title: A method of identifying the blood contributor in mixture stains through detecting blood specific mRNA polymorphism

text: In the past decades, messenger RNA (mRNA) biomarkers have been employed to identify the origin of body fluids in forensic medicine. We hypothesized that the polymorphism of mRNA could be applied to identifying individuals in mixture samples composed of two body fluids. In this study, we selected 5 blood-specific mRNA biomarkers of venous blood (SPTB, CD3G, AMICA1, ANK1, GYPA) that encompass 16 SNPs to identify the mixture contributor(s). Five specific gene markers for menstrual blood, semen, skin, saliva and vaginal secretions were amplified and typed as body-fluid positive controls. We established the system of multiplex PCR and single base extension reaction (SBE) followed by capillary electrophoresis. The amplicon size was between 90bp-294bp. The peripheral blood specificity was examined against other human body fluids, including saliva, semen, skin, menstrual blood, and vaginal secretion. The 16 SNPs were peripheral blood specific and could be successfully typed in home-made mixtures which are composed of different body fluids with 1ng peripheral blood mRNA added. This system showed a super sensitivity (1:100) in detecting the trace amount of peripheral blood mixed in other body fluids and a combined discrimination power (CDP) of 0.99929 in Chinese population. It was the first time to establish a method of identifying the blood donors and deconvoluting mixtures through detecting mRNA polymorphism with SNaPshot assay. This peripheral blood-specific SNP typing system showed high sensitivity to the typing of blood-source specific markers regardless of other body fluids in the mixture. This article is protected by copyright. All rights reserved.


title: Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis

text: The coronavirus-disease 2019 (COVID-19) was announced as a global pandemic by the World Health Organization. Challenges arise concerning how to optimally support the immune system in the general population, especially under self-confinement. An optimal immune response depends on an adequate diet and nutrition in order to keep infection at bay. For example, sufficient protein intake is crucial for optimal antibody production. Low micronutrient status, such as of vitamin A or zinc, has been associated with increased infection risk. Frequently, poor nutrient status is associated with inflammation and oxidative stress, which in turn can impact the immune system. Dietary constituents with especially high anti-inflammatory and antioxidant capacity include vitamin C, vitamin E, and phytochemicals such as carotenoids and polyphenols. Several of these can interact with transcription factors such as NF-kB and Nrf-2, related to anti-inflammatory and antioxidant effects, respectively. Vitamin D in particular may perturb viral cellular infection via interacting with cell entry receptors (angiotensin converting enzyme 2), ACE2. Dietary fiber, fermented by the gut microbiota into short-chain fatty acids, has also been shown to produce anti-inflammatory effects. In this review, we highlight the importance of an optimal status of relevant nutrients to effectively reduce inflammation and oxidative stress, thereby strengthening the immune system during the COVID-19 crisis.


title: Remote consultations in the era of COVID-19 pandemic: Preliminary experience in a regional Australian public acute mental health care setting

text: In the wake of the recent pandemic of Corona Virus Disease 2019 (COVID-19), with confirmed cases having crossed 750,000, health systems across the world are getting overwhelmed; making it strenuous to maintain essential health services. Several changes were implemented in our acute mental health care service using a collaborative approach to maintain a balance between preventive measures to 'flatten the curve' and to provide care to those who were in need. Mode of service delivery was changed predominantly to tele-medicine, amongst others. It was found to be a workable model, albeit further follow up will be required to better understand its viability and feasibility to withstand the COVID-19 cataclysm.


title: [Rheumatology and COVID-19]

text: Current pandemic implies changes in patient care in rheumatology to reduce the risk of coronavirus transmission to patients visiting health-care facilities, by organizing less frequent blood tests, using teleconsultations, and switching from intravenous to subcutaneous drug administration Patients under immunosuppressive treatment are considered at high risk of severe outcome and are protected accordingly by the Swiss authorities However, current, scarce scientific evidence suggests that patients under immunosuppressive therapy do not necessarily develop severe COVID-19 presentations Therefore, the current guidelines recommend pursuing the treatment throughout the pandemic In case of SARS-CoV-2 infection, immunosuppressive drugs should be temporarily stopped, except for glucocorticoids, hydroxychloroquine and sulfasalazine


title: SARS-CoV-2 infection and obesity: Common inflammatory and metabolic aspects

text: BACKROUND AND AIMS: According to the World Obesity Federation, "obesity-related conditions seem to worsen the effect of Covid-19 (SARS-CoV-2)"; additionally the Centres for Disease Control and Prevention reported that "people with heart disease and diabetes are at higher risk of SARS-CoV-2 complications and that severe obesity poses a higher risk for severe illness". Recent reports have shown elevated levels of cytokines due to increased inflammation in patients with SARS-CoV-2 disease. On the other hand, obesity represents a state of low-grade inflammation, with various inflammatory products directly excreted by adipose tissue. In this concise report we aimed to assess common elements of obesity and SARS-CoV-2 infection. METHODS: Pubmed search on obesity and SARS-CoV-2 infection. RESULTS: We present "mechanistic" obesity-related problems that aggravate SARS-CoV-2 infection as well as tentative inflammatory/metabolic links between these diseases. CONCLUSION: Obesity and SARS-CoV-2 share common elements of the inflammatory process (and possibly also metabolic disturbances), exacerbating SARS-CoV-2 infection in the obese.


title: Isolation and rapid sharing of the 2019 novel coronavirus (SARS-CoV-2) from the first patient diagnosed with COVID-19 in Australia

text: OBJECTIVES: To describe the first isolation and sequencing of SARS-CoV-2 in Australia and rapid sharing of the isolate. SETTING: SARS-CoV-2 was isolated from a 58-year-old man from Wuhan, China who arrived in Melbourne on 19 January 2020 and was admitted to the Monash Medical Centre, Melbourne from the emergency department on 24 January 2020 with fever, cough, and progressive dyspnoea. MAJOR OUTCOMES: Clinical course and laboratory features of the first reported case of COVID-19 (the illness caused by SARS-CoV-2) in Australia; isolation, whole genome sequencing, imaging, and rapid sharing of virus from the patient. RESULTS: A nasopharyngeal swab and sputum collected when the patient presented to hospital were each positive for SARS-CoV-2 (reverse transcription polymerase chain reaction). Inoculation of Vero/hSLAM cells with material from the nasopharyngeal swab led to the isolation of SARS-CoV-2 virus in culture. Electron microscopy of the supernatant confirmed the presence of virus particles with morphology characteristic of viruses of the family Coronaviridae. Whole genome sequencing of the viral isolate and phylogenetic analysis indicated the isolate exhibited greater than 99.99% sequence identity with other publicly available SARS-CoV-2 genomes. Within 24 hours of isolation, the first Australian SARS-CoV-2 isolate was shared with local and overseas reference laboratories and major North American and European culture collections. CONCLUSIONS: The ability to rapidly identify, propagate, and internationally share our SARS-CoV-2 isolate is an important step in collaborative scientific efforts to deal effectively with this international public health emergency by developing better diagnostic procedures, vaccine candidates, and antiviral agents.


title: Global changes and factors of increase in caloric/salty food, screen, and substance use, during the early COVID-19 containment phase in France: a general population online survey

text: BACKGROUND: The international outbreak of the COVID-19 pandemic has led many countries to enforce drastic containment measures. It has been suggested that this abrupt lockdown of populations would foster addiction-related habits, such as caloric/salty (C/S) food intake, screen use, and substance use. However, no data has supported this assumption until now. OBJECTIVE: To assess the global changes and factors of increase in addiction-related habits during the early COVID-19 containment phase in France. METHODS: Online survey among 11,391 participants, opened from day-8 to day-13 of the containment (started 03/17/2020). Questions explored sociodemographic features, psychiatric/addiction history, material conditions of lockdown, general stress ([1-10] Visual Analog Scale), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and reported changes in several addiction-related behaviors. Global changes were described, and factors of increase were explored using population-weighted and adjusted logistic regression models, providing adjusted odds ratios (aORs) and their 95% confidence intervals (95%CI). RESULTS: Overall, increases in addiction-related habits were more frequent than decreases, as they were reported by 28.4% (C/S food), 64.6% (screens), 35.6% (tobacco), 24.8% (alcohol), and 31.2% (cannabis) of the concerned subjects, respectively. Reduced well-being score and increase stress score were general factors of increase in addiction-related habits (p-values<0.001 for all types of habits). The main specific factors of increase in C/S food intake (n=10,771) were female gender (aOR=1.62; 95%CI=1.48-1.77), being aged less than 29 years (p-values<0.001), having a partner (aOR=1.19; 95%CI=1.06-1.35), being locked down in a more confined space (per one m2/person decrease: aOR=1.02; 95%CI=1.01-1.03), being locked down alone (aOR=1.29; 95%CI=1.11-1.49), and reporting a current (aOR=1.94; 95%CI=1.62-2.31) or past (aOR=1.27; 95%CI=1.09-1.47) psychiatric treatment. The main specific factors of increase in screen use (n=11,267) were female gender (aOR=1.31; 95%CI=1.21-1.43), being aged less than 29 years (p<0.001), having no partner (aOR=1.18; 95%CI=1.06-1.32), being professionally active (p-values <0.001), an intermediate/high education level (p-values <0.001), being locked down with no access to an outdoor space (aOR=1.16; 95%CI=1.05-1.29), being locked down alone (aOR=1.15; 95%CI=1.01-1.32), in an urban environment (p-values <0.01), and not working (p-values <0.001). The main specific factors of increase in tobacco use (n=2,787) were female gender (aOR=1.31; 95%CI=1.11-1.55), having no partner (aOR=1.30; 95%CI=1.06-1.59), having and intermediate/low education level (p-values <0.01), and still working at workplace (aOR=1.47; 95%CI=1.17-1.86). The main specific factors of increase in alcohol use (n= 7,108) were being aged 30-49 years (p-values <0.05), a high level of education (p-values <0.001), or a current psychiatric treatment (aOR=1.44; 95%CI=1.10-1.88). The main specific factor of increase in cannabis use (n=620) was an intermediate/low level of education (p-values <0.001). CONCLUSIONS: The early phase of the COVID-19 containment in France led to widespread increases in addiction-related habits in the general population. Reduced well-being and increased stress were universal factors of increase. More specific factors were associated with increases in each of the explored habits.


Preventing Dengue Epidemics during the COVID-19 Pandemic.


Secondary hemophagocytic lymphohistiocytosis, HScore and COVID-19


Letter: Gastrointestinal ACE2, COVID-19 and IBD - opportunity in the face of tragedy?


title: Management of COVID-19 Pandemic in Spanish Inflammatory Bowel Disease Units: Results From a National Survey

text: BACKGROUND: The outbreak of COVID-19 has rapidly evolved into a pandemic that has represented a challenge to health systems worldwide. Inflammatory bowel disease (IBD) units have been forced to change their practices to address the disease and to ensure the quality of care. METHODS: We conducted a national survey among IBD gastroenterologist members of the Spanish Working Group on Crohn's Disease and Colitis regarding changes of practice, IBD treatments, and diagnosis and treatment of COVID-19. RESULTS: We received 54 answers from Spanish hospitals. One hundred percent of the IBD units rescheduled onsite visits to telematic consultation, and elective endoscopic and surgical procedures were delayed. Protective measures were also taken in the infusion units (100% of health centers) and hospital pharmacies, with 40.7% sending subcutaneous medications to patients. No switching between intravenous and subcutaneous anti-tumor necrosis factor drugs were made. We also found that 96.1% of IBD units advised their patients to maintain treatment if they were asymptomatic for COVID-19. For patients with COVID-19 symptoms, 92.6% of IBD units referred them to primary care or the emergency department. In addition, 7.5% of IBD units made a COVID-19 diagnosis through polymerase chain reaction and/or chest x-ray.Modifications in IBD treatment and treatment recommended for COVID-19 are also discussed. CONCLUSIONS: We report a representative national survey of changes made in the structure, diagnosis of COVID-19, and modifications in IBD treatments within IBD units.


title: An Epidemic Model SIPHERD and its application for prediction of the spread of COVID-19 infection for India and USA

text: We propose an epidemic model SIPHERD in which three categories of infection carriers Symptomatic, Purely Asymptomatic, and Exposed are considered with different rates of transmission of infection that are taken dependent on the lockdown and social distancing. The rate of detection of the infected carriers is taken dependent on the tests done per day. The model is applied for the COVID outbreak in Germany and South Korea to validate its predictive capabilities and then applied to India and the United States for the prediction of its spread with different lockdown situations and testing in the coming months.


title: Recomendaciones nacionales sobre donación pediátrica./ [National recommendations on pediatric donation]

text: Despite being an international reference in donation and transplantation, Spain needs to improve pediatric donation, including donation after the circulatory determination of death. The present article, a summary of the consensus report prepared by the Organización Nacional de Trasplantes and the Spanish Pediatrics Association, intends the facilitation of donation procedures in newborns and children and the analysis of associated ethical dilemma. The ethical basis for donation in children, the principles of clinical assessment of possible donors, the criteria for the determination of death in children, intensive care management of donors, basic concepts of donation after the circulatory determination of death and the procedures for donation in newborns with severe nervous system's malformation incompatible with life, as well as in children receiving palliative care are commented. Systematically considering the donation of organs and tissues when a child dies in conditions consistent with donation is an ethical imperative and must become an ethical standard, not only because of the need of organs for transplantation, but also to ensure family centered care.


title: Clinical ethics during Covid-19: Plan for the whole health ecosystem

text:
During a pandemic, narrowing ethics into silos such as clinical and public health does not help the cause of ethics, which often gets neglected in desperate times. Our response to a recently published article in this journal, tries to take this discussion forward. Keeping medical ethics at the centre of our response to the Covid-19 pandemic would benefit healthcare systems at all levels. This would also help us be prepared for future pandemics. Strengthening healthcare systems would also provide an opportunity to improve non-Covid care.

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Mental health care for pregnant women in the COVID-19 outbreak is urgently needed


title: Epidemiological Characteristics and Forecast of COVID-19 Outbreak in the Republic of Kazakhstan

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic entered Kazakhstan on 13 March 2020 and quickly spread over its territory. This study aimed at reporting on the rates of COVID-19 in the country and at making prognoses on cases, deaths, and recoveries through predictive modeling. Also, we attempted to forecast the needs in professional workforce depending on implementation of quarantine measures. METHODS: We calculated both national and local incidence, mortality and case-fatality rates, and made forecast modeling via classic susceptible-exposed-infected-removed (SEIR) model. The Health Workforce Estimator tool was utilized for forecast modeling of health care workers capacity. RESULTS: The vast majority of symptomatic patients had mild disease manifestations and the proportion of moderate disease was around 10%. According to the SEIR model, there will be 156 thousand hospitalized patients due to severe illness and 15.47 thousand deaths at the peak of an outbreak if no measures are implemented. Besides, this will substantially increase the need in professional medical workforce. Still, 50% compliance with quarantine may possibly reduce the deaths up to 3.75 thousand cases and the number of hospitalized up to 9.31 thousand cases at the peak. CONCLUSION: The outcomes of our study could be of interest for policymakers as they help to forecast the trends of COVID-19 outbreak, the demands for professional workforce, and to estimate the consequences of quarantine measures.


title: A protocol for wide awake local anaesthetic no tourniquet (WALANT) hand surgery in the context of the coronavirus disease 2019 (COVID-19) pandemic

text: There are new and unique challenges to emergency surgery service provision posed by the Coronavirus disease 2019 global pandemic. It is in the best interests of patients for care providers to streamline services where possible to maximise the number of cases that can be performed by limited surgical and anaesthetic teams, as well as minimising patient interactions and admission times to reduce potential spread of the virus. There is evidence that wide awake local anaesthetic no tourniquet (WALANT) hand and upper limb surgery can meet this need in a number of ways, including reduced pre-operative work up, the lack of a need for an anaesthetist or ventilator, shorter inpatient stays and improved cost efficiencies. Though updated national guidelines exist that advocate increased use of WALANT surgery in response to the pandemic there are not yet clear protocols to facilitate this. We outline a protocol being developed at one UK Major Trauma Centre tailored to the expansion of WALANT hand and upper limb emergency surgery with particular emphasis on facilitating timely surgical care while minimising healthcare encounters pre and post-operatively. This will serve to reduce potential transmission of the virus and create cost efficiencies to free funding for COVID-19 related care. Our protocol is easily replicable and may be of benefit to other centres dealing with emergency upper limb surgery in the new climate of COVID-19.


title: GACELA -- A generative adversarial context encoder for long audio inpainting

text: We introduce GACELA, a generative adversarial network (GAN) designed to restore missing musical audio data with a duration ranging between hundreds of milliseconds to a few seconds, i.e., to perform long-gap audio inpainting. While previous work either addressed shorter gaps or relied on exemplars by copying available information from other signal parts, GACELA addresses the inpainting of long gaps in two aspects. First, it considers various time scales of audio information by relying on five parallel discriminators with increasing resolution of receptive fields. Second, it is conditioned not only on the available information surrounding the gap, i.e., the context, but also on the latent variable of the conditional GAN. This addresses the inherent multi-modality of audio inpainting at such long gaps and provides the option of user-defined inpainting. GACELA was tested in listening tests on music signals of varying complexity and gap durations ranging from 375~ms to 1500~ms. While our subjects were often able to detect the inpaintings, the severity of the artifacts decreased from unacceptable to mildly disturbing. GACELA represents a framework capable to integrate future improvements such as processing of more auditory-related features or more explicit musical features.


Treating hidradenitis suppurativa during the COVID-19 pandemic: teledermatology exams of sensitive body areas


The Father-Daughter Dinner Dance: A Waltz With Ethics and COVID-19 Commentary on "The Father-Daughter Dinner Dance: A Waltz With Ethics and COVID-19"


title: Neurotropism of SARS-CoV-2: COVID-19 presenting with an acute manic episode

text: A 41-year-old man with no significant medical history presented with acute behavioural disruption on the background of a 1-day history of severe headache and a 10-day history of dry cough and fever. He was sexually disinhibited with pressured speech and grandiose ideas. His behaviour worsened, necessitating heavy sedation and transfer to intensive care for mechanical ventilation despite no respiratory indication. Investigations confirmed that he was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neuroimaging and a lumbar puncture were normal. Initial screening for SARS-CoV-2 in the cerebrospinal fluid was negative although no validated assay was available. The patient's mental state remained abnormal following stepdown from intensive care. Psychiatric assessment found features consistent with acute mania, and he was detained under the Mental Health Act. This case indicates the need to consider COVID-19 in a wider series of clinical presentations and to develop a validated assay for SARS-CoV-2 in the cerebrospinal fluid.


title: Repurposing current therapeutics for treating COVID-19: A vital role of prescription records data mining

text: Since its outbreak in late 2019, the SARS-Cov-2 pandemic already infected over 3.7 million people and claimed more than 250,000 lives globally. At least 1 year may take for an approved vaccine to be in place, and meanwhile millions more could be infected, some with fatal outcome. Over thousand clinical trials with COVID-19 patients are already listed in ClinicalTrials.com, some of them for assessing the utility of therapeutics approved for other conditions. However, clinical trials take many months, and are typically done with small cohorts. A much faster and by far more efficient method for rapidly identifying approved therapeutics that can be repurposed for treating COVID-19 patients is data mining their past and current electronic health and prescription records for identifying drugs that may protect infected individuals from severe COVID-19 symptoms. Examples are discussed for applying health and prescription records for assessing the potential repurposing (repositioning) of angiotensin receptor blockers, estradiol, or antiandrogens for reducing COVID-19 morbidity and fatalities. Data mining of prescription records of COVID-19 patients will not cancel the need for conducting controlled clinical trials, but could substantially assist in trial design, drug choice, inclusion and exclusion criteria, and prioritization. This approach requires a strong commitment of health provides for open collaboration with the biomedical research community, as health provides are typically the sole owners of retrospective drug prescription records.


title: SARS-coronavirus-2 replication in Vero E6 cells: replication kinetics, rapid adaptation and cytopathology

text: The sudden emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019 from the Chinese province of Hubei and its subsequent pandemic spread highlight the importance of understanding the full molecular details of coronavirus infection and pathogenesis. Here, we compared a variety of replication features of SARS-CoV-2 and SARS-CoV and analysed the cytopathology caused by the two closely related viruses in the commonly used Vero E6 cell line. Compared to SARS-CoV, SARS-CoV-2 generated higher levels of intracellular viral RNA, but strikingly about 50-fold less infectious viral progeny was recovered from the culture medium. Immunofluorescence microscopy of SARS-CoV-2-infected cells established extensive cross-reactivity of antisera previously raised against a variety of non-structural proteins, membrane and nucleocapsid protein of SARS-CoV. Electron microscopy revealed that the ultrastructural changes induced by the two SARS viruses are very similar and occur within comparable time frames after infection. Furthermore, we determined that the sensitivity of the two viruses to three established inhibitors of coronavirus replication (remdesivir, alisporivir and chloroquine) is very similar, but that SARS-CoV-2 infection was substantially more sensitive to pre-treatment of cells with pegylated interferon alpha. An important difference between the two viruses is the fact that - upon passaging in Vero E6 cells - SARS-CoV-2 apparently is under strong selection pressure to acquire adaptive mutations in its spike protein gene. These mutations change or delete a putative furin-like cleavage site in the region connecting the S1 and S2 domains and result in a very prominent phenotypic change in plaque assays.


title: Modelling Recovered Cases and Death Probabilities for the COVID-19 Outbreak

text: From March 23rd, the data for the recovered cases of COVID-19 are missing from the standard repository maintained by the Johns Hopkins University in collaboration with the WHO. But since data concerning recovered patients are extremely important for modelling the COVID-19 outbreak, a method for estimating the missing data is provided and tested. As a byproduct, it produces estimates for the probabilities to die $k$ days after confirmation, or to survive after $d$ days.


Public health, health systems and palliation planning for COVID-19 on an exponential timeline


Second joint statement of the IPHA, IAPSM and IAE- Public health approach for COVID-19 pandemic control in India


COVID-19: An Update on Clinical Trials


Behind the scenes in the biosafety office


title: Diagnostic Tools for Coronavirus Disease (COVID-19): Comparing CT and RT-PCR Viral Nucleic Acid Testing

text: OBJECTIVE. Multiple studies suggest CT should be a primary diagnostic tool for coronavirus disease (COVID-19) because they reported sensitivities with CT far superior to that of reverse transcriptase polymerase chain reaction (RT-PCR) testing. This review aimed to assess these reports and found chest CT to have a clinical utility that is limited, particularly for patients who show no symptoms and patients who are screened early in disease progression. CONCLUSION. CT has limited sensitivity for COVID-19 and a lower specificity than RT-PCR testing, and it carries a risk of exposing providers to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Chest CT should be considered a supplemental diagnostic tool, particularly for patients who show symptoms.


title: COVID-19 and Kidney Transplantation: Results from the TANGO International Transplant Consortium

text: Kidney transplant recipients may be at high risk of developing critical COVID-19 illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the US, Italy and Spain who tested positive for COVID-19. Clinical presentation, laboratory values, immunosuppression and treatment strategies were reviewed and predictors of poor clinical outcomes were determined through multivariable analyses. Among 9,845 kidney transplant recipients across centers, 144 were hospitalized due to COVID-19 during the 9-week study period. 65% were male with a mean age of 60 (±12) years, 40% Hispanic and 25% African-American. Prevalent comorbidities included hypertension (95%), diabetes (52%), obesity (49%), heart (28%) and lung (19%) disease. Therapeutic management included antimetabolite withdrawal (68%), calcineurin inhibitor withdrawal (23%), hydroxychloroquine (71%), antibiotics (74%), tocilizumab (13%) and antivirals (14%). During a median follow-up period of 52 days (IQR: 16-66 days), acute kidney injury occurred in 52% cases, respiratory failure requiring intubation in 29%, and mortality was 32%. The 44 patients who died were older, had lower lymphocyte counts and eGFR, higher serum lactate dehydrogenase, procalcitonin and IL-6 levels. In sum, hospitalized kidney transplant recipients with COVID-19 have higher rates of acute kidney injury and mortality.


title: Humoral Immune Responses in COVID-19 Patients: A Window on the State of the Art

text: The novel SARS-CoV-2 is a recently emerging virus causing a human pandemic. A great variety of symptoms associated with COVID-19 disease, ranging from mild to severe symptoms, eventually leading to death. Specific SARS-CoV-2 RT-PCR is the standard method to screen symptomatic people; however, asymptomatic subjects and subjects with undetectable viral load escape from the screening, contributing to viral spread. Currently, the lock down imposed by many governments is an important measure to contain the spread, as there is no specific antiviral therapy or a vaccine and the main treatments are supportive. Therefore, there is urgent need to characterize the virus and the viral-mediated responses, in order to develop specific diagnostic and therapeutic tools to prevent viral transmission and efficiently cure COVID-19 patients. Here, we review the current studies on two viral mediated-responses, specifically the cytokine storm occurring in a subset of patients and the antibody response triggered by the infection. Further studies are needed to explore both the dynamics and the mechanisms of the humoral immune response in COVID-19 patients, in order to guide future vaccine design and antibody-based therapies for the management of the disease.


title: Psychological trauma and moral injury in religious leaders during COVID-19

text: Religious leaders are at risk of psychological trauma and moral injury during the COVID-19 pandemic. This article highlights potentially traumatic or morally injurious experiences for religious leaders and provides evidence-based recommendations for mitigating their impact. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Designing a psychological preparedness toolkit for healthcare workers in the wake of COVID-19: A Singapore perspective


A case of coronavirus disease 2019 with twice negative nucleic acid testing within 8 days


title: COVID-19 Outbreak in Italy: Protecting Worker Health and the Response of the Italian Industrial Hygienists Association

text: The number of people infected with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), i.e. the virus causing coronavirus disease (COVID-19), is dramatically increasing worldwide to the size of a pandemic. At the time of writing Italy is ranking first among countries both in terms of number of COVID-19 confirmed cases and in terms of number of deaths. Such a wide spread of COVID-19 has led to concern among workers who are facing the risk of becoming infected during the execution of their duties. We believe it is useful to remark on the need for professional expertise in the field of Occupational Hygiene in this emergency context, in which the indications provided by national and international bodies, the available scientific literature and the legal provisions are constantly and rapidly evolving. It is of fundamental importance that there is an effective analysis of expert inputs, to provide essential guidance to Health, Safety and Environmental managers and other prevention managers in workplaces. In this regard, not only a constant update of the regulatory framework is needed, but also a development and circulation of operational guidance to all the stakeholders to translate general indications into clear operating procedures and implementation tools to be adopted in the workplaces. We believe that the scientific associations in the field of Occupational Hygiene play a crucial role in guiding and assisting prevention professionals. There is considerable expertise in the occupational hygiene and exposure science communities that can help employers and workers to contain and delay the spread of COVID-19. For this reason, the Italian Association of Industrial Hygienists (AIDII-Associazione Italiana degli Igienisti Industriali) published documents containing operational guidelines to provide correct and constantly updated information for: (i) workers employed in essential activities (with low and medium risk of contagion), (ii) health workers and other workers at high or very high risk of contagion, and (iii) for the correct use and handling of personal protective equipment for workers and for the population in general. It is worth pointing out that the documents produced are not intended to replace those produced by authoritative bodies, but to comply with and complete them by reporting an effective summary and further indications about the measures that should be taken in practice under the light of the Italian legislation. At present, the challenge is to produce scientifically sound knowledge, appropriate tools, and effective methodologies, by coordinating the initiatives of different scientific associations, with the final aim to effectively transfer them to employers and workers.


SARS-CoV-2-Induced Immune Dysregulation and Myocardial Injury Risk in China: Insights from the ERS-COVID-19 Study


title: Arbidol combined with LPV/r versus LPV/r alone against Corona Virus Disease 2019: A retrospective cohort study

text: BACKGROUND: Corona Virus Disease 2019 (COVID-19) due to the 2019 novel coronavirus (SARS-CoV-2) emerged in Wuhan city and rapidly spread throughout China. We aimed to compare arbidol and lopinavir/ritonavir(LPV/r) treatment for patients with COVID-19 with LPV/r only. METHODS: In this retrospective cohort study, we included adults (age≥18years) with laboratory-confirmed COVID-19 without Invasive ventilation, diagnosed between Jan 17, 2020, and Feb 13, 2020. Patients, diagnosed after Jan 17, 2020, were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5-21 days. The primary endpoint was a negative conversion rate of coronavirus from the date of COVID-19 diagnosis(day7, day14), and assessed whether the pneumonia was progressing or improving by chest CT (day7). RESULTS: We analyzed 16 patients who received oral arbidol and LPV/r in the combination group and 17 who oral LPV/r only in the monotherapy group, and both initiated after diagnosis. Baseline clinical, laboratory, and chest CT characteristics were similar between groups. The SARS-CoV-2 could not be detected for 12(75%) of 16 patients' nasopharyngeal specimens in the combination group after seven days, compared with 6 (35%) of 17 in the monotherapy group (p < 0·05). After 14 days, 15 (94%) of 16 and 9 (52·9%) of 17, respectively, SARS-CoV-2 could not be detected (p < 0·05). The chest CT scans were improving for 11(69%) of 16 patients in the combination group after seven days, compared with 5(29%) of 17 in the monotherapy group (p < 0·05). CONCLUSION: In patients with COVID-19, the apparent favorable clinical response with arbidol and LPV/r supports further LPV/r only.


title: Impact of sex and gender on COVID-19 outcomes in Europe

text: BACKGROUND: Emerging evidence from China suggests that coronavirus disease 2019 (COVID-19) is deadlier for infected men than women with a 2.8% fatality rate being reported in Chinese men versus 1.7% in women. Further, sex-disaggregated data for COVID-19 in several European countries show a similar number of cases between the sexes, but more severe outcomes in aged men. Case fatality is highest in men with pre-existing cardiovascular conditions. The mechanisms accounting for the reduced case fatality rate in women are currently unclear but may offer potential to develop novel risk stratification tools and therapeutic options for women and men. CONTENT: The present review summarizes latest clinical and epidemiological evidence for gender and sex differences in COVID-19 from Europe and China. We discuss potential sex-specific mechanisms modulating the course of disease, such as hormone-regulated expression of genes encoding for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) entry receptors angiotensin converting enzyme (ACE) 2 receptor and TMPRSS2 as well as sex hormone-driven innate and adaptive immune responses and immunoaging. Finally, we elucidate the impact of gender-specific lifestyle, health behavior, psychological stress, and socioeconomic conditions on COVID-19 and discuss sex specific aspects of antiviral therapies. CONCLUSION: The sex and gender disparities observed in COVID-19 vulnerability emphasize the need to better understand the impact of sex and gender on incidence and case fatality of the disease and to tailor treatment according to sex and gender. The ongoing and planned prophylactic and therapeutic treatment studies must include prospective sex- and gender-sensitive analyses.


Papel de la hemodiálisis extendida en COVID-19: a propósito de un caso./ Papel de la hemodiálisis extendida en COVID-19: a propósito de un caso./ Role of expanded hemodialysis in COVID-19: a case report


Asymptomatic Seroconversion of Immunoglobulins to SARS-CoV-2 in a Pediatric Dialysis Unit


title: Holding a Conference Online and Live due to COVID-19

text: The joint EDBT/ICDT conference (International Conference on Extending Database Technology/International Conference on Database Theory) is a well established conference series on data management, with annual meetings in the second half of March that attract 250 to 300 delegates. Three weeks before EDBT/ICDT 2020 was planned to take place in Copenhagen, the rapidly developing Covid-19 pandemic led to the decision to cancel the face-to-face event. In the interest of the research community, it was decided to move the conference online while trying to preserve as much of the real-life experience as possible. As far as we know, we are one of the first conferences that moved to a fully synchronous online experience due to the COVID-19 outbreak. With fully synchronous, we mean that participants jointly listened to presentations, had live Q&A, and attended other live events associated with the conference. In this report, we share our decisions, experiences, and lessons learned.


title: Stress, Anxiety, and Depression in People Aged Over 60 in the COVID-19 Outbreak in a Sample Collected in Northern Spain

text: OBJECTIVE: This study examines the levels of stress, anxiety, and depression in people over 60 years of age at the time of the COVID-19 outbreak. DESIGN: The study used an exploratory-descriptive cross-sectional methodology. The resulting responses were analyzed using SPSS v.25 PARTICIPANTS: Participants (Nâ¯=â¯290) were aged 60 years and above. SETTING: The study was carried out in the Basque Country (North of Spain). MEASUREMENTS: Stress, anxiety, and depression were measured using the Anxiety and Stress Scale - 21 (DASS-21) RESULTS: Most of the participants did not report levels of stress, anxiety, and depression. Among participants age 66 and above and those with chronic illness, a proportion reported experiencing one, two or all three of these symptoms.


Echocardiographic Features of COVID-19 Illness and Association with Cardiac Biomarkers


COVID-19 and Outpatient Parenteral Antimicrobial Therapy: The Need to Protect Vulnerable Medicare Beneficiaries


docid: vkykqbso

title: Tracheotomy in COVID-19 patients: Optimizing patient selection and identifying prognostic indicators

text: BACKGROUND: Tracheotomy, through its ability to wean patients off ventilation, can shorten ICU length of stay and in doing so increase ICU bed capacity, crucial for saving lives during the COVID-19 pandemic. To date, there is a paucity of patient selection criteria and prognosticators to facilitate decision making and enhance precious ICU capacity. METHODS: Prospective study of COVID-19 patients undergoing tracheotomy (n = 12) over a 4-week period (March-April 2020). Association between preoperative and postoperative ventilation requirements and outcomes (ICU stay, time to decannulation, and death) were examined. RESULTS: Patients who sustained FiO2 ≤ 50% and PEEP ≤ 8 cm H2 O in the 24 hours pretracheotomy exhibited a favorable outcome. Those whose requirements remained below these thresholds post-tracheotomy could be safely stepped down after 48 hours. CONCLUSION: Sustained FiO2 ≤ 50% and PEEP ≤ 8 cm H2 O in the 48 hours post-tracheotomy are strong predictive factors for a good outcome, raising the potential for these patients to be stepped down early, thus increasing ICU capacity.


Erythrocyte sedimentation rate is associated with severe coronavirus disease 2019 (COVID-19): a pooled analysis


title: Protecting Labor and Delivery Personnel from COVID-19 during the Second Stage of Labor

text: The novel coronavirus disease 2019 (COVID-19) is spreading fast and is affecting the clinical workers at much higher risk than the general population. Little is known about COVID-19 effect on pregnant women; however, the emerging evidence suggests they may be at high risk of asymptomatic disease. In light of projected shortage of personal protective equipment (PPE), there is an aggressive attempt at conservation. In obstetrics, the guidelines on PPE use are controversial and differ among hospitals, globally, as well as nationally. The centers for disease control and prevention (CDC) recommend using N95 respirators, which are respirators that offer a higher level of protection instead of a facemask for when performing or present for an aerosol-generating procedures (AGP). However, the second stage of labor is not considered an AGP. The second stage of labor can last up to 4 hours. During that time, labor and delivery personnel is in close contact to patients, who are exerting extreme effort during and frequently blow out their breath, cough, shout, and vomit, all of which put the health care team at risk, considering that COVID-19 transmission occurs through aerosol generated by coughing and sneezing. The CDC and the American College of Obstetricians and Gynecologists (ACOG) do not provide clarification on the use of N95 during the second stage. We recommend that labor and delivery personnel have the utmost caution and be granted the protection they need to protect themselves and other patients. This includes providing labor and delivery personnel full PPE including N95 for the second stage of labor. This is critical to ensure the adequate protection for health care workers and to prevent spread to other health care workers and patients. KEY POINTS: · Second stage of labor exposes providers to aerosol.. · COVID-19 risk during second stage of labor is high.. · N95 should be used during second stage of labor..


Europe, democracy and health after COVID-19: a strong union


COVID-19 pneumonia misdiagnosed as pulmonary contusion in a child


Colombia en tiempos de COVID-19


Convalescent plasma: possible therapy for novel coronavirus disease 2019


docid: tfdeynuh

title: L'imaging integrato nel percorso del paziente con COVID-19: dalla diagnosi, al monitoraggio clinico, alla prognosi./ [The role of multimodality imaging in COVID-19 patients: from diagnosis to clinical monitoring and prognosis]

text: The integrated clinical, laboratory and ultrasound approach is essential for the diagnosis, monitoring and evaluation of the patient's therapy in COVID-19 pneumonia. The ideal imaging strategy in this setting is not yet well defined. Bedside pulmonary ultrasound presents an undeniable series of advantages in patients at high risk of infection, and can provide incremental data in the respiratory intensive care for the serial control of the individual patient, as well as for home delivery of stabilized patients. Chest X-ray is characterized by low sensitivity in identifying earlier lung changes. Pulmonary computed tomography shows high sensitivity but should not be routinely performed in all patients, because in the first 48 h it can be absolutely negative, and in the late phase imaging findings may not change the therapeutic approach. Echocardiography should be limited to patients with hemodynamic instability.


title: The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis

text: CONTEXT: During the course of March and April 2020, New York City experienced a surge of a 170,000 coronavirus disease 2019 (COVID-19) cases, overwhelming hospital systems and leading to an unprecedented need for palliative care services. OBJECTIVES: To present a model for rapid palliative care workforce expansion under crisis conditions, using supervised advanced psychiatry trainees to provide primary palliative services in the acute care and emergency setting. METHODS: In response to the New York City COVID-19 surge, advanced psychiatry trainees at New York-Presbyterian Columbia University Irving Medical Center were rapidly trained and redeployed to a newly formed psychiatry-palliative care liaison team. Under the supervision of consultation-liaison psychiatrists (who also served as team coordinators), these trainees provided circumscribed palliative care services to patients and/or their families, including goals-of-care discussions and psychosocial support. Palliative care attendings remained available to all team members for more advanced and specialized supervision. RESULTS: The psychiatry-palliative care liaison team effectively provided palliative care services during the early phase and peak of New York City's COVID-19 crisis, managing up to 16 new cases per day and provided longitudinal follow-up, thereby enabling palliative care specialists to focus on providing services requiring specialist-level palliative care expertise. CONCLUSION: By training and supervising psychiatrists and advanced psychiatry trainees in specific palliative care roles, palliative care teams could more effectively meet markedly increased service needs of varying complexity during the COVID-19 crisis. As new geographic regions experience possible COVID-19 surges in the coming months, this may serve as a model for rapidly increasing palliative care workforce.


The possible protective role of α-synuclein against the SARS-CoV-2 infections in patients with Parkinson's disease


title: Medidas de distanciamento social e mobilidade na Am\'erica do Sul durante a pandemia por COVID-19: Condi\c{c}\~oes necess\'arias e suficientes?

text: In a scenario where there is no vaccine for COVID-19, non-pharmaceutical interventions are necessary to contain the spread of the virus and the collapse of the health system in the affected regions. One of these measures is social distancing, which aims to reduce interactions in the community by closing public and private establishments that involve crowds of people. The lockdown presupposes a drastic reduction in community interactions, representing a more extreme measure of social distancing. Based on geolocation data provided by Google for six categories of physical spaces, this article identifies the variations in the circulation of people in South America for different types of social distancing measures adopted during the COVID-19 pandemic. In this study, population mobility trends for a group of countries between February 15, 2020 and May 16, 2020 were analyzed. To summarize these trends in a single metric, a general circulation index was created, and to identify regional mobility patterns, descriptive analyzes of spatial autocorrelation (global and local Moran index) were used. The first hypothesis of this study is that countries with a lockdown decree can achieve greater success in reducing the mobility of the population, and the second hypothesis is that Argentina, Brazil and Colombia have regional mobility patterns. The first hypothesis was partially confirmed (considering 10 countries in South America), and the results obtained in the spatial analyzes confirmed the second hypothesis. In general, the observed data shows that less rigid lockdown or social distancing measures are necessary, however, they are not sufficient to achieve a significant reduction in the circulation of people during the pandemic.


The Coronavirus 2019 Pandemic and Diabetes: An International Perspective


Transnasal endoscopic skull base surgery during COVID-19 pandemic: algorithm of management in an Italian reference COVID center


title: Pore-Scale Transport and Two-Phase Fluid Structures in Fibrous Porous Layers: Application to Fuel Cells and Beyond

text: We present pore-scale simulations of two-phase flows in a reconstructed fibrous porous layer. The three dimensional microstructure of the material, a fuel cell gas diffusion layer, is acquired via X-ray computed tomography and used as input for lattice Boltzmann simulations. We perform a quantitative analysis of the multiphase pore-scale dynamics and we identify the dominant fluid structures governing mass transport. The results show the existence of three different regimes of transport: a fast inertial dynamics at short times, characterised by a compact uniform front, a viscous-capillary regime at intermediate times, where liquid is transported along a gradually increasing number of preferential flow paths of the size of one-two pores, and a third regime at longer times, where liquid, after having reached the outlet, is exclusively flowing along such flow paths and the two-phase fluid structures are stabilised. We observe that the fibrous layer presents significant variations in its microscopic morphology, which have an important effect on the pore invasion dynamics. Liquid transport is affected by the presence of a microstructure-induced capillary pressure acting adversely to the flow, leading to capillary fingering transport mechanisms even in the absence of hydrophobic treatments of the porous material. We propose a macroscopic model based on an effective contact angle that mimics the effects of the such a dynamic capillary pressure. Finally, we underline the significance of the results for the optimal design of face masks in an effort to mitigate the current COVID-19 pandemic.


title: "Virtual" Boot Camp: Orthopaedic Intern Education in the Time of COVID-19 and Beyond

text: The emergence of COVID-19 as a viral pandemic in early 2020 resulted in notable changes to the daily practice, workflow, and education of orthopaedic residencies internationally. In particular, social distancing, residency restructuring, and redeployment to other services has increased heterogeneity in schedules and made the in-person gathering of trainees for education increasingly challenging. These changes may last until 2024 based on some mathematical models, resulting in notable disruptions to orthopaedic education, especially for junior residents. Therefore, in this study, we describe how we converted our in-person PGY-1 skills course into a "virtual" boot camp based on validated training modules and existing American Board of Orthopaedic Surgeons guidelines. Lessons learned from the experience and potential areas for improvement in the use of newer technology to teach cognitive knowledge and skills modules are highlighted with the hope that this can be useful to other orthopaedic residency programs, during the pandemic and also beyond.


docid: uqmbacva

title: Regarding "Understanding the 'Scope' of the Problem: Why Laparoscopy Is Considered Safe during the COVID-19 Pandemic"


title: Global Coronavirus Pandemic (SARS CoV-2): Past, Present, And Future Of Pediatric Dermatology

text: Two months have passed since the World Health Organization (WHO) declared the pandemic of the Coronavirus Disease 19 (COVID-19), caused by the SARS CoV-2 virus, on March 11, 2020. Medical and healthcare workers have continued to be on the frontline to defeat this disease, however, continual changes are being made to their working habits which are proving to be difficult. Although the skin is not the main target of the SARS CoV-2 infection, it is strongly involved both directly and indirectly, in many aspects of dermatological disease management, and particularly in pediatric dermatology. In this manuscript, our goal was to provide a "up-to-date" account on this topic, through analysis of current literature and sharing our experiences during this pandemic. This article is protected by copyright. All rights reserved.


title: Global coronavirus pandemic (SARS-CoV-2): Past, present, and future of pediatric dermatology

text: Two months have passed since the World Health Organization (WHO) declared the pandemic of the Coronavirus Disease 19 (COVID-19), caused by the SARS-CoV-2 virus, on 11 March 2020. Medical and healthcare workers have continued to be on the frontline to defeat this disease, however, continual changes are being made to their working habits which are proving to be difficult. Although the skin is not the main target of the SARS-CoV-2 infection, it is strongly involved both directly and indirectly, in many aspects of dermatological disease management, and particularly in pediatric dermatology. In this manuscript, our goal was to provide a "up-to-date" account on this topic, through analysis of current literature and sharing our experiences during this pandemic.


title: Incidence trend of 2019 novel coronavirus diseases (COVID-19) in China/ 上海预防医学

text: Objective To investigate the epidemical characteristics and analyze the incidence trend of 2019 novel coronavirus diseases (COVID-19) in China. Methods The daily new confirmed cases of 2019 novel coronavirus diseases (COVID-19) in China from January 25 to February 8,2020 were collected for epidemiological descriptive analysis. Results During the period from January 25 to February 8, 2020, the number of daily new confirmed cases fell for five consecutive days, from 890 cases on February 3 to 509 cases on February 8. Conclusion The incidence of 2019 novel coronavirus diseases (COVID-19) slowed down in 30 provinces (autonomous regions and municipalities directly under the central government) except Hubei and Xinjiang production and construction corps , but the overall situation is still not optimistic. It is imperative to pay close attention to the origin and destination of migrant workers and the incidence of disease in various areas, and take targeted measures to strengthen prevention and control of the disease.


COVID-19: The Isolation That Has Brought Us Together


title: Long Survival and Prolonged Remission after Surgery and Chemotherapy in a Metastatic Mismatch Repair Deficient Pancreatic Neuroendocrine Carcinoma with MLH1/PMS2 Immunodeficiency and Minimal Microsatellite Shift

text: Pancreatic neuroendocrine carcinomas (NECs) are rare and very aggressive neoplasms with dismal prognosis, especially when metastatic or with negative prognostic factors, such as vascular invasion. To the best of our knowledge, no case of pancreatic NEC with mismatch repair deficiency has been reported to date. We describe a 62-year-old patient who underwent pancreaticoduodenectomy for a NEC located in the pancreatic head, with peripancreatic lymph node metastases. Tumor necrosis was prominent and the Ki67 proliferative index was 60%. One year after the diagnosis, the patient experienced recurrence with a left supraclavicular lymph node metastasis, which was surgically removed, followed by standard cisplatin-etoposide chemotherapy. Neoplastic cells showed combined loss of expression of MLH1 and PMS2 in both primary tumor and lymph node metastasis. Microsatellite instability (MSI) test using a mononucleotide repeats pentaplex PCR (BAT-25, BAT-26, NR-21, NR-22, and NR-24) revealed minimal mononucleotide shifts showing deletion of less than 3 bp at NR-21, BAT-26, NR-24, and NR-22 loci. MLH1 methylation analysis revealed absence of the gene promoter methylation. BRAF and KRAS mutations were not detected. In gut, NECs' mismatch repair deficiency phenotype has been reported in about 10% of cases, and it represents an independent factor of more favorable outcome. Likewise, our patient is currently alive with a follow-up of more than 12 years after pancreaticoduodenectomy, by itself an unexpected finding for such an aggressive neoplasm.


Reply to Wachholz and Jacinto


Patient-Driven Discontinuation of Dupilumab During the COVID-19 Pandemic in Two Academic Hospital Clinics at the University of Toronto


title: Lessons from being challenged by COVID-19

text: We present results of different approaches to model the evolution of the COVID-19 epidemic in Argentina, with a special focus on the megacity conformed by the city of Buenos Aires and its metropolitan area, including a total of 41 districts with over 13 million inhabitants. We first highlight the relevance of interpreting the early stage of the epidemic in light of incoming infectious travelers from abroad. Next, we critically evaluate certain proposed solutions to contain the epidemic based on instantaneous modifications of the reproductive number. Finally, we build increasingly complex and realistic models, ranging from simple homogeneous models used to estimate local reproduction numbers, to fully coupled inhomogeneous (deterministic or stochastic) models incorporating mobility estimates from cell phone location data. The models are capable of producing forecasts highly consistent with the official number of cases with minimal parameter fitting and fine-tuning. We discuss the strengths and limitations of the proposed models, focusing on the validity of different necessary first approximations, and caution future modeling efforts to exercise great care in the interpretation of long-term forecasts, and in the adoption of non-pharmaceutical interventions backed by numerical simulations.


title: Novel coronavirus infection in children outside of Wuhan, China

text: BACKGROUND: Since December 8, 2019, an epidemic of coronavirus disease 2019 (COVID-19) has spread rapidly, but information about children with COVID-19 is limited. METHODS: This retrospective and the single-center study were done at the Public Health Clinic Center of Changsha, Hunan, China. We identified all hospitalized children diagnosed with COVID-19 between January 8, 2019 and February 19, 2020, in Changsha. Epidemiological and clinical data of these children were collected and analyzed. Outcomes were followed until February 26th, 2020. RESULTS: By February 19, 2020, nine pediatric patients were identified as having 2019-nCoV infection in Changsha. Six children had a family exposure and could provide the exact dates of close contact with someone who was confirmed to have 2019-nCoV infection, among whom the median incubation period was 7.5 days. The initial symptoms of the nine children were mild, including fever (3/9), diarrhea (2/9), cough (1/9), and sore throat (1/9), two had no symptoms. Two of the enrolled patients showed small ground-glass opacity of chest computed tomography scan. As of February 26, six patients had a negative RT-PCR for 2019-nCoV and were discharged. The median time from exposure to a negative RT-PCR was 14 days. CONCLUSIONS: The clinical symptoms of the new coronavirus infection in children were not typical and showed a less aggressive clinical course than teenage and adult patients. Children who have a familial clustering or have a family member with a definite diagnosis should be reported to ensure a timely diagnosis.


Scientists put survivors' blood plasma to the test


title: Modeling the molecular impact of the SARS-CoV-2 infection on the renin-angiotensin system

text: Infection by the SARS-CoV-2 virus is mediated by the binding of its spike protein to the membrane-bound angiotensin converting enzyme 2 (ACE2), which plays a pivotal role in the renin-angiotensin system (RAS). The understanding of RAS dysregulation due to this viral infection is of fundamental importance to better understand the pathogenic mechanisms and risk factors of the coronavirus disease COVID-19, and to design effective therapeutic strategies. To address this issue, we built a mathematical model of RAS based on data about protein and peptide concentrations in normotensive and hypertensive individuals. We first tested our model on clinical data on the action of antihypertensive RAS-blocking drugs in control individuals. Despite the simplicity of our model, it reproduces very well, without any fitting of additional parameters, the impact of a series of drugs, i.e. angiotensin-converting enzyme inhibitors (ACE-I), direct renin inhibitors (DRI) and angiotensin II receptor blockers (ARB). We applied our model to analyze the impact of SARS-CoV-2 infection on the RAS system, which we modeled through a downregulation of ACE2 related to viral load. Moreover, we analyzed the effect of RAS-blockers and other RAS-targeting drugs, i.e. human recombinant ACE2 (rhACE2) and angiotensin 1-7 peptide (Ang1-7), on the RAS system of normotensive and hypertensive COVID-19 patients. We found that while ACE-I, DRI, rhACE2 and Ang1-7 tend to improve the clinical outcomes in a tension-dependent manner, the use of ARB appears to worsen it. The mathematical model that we developed offers the interesting possibility of testing in silico the RAS dysregulation upon SARS-CoV-2 infection and of predicting how risk factors as well as different drugs, alone or in combination, impact on RAS and disease severity.


title: Total Variation Regularization for Compartmental Epidemic Models with Time-Varying Dynamics

text: Compartmental epidemic models are among the most popular ones in epidemiology. For the parameters (e.g., the transmission rate) characterizing these models, the majority of researchers simplify them as constants, while some others manage to detect their continuous variations. In this paper, we aim at capturing, on the other hand, discontinuous variations, which better describe the impact of many noteworthy events, such as city lockdowns, the opening of field hospitals, and the mutation of the virus, whose effect should be instant. To achieve this, we balance the model's likelihood by total variation, which regulates the temporal variations of the model parameters. To infer these parameters, instead of using Monte Carlo methods, we design a novel yet straightforward optimization algorithm, dubbed Iterated Nelder--Mead, which repeatedly applies the Nelder--Mead algorithm. Experiments conducted on the simulated data demonstrate that our approach can reproduce these discontinuities and precisely depict the epidemics.


Necessity of 45-Day Transesophageal Echocardiography After the WATCHMAN Procedure Amid the COVID-19 Pandemic


title: From COVID-19 research to vaccine application: why might it take 17 months not 17 years and what are the wider lessons?

text: It is often said that it takes 17 years to move medical research from bench to bedside. In a coronavirus disease (COVID-19) world, such time-lags feel intolerable. In these extraordinary circumstances could years be made into months? If so, could those lessons be used to accelerate medical research when the crisis eases?To measure time-lags in health and biomedical research as well as to identify ways of reducing them, we developed and published (in 2015) a matrix consisting of overlapping tracks (or stages/phases) in the translation from discovery research to developed products, policies and practice. The matrix aids analysis by highlighting the time and actions required to develop research (and its translation) both (1) along each track and (2) from one track to another, e.g. from the discovery track to the research-in-humans track. We noted four main approaches to reducing time-lags, namely increasing resources, working in parallel, starting or working at risk, and improving processes.Examining these approaches alongside the matrix helps interpret the enormous global effort to develop a vaccine for the 2019 novel coronavirus SARS-CoV-2, the causative agent of COVID-19. Rapid progress in the discovery/basic and human research tracks is being made through a combination of large-scale funding, work being conducted in parallel (between different teams globally and through working in overlapping tracks), working at greater (but proportionate) risk to safety than usual, and adopting various new processes. The overlapping work of some of the teams involves continuing animal research whilst entering vaccine candidates into Phase I trials alongside planning their Phase II trials. The additional funding available helps to reduce some of the usual financial risks in moving so quickly. Going forward through the increasingly large human trials for safety, dosage and efficacy, it will be vital to overlap work in parallel in the often challenging public policy and clinical tracks. Thus, regulatory and reimbursement bodies are beginning and preparing rapid action to pull vaccines proving to be safe and effective through to extraordinarily rapid application to the general population. Monitoring the development of a COVID-19 vaccine using the matrix (modified as necessary) could help identify which of the approaches speeding development and deployment could be usefully applied more widely in the future.


Blocking information on COVID-19 can fuel the spread of misinformation


title: Coronavirus (COVID-19): ARIMA based time-series analysis to forecast near future

text: COVID-19, a novel coronavirus, is currently a major worldwide threat. It has infected more than a million people globally leading to hundred-thousands of deaths. In such grave circumstances, it is very important to predict the future infected cases to support prevention of the disease and aid in the healthcare service preparation. Following that notion, we have developed a model and then employed it for forecasting future COVID-19 cases in India. The study indicates an ascending trend for the cases in the coming days. A time series analysis also presents an exponential increase in the number of cases. It is supposed that the present prediction models will assist the government and medical personnel to be prepared for the upcoming conditions and have more readiness in healthcare systems.


title: Connecting data, tools and people across Europe: ELIXIR's response to the COVID-19 pandemic

text: ELIXIR, the European research infrastructure for life science data, provides open access to data, tools and workflows in the response to the COVID-19 pandemic. ELIXIR's 23 nodes have reacted swiftly to support researchers in their combined efforts against the pandemic setting out three joint priorities: 1. Connecting national COVID-19 data platforms to create federated European COVID-19 Data Spaces; 2. Fostering good data management to make COVID-19 data open, FAIR and reusable over the long term; 3. Providing open tools, workflows and computational resources to drive reproducible and collaborative science. ELIXIR's strategy is based on the support given by our national nodes - collectively spanning over 200 institutes - to research projects and on partnering with community initiatives to drive development and adoption of good data practice and community driven standards. ELIXIR Nodes provide support activities locally and internationally, from provisioning compute capabilities to helping collect viral sequence data from hospitals. Some Nodes have prioritised access to their national cloud and compute facilities for all COVID-19 research projects, while others have developed tools to search, access and share all data related to the pandemic in a national healthcare setting.


title: Vexing, Veiled, and Inequitable: Social Distancing and the "Rights" Divide in the Age of COVID-19

text: Although unprecedented in scope and beyond all our life experiences, sweeping social distancing measures are not without historical precedent. Historically, racism, stigma, and discrimination resulted in grossly inequitable application of disease containment measures. But history also provides examples in which broad measures enjoyed remarkable public support. When it comes to COVID-19, blame and division continue to shape containment responses. But the COVID-19 pandemic also resonates with moments in which there was broad social support for containment precisely because lockdowns or stay at home orders are, on the surface, remarkably equitable. Yet even in a context in which a majority of Americans support social distancing, small but coordinated conservative groups are challenging social distancing as a matter of individual rights. In sharp contrast, vulnerable populations, who bear the heaviest burden of disease, have claimed a right to social distancing as a matter of protection.


Skin amidst COVID-19 pandemic


Combination prevention for COVID-19


title: Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020

text: A novel coronavirus (2019-nCoV) is causing an outbreak of viral pneumonia that started in Wuhan, China. Using the travel history and symptom onset of 88 confirmed cases that were detected outside Wuhan in the early outbreak phase, we estimate the mean incubation period to be 6.4 days (95% credible interval: 5.6-7.7), ranging from 2.1 to 11.1 days (2.5th to 97.5th percentile). These values should help inform 2019-nCoV case definitions and appropriate quarantine durations.


title: Under the COVID-19 lockdown: Rapid review about the unique case of North Cyprus

text: COVID-19 has been causing tragic outcomes all over the world. On one island nation, North Cyprus, that has been politically isolated from the rest of the world due to a very complicated history and political stance, the rapid enforcement of lockdown measures, despite having negative psychological effects, helped interfere with the spread of COVID-19 and flatten the curve. We propose that the traumas of the past may have caused resilient factors when faced with the psychological impact of COVID-19, and lack of trust toward the capacities of governing bodies may have caused people take strict precautions to help contain the spread of the virus. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


A blueprint for recovery for the postcoronavirus (COVID-19) world


title: Coronavirus disease-19 and fertility: viral host entry protein expression in male and female reproductive tissues

text: OBJECTIVE: To identify cell types in the male and female reproductive systems at risk for SARS-CoV-2 infection because of the expression of host genes and proteins used by the virus for cell entry. DESIGN: Descriptive analysis of transcriptomic and proteomic data. SETTING: Academic research department and clinical diagnostic laboratory. PATIENT(S): Not applicable (focus was on previously generated gene and protein expression data). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Identification of cell types coexpressing the key angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) genes and proteins as well as other candidates potentially involved in SARS-CoV-2 cell entry. RESULT(S): On the basis of single-cell RNA sequencing data, coexpression of ACE2 and TMPRSS2 was not detected in testicular cells, including sperm. A subpopulation of oocytes in nonhuman primate ovarian tissue was found to express ACE2 and TMPRSS2, but coexpression was not observed in ovarian somatic cells. RNA expression of TMPRSS2 in 18 samples of human cumulus cells was shown to be low or absent. There was general agreement between publicly available bulk RNA and protein datasets in terms of ACE2 and TMPRSS2 expression patterns in testis, ovary, endometrial, and placental cells. CONCLUSION(S): These analyses suggest that SARS-CoV-2 infection is unlikely to have long-term effects on male and female reproductive function. Although the results cannot be considered definitive, they imply that procedures in which oocytes are collected and fertilized in vitro are associated with very little risk of viral transmission from gametes to embryos and may indeed have the potential to minimize exposure of susceptible reproductive cell types to infection in comparison with natural conception.


title: Genetic factors associated with response to as-needed aflibercept therapy for typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

text: In the present study, we investigated the association between susceptible genetic variants to age-related macular degeneration (AMD) and response to as-needed intravitreal aflibercept injection (IAI) therapy for exudative AMD including both typical neovascular AMD and polypoidal choroidal vasculopathy (PCV) over 12-months. A total of 234 patients with exudative AMD were initially treated with 3 monthly IAI and thereafter as-needed IAI over 12 months. Seven variants of 6 genes including ARMS2 A69S (rs10490924), CFH (I62V:rs800292 and rs1329428), C2-CFB-SKIV2L(rs429608), C3 (rs2241394), CETP (rs3764261) and ADAMTS-9 (rs6795735) were genotyped for all participants using TaqMan technology. After adjusting for age, gender, baseline BCVA and AMD subtype, A (protective) allele of C2-CFB-SKIV2L rs429608 was associated with visual improvement at 12-month (P = 0.003). Retreatment was associated with T(risk) allele of ARMS2 A69S (P = 2.0 × 10-4; hazard ratio: 2.18:95%CI: 1.47-3.24) and C(risk) allele of CFH rs1329428 (P = 2.0 × 10-3; hazard ratio: 1.74:95%CI: 1.16-2.59) after adjusting for the baseline confounders. The need for additional injections was also associated with T allele of ARMS2 A69S (P = 1.0 × 10-5) and C allele of CFH rs1329428 (P = 3.0 × 10-3) after adjusting for the baseline confounders. The variants of ARMS2 and CFH are informative for both physicians and patients to predict recurrence and to quantify the need for additional injections.


COVID-19: cosa dice oggi l'epidemiologia ai decisori?/ [COVID-19: what does epidemiology tell to decisionmakers?]


Are there any association between COVID-19 severity and immunosuppressive therapy?


title: Geographical tracking and mapping of coronavirus disease COVID-19/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic and associated events around the world: how 21st century GIS technologies are supporting the global fight against outbreaks and epidemics

text: In December 2019, a new virus (initially called 'Novel Coronavirus 2019-nCoV' and later renamed to SARS-CoV-2) causing severe acute respiratory syndrome (coronavirus disease COVID-19) emerged in Wuhan, Hubei Province, China, and rapidly spread to other parts of China and other countries around the world, despite China's massive efforts to contain the disease within Hubei. As with the original SARS-CoV epidemic of 2002/2003 and with seasonal influenza, geographic information systems and methods, including, among other application possibilities, online real-or near-real-time mapping of disease cases and of social media reactions to disease spread, predictive risk mapping using population travel data, and tracing and mapping super-spreader trajectories and contacts across space and time, are proving indispensable for timely and effective epidemic monitoring and response. This paper offers pointers to, and describes, a range of practical online/mobile GIS and mapping dashboards and applications for tracking the 2019/2020 coronavirus epidemic and associated events as they unfold around the world. Some of these dashboards and applications are receiving data updates in near-real-time (at the time of writing), and one of them is meant for individual users (in China) to check if the app user has had any close contact with a person confirmed or suspected to have been infected with SARS-CoV-2 in the recent past. We also discuss additional ways GIS can support the fight against infectious disease outbreaks and epidemics.


title: Optimising Secondary Prevention and Cardiac Rehabilitation for Atherosclerotic Cardiovascular Disease During the COVID-19 Pandemic: A Position Statement from the Cardiac Society of Australia and New Zealand (CSANZ)

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has introduced a major disruption to the delivery of routine health care across the world. This provides challenges for the use of secondary prevention measures in patients with established atherosclerotic cardiovascular disease (CVD). The aim of this Position Statement is to review the implications for effective delivery of secondary prevention strategies during the COVID-19 pandemic. CHALLENGES: The COVID-19 pandemic has introduced limitations for many patients to access standard health services such as visits to health care professionals, medications, imaging and blood tests as well as attendance at cardiac rehabilitation. In addition, the pandemic is having an impact on lifestyle habits and mental health. Taken together, this has the potential to adversely impact the ability of practitioners and patients to adhere to treatment guidelines for the prevention of recurrent cardiovascular events. RECOMMENDATIONS: Every effort should be made to deliver safe, ongoing access to health care professionals and the use of evidenced based therapies in individuals with CVD. An increase in use of a range of electronic health platforms has the potential to transform secondary prevention. Integrating research programs that evaluate the utility of these approaches may provide important insights into how to develop more optimal approaches to secondary prevention beyond the pandemic.


title: A HaloTag-TEV genetic cassette for mechanical phenotyping of proteins from tissues

text: Single-molecule methods using recombinant proteins have generated transformative hypotheses on how mechanical forces are generated and sensed in biological tissues. However, testing these mechanical hypotheses on proteins in their natural environment remains inaccesible to conventional tools. To address this limitation, here we demonstrate a mouse model carrying a HaloTag-TEV insertion in the protein titin, the main determinant of myocyte stiffness. Using our system, we specifically sever titin by digestion with TEV protease, and find that the response of muscle fibers to length changes requires mechanical transduction through titin's intact polypeptide chain. In addition, HaloTag-based covalent tethering enables examination of titin dynamics under force using magnetic tweezers. At pulling forces < 10 pN, titin domains are recruited to the unfolded state, and produce 41.5 zJ mechanical work during refolding. Insertion of the HaloTag-TEV cassette in mechanical proteins opens opportunities to explore the molecular basis of cellular force generation, mechanosensing and mechanotransduction.


title: Photosynthetic protein classification using genome neighborhood-based machine learning feature

text: Identification of novel photosynthetic proteins is important for understanding and improving photosynthetic efficiency. Synergistically, genome neighborhood can provide additional useful information to identify photosynthetic proteins. We, therefore, expected that applying a computational approach, particularly machine learning (ML) with the genome neighborhood-based feature should facilitate the photosynthetic function assignment. Our results revealed a functional relationship between photosynthetic genes and their conserved neighboring genes observed by 'Phylo score', indicating their functions could be inferred from the genome neighborhood profile. Therefore, we created a new method for extracting patterns based on the genome neighborhood network (GNN) and applied them for the photosynthetic protein classification using ML algorithms. Random forest (RF) classifier using genome neighborhood-based features achieved the highest accuracy up to 87% in the classification of photosynthetic proteins and also showed better performance (Mathew's correlation coefficient = 0.718) than other available tools including the sequence similarity search (0.447) and ML-based method (0.361). Furthermore, we demonstrated the ability of our model to identify novel photosynthetic proteins compared to the other methods. Our classifier is available at http://bicep2.kmutt.ac.th/photomod_standalone, https://bit.ly/2S0I2Ox and DockerHub: https://hub.docker.com/r/asangphukieo/photomod.


The COVID-19 Pandemic: Consideration for Brain Infection


Prevalence and Characteristics of Gastrointestinal Symptoms in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the United States: A Multicenter Cohort Study


title: Insights into aphid prey consumption by ladybirds: Optimising field sampling methods and primer design for high throughput sequencing

text: Elucidating the diets of insect predators is important in basic and applied ecology, such as for improving the effectiveness of conservation biological control measures to promote natural enemies of crop pests. Here, we investigated the aphid diet of two common aphid predators in Central European agroecosystems, the native Coccinella septempunctata (Linnaeus) and the invasive Harmonia axyridis (Pallas; Coleoptera: Coccinellidae) by means of high throughput sequencing (HTS). For acquiring insights into diets of mobile flying insects at landscape scale minimizing trapping bias is important, which imposes methodological challenges for HTS. We therefore assessed the suitability of three field sampling methods (sticky traps, pan traps and hand-collection) as well as new aphid primers for identifying aphid prey consumption by coccinellids through HTS. The new aphid primers facilitate identification to species level in 75% of the European aphid genera investigated. Aphid primer specificity was high in silico and in vitro but low in environmental samples with the methods used, although this could be improved in future studies. For insect trapping we conclude that sticky traps are a suitable method in terms of minimizing sampling bias, contamination risk and trapping success, but compromise on DNA-recovery rate. The aphid diets of both field-captured ladybird species were dominated by Microlophium carnosum, the common nettle aphid. Another common prey was Sitobion avenae (cereal aphid), which got more often detected in C. septempunctata compared to H. axyridis. Around one third of the recovered aphid taxa were common crop pests. We conclude that sampling methodologies need constant revision but that our improved aphid primers offer currently one of the best solutions for broad screenings of coccinellid predation on aphids.


COVID-19: opening a new paradigm in thromboprophylaxis for critically ill patients?


title: SARS-CoV-2, a Threat to Privacy?

text: The global SARS-CoV-2 pandemic is currently putting a massive strain on the world's critical infrastructures. With healthcare systems and internet service providers already struggling to provide reliable service, some operators may, intentionally or unintentionally, lever out privacy-protecting measures to increase their system's efficiency in fighting the virus. Moreover, though it may seem all encouraging to see the effectiveness of authoritarian states in battling the crisis, we, the authors of this paper, would like to raise the community's awareness towards developing more effective means in battling the crisis without the need to limit fundamental human rights. To analyze the current situation, we are discussing and evaluating the steps corporations and governments are taking to condemn the virus by applying established privacy research.


COVID-19 e Estado de Hipercoagulabilidade: Uma Nova Perspectiva Terapêutica./ COVID-19 e Estado de Hipercoagulabilidade: Uma Nova Perspectiva Terapêutica./ COVID-19 and Hypercoagulable State: A New Therapeutic Perspective


SARS-CoV-2 and dentistry


title: Effects of air pollutants on the transmission and severity of respiratory viral infections

text: Particulate matter, sulfur dioxide, nitrogen oxides, ozone, carbon monoxide, volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) are among the outdoor air pollutants that are major factors in diseases, causing especially adverse respiratory effects in humans. On the other hand, the role of respiratory viruses in the pathogenesis of severe respiratory infections is an issue of great importance. The present literature review was aimed at assessing the potential effects of air pollutants on the transmission and severity of respiratory viral infections. We have reviewed the scientific literature regarding the association of outdoor air pollution and respiratory viruses on respiratory diseases. Evidence supports a clear association between air concentrations of some pollutants and human respiratory viruses interacting to adversely affect the respiratory system. Given the undoubted importance and topicality of the subject, we have paid special attention to the association between air pollutants and the transmission and severity of the effects caused by the coronavirus named SARS-CoV-2, which causes the COVID-19. Although to date, and by obvious reasons, the number of studies on this issue are still scarce, most results indicate that chronic exposure to air pollutants delays/complicates recovery of patients of COVID-19 and leads to more severe and lethal forms of this disease. This deserves immediate and in-depth experimental investigations.


title: The SARS-CoV-2 Vaccine Pipeline: an Overview

text: Purpose of Review: The goal of this review is to provide a timely overview on efforts to develop a vaccine for the 2019 novel coronavirus SARS-CoV-2, the causative agent of coronavirus disease (COVID-19). Recent Findings: Previous research efforts to develop a severe acute respiratory syndrome coronavirus (SARS-CoV) vaccine in the years following the 2003 pandemic have opened the door for investigators to design vaccine concepts and approaches for the COVID-19 epidemic in China. Both SARS-CoV and SARS-CoV-2 exhibit a high degree of genetic similarity and bind to the same host cell ACE2 receptor. Based on previous experience with SARS-CoV vaccines, it is expected that all COVID-19 vaccines will require careful safety evaluations for immunopotentiation that could lead to increased infectivity or eosinophilic infiltration. Besides this, a COVID-19 vaccine target product profile must address vaccinating at-risk human populations including frontline healthcare workers, individuals over the age of 60, and those with underlying and debilitating chronic conditions. Among the vaccine technologies under evaluation are whole virus vaccines, recombinant protein subunit vaccines, and nucleic acid vaccines. Summary: Each current vaccine strategy has distinct advantages and disadvantages. Therefore, it is paramount that multiple strategies be advanced quickly and then evaluated for safety and efficacy. Ultimately, the safety studies to minimize undesired immunopotentiation will become the most significant bottleneck in terms of time.


title: COVID-19 and the production of knowledge regarding recommendations during pregnancy: a scoping review

text: OBJECTIVE: to map the production of knowledge regarding recommendations for providing care to pregnant women dealing with the novel coronavirus. METHOD: scoping review, using a broadened strategy to search databases and repositories, as well as the reference lists in the sources used. Data were collected and analyzed by two independent reviewers. Data were analyzed and synthesized in the form of a narrative. RESULTS: the final sample was composed of 24 records, the content of which was synthesized in these conceptual categories: clinical manifestations, diagnosis, treatment, working pregnant women, vaccine development, complications, prenatal care, vertical transmission, and placental transmissibility. It is recommended to confirm pregnancy and disease early on, to use technological resources for screening and providing guidance and support to pregnant women. CONCLUSION: recommendations emphasize isolation, proper rest, sleep, nutrition, hydration, medications, and in the more severe cases, oxygen support, monitoring of vital signs, emotional support, and multiprofessional and individualized care. Medications should be used with caution due to a lack of evidence. Future research is needed to analyze the impact of the infection at the beginning of pregnancy and the psychological aspects of pregnant women infected with the virus.


title: Disability Rights as a Necessary Framework for Crisis Standards of Care and the Future of Health Care

text: In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) "Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations," which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both distributive and recognitive justice. The disability rights movement's demand "Nothing about us, without us" requires substantive inclusion of disabled people in decision-making related to their interests, including in crisis planning before, during, and after a pandemic like Covid-19.


Virtual Cafes: An Innovative Way for Rapidly Disseminating Educational Best Practices and Building Community During COVID-19


Adrenomedullin in COVID-19 induced endotheliitis


title: Air pollution in Ontario, Canada during the COVID-19 State of Emergency

text: In March of 2020, the province of Ontario declared a State of Emergency (SOE) to reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (COVID-19). This disruption to the economy provided an opportunity to measure change in air pollution when the population spends more time at home with fewer trips. Hourly air pollution observations were obtained for fine particulate matter, nitrogen dioxide, nitrogen oxides and ozone from the Ontario air monitoring network for 2020 and the previous five years. The analysis is focused on a five-week period during the SOE with a previous five-week period used as a control. Fine particulate matter did not show any significant reductions during the SOE. Ozone concentrations at 12 of the 32 monitors were lower than any of the previous five-years; however, four locations were above average. Average ozone concentrations were 1 ppb lower during the SOE, but this ranged at individual monitors from 1.5 ppb above to 4.2 ppb below long-term conditions. Nitrogen dioxide and nitrogen oxides demonstrated a reduction across Ontario, and both pollutants displayed their lowest concentrations for 22 of 29 monitors. Individual monitors ranged from 1 ppb (nitrogen dioxide) and 5 ppb (nitrogen oxides) above average to 4.5 (nitrogen dioxide) and 7.1 ppb (nitrogen oxides) below average. Overall, both nitrogen dioxide and nitrogen oxides demonstrated a reduction across Ontario in response to the COVID-19 SOE, ozone concentrations suggested a possible reduction, and fine particulate matter has not varied from historic concentrations.


COVID-19 Guideline Modifications as CMS Announces "Opening Up America Again": Comments from the Society of Surgical Oncology


title: Biodiversity and Phylogenetic Relationships of Novel Bacteriocinogenic Strains Isolated from Animal's Droppings at the Zoological Garden of Lille, France

text: This study aimed at exploring droppings of animals living in captivity in the zoological garden (Zoo) of Lille (France), as novel sources of bacteriocinogenic strains. A collection of 295 bacterial isolates was constituted from droppings of capybara, alpaca, muntjac, zebra, tapir, rhinoceros, binturong, armadillo, saki monkey and cockatoo. Of 295 isolates, 51 exhibited antagonism against a panel of pathogenic target bacteria like Escherichia coli MC4100, Clostridium perfringens DSM 756 and Salmonella enterica subsp. enterica Newport ATCC6962. Remarkably, within this collection, only 2 Gram-negative bacilli exhibited activity against E. coli MC4100 strain used as target organism. Then, the 16S rDNA sequencing revealed these thereafter cited species, Pediococcus pentosaceus, Weissella cibaria, E. coli, Lactobacillus reuteri, Enterococcus hirae and Enterococcus faecalis. Characterization of this antagonism has revealed 11 strains able producing extracellular protease-sensitive inhibitory compounds. These strains included E. coli ICVB442 and ICVB443, Ent. faecalis ICVB472, ICVB474, ICVB477 ICVB479, ICVB481, ICVB497 and ICVB501 and Ped. pentosaceus ICVB491 and ICVB492. The genomes of the 5 most promising bacteriocinogenic strains were sequenced and analysed with Bagel4 software. Afterwards, this bioinformatics analysis permitted to locate genes encoding bacteriocins like colicin Y (E. coli), enterocin 1071A, enterocin 107 B (Ent. faecalis) and penocin A (Ped. pentosaceus), associating the above-mentioned antibacterial activity of proteinaceous nature to possible production of bacteriocins. All these results enabled us to select different bacteriocinogenic strains for a further characterization in terms of beneficial traits.


Pandemic: examining readiness for infectious disease outbreaks


docid: iaoxjush

title: Collateral effects of COVID-19 pandemic in pediatric hematooncology: Fatalities caused by diagnostic delay


A Bold Response to the COVID-19 Pandemic: Medical Students, National Service, and Public Health


title: Asymptomatic SARS-CoV-2 Infection in Household Contacts of a Healthcare Provider, Wuhan, China

text: We found that all 5 asymptomatic household contacts of a Wuhan, China, physician with coronavirus disease had severe acute respiratory syndrome coronavirus 2 detected by PCR. The index patient and 2 contacts also had abnormal chest computed tomography scans. Asymptomatic infected household contacts of healthcare workers with coronavirus disease might be underrecognized.


title: SARS-CoV-2 viral spike G614 mutation exhibits higher case fatality rate

text: AIM: The COVID-19 pandemic is caused by infection with the SARS-CoV-2 virus. The major mutation detected to date in the SARS-CoV-2 viral envelope spike protein, which is responsible for virus attachment to the host and is also the main target for host antibodies, is a mutation of an aspartate (D) at position 614 found frequently in Chinese strains to a glycine (G). We sought to infer health impact of this mutation. RESULT: Increased case fatality rate correlated strongly with the proportion of viruses bearing G614 on a country by country basis. The amino acid at position 614 occurs at an internal protein interface of the viral spike, and the presence of G at this position was calculated to destabilise a specific conformation of the viral spike, within which the key host receptor binding site is more accessible. CONCLUSION: These results imply that G614 is a more pathogenic strain of SARS-CoV-2, which may influence vaccine design. The prevalence of this form of the virus should also be included in epidemiologic models predicting the COVID-19 health burden and fatality over time in specific regions. Physicians should be aware of this characteristic of the virus to anticipate the clinical course of infection.


title: A Sever case of of SARS-CoV-2 infection in Gansu

text: An outbreak infection with the novel coronavirus (SARS-CoV-2) has developed in Wuhan since December 2019.This paper describes the first critical case in Gansu China.


COVID-19 and cancer: do we really know what we think we know?


The dilemmas of the classification of SARS-CoV-2 infection without clinical manifestations: Asymptomatic or presymptomatic


Governance of the Covid-19 response: a call for more inclusive and transparent decision-making


Predictive Mathematical Models of the COVID-19 Pandemic: Underlying Principles and Value of Projections


title: The impact of the novel coronavirus on trauma and orthopaedics in the UK

text: At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.


Oncology in the Time of COVID-19


title: Corona Games: Masks, Social Distance and Mechanism Design

text: Pandemic response is a complex affair. Most governments employ a set of quasi-standard measures to fight COVID-19 including wearing masks, social distancing, virus testing and contact tracing. We argue that some non-trivial factors behind the varying effectiveness of these measures are selfish decision-making and the differing national implementations of the response mechanism. In this paper, through simple games, we show the effect of individual incentives on the decisions made with respect to wearing masks and social distancing, and how these may result in a sub-optimal outcome. We also demonstrate the responsibility of national authorities in designing these games properly regarding the chosen policies and their influence on the preferred outcome. We promote a mechanism design approach: it is in the best interest of every government to carefully balance social good and response costs when implementing their respective pandemic response mechanism.