bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential interruptions in HIV prevention and treatment services for gay, bisexual, and other men who have sex with men associated with COVID-19
Authors: Rao Amrita , Rucinski Katherine , Jarrett Brooke , Ackerman Benjamin , Wallach Sara , Marcus Julia , Adamson Tyler , Garner Alex , Santos Glenn-Milo , Beyrer Chris , Howell Sean , Baral Stefan 
Published: August 2020

ABSTRACTBackgroundGlobally, the coronavirus pandemic has necessitated a range of population-based measures in order to stem the spread of infection and reduce COVID-19-related morbidity and mortality. These measures may be associated with disruptions to other health services including for gay, bisexual, and other men who have sex with men (MSM) at risk for or living with HIV. Here, we assess the relationship between stringency of COVID-19 mitigation strategies and interruptions to HIV prevention and treatment services for MSM.MethodsData for this study were collected as part of a COVID-19 Disparities Survey implemented by the gay social networking app Hornet, with data collected between April 16th, 2020 and May 24th, 2020. Data were assessed for countries where at least 50 participants completed the survey, to best evaluate country-level heterogeneity. We used a modified Poisson regression model, with clustering at the country-level, to assess the association between stringency of pandemic control measures and access to HIV services. Pandemic control measures were quantified using the Oxford Government Response Tracker Stringency Index; each country received a score (0-100) based on the number and strictness of nine indicators related to school and workplace closures and travel bans.ResultsA total of 10,654 MSM across 20 countries were included in these analyses. The mean age was 34.2 (standard deviation: 10.8), and 12% (1264/10540) of participants reported living with HIV. The median stringency score was 82.31 (Range:[19.44, Belarus]-[92.59, Ukraine]). For every ten-point increase in stringency, there was a 3% reduction in the prevalence of access to in-person testing (aPR: 0.97, 95% Cl:[0.96, 0.98]), a 6% reduction in the prevalence of access to self-testing (aPR: 0.94, 95% Cl:[0.93, 0.95]), and a 5% reduction in access to PrEP (aPR: 0.95, 95% Cl:[0.95, 0.97]). Among those living with HIV, close to one in five (n = 218/1105) participants reported being unable to access their provider either in-person or via telemedicine during the COVID-19 pandemic, with a greater proportion of interruptions to treatment services reported in Belarus and Mexico. Almost half (n = 820/1254) reported being unable to refill their HIV medicine prescription remotely.ConclusionsMore stringent government responses were associated with decreased access to HIV diagnostic, prevention, and treatment services. To minimize increases in HIV-related morbidity and mortality, innovative strategies are needed to facilitate minimize service interruptions to MSM communities during this and potential future waves of COVID-19.
Evaluating aerosol and splatter during orthodontic debonding: implications for the COVID-19 pandemic
Authors: Llandro Hayley , Allison James R , Currie Charlotte C , Edwards David C , Bowes Charlotte , Durham Justin , Jakubovics Nicholas , Rostami Nadia , Holliday Richard 
Published: August 2020

AbstractIntroductionDental procedures often produce splatter and aerosol which have potential to spread pathogens such as SARS-CoV-2. Mixed guidance exists on the aerosol generating potential of orthodontic procedures. The aim of this study was to evaluate aerosol and/or splatter contamination during an orthodontic debonding procedure.Material and MethodsFluorescein dye was introduced into the oral cavity of a mannequin. Orthodontic debonding was carried out in triplicate with filter papers placed in the immediate environment. Composite bonding cement was removed using a slow-speed handpiece with dental suction. A positive control condition included a high-speed air-turbine crown preparation. Samples were analysed using digital image analysis and spectrofluorometric analysis.ResultsContamination across the 8-metre experimental rig was 3% of the positive control on spectrofluorometric analysis and 0% on image analysis. There was contamination of the operator, assistant, and mannequin, representing 8%, 25%, and 28% of the positive control spectrofluorometric measurements, respectively.DiscussionOrthodontic debonding produces splatter within the immediate locality of the patient. Widespread aerosol generation was not observed.ConclusionsOrthodontic debonding procedures are low risk for aerosol generation, but localised splatter is likely. This highlights the importance of personal protective equipment for the operator, assistant, and patient.Three ‘In brief’ pointsOrthodontic debonding, including removal of composite using a slow speed handpiece with dental suction, appears to be a low risk procedure for aerosol generation.Splatter was produced during the debonding procedure, however this was mainly localised to the patient, operator and assistant.A single positive reading was identified 3.5 meters away from the patient, highlighting the need for suitable distancing and/or barriers in open clinical environments.
Inhaled corticosteroids downregulate SARS-CoV-2-related gene expression in COPD: results from a RCT
Authors: Milne Stephen , Li Xuan , Yang Chen Xi , Cordero Ana I Hernandez , Filho Fernando Sergio Leitao , Yang Cheng Wei Tony , Shaipanich Tawimas , van Eeden Stephan F , Leung Janice M , Lam Stephen , Sin Don D 
Published: August 2020

AbstractRationaleChronic obstructive pulmonary disease (COPD) is a risk factor for severe COVID-19. Inhaled corticosteroids (ICS) are commonly prescribed for the prevention of acute exacerbations in people with COPD, but their use is associated with increased risk of respiratory infections. The effects of ICS on SARS-CoV-2 susceptibility or COVID-19 severity are currently unknown.ObjectivesTo determine the effects of ICS treatment on the bronchial epithelial cell expression of key SARS-CoV-2-related genes in volunteers with COPD.MethodsWe performed a randomized, open-label, parallel treatment trial of 12 weeks treatment with ICS in combination with long-acting beta-agonist (formoterol/budesonide 12/400 µg twice daily or salmeterol/fluticasone propionate 25/250 µg twice daily), or treatment with LABA only (formoterol 12 µg twice daily), in volunteers with mild to very severe COPD. We obtained bronchial epithelial cell samples via bronchoscopy before and after treatment, and determined transcriptome-wide gene expression by RNA sequencing.Main Results63 volunteers were randomized to receive treatment. Compared to formoterol alone, formoterol/budesonide treatment decreased the expression of the SARS-CoV-2 receptor gene ACE2 and the host cell protease gene ADAM17. These genes were highly co-expressed with innate immune response genes, particularly those of the type I interferon and anti-viral response pathways, which also tended to decrease following ICS treatment.ConclusionsThis is the first randomized controlled trial to show that ICS affect the expression of key SARS-CoV-2-related genes in COPD. Their relation to important anti-viral response genes may have critical implications for SARS-CoV-2 susceptibility or COVID-19 severity in this vulnerable population.
Estimating healthcare resource needs for COVID-19 patients in Nigeria
Authors: Ogunbameru Adeteju , Barrett MD Kali , Joda Arinola E. , Khan MD Yasin A , Pechlivanoglou Petros , Mac Stephen , Naimark MD David , Ximenes Raphel , Sander Beate 
Published: August 2020

AbstractBackgroundPredicting potential healthcare resource use under different scenarios will help to prepare the healthcare system for a surge in COVID-19 patients. In this study, we aim to predict the effect of COVID-19 on hospital resources in Nigeria.MethodWe adopted a previously published discrete-time, individual-level, health-state transition model of symptomatic COVID-19 patients to the Nigerian healthcare system and COVID-19 epidemiology. We simulated different combined scenarios of epidemic trajectories and acute care capacity. Primary outcomes included expected cumulative number of cases, days until depletion resources, and number of deaths associated with resource constraints. Outcomes were predicted over a 60-day time horizon.ResultsIn our best-case epidemic trajectory, which implies successful implementation of public health measures to control COVID-19 spread, the current number of ventilator resources in Nigeria (conservative resources scenario), were expended within five days, and 901 patients may die while waiting for hospital resources in conservative resource scenario. In our expanded resource scenarios, ventilated ICU beds were depleted in all three epidemic trajectories within 60 days. Acute care resources were only sufficient in the best-case and intermediate epidemic scenarios, combined with a substantial increase in healthcare resources.ConclusionCurrent hospital resources are inadequate to manage the COVID-19 pandemic in Nigeria. Given Nigeria’s limited resources, it is imperative to increase healthcare resources and maintain aggressive public health measures to reduce COVID-19 transmission.KEY QUESTIONSWhat is already known on this subject?While western countries seem to be recovering from the COVID-19 pandemic, there is an increasing community spread of the virus in many African countries.The limited healthcare resources available in the region may not be sufficient to cope with increasing numbers of COVID-19 cases.What this study adds?Using the COVID-19 Resource Estimator (CORE) model, we demonstrate that implementing and maintaining aggressive public health measures to keep the epidemic growth at a low rate, while simultaneously substantially increasing healthcare resources is critical to minimize the impact of COVID-19 on morbidity and mortality.The impact of COVID-19 in low resource settings will likely overwhelm health system capacity if aggressive public health measures are not implemented. To mitigate the impact of COVID-19 in these settings, it is essential to develop strategies to substantially increase health system capacities, including hospital resources, personal protective equipment and trained healthcare personnel and to implement and maintain aggressive public health measures.
Iota-carrageenan and Xylitol inhibit SARS-CoV-2 in cell culture
Authors: Bansal Shruti , Jonsson Colleen B. , Taylor Shannon L. , Figueroa Juan Manuel , Dugour Andrea Vanesa , Palacios Carlos , César Vega Julio 
Published: August 2020

AbstractCOVID-19 (coronavirus disease 2019) is a pandemic caused by SARS-CoV-2 (severe acute respiratory syndrome-coronavirus 2) infection affecting millions of persons around the world. There is an urgent unmet need to provide an easy-to-produce, affordable medicine to prevent transmission and provide early treatment for this disease. The nasal cavity and the rhinopharynx are the sites of initial replication of SARS-CoV-2. Therefore, a nasal spray may be a suitable dosage form for this purpose. The main objective of our study was to test the antiviral action of three candidate nasal spray formulations against SARS-CoV-2. We have found that iota-carrageenan in concentrations as low as 6 µg/ mL inhibits SARS-CoV-2 infection in Vero cell cultures. The concentrations found to be active in vitro against SARS-CoV-2 may be easily achieved by the application of nasal sprays already marketed in several countries. Xylitol at a concentration of 5 % m/V has proved to be viricidal on its own and the association with iota-carrageenan may be beneficial, as well.
High SARS-CoV-2 Seroprevalence in Children and Adults in the Austrian Ski Resort Ischgl
Authors: Knabl Ludwig , Mitra Tanmay , Kimpel Janine , Rössler Annika , Volland André , Walser Andreas , Ulmer Hanno , Pipperger Lisa , Binder Sebastian C. , Riepler Lydia , Bates Katie , Bandyopadhyay Arnab , Schips Marta , Ranjan Mrinalini , Falkensammer Barbara , Borena Wegene , Meyer-Hermann Michael , von Laer Dorothee 
Published: August 2020

AbstractBackgroundEarly March 2020, a SARS-CoV-2 outbreak in the ski resort Ischgl in Austria initiated the spread of SARS-CoV-2 throughout Austria and Northern Europe.MethodsBetween April 21 and 27, a cross-sectional epidemiologic study targeting the full population of Ischgl (n = 1867), of which 79 % could be included (n = 1473, incl. 214 children), was performed. For each individual, the study involved a SARS-CoV-2 PCR, antibody testing and structured questionnaires. A mathematical model was used to help understand the influence of the determined seroprevalence on virus transmission.FindingsThe seroprevalence was 42.4% (95% CI 39.8–44.7). Individuals under 18 showed a significantly lower seroprevalence of 27.1% (95% CI 21.3–33.6) than adults (45%; 95% CI 42.2–47.7; OR of 0.455, 95% CI 0.356–0.682, p< 0.001). Of the seropositive individuals, 83.7% had not been diagnosed to have had SARS-CoV-2 infection previously. The clinical course was generally mild. Over the previous two months, two COVID-19-related deaths had been recorded, corresponding to an infection fatality rate (IFR) of 0.25% (95% CI 0.03–0.91). Only 8 (0.5 %) individuals were newly diagnosed to be infected with SARS-CoV-2 during this study.InterpretationIschgl was hit early and hard by SARS-CoV-2 leading to a high local seroprevalence of 42.4%, which was lower in individuals below the age of 18 than in adults. Mathematical modeling suggests that a drastic decline of newly infected individuals in Ischgl by the end of April occured due to the dual impact from the non-pharmacological interventions (NPIs) and a significant immunization of the Ischgl population.FundingHelmholtz Association, European Union’s Horizon 2020 research and innovation program, German Research Foundation (DFG), state Tyrol.
COVID-19 Pandemic Preparedness in a United Kingdom Tertiary and Quaternary Children’s Hospital: Tales of the Unexpected
Authors: Alders Nele , Penner Justin , Grant Karlie , Patterson Charlotte , Hassell Jane , MacDermott Nathalie , Pincott Sian , Bamford Alasdair , Pré Pascale du , Johnson Mae , Moshal Karyn 
Published: August 2020

AbstractBackgroundThe paucity of data describing SARS-CoV-2 in the paediatric population necessitated a broad-arching approach to pandemic planning, with preparations put in place to manage a heterogeneous cohort. We describe a diverse group of SARS-CoV-2 positive paediatric patients treated at a large tertiary/quaternary children’s hospital in the United Kingdom and the adaptive coping strategies required.MethodsAll paediatric patients with positive RT-PCR on a respiratory sample and/or serology for SARS-CoV-2 up to 19th May 2020 were included.Results57 children met the inclusion criteria. 70% were of non-Caucasian ethnicity with a median age of 9.3 years (IQR 5.16–13.48). Four distinct groups were identified: paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) (54%), primary respiratory (18%), incidental (7%), and non-specific febrile illnesses with or without extra-pulmonary organ dysfunction (21%). These groups presented in distinct chronological blocks as the pandemic unfolded.DiscussionThe diverse range of presentations of SARS-CoV-2 infection in this population exemplified the importance of preparedness for the unknown in the midst of a novel infectious pandemic. Descriptions of paediatric patients during the initial phase of the pandemic from other parts of the globe and extrapolation from adult data did not serve as an accurate representation of paediatric COVID-19 in our centre. An adaptive, multidisciplinary approach was paramount. Expanded laboratory testing and incorporation of technology platforms to facilitate remote collaboration in response to strict infection control precautions were both indispensable. Lessons learned during the preparation process will be essential in planning for a potential second wave of SARS-CoV-2.
Engagement and adherence trade-offs for SARS-CoV-2 contact tracing
Authors: Lucas Tim C. D. , Davis Emma L. , Ayabina Diepreye , Borlase Anna , Crellen Thomas , Pi Li , Medley Graham F. , Yardley Lucy , Klepac Petra , Gog Julia , Hollingsworth T. Déirdre 
Published: August 2020

AbstractContact tracing is an important tool for allowing countries to ease lock-down policies introduced to combat SARS-CoV-2. For contact tracing to be effective, those with symptoms must self-report themselves while their contacts must self-isolate when asked. However, policies such as legal enforcement of self-isolation can create trade-offs by dissuading individuals from self-reporting. We use an existing branching process model to examine which aspects of contact tracing adherence should be prioritised. We consider an inverse relationship between self-isolation adherence and self-reporting engagement, assuming that increasingly strict self-isolation policies will result in fewer individuals self-reporting to the programme. We find that policies that increase the average duration of self-isolation, or that increase the probability that people self-isolate at all, at the expense of reduced self-reporting rate, will not decrease the risk of a large outbreak and may increase the risk, depending on the strength of the trade-off. These results suggest that policies to increase self-isolation adherence should be implemented carefully. Policies that increase self-isolation adherence at the cost of self-reporting rates should be avoided.
Development of antibodies to pan-coronavirus spike peptides in convalescent COVID-19 patients
Authors: Rabets Andrii , Bila Galyna , Grytsko Roman , Samborsky Markian , Rebets Yuriy , Vari Sandor , Pagneux Quentin , Barras Alexandre , Boukherroub Rabah , Szunerits Sabine , Bilyy Rostyslav 
Published: August 2020

AbstractCoronaviruses are sharing several protein regions notable the spike protein (S) on their enveloped membrane surface, with the S1 subunit recognizing and binding to the cellular receptor, while the S2 subunit mediates viral and cellular membrane fusion. This similarity opens the question whether infection with one coronavirus will confer resistance to other coronaviruses? Investigating patient serum samples after SARS-CoV-2 infection in cross-reactivity studies of immunogenic peptides from Middle East respiratory syndrome coronavirus (MERS-CoV), we were able to detect the production of antibodies also recognizing MERS virus antigens. The cross-reactive peptide comes from the heptad repeat 2 (HR2) domain of the MERS virus spike protein. Indeed, the peptide of the HR2 domain of the MERS spike protein, previously proven to induce antibodies against MERS-CoV is sharing 74% homology with the corresponding sequence of SARS-CoV-19 virus. Sera samples of 47 convalescent SARS-CoV-2 patients, validated by RT-PCR-negative testes 30 days post-infection, and samples of 40 sera of control patients (not infected with SARS-CoV-2 previously) were used to establish eventual cross-bind reactivity with the MERS peptide antigen. Significantly stronger binding (p< 0.0001) was observed for IgG antibodies in convalescent SARS-CoV-2 patients compared to the control group. If used as an antigen, the peptide of the HR2 domain of the MERS spike protein allows discrimination between post-Covid populations from non-infected ones by the presence of antibodies in blood samples. This suggests that polyclonal antibodies established during SARS-CoV-2 infection has the ability to recognize and probably decrease infectiveness of MERS-CoV infections as well as other coronaviruses. The high homology of the spike protein domain suggests in addition that the opposite effect can also be true: coronaviral infections producing cross-reactive antibodies affective against SARS-CoV-19. The collected data prove in addition that despite the core HR2 region being hidden in the native viral conformation, its exposure during cell entry makes it highly immunogenic. Since inhibitory peptides to this region were previously described, this opens new possibilities in fighting coronaviral infections.
Systematic review and patient-level meta-analysis of SARS-CoV-2 viral dynamics to model response to antiviral therapies
Authors: Gastine Silke , Pang Juanita , Boshier Florencia A.T. , Carter Simon J. , Lonsdale Dagan O. , Cortina-Borja Mario , Hung Ivan F.N. , Breuer Judy , Kloprogge Frank , Standing Joseph F. 
Published: August 2020

ABSTRACTSARS-CoV-2 viral loads change rapidly following symptom onset so to assess antivirals it is important to understand the natural history and patient factors influencing this. We undertook an individual patient-level meta-analysis of SARS-CoV-2 viral dynamics in humans to describe viral dynamics and estimate the effects of antivirals used to-date. This systematic review identified case reports, case series and clinical trial data from publications between 1/1/2020 and 31/5/2020 following PRISMA guidelines. A multivariable Cox proportional hazards regression model (Cox-PH) of time to viral clearance was fitted to respiratory and stool samples. A simplified four parameter nonlinear mixed-effects (NLME) model was fitted to viral load trajectories in all sampling sites and covariate modelling of respiratory viral dynamics was performed to quantify time dependent drug effects. Patient-level data from 645 individuals (age 1 month-100 years) with 6316 viral loads were extracted. Model-based simulations of viral load trajectories in samples from the upper and lower respiratory tract, stool, blood, urine, ocular secretions and breast milk were generated. Cox-PH modelling showed longer time to viral clearance in older patients, males and those with more severe disease. Remdesivir was associated with faster viral clearance (adjusted hazard ratio (AHR) = 9.19,p<0.001), as well as interferon, particularly when combined with ribavirin (AHR = 2.2,p=0.015; AHR = 6.04,p =0.006). Combination therapy should be further investigated. A viral dynamic dataset and NLME model for designing and analysing antiviral trials has been established.
Forecasting PPE Consumption during a Pandemic: The Case of Covid-19
Authors: Lum Kristian , Johndrow James , Cardone April , Fuchs Barry , Cotner Cody E. , Jew Olivia , Parikh Ravi B. , Draugelis Michael , Luong ThaiBinh , Hanish Asaf , Weissman Gary E. , Terwiesch Christian , Volpp Kevin G. 
Published: August 2020

AbstractDue to the global shortage of PPE caused by increasing number of COVID-19 patients in recent months, many hospitals have had difficulty procuring adequate PPE for the clinicians who care for these patients. Faced with a shortage, hospitals have had to implement new PPE conservation policies. In this paper, we describe a tool to help hospitals better project PPE needs under various conservation policies. Though this tool is built on top of projections of the number of hospitalized COVID-19 patients, it is agnostic as to which model—of which many are available—provides these projections. The tool combines COVID-19 patient census projections with information like staffing ratios and frequency of patient contact to provide projections of the number of items of key types of PPE needed under three built-in conservation scenarios: standard, contingency, and crisis. Users are also able to customize the tool to the specifics of their hospital and design custom conservation policies.