bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relatively young and rural population may limit the spread and severity of Covid-19 in Africa: a modelling study
Authors: Diop Binta Zahra , Ngom Marième , Biyong Clémence Pougué , Biyong John N. Pougué 
Published: May 2020

AbstractIntroductionA novel coronavirus disease 2019 (COVID-19) has spread to all regions of the world. There is great uncertainty regarding how countries characteristics will affect the spread of the epidemic; to date, there are few studies that attempt to predict the spread of the epidemic in African countries. In this paper, we investigate the role of demographic patterns, urbanization and co-morbidities on the possible trajectories of COVID-19 in Ghana, Kenya, and Senegal.MethodsWe use an augmented deterministic SIR model to predict the true spread of the disease, under the containment measures taken so far. We dis-aggregate the infected compartment into asymptomatic, mildly symptomatic, and severely symptomatic to match observed clinical development of COVID-19. We also account for age structures, urbanization, and co-morbidities (HIV, tuberculosis, anemia).ResultsIn our baseline model, we project that the peak of active cases will occur in July, subject to the effectiveness of policy measures. When accounting for the urbanization, and factoring-in co-morbidities, the peak may occur between June 2ndand June 17th(Ghana), July 22ndand August 29th(Kenya), and finally May 28thand June 15th(Senegal). Successful containment policies could lead to lower rates of severe infections. While most cases will be mild, we project in the absence of policies further containing the spread, that between 0.78 and 1.03%, 0.61 and 1.22%, and 0.60 and 0.84% of individuals in Ghana, Kenya, and Senegal respectively may develop severe symptoms at the time of the peak of the epidemic.ConclusionCompared to Europe, Africa’s younger and rural population may modify the severity of the epidemic. The large youth population may lead to more infections but most of these infections will be asymptomatic or mild, and will probably go undetected. The higher prevalence of underlying conditions must be considered.SummaryWhat is known?While most COVID-19 studies focus on western and Asian countries, very few are concerned with the spread of the virus in African countries.Most African countries have relatively low urbanization rates, a young population and context-specific co-morbidities that are still to be explored in the spread of COVID-19.What are the new findings?In our baseline predictions 33 to 50% of the public will be actively infected at the peak of the epidemic and 1 in 36 (Ghana), 1 in 40 (Kenya) and 1 in 42 (Senegal) of these active cases may be severe.With rural areas, infection may be lowered to 65-73% (Ghana), 48-71% (Kenya) and 61-69% (Senegal) of the baseline infections.Comorbidities may however increase the ratio of severe infections among the active cases at the peak of the epidemic.What do the new findings imply?Rural areas and large youth population may limit the spread and severity of the epidemic and outweigh the negative impact of HIV, tuberculosis and anemia.
The Impact of Coronavirus Disease 2019 (COVID-19) on Liver Injury in China: A Systematic Review and Meta-analysis
Authors: Zhao Xin , Lei Zehua , Gao Fengwei , Xie Qingyun , Jang Kangyi , Wu Jianping , Fu Jinqiang , Du Bo , Wang Zhixu 
Published: May 2020

AbstractBackgroundThe evidence for the incidence and severity of liver injury in Chinese patients with COVID-19 is still controversial.AimsThe purpose of this study was to summarize the incidence of liver injury and the differences between liver injury markers among different patients with COVID-19 in China.MethodsComputer searches of PubMed, Embase, CNKI and medRxiv were used to obtain reports on the incidence and markers of liver injury in Chinese patients with COVID-19, from January 1, 2020 to April 10, 2020. (No. CRD42020181350)ResultsA total of 57 reports from China were included, including 9889 confirmed cases of COVID-19 infection. The results of the meta-analysis showed that among the patients with early COVID-19 infection in China, the incidence of liver injury events was 24.7% (95% CI, 23.4%-26.4%). Liver injury in severe patients was more common than that in non-severe patients, with a risk ratio of 2.07 (95% CI, 1.77 to 2.43). Quantitative analysis showed that the severe the coronavirus infection, the higher the level of AST, ALT, TB, ALP, GGT and the lower the level of ALB. The changing trend of the appeal index was similar in ICU patients and dead patients.ConclusionThere is a certain risk of liver injury in Chinese patients with COVID-19, and the risk and degree of liver injury are related to the severity of COVID-19.
Social determinants of COVID-19 mortality at the county level
Authors: Fielding-Miller Rebecca K. , Sundaram Maria E. , Brouwer Kimberly 
Published: May 2020

AbstractThe United States is currently the global epicenter of the COVID-19 pandemic. Emerging data suggests that social determinants of health may be key drivers of the epidemic, and that minorities, migrants, and essential workers may bear a disproportionate degree of risk. We used publicly accessible datasets to build a series of spatial autoregressive models assessing county level associations between COVID- 19 mortality and (1) Percentage of Non-English speaking households, (2) percentage of individuals engaged in hired farm work, (3) percentage of uninsured individuals under the age of 65, and (3) percentage of individuals living at or below the poverty line. Across all counties (n=2940), counties with more farmworkers, more residents living in poverty, higher density, and more residents over the age of 65 had significantly higher levels of mortality. In urban counties (n=114), only county density was significantly associated with mortality. In non-urban counties (n=2826), counties with more non- English speaking households and more farm workers had significantly higher levels of mortality, as did counties with higher levels of poverty and more residents over the age of 65. More uninsured residents was significantly associated with decreased reported COVID-19 mortality. Individuals who do not speak English, individuals engaged in farm work, and individuals living in poverty may be at heightened risk for COVID-19 mortality in non-urban counties. Mortality among the uninsured may be being systematically undercounted in county and national level surveillance.
Cocooning is essential to relaxing social distancing
Authors: Wang Xutong , Du Zhanwei , Huang George , Pasco Remy F , Fox Spencer J , Galvani Alison P , Pignone Michael , Johnston S. Claiborne , Meyers Lauren Ancel 
Published: May 2020

AbstractAs the first wave of COVID-19 recedes, policymakers are contemplating the relaxation of shelter-in-place orders. Using a model capturing high-risk populations and transmission rates estimated from hospitalization data, we find that postponing relaxation will only delay a second wave and cocooning vulnerable populations is needed to prevent overwhelming medical surges.
Reentrant liquid condensate phase of proteins is stabilized by hydrophobic and non-ionic interactions
Authors: Krainer Georg , Welsh Timothy J. , Joseph Jerelle A. , Espinosa Jorge R. , Wittmann Sina , Csilléry Ella de , Sridhar Akshay , Toprakcioglu Zenon , Gudiškytė Giedre , Czekalska Magdalena A. , Arter William E. , George-Hyslop Peter St , Hyman Anthony A. , Collepardo-Guevara Rosana , Alberti Simon , Knowles Tuomas P.J. 
Published: May 2020

AbstractMany cellular proteins demix spontaneously from solution to form liquid condensates. These phase-separated systems have wide-ranging roles in health and disease. Elucidating the molecular driving forces underlying liquid–liquid phase separation (LLPS) is therefore a key objective for understanding biological function and malfunction. Here we show that proteins implicated in cellular LLPS, including FUS, TDP-43, Brd4, Sox2, and Annexin A11, which form condensates at low salt concentrations, can reenter a phase-separated regime at high salt concentrations. By bringing together experiments and simulations, we demonstrate that phase separation in the high-salt regime is driven by hydrophobic and non-ionic interactions, and is mechanistically distinct from the low-salt regime, where condensates are additionally stabilized by electrostatic forces. Our work thus provides a new view on the cooperation of hydrophobicity and non-ionic interactions as non-specific driving forces for the condensation process, with important implications for aberrant function, druggability, and material properties of biomolecular condensates.
COVID-19 and homelessness in England: a modelling study of the COVID-19 pandemic among people experiencing homelessness, and the impact of a residential intervention to isolate vulnerable people and care for people with symptoms
Authors: Lewer Dan , Braithwaite Isobel , Bullock Miriam , Eyre Max T , Aldridge Robert W , Story Alistair , Hayward Andrew 
Published: May 2020

AbstractBackgroundThere is an ongoing pandemic of the viral respiratory disease COVID-19. People experiencing homelessness are vulnerable to infection and severe disease. Health and housing authorities in England have developed a residential intervention that aims to isolate those vulnerable to severe disease (COVID-PROTECT) and care for people with symptoms (COVID-CARE).MethodsWe used a discrete-time Markov chain model to forecast COVID-19 infections among people experiencing homelessness, given strong containment measures in the general population and some transmission among 35,817 people living in 1,065 hostels, and 11,748 people sleeping rough (the ’do nothing’ scenario). We then estimated demand for beds if those eligible are offered COVID-PROTECT and COVID-CARE. We estimated the reduction in the number of COVID-19 cases, deaths, and hospital admissions that could be achieved by these interventions. We also conducted sensitivity and scenario analyses to identify programme success factors.ResultsIn a ’do nothing’ scenario, we estimate that 34% of the homeless population could get COVID-19 between March and August 2020, with 364 deaths, 4,074 hospital admissions and 572 critical care admissions. In our ’base intervention’ scenario, demand for COVID-PROTECT peaks at 9,934 beds, and demand for COVID-CARE peaks at 1,366 beds. The intervention could reduce transmission by removing symptomatic individuals from the community, and preventing vulnerable individuals from being infected. This could lead to a reduction of 164 deaths, 2,624 hospital admissions, and 248 critical care admissions over this period. Sensitivity analyses showed that the number of deaths is sensitive to transmission of COVID-19 in COVID-PROTECT. If COVID-PROTECT capacity is limited, scenario analyses show the benefit of prioritising people who are vulnerable to severe disease.ConclusionSupportive accommodation can mitigate the impact of the COVID-19 pandemic on the homeless population of England, and reduce the burden on acute hospitals.
IDentif.AI: Artificial Intelligence Pinpoints Remdesivir in Combination with Ritonavir and Lopinavir as an Optimal Regimen Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
Authors: Blasiak Agata , Lim Jhin Jieh , Seah Shirley Gek Kheng , Kee Theodore , Remus Alexandria , Chye De Hoe , Wong Pui San , Hooi Lissa , Truong Anh T.L. , Le Nguyen , Chan Conrad E.Z. , Desai Rishi , Ding Xianting , Hanson Brendon J. , Chow Edward Kai-Hua , Ho Dean 
Published: May 2020

ABSTRACTThe emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) has led to the rapid initiation of urgently needed clinical trials of repurposed drug combinations and monotherapies. These regimens were primarily relying on mechanism-of-action based selection of drugs, many of which have yielded positive in vitro but largely negative clinical outcomes. To overcome this challenge, we report the use of IDentif.AI, a platform that rapidly optimizes infectious disease (ID) combination therapy design using artificial intelligence (AI). In this study, IDentif.AI was implemented on a 12-drug candidate therapy search set representing over 530,000 possible drug combinations. IDentif.AI demonstrated that the optimal combination therapy against SARS-CoV-2 was comprised of remdesivir, ritonavir, and lopinavir, which mediated a 6.5-fold improvement in efficacy over remdesivir alone. Additionally, IDentif.AI showed hydroxychloroquine and azithromycin to be relatively ineffective. The identification of a clinically actionable optimal drug combination was completed within two weeks, with a 3-order of magnitude reduction in the number of tests typically needed. IDentif.AI analysis was also able to independently confirm clinical trial outcomes to date without requiring any data from these trials. The robustness of the IDentif.AI platform suggests that it may be applicable towards rapid development of optimal drug regimens to address current and future outbreaks.
The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis
Authors: Allan Sophie M. , Bealey Rebecca , Birch Jennifer , Cushing Toby , Parke Sheryl , Sergi Georgina , Bloomfield Michael , Meiser-Stedman Richard 
Published: May 2020

AbstractBackgroundHealthcare workers (HCWs) are considered at elevated risk of experiencing mental health disorders in working with patients with COVID-19.AimsTo estimate the prevalence of common mental health disorders in HCWs based in hospitals where pandemic-affected patients were treated.MethodDatabases were searched for studies published before 30th March 2020. Quantitative synthesis was used to obtain estimates of the prevalence of mental health disorders in four time windows, determined a priori (the acute phase, i.e. during and up to 1.5 months post-pandemic; 1.5-5.9 months; 6-11.9 months; 12 months and later).ResultsNineteen studies met the review criteria. They predominantly addressed the acute phase of the SARS outbreak in Asia. The most studied outcomes were clinically-significant post-traumatic stress symptoms (PTSS) and general psychiatric caseness. For clinically significant PTSS in the acute phase, the prevalence estimate was 23.4% (95% CI 16.3, 31.2; N=4147; I2=96.2%); in the 12 months plus window, the estimate was 11.9% (8.4, 15.8; N=1136; I2=74.3%). For general psychiatric caseness, prevalence estimates were: acute phase, 34.1% (18.7, 51.4; N=3971; I2=99.1%); 6-12 months, 17.9% (13.1, 23.2; N=223; I2=0.0%); 12 months plus, 29.3% (6.0, 61.0; N=710; I2=97.8%).ConclusionsMental health disorders are particularly common in HCWs working with pandemic-afflicted patients immediately following a pandemic, but the course of disorders following this period is poorly understood. PTSS remained elevated compared to the general population at 12 months, despite there being some evidence for natural recovery. There was considerable heterogeneity, likely linked to methodological differences. More extended follow up of HCWs is needed.
Association of previous medications with the risk of COVID-19: a nationwide claims-based study from South Korea
Authors: Huh Kyungmin , Ji Wonjun , Kang Minsun , Hong Jinwook , Bae Gi Hwan , Lee Rugyeom , Na Yewon , Choi Hyoseon , Gong Seon Yeong , Jung Jaehun 
Published: May 2020

AbstractBackgroundIdentifying the association between medications taken prior to the infection of coronavirus disease (COVID-19) might be useful during the current pandemic until a proven treatment is developed. We aimed to determine whether the risk of developing COVID-19 was associated with the use of various drugs that may increase or decrease susceptibility to severe acute respiratory syndrome coronavirus 2 infection and COVID-19.Methods and FindingsA case-control study was performed using a nationwide claims database of South Korea, where a large testing capacity has been available throughout the pandemic. Exposure was defined as the prescription of study drugs that would have been continued until ≤7 days before the testing for COVID-19. Adults were considered eligible if they were ≥18 years old and tested for COVID-19. Among the 65,149 eligible subjects (mean age, 48.3 years; 49.4% male), 5,172 (7.9%) were diagnosed with COVID-19. Hydroxychloroquine was not significantly associated with the risk of COVID-19 (adjusted odds ratio [aOR], 1.48; 95% CI, 0.95–2.31). In the overall population, lower risks of COVID-19 were associated with the use of camostat (aOR, 0.45; 95% CI, 0.20–1.02) and amiodarone (aOR, 0.54; 95% CI, 0.33–0.89), although the differences were not significant in the subgroup analyses. Angiotensin receptor blockers were also associated with a slightly increased risk of COVID-19 (aOR, 1.13; 95% CI, 1.01–1.26), which was also not observed in the subgroup analysis. The study limitations include potential bias regarding the controls’ characteristics, inability to determine prescription compliance, and a lack of information regarding the severity of underlying conditions.ConclusionsNo medications were consistently associated with increased or decreased risks of COVID-19. These findings suggest that a more cautious approach is warranted for the clinical use of re-purposed drugs until the results are available from clinical trials.
Hospitalization and 30-day fatality in 121,263 COVID-19 outpatient cases
Authors: Prieto-Alhambra Daniel , Balló Elisabet , Coma Ermengol , Mora Núria , Aragón María , Prats-Uribe Albert , Fina Francesc , Benítez Mència , Guiriguet Carolina , Fàbregas Mireia , Medina-Peralta Manuel , Duarte-Salles Talita 
Published: May 2020

ABSTRACTBackgroundTo date, characterisation studies of COVID-19 have focussed on hospitalised or intensive care patients. We report for the first time on the natural history of COVID-19 disease from first diagnosis, including both outpatient and hospital care.MethodsData was obtained from SIDIAP, a primary care records database covering >6 million people (>80% of the population of Catalonia), linked to COVID-19 RT-PCR tests, hospital emergency and inpatient, and mortality registers. All participants >=15 years, diagnosed with COVID-19 in outpatient between 15th March and 24th April 2020 (10thApril for outcome studies) were included. Baseline characteristics, testing, and 30-day outcomes (hospitalisation for COVID-19 and all-cause fatality) were analysed.ResultsA total of 121,263 and 95,467 COVID-19 patients were identified for characterisation and outcome studies, respectively. Women (57.8%) and age 45-54 (20.2%) were predominant. 44,709 were tested, with 32,976 (73.8%) PCR+. From 95,467 cases, a 14.6% [14.4–14.9] were hospitalised in the month after diagnosis, with male predominance (19.2% vs 11.3%), peaking at age 75-84. Overall 30-day fatality was 4.0% [95%CI 3.9%-4.2%], higher in men (4.8%) than women (3.4%), increasing with age, and highest in those residing in nursing homes (25.3% [24.2% to 26.4%]).ConclusionsCOVID-19 is seen in all age-sex strata, but severe forms of disease cluster in older men and nursing home residents. Although initially managed in primary care, 15% of cases require hospitalization within a month, with overall fatality of 4%.
Respiratory infection during lithium and valproate medication: a within-individual prospective study of 50,000 patients with bipolar disorder
Authors: Landén Mikael , Lichtenstein Paul , Larsson Henrik , Song Jie 
Published: May 2020

AbstractObjectiveIn vitrostudies have demonstrated that lithium has antiviral properties, but evidence from human studies is scarce. Lithium is used as a mood stabilizer to treat patients with bipolar disorder. Here, the aim was to investigate the association between lithium use and the risk of respiratory infections in patients with bipolar disorder. To rule out the possibility that a potential association could be due to lithium’s effect on psychiatric symptoms, we also studied the effect of the most common alternative to lithium to prevent mood episodes in bipolar disorder, valproate.MethodWe followed 51,509 individuals diagnosed with bipolar disorder in the Swedish Patient register 2005–2013. We applied a with-individual design using stratified Cox regression to estimate the hazard ratios (HRs) of respiratory infections during treated periods compared with untreated periods.ResultsDuring follow-up, 5,760 respiratory infections were documented in the Swedish Patient Register. The incidence rate was 28% lower during lithium treatment (HR 0.73, 95% CI 0.61–0.86) and 35% higher during valproate treatment (HR 1.35, 95% CI 1.06–1.73) compared with periods off treatment.ConclusionsThis study provides real-world evidence that lithium protects against respiratory infections and suggests that the repurposing potential of lithium for antiviral effects is worthy of investigation.
Multivariable prediction model of intensive care unit transfer and death: a French prospective cohort study of COVID-19 patients
Authors: Allenbach Yves , Saadoun David , Maalouf Georgina , Vieira Matheus , Hellio Alexandra , Boddaert Jacques , Gros Hélène , Salem Joe Elie , Rigon Matthieu Resche , Biard Lucie , Benveniste Olivier , Cacoub Patrice 
Published: May 2020

AbstractBackgroundPrognostic factors of coronavirus disease 2019 (COVID-19) patients among European population are lacking. Our objective was to identify early prognostic factors upon admission to optimize the management of COVID-19 patients hospitalized in a medical ward.MethodsFrench single-center prospective cohort study of 152 patients with positive Severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay, hospitalized in a medical ward. Multivariable models and a simplified scoring system assessed predictive factors of intensive care unit (ICU) transfer or death at day 14 (D14), of being discharge alive and severe status at D14 (remaining with ventilation, or death). A validation was performed on an external sample of 132 patients.FindingsAt D14, the probability of ICU transfer or death was 32% (95% CI 25-40). Older age (OR 2·61, 95% CI 0·96-7·10), poorer respiratory presentation (OR 4·04 per 1-point increment on World Health Organization (WHO) clinical scale, 95% CI 1·76-9·25), higher CRP-level (OR 1·63 per 100mg/L increment, 95% CI 0·98-2·71) and lower lymphocytes count (OR 0·36 per 1000/mm3 increment, 95% CI 0·13-0·99) were associated with an increased risk of ICU requirement or death. A 8-point ordinal scale scoring system defined low (score 0-2), moderate (score 3-5), and high (score 6-8) risk patients, with predicted respectively 2%, 25% and 81% risk of ICU transfer or death at D14.InterpretationIn this prospective cohort study of laboratory-confirmed COVID-19 patients hospitalized in a medical ward in France, 32% were transferred to ICU or died. A simplified scoring system at admission predicted the outcome at D14.FundingNo funding.