiology Counterargument


Nebulisers as a potential source of airborne virus


title: COVID-19 Outbreak Among Three Affiliated Homeless Service Sites - King County, Washington, 2020

text: On March 30, 2020, Public Health - Seattle and King County (PHSKC) was notified of a confirmed case of coronavirus disease 2019 (COVID-19) in a resident of a homeless shelter and day center (shelter A). Residents from two other homeless shelters (B and C) used shelter A's day center services. Testing for SARS-CoV-2, the virus that causes COVID-19, was offered to available residents and staff members at the three shelters during March 30-April 1, 2020. Among the 181 persons tested, 19 (10.5%) had positive test results (15 residents and four staff members). On April 1, PHSKC and CDC collaborated to conduct site assessments and symptom screening, isolate ill residents and staff members, reinforce infection prevention and control practices, provide face masks, and advise on sheltering-in-place. Repeat testing was offered April 7-8 to all residents and staff members who were not tested initially or who had negative test results. Among the 118 persons tested in the second round of testing, 18 (15.3%) had positive test results (16 residents and two staff members). In addition to the 31 residents and six staff members identified through testing at the shelters, two additional cases in residents were identified during separate symptom screening events, and four were identified after two residents and two staff members independently sought health care. In total, COVID-19 was diagnosed in 35 of 195 (18%) residents and eight of 38 (21%) staff members who received testing at the shelter or were evaluated elsewhere. COVID-19 can spread quickly in homeless shelters; rapid interventions including testing and isolation to identify cases and minimize transmission are necessary. CDC recommends that homeless service providers implement appropriate infection control practices, apply physical distancing measures including ensuring resident's heads are at least 6 feet (2 meters) apart while sleeping, and promote use of cloth face coverings among all residents (1).


The Coming Coronavirus Recession : And the Uncharted Territory Beyond


Filtration evaluation and clinical use of expired elastomeric P-100 filter cartridges during the COVID-19 pandemic


title: Characteristics, Symptom Management, and Outcomes of 101 Patients With COVID-19 Referred for Hospital Palliative Care

text: Hospital palliative care is an essential part of the COVID-19 response but data are lacking. We identified symptom burden, management, response to treatment, and outcomes for a case series of 101 inpatients with confirmed COVID-19 referred to hospital palliative care. Patients (64 men, median [interquartile range {IQR}] age 82 [72-89] years, Elixhauser Comorbidity Index 6 [2-10], Australian-modified Karnofsky Performance Status 20 [10-20]) were most frequently referred for end-of-life care or symptom control. Median [IQR] days from hospital admission to referral was 4 [1-12] days. Most prevalent symptoms (n) were breathlessness (67), agitation (43), drowsiness (36), pain (23), and delirium (24). Fifty-eight patients were prescribed a subcutaneous infusion. Frequently used medicines (median [range] dose/24 hours) were opioids (morphine, 10 [5-30] mg; fentanyl, 100 [100-200] mcg; alfentanil, 500 [150-1000] mcg) and midazolam (10 [5-20] mg). Infusions were assessed as at least partially effective for 40/58 patients, while 13 patients died before review. Patients spent a median [IQR] of 2 [1-4] days under the palliative care team, who made 3 [2-5] contacts across patient, family, and clinicians. At March 30, 2020, 75 patients had died; 13 been discharged back to team, home, or hospice; and 13 continued to receive inpatient palliative care. Palliative care is an essential component to the COVID-19 response, and teams must rapidly adapt with new ways of working. Breathlessness and agitation are common but respond well to opioids and benzodiazepines. Availability of subcutaneous infusion pumps is essential. An international minimum data set for palliative care would accelerate finding answers to new questions as the COVID-19 pandemic develops.


title: SARS-CoV-2 infection in a patient on chronic hydroxychloroquine therapy: Implications for prophylaxis

text: People exposed to COVID-19 have a risk of developing disease, and health care workers are at risk at a time when they are badly needed during a health care crisis. Hydroxychloroquine and chloroquine have been used as treatment and are being considered as prophylaxis. Our patient developed COVID-19 while on hydroxychloroquine and although more work is needed, this calls into question the role of these medications as preventive therapy.


Routine vaccination during covid-19 pandemic response


title: Avaliação do conhecimento em Boas Práticas de Fabricação de manipuladores de Unidades de Alimentação e Nutrição off shore

text: Em uma Unidade de Alimentação e Nutrição (UAN) o manipulador de alimentos é responsável por produzir refeições de boa qualidade em condições adequadas, que não coloquem em risco a saúde do comensal. Diante disso, a avaliação do conhecimento desses manipuladores sobre boas práticas de fabricação se toma essencial. O presente estudo objetivou avaliar o conhecimento em Boas Práticas de Fabricação (BPF) de manipuladores de UAN offshore, localizadas na bacia de Campos. A pesquisa foi realizada em 19 unidades offshore. Foram usados como critérios avaliativos questionários que avaliaram dados socioeconômico-demográficos, nível de conhecimento sobre as boas práticas de fabricação e treinamentos em BPF. Os manipuladores foram abordados no momento do desembarque. Foi avaliado o conhecimento de 71 manipuladores. Verificou-se que a maior parte pertence ao sexo masculino (95,8%), com idade média de 37,45 ± 10,29 anos. Quanto ao nível de escolaridade 68% dos manipuladores apresentaram o ensino médio completo e 78% recebem dois salários mínimos. Todos os manipuladores (100%) já haviam recebido treinamento sobre BPF. Em relação ao conhecimento sobre BPF todas as respostas atingiram mais de 75% de acertos. Não foi encontrada relação significativa (p<0,05) entre conhecimento de BPF com tempo de profissão, grau de escolaridade e realização de treinamento. Os resultados demonstraram que o conhecimento em BPF e treinamentos obtiveram porcentagens de acertos consideradas satisfatórias, mostrando que os manipuladores das UANs offshore apresentam bom nível de conhecimento sobre o assunto.(AU)


There is no stopping covid-19 without stopping racism


title: The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease)

text: BACKGROUND: A novel form of Coronavirus (2019-nCoV) in Wuhan has created a confused and rapidly evolving situation. In this situational framework, patients and front-line healthcare workers are vulnerable. METHOD: Studies were identified using large-circulation international journals found in two electronic databases: Scopus and Embase. RESULTS: Populations of patients that may require tailored interventions are older adults and international migrant workers. Older adults with psychiatric conditions may be experiencing further distress. The COVID-19 epidemic has underscored potential gaps in mental health services during emergencies. CONCLUSIONS: Most health professionals working in isolation units and hospitals do not receive any training for providing mental health care. Fear seems more certainly a consequence of mass quarantine.


title: Tracheostomy in the COVID-19 pandemic

text: PURPOSE: The role of tracheostomy in COVID-19-related ARDS is unknown. Nowadays, there is no clear indication regarding the timing of tracheostomy in these patients. METHODS: We describe our synergic experience between ENT and ICU Departments at University Hospital of Modena underlining some controversial aspects that would be worth discussing tracheostomies in these patients. During the last 2 weeks, we performed 28 tracheostomies on patients with ARDS due to COVID-19 infection who were treated with IMV. RESULTS: No differences between percutaneous and surgical tracheostomy in terms of timing and no case of team virus infection. CONCLUSION: In our experience, tracheostomy should be performed only in selected patients within 7- and 14-day orotracheal intubation.


title: COVID-19 and psoriasis: biologic treatment and challenges

text: Background: There is concern about susceptibility of psoriatic patients on biologics to coronavirus disease 2019 (COVID-19) and its clinical course.Purpose: The aims of present review were to determine whether the biologic treatment of psoriasis increases the risk of SARS-CoV-2 infection and if biologics affect the clinical course of COVID-19 in these patients.Methods: We searched database of MEDLINE (PubMed) for key term of psoriasis biologic and COVID-19 until June 9, 2020 and all published 14 papers and an experience from Iran (10509 cases) related to the psoriatic patients on biologics and COVID-19 along with relevant papers were summarized. In spite of limitation in some reports, due to some of strengths that will be discussed, all papers were included in this review.Results: According to 8769 medical reports around 0.3% of psoriatic patients had COVID-19 and the rate of hospitalization was 0.1%. No death due to COVID-19 was reported among 10509 patients. Reports indicated psoriatic patients on biologics were not more susceptible to COVID-19 and the severe clinical course of disease.Conclusion: While there is not definitive controlled trial data, the available evidence suggests that patients with psoriasis without COVID-19 can continue the biologic therapy for psoriasis.


New Guidance on Managing Inpatient Hyperglycaemia during the COVID-19 Pandemic


docid: kkgowquh

text: The COVID-19 pandemic has had a dramatic impact on the provision of acute inpatient care with specialists from all disciplines having to manage patients outside of their usual speciality areas. In many UK hospitals diabetes consultants and diabetes inpatient specialist nurses have been redeployed to the wards to care for COVID-19 positive or suspected cases. Consequently, clinicians relatively unfamiliar with managing hyperglycaemia have been required to do so as the usual input from diabetes specialist teams has not been possible in many areas.


Coronavirus Disease 2019 (COVID-19): Radiology Department Financial Impact and Planning for Post-COVID Recovery


Maternal deaths with coronavirus disease 2019: a different outcome from low- to middle-resource countries?


title: SARS-CoV-2 does not replicate in embryonated hen's eggs or in MDCK cell lines

text: The advent of COVID-19, has posed a risk that human respiratory samples containing human influenza viruses may also contain SARS-CoV-2. This potential risk may lead to SARS-CoV-2 contaminating conventional influenza vaccine production platforms as respiratory samples are used to directly inoculate embryonated hen's eggs and continuous cell lines that are used to isolate and produce influenza vaccines. We investigated the ability of these substrates to propagate SARS-CoV-2 and found that neither could support SARS-CoV-2 replication.


title: Bat SARS-Like WIV1 coronavirus uses the ACE2 of multiple animal species as receptor and evades IFITM3 restriction via TMPRSS2 activation of membrane fusion

text: Diverse SARS-like coronaviruses (SL-CoVs) have been identified from bats and other animal species. Like SARS-CoV, some bat SL-CoVs, such as WIV1, also use angiotensin converting enzyme 2 (ACE2) from human and bat as entry receptor. However, whether these viruses can also use the ACE2 of other animal species as their receptor remains to be determined. We report herein that WIV1 has a broader tropism to ACE2 orthologs than SARS-CoV isolate Tor2. Among the 9 ACE2 orthologs examined, human ACE2 exhibited the highest efficiency to mediate the infection of WIV1 pseudotyped virus. Our findings thus imply that WIV1 has the potential to infect a wide range of wild animals and may directly jump to humans. We also showed that cell entry of WIV1 could be restricted by interferon-induced transmembrane proteins (IFITMs). However, WIV1 could exploit the airway protease TMPRSS2 to partially evade the IFITM3 restriction. Interestingly, we also found that amphotericin B could enhance the infectious entry of SARS-CoVs and SL-CoVs by evading IFITM3-mediated restriction. Collectively, our findings further underscore the risk of exposure to animal SL-CoVs and highlight the vulnerability of patients who take amphotericin B to infection by SL-CoVs, including the most recently emerging (SARS-CoV-2).


docid: qabbntov

title: Agrodiag PorCoV: A multiplex immunoassay for the differential diagnosis of porcine enteric coronaviruses

text: Three different porcine enteric coronaviruses (PECs), i.e., porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV) and porcine Deltacoronavirus (PDCoV) are currently circulating in U.S. commercial swine herds. Differential diagnosis of PECs relies on laboratory methods. This study describes the development of an ELISA-like multiplex planar immunoassay based on virus-specific recombinant S1 proteins printed in an array of spots at the bottom of a 96-well microplate for simultaneous detection differential serodiagnosis of PEDV, TGEV, PDCoV in a single sample. The technology overall format and working principle is similar to the solid-phase standard ELISA. After the three typical incubation steps, the reaction was visualized as blue spots which intensity correlated with antibody levels to specific viral antigen target in the array. The diagnostic performance of the assay was evaluated on known status serum samples (n = 480) collected over time (day post-inoculation -7, 0, 7, 14, 21, 28, 35, and 42) from pigs inoculated with PEDV, TGEV Purdue, TGEV Miller, PDCoV (USA/IL/2014), or mock inoculated with culture media under experimental conditions. Antigen-specific cut-offs were selected to ensure 100% diagnostic and analytical specificity for each given antigen target. The overall diagnostic sensitivity was 92% (44/48 positives, 95% confidence interval (CI) 98,100) for PEDV S1, 100% (95/95 positives, 95% CI 98, 100) for TGEV S1, and 98% (47/48 positives, 95% CI 97, 100) for PDCoV S1. The results of this study demonstrate that the AgroDiag PEC multiplex immunoassay is an efficient and reliable test for differential detection and serodiagnosis of PEDV, TGEV and PDCoV.


Comment on "Hearing loss and COVID-19: A note"


title: Distant sequence similarity between hepcidin and the novel coronavirus spike glycoprotein: a potential hint at the possibility of local iron dysregulation in COVID-19

text: The spike glycoprotein of the SARS-CoV-2 virus, which causes COVID-19, has attracted attention for its vaccine potential and binding capacity to host cell surface receptors. Much of this research focus has centered on the ectodomain of the spike protein. The ectodomain is anchored to a transmembrane region, followed by a cytoplasmic tail. Here we report a distant sequence similarity between the cysteine-rich cytoplasmic tail of the coronavirus spike protein and the hepcidin protein that is found in humans and other vertebrates. Hepcidin is thought to be the key regulator of iron metabolism in humans. An implication of this preliminary observation is to suggest a potential route of investigation in the coronavirus research field making use of an already-established literature on the interplay of local and systemic iron regulation, cytokine-mediated inflammatory processes, respiratory infections and the hepcidin protein. The question of possible homology and an evolutionary connection between the viral spike protein and hepcidin is not assessed in this report, but some scenarios for its study are discussed.