title: COVID-19 information propagation dynamics in the Chinese Sina-microblog

text: The outbreak of a novel coronavirus (COVID-19) generated an outbreak of public opinions in the Chinese Sina-microblog. To help in designing effective communication strategies during a major public health emergency, we propose a multiple-information susceptible-discussing-immune (M-SDI) model in order to understand the patterns of key information propagation on social networks. We develop the M-SDI model, based on the public discussion quantity and take into account of the behavior that users may re-enter another related topic or Weibo after discussing one. Data fitting using the real data of COVID-19 public opinion obtained from Chinese Sina-microblog can parameterize the model to make accurate prediction of the public opinion trend until the next major news item occurs. The reproduction ratio has fallen from 1.7769 and maintained around 0.97, which reflects the peak of public opinion has passed but it will continue for a period of time.


title: Sleepless in COVID-19: how not to lose sleep in lockdowns

text: The corona virus disease 2019 (COVID-19) outbreak started in December 2019 in Wuhan, China, and spread all over the world leading to declaration of a pandemic by World Health Organization (WHO) on 11th March 2020. Most countries around the world have been on lockdown in an effort to halt the spread of virus. People around the world have been pushed into uncharted waters of uncertainty, fear, anxiety, stress and depression due to economic crash down, job losses and fear for their own health and that of their loved ones. There is a known association between anxiety/stress and sleep disturbances and vice versa. The most vulnerable population in this isolation like condition, in this lockdown, are the chief earning member of the family, women, young ones, and people with psychiatric illness.


Prisons are "in no way equipped" to deal with COVID-19


title: Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders are Associated with Alterations in Mental Health Search Behavior in the United States

text: BACKGROUND: COVID-19 has led to dramatic changes globally in persons' everyday lives. To combat the pandemic, many governments have implemented social distancing, quarantine, and stay-at-home orders. There is limited research on the impact of such extreme measures on mental health. OBJECTIVE: The goal of the present study was to examine whether stay-at-home orders produced differential changes in mental health symptoms using internet search queries at a national scale. METHODS: In the United States, individual states vary in their adoption of measures to reduce the spread of COVID-19; as of March 23, 2020, eleven of the fifty states had issued stay-at-home orders. The staggered rollout of stay-at-home measures across the U.S. allows us to investigate whether these measures impact mental health by exploring variations in mental health search queries across the states. The current manuscript examines the changes in mental health search queries on Google between March 16-23, 2020 across each state and Washington D.C. Specifically, the current manuscript examines differential change in mental health searches based on patterns of search activity following issuance of stay-at-home orders in these states compared to all other states. Participants included all persons who searched mental health terms in Google between March 16-23. Between March 16-23, eleven states underwent stay-at-home orders to prevent the transmission of COVID-19. Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation. RESULTS: Analyzing over 10 million search queries using generalized additive mixed models, the results suggested that the implementation of stay-at-home orders are associated with a significant flattening of the curve for searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances with the most prominent flattening associated with suicidal ideation and anxiety. CONCLUSIONS: These results suggest that, despite decreased social contact, mental health search queries increased rapidly prior to the issuance of stay-at-home orders, and these changes dissipated following the announcement and enactment of these orders. Although more research is needed to examine sustained effects, these results suggest mental health symptoms were associated with an immediately leveling off following the issuance of stay-at-home orders.


title: Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibody Responses in Coronavirus Disease Patients

text: A new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged to cause a human pandemic. Although molecular diagnostic tests were rapidly developed, serologic assays are still lacking, yet urgently needed. Validated serologic assays are needed for contact tracing, identifying the viral reservoir, and epidemiologic studies. We developed serologic assays for detection of SARS-CoV-2 neutralizing, spike protein-specific, and nucleocapsid-specific antibodies. Using serum samples from patients with PCR-confirmed SARS-CoV-2 infections, other coronaviruses, or other respiratory pathogenic infections, we validated and tested various antigens in different in-house and commercial ELISAs. We demonstrated that most PCR-confirmed SARS-CoV-2-infected persons seroconverted by 2 weeks after disease onset. We found that commercial S1 IgG or IgA ELISAs were of lower specificity, and sensitivity varied between the 2 assays; the IgA ELISA showed higher sensitivity. Overall, the validated assays described can be instrumental for detection of SARS-CoV-2-specific antibodies for diagnostic, seroepidemiologic, and vaccine evaluation studies.


title: Disequilibrium between the Classic Renin-angiotensin System and Its Opposing Arm in Sars-cov-2 Related Lung Injury

text: A dysregulation of the renin-angiotensin-system (RAS) has been involved in the genesis of lung injury and acute respiratory distress syndrome (ARDS) from different causes, including several viral infections. The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection of pneumocytes, the hallmark of the pandemic coronavirus disease 2019 (COVID-19) involving both alveolar interstitium and capillaries, is linked to angiotensin-converting-enzyme 2 (ACE2) binding and its functional downregulation. ACE2 is a key enzyme for the balance between the two main arms of the RAS: the ACE/Angiotensin (Ang) II/Ang II type 1 receptor axis ("classic RAS"), and the ACE2/Ang 1-7/MasR axis ("anti-RAS"). The ACE2 downregulation, as a result of SARS-coronaviruses binding, enhances the "classic RAS", leading to lung damage and inflammation with leaky pulmonary blood vessels and fibrosis, when the attenuation mediated by the "anti-RAS" arm is reduced. ACE inhibitors (ACE-I) and Ang II type 1 receptor blockers (ARB), effective in cardiovascular diseases, were found to prevent and counteract acute lung injury in several experimental models, by restoring the balance between these two opposing arms. The evidence of RAS arms disequilibrium in COVID-19 and the hypothesis of a beneficial role of RAS modulation supported by preclinical and clinical studies are the focus of the present review. Preclinical and clinical studies on drugs balancing RAS arms might be the right way to counter COVID-19.


Student placement adaptability during COVID-19: Lessons learnt in 2020


COVID-19 convalescent plasma transfusion


title: Forecasting the daily and cumulative number of cases for the COVID-19 pandemic in India

text: The ongoing novel coronavirus epidemic has been announced a pandemic by the World Health Organization on March 11, 2020, and the Govt. of India has declared a nationwide lockdown from March 25, 2020, to prevent community transmission of COVID-19. Due to absence of specific antivirals or vaccine, mathematical modeling play an important role to better understand the disease dynamics and designing strategies to control rapidly spreading infectious diseases. In our study, we developed a new compartmental model that explains the transmission dynamics of COVID-19. We calibrated our proposed model with daily COVID-19 data for the four Indian provinces, namely Jharkhand, Gujarat, Andhra Pradesh, and Chandigarh. We study the qualitative properties of the model including feasible equilibria and their stability with respect to the basic reproduction number $\mathcal{R}_0$. The disease-free equilibrium becomes stable and the endemic equilibrium becomes unstable when the recovery rate of infected individuals increased but if the disease transmission rate remains higher then the endemic equilibrium always remain stable. For the estimated model parameters, $\mathcal{R}_0>1$ for all the four provinces, which suggests the significant outbreak of COVID-19. Short-time prediction shows the increasing trend of daily and cumulative cases of COVID-19 for the four provinces of India.


title: The impact of type 2 diabetes and its management on the prognosis of patients with severe COVID-19

text: BACKGROUND: Although T2DM patients with COVID-19 develop a more severe condition compared to those without diabetes, the mechanisms for this are unknown. Moreover, the impact of treatment with anti-hyperglycemic drugs and glucocorticoids is unclear. METHODS: From 1584 COVID-19 patients, 364 severe/critical COVID-19 patients with clinical outcome were enrolled for the final analysis and patients without pre-existing T2DM but elevated glucose levels were excluded. Epidemiological data were obtained and clinical-status evaluation carried out to assess the impact of T2DM and its management on clinical outcomes. RESULTS: Of 364 enrolled severe COVID-19 inpatients, 114 (31.3%) cases had a history of T2DM. 27(23.7%) cases died in T2DM patients, who had more severe inflammation, coagulation activation, myocardia injury, hepatic injury, and kidney injury, compared with non-DM patients. In severe COVID-19 patients with T2DM, we demonstrate a higher risk of all-cause fatality with glucocorticoid treatment (Adjusted HR, 3.61; 95%CI, 1.14-11.46; P = 0.029), and severe hyperglycemia (FPG ≥11.1 mmol/L) (Adjusted HR, 11.86; 95%CI, 1.21-116.44; P = 0.034). CONCLUSIONS: T2DM status aggravated the clinical condition of COVID-19 patients and increased their critical illness risk. Poor fasting blood glucose (≥ 11.1 mmol/L) and glucocorticoid treatment are associated with poor prognosis for T2DM patients with severe COVID-19. This article is protected by copyright. All rights reserved.


title: Beyond $R_0$: Heterogeneity in secondary infections and probabilistic epidemic forecasting

text: The basic reproductive number --- $R_0$ --- is one of the most common and most commonly misapplied numbers in public health. Although often used to compare outbreaks and forecast pandemic risk, this single number belies the complexity that two different pathogens can exhibit, even when they have the same $R_0$. Here, we show how to predict outbreak size using estimates of the distribution of secondary infections, leveraging both its average $R_0$ and the underlying heterogeneity. To do so, we reformulate and extend a classic result from random network theory that relies on contact tracing data to simultaneously determine the first moment ($R_0$) and the higher moments (representing the heterogeneity) in the distribution of secondary infections. Further, we show the different ways in which this framework can be implemented in the data-scarce reality of emerging pathogens. Lastly, we demonstrate that without data on the heterogeneity in secondary infections for emerging infectious diseases like COVID-19, the uncertainty in outbreak size ranges dramatically. Taken together, our work highlights the critical need for contact tracing during emerging infectious disease outbreaks and the need to look beyond $R_0$ when predicting epidemic size.


Crisis Leadership During and Following COVID-19


title: When Wireless Communication Faces COVID-19: Combating the Pandemic and Saving the Economy

text: The year 2020 is experiencing a global health and economic crisis due to the COVID-19 pandemic. Countries across the world are using digital technologies to fight this global crisis. These digital technologies, in one way or another, strongly rely on the availability of wireless communication technologies. In this paper, we present the role of wireless communications in the COVID-19 pandemic from different perspectives. First, we show how these technologies are helping to combat this pandemic, including monitoring of the virus spread, enabling healthcare automation, and allowing virtual education and conferencing. Also, we show the importance of digital inclusiveness in the pandemic and possible solutions to connect the unconnected. Next, we discuss the challenges faced by wireless technologies, including privacy, security, and misinformation. Then, we present the importance of wireless communication technologies in the survival of the global economy, such as automation of industries and supply chain, e-commerce, and supporting occupations that are at risk. Finally, we reveal that how the technologies developed during the pandemic can be helpful in the post-pandemic era.


Considerations for the Use of Respiratory Filters in Children During the COVID-19 Pandemic


title: Consensus guidelines for interventional cardiology services delivery during covid-19 pandemic in Australia and new Zealand

text: The global coronavirus disease (COVID-19) pandemic poses an unprecedented stress on healthcare systems internationally. These Health system-wide demands call for efficient utilisation of resources at this time in a fair, consistent, ethical and efficient manner would improve our ability to treat patients. Excellent co-operation between hospital units (especially intensive care unit [ICU], emergency department [ED] and cardiology) is critical in ensuring optimal patient outcomes. The purpose of this document is to provide practical guidelines for the effective use of interventional cardiology services in Australia and New Zealand. The document will be updated regularly as new evidence and knowledge is gained with time. Goals Considerations.


title: Management of Osteoarthritis During the COVID-19 Pandemic

text: The pandemic spread of the new coronavirus disease 2019 (COVID-19) infection in China first, and all over the world at present, has become a global health emergency due to the rapidly increasing number of affected patients. Currently, a clear relationship between COVID-19 infection incidence and/or complications due to chronic or occasional treatments for other pathologies is still not clear, albeit the COVID-19 pandemic may condition the treatment strategy of complex disorders, such as osteoarthritis (OA). Importantly, OA is the most common age-related joint disease, affecting more than 80% of people older than the age of 55, an age burden also shared with the highest severity in COVID-19 patients. OA patients often show a large array of concomitant pathologies, such as diabetes, inflammation, and cardiovascular diseases that are again shared with COVID-19 patients and may therefore increase complications. Moreover, different OA treatments, such as NSAIDs, paracetamol, corticosteroids, opioids, or other molecules have a wide array of iatrogenic effects, potentially increasing COVID-19 secondary infection incidence or complications. In this review we critically analyze the evidence on either negative or positive effects of drugs commonly used to manage OA in this particular scenario. This would provide orthopedic surgeons in particular, and physicians, pharmacologists, and clinicians in general, a comprehensive description about the safety of the current pharmacological approaches and a decision-making tool to treat their OA patients as the coronavirus pandemic continues.


Saliva samples as an alternative for novel coronavirus (COVID-19) diagnosis


How will country-based mitigation measures influence the course of the COVID-19 epidemic?


Toward a clinically based classification of disease severity for paediatric COVID-19


title: Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study

text: Since the end of 2019, Corona Virus Disease 2019 (COVID-19) has been the cause of a worldwide pandemic. The mental status of patients with COVID-19 who have been quarantined and the interactions between their psychological distress and physiological levels of inflammation have yet to be analyzed. Using a mixed-method triangulation design (QUAN + QUAL), this study investigated and compared the mental status and inflammatory markers of 103 patients who, while hospitalized with mild symptoms, tested positive with COVID-19 and 103 matched controls that were COVID-19 negative. The severity of depression, anxiety, and post-traumatic stress symptoms (PTSS) was measured via an on-line survey. Using a convenience sampling technique, qualitative data were collected until the point of data saturation. In addition, a semi-structured interview was conducted among five patients with COVID-19. Peripheral inflammatory markers were also collected in patients, both at baseline and within ± three days of completing the on-line survey. Results revealed that COVID-19 patients, when compared to non-COVID controls, manifested higher levels of depression (P < 0.001), anxiety (P < 0.001), and post-traumatic stress symptoms (P < 0.001). A gender effect was observed in the score of "Perceived Helplessness", the subscale of PSS-10, with female patients showing higher scores compared to male patients (Z = 2.56, P = 0.010), female (Z = 2.37, P = 0.018) and male controls (Z = 2.87, P = 0.004). Levels of CRP, a peripheral inflammatory indicator, correlated positively with the PHQ-9 total score (R = 0.37, P = 0.003, Spearman's correlation) of patients who presented symptoms of depression. Moreover, the change of CRP level from baseline inversely correlated with the PHQ-9 total score (R = -0.31, P = 0.002), indicative of improvement of depression symptoms. Qualitative analysis revealed similar results with respect to patient reports of negative feelings, including fear, guilt, and helplessness. Stigma and uncertainty of viral disease progression were two main concerns expressed by COVID-19 patients. Our results indicate that significant psychological distress was experienced by hospitalized COVID-19 patients and that levels of depressive features may be related to the inflammation markers in these patients. Thus, we recommend that necessary measures should be provided to address depression and other psychiatric symptoms for COVID-19 patients and attention should be paid to patient perceived stigma and coping strategies when delivering psychological interventions.


A Call to Action: Novel Ways that Hepatologists Can Contribute to Patient Care During the COVID-19 Pandemic


The Response of the Anesthesia & Analgesia Community to COVID-19


title: Diagnostic Performance of Chest X-Ray for COVID-19 Pneumonia During the SARS-CoV-2 Pandemic in Lombardy, Italy

text: Chest x-ray (CXR) can play a role in diagnosing patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but only few small-scale studies are available. We assessed the diagnostic performance of CXR in consecutive patients presenting at the emergency room at the Policlinico San Donato, Milan, Italy from February 24 to April 8, 2020 for suspected SARS-CoV-2 infection. The results of CXR were classified as positive or negative according to the original prospective radiologic reports. To overcome the limitations of reverse transcriptase-polymerase chain reaction (RT-PCR) swab, especially oscillating sensitivity, we added the information obtained from phone calls to discharged patients with negative initial RT-PCR. Thus, we included 535 patients with concomitant CXR and RT-PCR on admission (aged 65±17 y; 340 males, 195 females), resulting in 408 RT-PCR positive and 127 negative patients at the composite reference standard. Original CXR reports showed an 89.0% sensitivity (95% confidence intervals [CI], 85.5%-91.8%), 60.6% specificity (95% CI, 51.6%-69.2%), 87.9% positive predictive value (95% CI, 84.4%-90.9%), and 63.1% negative predictive value (95% CI, 53.9%-71.7%). The adoption of CXR alongside RT-PCR to triage patients with suspected SARS-CoV-2 infection could foster a safe and efficient workflow, counteracting possible false negative RT-PCR results.


title: Delayed Primary and Specialty Care: The Coronavirus Disease-2019 Pandemic Second Wave

text: Time is of the essence to continue the pandemic disaster cycle with a comprehensive post-COVID-19 health care delivery system RECOVERY analysis, plan and operation at the local, regional and state level.The second wave of COVID-19 pandemic response are not the ripples of acute COVID-19 patient clusters that will persist until a vaccine strategy is designed and implemented to effect herd immunity. The COVID-19 second wave are the patients that have had their primary and specialty care delayed. This exponential wave of patients requires prompt health care delivery system planning and response.


title: Considerations for people with diabetes during the Coronavirus Disease (COVID-19) Pandemic

text: INTRODUCTION: The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) continues to cause havoc globally, resulting in unprecedented healthcare, societal and economic disruption. People with diabetes have been shown to be at higher risk of complications and death when exposed to pneumonia, influenza and other coronaviruses. Despite pandemic scale infection, there is currently limited understanding on the potential impact of SARS-CoV-2 on people with diabetes. AIMS: (1) To characterise the outcomes of SARS-CoV-2 for people with diabetes and (2) add value to current recommendations for healthcare providers and people with diabetes to encourage optimal management. METHODS: A search of PubMed, Embase and MEDLINE to March 2020 was undertaken, using search terms pertaining to diabetes, coronavirus and acute respiratory distress syndrome (ARDS). We briefly reviewed the epidemiology and pathophysiology of SARS-CoV in the context of diabetes. CONCLUSION: People with diabetes are at greater risk of severe infection and death with COVID-19. COVID-19 has significantly impacted the daily lives of individuals living with diabetes through financial implications, food and medication scarcity and its burden on mental health. In Australia, delivery of medical care has been adapted to reduce the risk of transmission, with a particular emphasis on telehealth and remote monitoring.


title: Pause, Persist, Pivot: Key Decisions Health Professions Education Researchers Must Make About Conducting Studies During Extreme Events

text: When extreme events occur some research becomes a clear priority, but what becomes of all other research? Does it stop indefinitely, or can it be paused with plans to resume, persist with modifications, or pivot to address new priorities? Facing this dilemma and witnessing it among their fellow health professions education researchers, the authors recognized a need for guidance. This commentary presents a framework, organized as key questions related to the research stage and process, to assist health professions education researchers in making decisions about how to proceed with research that was planned or in progress when an extreme event occurred. Although at the time of this writing, the COVID-19 pandemic was the extreme event at hand, the authors intentionally created questions and discussed considerations that can be helpful for thinking through decisions in a variety of disruptions in health professions education research-many of which require similar difficult decisions and creative solutions to carry important research forward and maintain high quality.


title: Assessing the Efficiency of Different Control Strategies for the Coronavirus (COVID-19) Epidemic

text: The goal of this work is to analyse the effects of control policies for the coronavirus (COVID-19) epidemic in Brazil. This is done by considering an age-structured SEIR model with a quarantine class and two types of controls. The first one studies the sensitivity with regard to the parameters of the basic reproductive number R0 which is calculated by the next generation method. The second one evaluates different quarantine strategies by comparing their relative total number of deaths.


SARS-CoV-2: What can saliva tell us?


title: COVID-19: The first documented coronavirus pandemic in history

text: The novel human coronavirus disease COVID-19 has become the fifth documented pandemic since the 1918 flu pandemic. COVID-19 was first reported in Wuhan, China, and subsequently spread worldwide. The coronavirus was officially named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses based on phylogenetic analysis. SARS-CoV-2 is believed to be a spillover of an animal coronavirus and later adapted the ability of human-to-human transmission. Because the virus is highly contagious, it rapidly spreads and continuously evolves in the human population. In this review article, we discuss the basic properties, potential origin, and evolution of the novel human coronavirus. These factors may be critical for studies of pathogenicity, antiviral designs, and vaccine development against the virus.


The plight of essential workers during the COVID-19 pandemic


COVID-19 in Hemodialysis Patients: A Report of 5 Cases


Delayed access or provision of care in Italy resulting from fear of COVID-19


title: Dynamics of SIR model with vaccination and heterogeneous behavioral response of individuals modeled by the Preisach operator

text: We study global dynamics of an SIR model with vaccination, where we assume that individuals respond differently to dynamics of the epidemic. Their heterogeneous response is modeled by the Preisach hysteresis operator. We present a condition for the global stability of the infection-free equilibrium state. If this condition does not hold true, the model has a connected set of endemic equilibrium states characterized by different proportion of infected and immune individuals. In this case, we show that every trajectory converges either to an endemic equilibrium or to a periodic orbit. Under additional natural assumptions, the periodic attractor is excluded, and we guarantee the convergence of each trajectory to an endemic equilibrium state. The global stability analysis uses a family of Lyapunov functions corresponding to the family of branches of the hysteresis operator.


title: Psychological status of postpartum women under the COVID-19 pandemic in Japan

text: Under the COVID-19 (Coronavirus Disease 2019) pandemic, limitations are known to cause some psychosocial problems. We compared the results of mental screening of the postpartum women conducted during the COVID-19 epidemic with those at the same period last year. Based on the results, the worse mother-infant bonding was suspected at 1 month after birth under the COVID-19 pandemic.


title: FDG-PET/CT imaging during the Covid-19 emergency: a southern Italian perspective

text: PURPOSE: To assess the impact of the Covid-19 pandemic on FDG-PET/CT work volume and to evaluate the occurrence of abnormal imaging findings suspicious or potentially diagnostic for interstitial pneumonia by Covid-19 infection in south Italy. METHODS: We retrospectively reviewed the number and the findings of FDG-PET/CT studies acquired between February and April 2020 during the Covid-19 pandemic at the University of Napoli Federico II. The number and the findings of FDG-PET/CT studies acquired in the corresponding period of 2019 were also assessed for direct comparison. RESULTS: The number of FDG-PET/CT studies performed during the pandemic (n = 299) and in the corresponding period of 2019 (n = 335) were comparable. The percentage of abnormal FDG-PET/CT findings, suspicious for interstitial pneumonia by Covid-19 infection, was significantly higher during the pandemic (9%) compared with that found in the corresponding period of 2019 (4%) (χ2 5.45, P = 0.02). No significant differences were observed in the distribution of Covid-19 reporting and data system (CO-RADS) classification and in the maximum standardized uptake value between the pandemic (2.6 ± 2.2) and the corresponding period of 2019 (3.2 ± 1.4). Of note, patients with abnormal imaging findings during the pandemic time had clinical data and/or laboratory tests negative for Covid-19 infection. CONCLUSION: Despite the restrictive medical measures for the emergency, the number of FDG-PET/CT studies was unchanged during the pandemic compared with the previous year. Our findings also indicate that Covid-19 infection was contained in our series of patients from southern Italy.


title: Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China

text: BACKGROUND: The SARS-CoV-2 pandemic is an ongoing global health emergency. The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients. METHOD: This retrospective, single-centre study was conducted on 115 confirmed cases of COVID-19 in Zhongnan hospital of Wuhan University from 18 January 2020 to 22 February 2020. Liver function and related indexes were analysed to evaluate its relationship with disease progression in COVID-19 patients. RESULTS: Part of the COVID-19 patients presented with varying degrees of abnormality in liver function indexes. However, the levels of ALT, AST, TBIL, GGT and LDH in COVID-19 patients were not significantly different when compared with hospitalised community-acquired pneumonia patients, and the levels of albumin is even significantly higher. The levels of ALT, AST, TBIL, LDH and INR showed statistically significant elevation in severe COVID-19 cases compared with that in mild cases. However, the clinical significance of the elevation is unremarkable. Majority of severe COVID-19 patients showed significantly decreasing in albumin level and continuously decreasing in the progress of illness. Most of the liver function indexes in COVID-19 patients were correlated with CRP and NLR, the markers of inflammation. Logistic regression analysis further identified NLR as the independent risk factor for severe COVID-19, as well as age. CONCLUSIONS: Although abnormalities of liver function indexes are common in COVID-19 patients, the impairment of liver function is not a prominent feature of COVID-19, and also may not have serious clinical consequences.


title: User Attention and Behaviour in Virtual Reality Art Encounter

text: With the proliferation of consumer virtual reality (VR) headsets and creative tools, content creators have started to experiment with new forms of interactive audience experience using immersive media. Understanding user attention and behaviours in virtual environment can greatly inform creative processes in VR. We developed an abstract VR painting and an experimentation system to study audience encounters through eye gaze and movement tracking. The data from a user experiment with 35 participants reveal a range of user activity patterns in art exploration. Deep learning models are used to study the connections between behavioural data and audience background. New integrated methods to visualise user attention as part of the artwork are also developed as a feedback loop to the content creator.


title: The effect of the Covid-19 Pandemic on pediatric urology

text: Medical and surgical priorities have changed dramatically at the time of this pandemic. Scientific societies around the World have provided rapid guidance, underpinned by the best knowledge available, on the adaptation of their guidelines recommendations to the current situation. There are very limited scientific evidence especially in our subspecialty of pediatric urology. We carry out a review of the little scientific evidence based mainly on the few publications available to date and on the recommendations of the main scientific societies regarding which patients should undergo surgery, when surgery should be performed and how patient visits should be organize.


title: Review of Mental Health Response to COVID-19, China

text: Public mental health response to coronavirus disease is essential. After reviewing systemic and local efforts in China, we found efficient coordination and human resources. We recommend better symptom assessment, monitoring of organizations, and basic needs protection. This recommendation can inform how other countries can overcome mental health challenges during this pandemic.


Invited response to the comment on "Dermatology residents and the care of COVID-19 patients"


title: Immune monitoring of a child with autoimmune hepatitis and type 1 diabetes during COVID-19 infection

text: Immunocompromised patients may be at increased risk to develop COVID-19 during the 2019 ß-coronavirus infection. We present the unique opportunity we had to monitor the liver, IL-6 and immune cell course before, during and after COVID-19 in a boy with autoimmune hepatitis (AIH) and type 1 diabetes (T1D). CD4 and CD8 T cells frequencies decreased because of prednisolone, followed by a plateauing increase whereas CD19CD20 B cell increased strongly and was unaffected by COVID-19 infection. Moreover, the percentage of activated CD8 T cells expressing HLA-DR (CD8HLA-DR) increased during COVID-19 and subsided after its clearance. Total regulatory T cells (Tregs: CD4CD25CD127FOXP3) remained stable. Although activated Tregs (CD4CD45RAFOXP3) strongly increased upon prednisolone, it decreased afterwards. Furthermore, regulatory B cells (Bregs: CD19CD20CD24CD38) declined sharply owing to prednisolone. Serum IL-6 remained undetectable at all times. We demonstrated for the first time immune monitoring in a child with AIH and T1D before, during and after COVID-19. We hypothesize that continuing with low level of prednisolone without azathioprine may have abrogated activated Tregs, Bregs and IL-6 production and therefore permitting the activation of CD8 T cells, clearing the virus.


title: "Quantifying the precision of ecological risk: Misunderstandings and errors in the methods for assessment factors versus species sensitivity distributions"

text: The science of species sensitivity distributions (SSDs) is a blend of statistical theory, ecotoxicological testing, study reliability, and biodiversity. The utility of SSDs has been well reviewed and they are viewed as a high tier assessment tool in environmental risk assessment and other disciplines. SSDs seek to improve upon probabilistic extrapolation of laboratory (and sometimes field) collected ecotoxicity data for environmental protection by modeling the diversity of multiple experimental results in the form of a single statistical distribution which reduces or eliminates the need for extrapolation with deterministic assessment factors. SSDs thus depend heavily on both statistical and biological knowledge. In this commentary we review recently published literature identifying areas of improvement based on fundamental statistical theory or application in environmental assessment contexts. We reveal that sound application of SSDs relies heavily upon a grasp of probability distributions, how asymmetric confidence intervals are derived for distributions common to SSDs, the influence of sample size on parameter estimation, and how these are collectively applied across the myriad of regulatory systems globally. Statisticians and ecotoxicologists are inextricably bound together in the goal of actually improving hazard assessment using both probabilistic and deterministic methodologies.


Alcohol and COVID-19


title: Targeted Pandemic Containment Through Identifying Local Contact Network Bottlenecks

text: Decision-making about pandemic mitigation often relies upon mathematical modelling. Models of contact networks are increasingly used for these purposes, and are often appropriate for infections that spread from person to person. Real-world human contact networks are rich in structural features that influence infection transmission, such as tightly-knit local communities that are weakly connected to one another. In this paper, we propose a new flow-based edge-betweenness centrality method for detecting bottleneck edges that connect communities in contact networks. In particular, we utilize convex optimization formulations based on the idea of diffusion with $p$-norm network flow. Using mathematical models of COVID-19 transmission through real network data at both individual and county levels, we demonstrate that targeting bottleneck edges identified by the proposed method reduces the number of infected cases by up to $10\%$ more than state-of-the-art edge-betweenness methods. Furthermore, we demonstrate empirically that the proposed method is orders of magnitude faster than existing methods.


title: [Management strategies for three patients with gynecological malignancies during the outbreak of COVID-19]

text: Objective: To explore the management strategies for patients with gynecological malignant tumors during the outbreak and transmission of COVID-19. Methods: We retrospectively analyzed the clinical characteristics, treatment, and disease outcomes of three patients with gynecological malignancies associated with COVID-19 in Renmin Hospital of Wuhan University, and proposed management strategies for patients with gynecological tumors underriskof COVID-19. Results: Based on the national diagnosis and treatment protocol as well as research progress for COVID-19, three patients with COVID-19 were treated. Meanwhile, they were also appropriately adjusted the treatment plan in accordance with the clinical guidelines for gynecological tumors. Pneumonia was cured in 2 patients, and one patient died of COVID-19. Conclusions: Patients with gynecological malignant tumors are high-risk groups prone to COVID-19, and gynecological oncologists need to carry out education, prevention, control and treatment according to specific conditions. While, actively preventing and controlling COVID-19, the diagnosis and treatment of gynecological malignant tumors should be carried out in an orderly and safe manner.


title: Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma

text: Importance: Coronavirus disease 2019 (COVID-19) is a pandemic with no specific therapeutic agents and substantial mortality. It is critical to find new treatments. Objective: To determine whether convalescent plasma transfusion may be beneficial in the treatment of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design, Setting, and Participants: Case series of 5 critically ill patients with laboratory-confirmed COVID-19 and acute respiratory distress syndrome (ARDS) who met the following criteria: severe pneumonia with rapid progression and continuously high viral load despite antiviral treatment; Pao2/Fio2 <300; and mechanical ventilation. All 5 were treated with convalescent plasma transfusion. The study was conducted at the infectious disease department, Shenzhen Third People's Hospital in Shenzhen, China, from January 20, 2020, to March 25, 2020; final date of follow-up was March 25, 2020. Clinical outcomes were compared before and after convalescent plasma transfusion. Exposures: Patients received transfusion with convalescent plasma with a SARS-CoV-2-specific antibody (IgG) binding titer greater than 1:1000 (end point dilution titer, by enzyme-linked immunosorbent assay [ELISA]) and a neutralization titer greater than 40 (end point dilution titer) that had been obtained from 5 patients who recovered from COVID-19. Convalescent plasma was administered between 10 and 22 days after admission. Main Outcomes and Measures: Changes of body temperature, Sequential Organ Failure Assessment (SOFA) score (range 0-24, with higher scores indicating more severe illness), Pao2/Fio2, viral load, serum antibody titer, routine blood biochemical index, ARDS, and ventilatory and extracorporeal membrane oxygenation (ECMO) supports before and after convalescent plasma transfusion. Results: All 5 patients (age range, 36-65 years; 2 women) were receiving mechanical ventilation at the time of treatment and all had received antiviral agents and methylprednisolone. Following plasma transfusion, body temperature normalized within 3 days in 4 of 5 patients, the SOFA score decreased, and Pao2/Fio2 increased within 12 days (range, 172-276 before and 284-366 after). Viral loads also decreased and became negative within 12 days after the transfusion, and SARS-CoV-2-specific ELISA and neutralizing antibody titers increased following the transfusion (range, 40-60 before and 80-320 on day 7). ARDS resolved in 4 patients at 12 days after transfusion, and 3 patients were weaned from mechanical ventilation within 2 weeks of treatment. Of the 5 patients, 3 have been discharged from the hospital (length of stay: 53, 51, and 55 days), and 2 are in stable condition at 37 days after transfusion. Conclusions and Relevance: In this preliminary uncontrolled case series of 5 critically ill patients with COVID-19 and ARDS, administration of convalescent plasma containing neutralizing antibody was followed by improvement in their clinical status. The limited sample size and study design preclude a definitive statement about the potential effectiveness of this treatment, and these observations require evaluation in clinical trials.


Opportunities and challenges of traditional Chinese medicine going abroad for COVID-19 treatment


title: Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists

text: Severe acute respiratory syndrome-corona virus-2, which causes coronavirus disease 2019 (COVID-19), is highly contagious. Airway management of patients with COVID-19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID-19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID-19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID-19. The advice in this document is designed to be adapted in line with local workplace policies.


Scientific Response to the Coronavirus Crisis in Spain: Collaboration and Multidisciplinarity


Coronavirus: why a permanent ban on wildlife trade might not work in China


Optimising influenza vaccination during a SARS-CoV-2 epidemic in South Africa could help maintain the integrity of our healthcare system


Adaption of the emergency department decontamination room for airway management during COVID-19


title: Data Quality of Chinese Surveillance of COVID-19: Objective Analysis Based on WHO's Situation Reports

text: Was there quality in the Chinese epidemiological surveillance system during the COVID-19 pandemic? Using data of World Health Organization's situation reports (until situation report 55), an objective analysis was realized to answer this important question. Fulfillment of Benford's law (first digit law) is a rapid tool to suggest good data quality. Results suggest that China had an acceptable quality in its epidemiological surveillance system. Furthermore, more detailed and complete analyses could complement the evaluation of the Chinese surveillance system.


Drama out of a crisis: the cultural sector responds to healthcare professionals impacted by COVID-19


The Novel Coronavirus 2019 epidemic and kidneys


title: Epidemiology and clinical features of emergency department patients with suspected COVID-19: Initial results from the COVID-19 Emergency Department Quality Improvement Project (COVED-1)

text: OBJECTIVE: The COVID-19 Emergency Department (COVED) Quality Improvement Project aims to provide regular and real-time clinical information to ED clinicians caring for patients with suspected and confirmed COVID-19. The present study summarises data from the first 2 weeks of the study. METHODS: COVED is an ongoing prospective cohort study that commenced on 1 April 2020. It includes all adult patients presenting to a participating ED who undergo testing for SARS-CoV-2. Data are collected prospectively and entered into a bespoke registry. Outcomes include a positive SARS-CoV-2 polymerase chain reaction test result and requirement for intensive respiratory support. RESULTS: In the period 1-14 April 2020, 240 (16%) of 1508 patients presenting to The Alfred Emergency and Trauma Centre met inclusion criteria. Of these, 11 (5%) tested positive for SARS-CoV-2. The mean age of patients was 60 years and the commonest symptoms were acute shortness of breath (n = 122 [67%]), cough (n = 108 [56%]) or fever (n = 98 [51%]). Overseas travel or known contact with a confirmed case was reported by 24 (14%) and 16 (10%) patients, respectively. Fever or hypoxia was recorded in 23 (10%) and 11 (5%) patients, respectively. Eleven (5%) patients received mechanical ventilation in the ED, of whom none tested positive for SARS-CoV-2. CONCLUSIONS: Among patients presenting to a tertiary ED with suspected COVID-19, only a small proportion tested positive for SARS-CoV-2. Although the low incidence of positive cases currently precludes the development of predictive tools, the COVED Project demonstrates that the rapid establishment of an agile clinical registry for emergency care is feasible.


title: The Outcome and Implications of Public Precautionary Measures in Taiwan-Declining Respiratory Disease Cases in the COVID-19 Pandemic

text: With the rapid development of the COVID-19 pandemic, countries are trying to cope with increasing medical demands, and, at the same time, to reduce the increase of infected numbers by implementing a number of public health measures, namely non-pharmaceutical interventions (NPIs). These public health measures can include social distancing, frequent handwashing, and personal protective equipment (PPE) at the personal level; at the community and the government level, these measures can range from canceling activities, avoiding mass gatherings, closing facilities, and, at the extreme, enacting national or provincial lockdowns. Rather than completely stopping the infectious disease, the major purpose of these NPIs in facing an emerging infectious disease is to reduce the contact rate within the population, and reduce the spread of the virus until the time a vaccine or reliable medications become available. The idea is to avoid a surge of patients with severe symptoms beyond the capacity of the hospitals' medical resources, which would lead to more mortality and morbidity. While many countries have experienced steep curves in new cases, some, including Hong Kong, Vietnam, South Korea, New Zealand, and Taiwan, seem to have controlled or even eliminated the infection locally. From its first case of COVID-19 on the 21 January until the 12 May, Taiwan had 440 cases, including just 55 local infections, and seven deaths in total, representing 1.85 cases per 100,000 population and a 1.5% death rate (based on the Worldometer 2020 statistics of Taiwan's population of 23.8 million). This paper presents evidence that spread prevention involving mass masking and universal hygiene at the early stage of the COVID-19 pandemic resulted in a 50% decline of infectious respiratory diseases, based on historical data during the influenza season in Taiwan. These outcomes provide potential support for the effectiveness of widely implementing public health precaution measures in controlling COVID-19 without a lockdown policy.


title: Implications of the lack of a unified research project framework: an investigation into the registration of clinical trials of COVID-19

text: Objective: The aim of this study was to provide recommendations for improving the design of subsequent studies through analysis of the registered coronavirus disease 2019 (COVID-19) clinical trials.Methods: A retrospective analysis of 189 trial retrievals achieved on 20 February 2020.Results: A total of 189 trials are included in the study. There were 69.3% interventional studies, 21.7% observational studies, 5.3% diagnostic tests and 3.7% other studies. The following statistics are provided only for the interventional studies. Severity of disease: 5.3% light and common type, 17.6% severe and critically ill and 59.6% with no restricted classification. Medication use: 51.1% Western medicine, 32.1% Chinese medicine, 10.7% blood related product and 6.1% non-drug therapy. The median and inner quantile range of the sample sizes included in these studies: 104 (IQR: 60, 200). Primary outcome type most used: 45.8% with clinical characteristics and 21.4% with virological. Study design characteristics: 71% of all studies were randomized, 5% of all studies were blinded, 18% of all studies were multicenter and 76% of all studies were single center.Conclusion: Although many COVID-19 studies include randomization in their design, the lack of additional double-blind and placebo-controlled elements in their designs result in a less robust evaluation of intervention safety and efficacy. Furthermore, similar or repeated research and small sample studies that have less promise in gains of new information have possibly led to a shortage of recruitable patients and become a barrier to the completion of large multicenter clinical trial studies.


title: COVID-19 infections among HCWs exposed to a patient with a delayed diagnosis of COVID-19

text: We report on COVID-19 risk among HCWs exposed to a patient diagnosed with COVID-19 on day 13 of hospitalization. There were 44 HCWs exposed to the patient before contact and droplet precautions were implemented: of these, 2 of 44 (5%) developed COVID-19 potentially attributable to the exposure.


Converting gas-driven ventilators from oxygen to air


title: Virological and clinical cure in COVID-19 patients treated with hydroxychloroquine: A systematic review and meta-analysis

text: Following the demonstration of the efficacy of hydroxychloroquine against severe acute respiratory syndrome coronavirus 2 in vitro, many trials started to evaluate its efficacy in clinical settings. However, no systematic review and meta-analysis have addressed the issue of the safety and efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019. We conducted a systematic review and meta-analysis with the objectives of evaluation of safety and efficacy of HCQ alone or in combination in terms of "time to clinical cure," "virological cure," "death or clinical worsening of disease," "radiological progression," and safety. RevMan was used for meta-analysis. We searched 16 literature databases out of which seven studies (n = 1358) were included in the systematic review. In terms of clinical cure, two studies reported possible benefit in "time to body temperature normalization" and one study reported less "cough days" in the HCQ arm. Treatment with HCQ resulted in less number of cases showing the radiological progression of lung disease (odds ratio [OR], 0.31, 95% confidence interval [CI], 0.11-0.9). No difference was observed in virological cure (OR, 2.37, 95% CI, 0.13-44.53), death or clinical worsening of disease (OR, 1.37, 95% CI, 1.37-21.97), and safety (OR, 2.19, 95% CI, 0.59-8.18), when compared with the control/conventional treatment. Five studies reported either the safety or efficacy of HCQ + azithromycin. Although seems safe and effective, more data are required for a definitive conclusion. HCQ seems to be promising in terms of less number of cases with radiological progression with a comparable safety profile to control/conventional treatment. We need more data to come to a definite conclusion.


COVID-19 and spinal cord injury professionals: Maintaining a scholarly perspective


title: A review of information security aspects of the emerging COVID-19 contact tracing mobile phone applications

text: This paper discusses the aspects of data reliability and user privacy for the emerging practice of mobile phone based contact tracing for the COVID-19 pandemic. Various countries and large technology companies have already used or plan to design and use mobile phone based solutions, in an effort to urgently expedite the process of identifying people who may have been exposed to the disease and limit its spread to the general population. However, serious concerns have been raised both in terms of the validity of the collected data as well as the extent to which implemented approaches can breach the privacy of the mobile phone users. This review examines the weaknesses of existing implementations and concludes with specific recommendations that can contribute towards increasing the safety of infrastructures that collect and process this kind of information, as well as the adoption and acceptance of these solutions from the public.


title: Acute Kidney Injury in Coronavirus Disease 2019 Infected Patients: A Meta-Analytic Study

text: INTRODUCTION: In clinical reports on coronavirus disease 2019 (COVID-19), the incidence of acute kidney injury (AKI) is extremely variable, although AKI is described as an independent risk factor for mortality. A meta-analysis was performed to clarify the incidence and the impact of COVID-19-related AKI on mortality. METHODS: All trials reporting the incidence of AKI in COVID-19 patients were searched using MEDLINE, the Cochrane Library, and EMBASE databases (last update April 26, 2020). RESULTS: Ten trials with a sample of 5,166 patients were included. AKI occurred in 947 out of 5,166 (18.3%) patients. AKI incidence was higher in severe cases: 62/305 severe patients developed AKI (20%) versus 27/1,268 nonsevere patients (2%) (p = 0.00001). AKI occurred in 475 out of 915 (52%) deceased patients versus 183 out of 2,678 (7%) survivors (p = 0.00001). Continuous renal replacement therapy was significantly more frequent in severe cases and in dead patients. CONCLUSION: A significant increase in mortality rate was observed in COVID patients who developed AKI, and AKI incidence was also higher in severe cases. Any supportive strategies to protect kidney could represent valuable intervention to reduce mortality in severe COVID-19 patients.


title: Risk factors associated with disease progression in a cohort of patients infected with the 2019 novel coronavirus

text: BACKGROUND: The emerging infection of the 2019 novel coronavirus (2019-nCoV) in late December, 2019 in Wuhan, China, has caused an extreme health concern, with many patients having progressed to acute respiratory disease or other complications in a short period. Meanwhile, the risk factors associated with the disease progression still remain elusive. METHODS: A cohort of 17 patients with laboratory-confirmed 2019-nCoV infections who were admitted to the Ninth Hospital of Nanchang between January 28 and February 6, 2020, were enrolled in this study. All the patients received standardized treatment. The disease progression was evaluated every 7 days after admission. The clinical, radiologic, and laboratory characteristics were retrospectively analyzed, and the factors associated with the disease progression were screened by binary logistic regression analysis. RESULTS: The cohort comprised 11 women (64.7%) and 6 men (35.3%) between the ages of 18 to 70 years old. All patients had a reported history of contact with infection-confirmed patients. Fever (11/64.7%) and cough (8/47.1%) were the most common symptoms, whereas dyspnea (2/11.8%) and fatigue (3/17.6%) were rare, and there was no patient with diarrhea symptoms. There were 5 patients with aggravated disease at the first disease progression evaluation, and no patient received mechanical ventilation, transferred to the intensive care unit (ICU), or progressed to acute respiratory distress syndrome, septic shock, refractory metabolic acidosis, coagulation dysfunction, or death. Based on the disease progression, patients were divided into the non-aggravation group (12 cases) and the aggravation group (5 cases). There were no significant differences between the 2 groups with respect to their clinical characteristics. Chest computed tomography (CT) on admission revealed there were 8 patients (47.1%) with invasive lesions found bilaterally on the lungs on multiple lobes, 4 patients (23.5%) with invasive lesions on 1 lobe, and 5 patients (29.4%) with normal chest CT. The aggravation group had1 patient (20.0%) with invasive lesions on one lobe, 3 (60.0%) with invasive lesions on multiple lobes, bilaterally, and 1 (20.0%) with normal chest CT; meanwhile, the nonaggravation group had 3 patients (25.0%) with invasive lesions on one lobe, 5 (41.7%) with invasive lesions on multiple lobes, bilaterally, and 4 (33.3%) with normal chest CT. No significant difference was found between the 2 groups. In the aggravation group, the total lymphocyte counts significantly decreased in comparison to that in the non-aggravation group. Further analysis showed that the CD4+ T cell count but not the CD8+ T cell count of the aggravation group was significantly lower than that of the non-aggravation group. Correlation analysis indicated total lymphocyte count was positively correlated with CD4+ T cell count, and no significant differences were found between the 2 groups in other laboratory measurements, including those of white blood cell (WBC) count, C-reactive protein (CRP), albumin, lactate dehydrogenase (LDH), and D-dimer. Finally, a binary logistic regression model was used to identify the factors associated with the disease progression. It was found that total lymphocyte count was a risk factor associated with disease progression in patients infected with 2019-nCoV. CONCLUSIONS: A higher cell count of total lymphocytes may indicate a better outcome of the disease, and immune response may be a vital factor for directing disease progression in the early stage of 2019-nCoV infection.


Thrombotic microangiopathy in a patient with COVID-19


title: Evaluation of novel antigen-based rapid detection test for the diagnosis of SARS-CoV-2 in respiratory samples

text: OBJECTIVES: In the context of the Covid-19 pandemic, the development and validation of rapid and easy-to-perform diagnostic methods are of high priority. We evaluated a novel rapid antigen detection test (RDT) for SARS-CoV-2 in respiratory samples. METHODS: The fluorescence immunochromatographic SARS-CoV-2 antigen test (Bioeasy Biotechnology Co., Shenzhen, China) was evaluated using universal transport medium with nasopharyngeal (NP) and oropharyngeal (OP) swabs from suspected Covid-19 cases. Diagnostic accuracy was determined in comparison to SARS-CoV-2 real time (RT)-PCR. RESULTS: A total of 127 samples were included; 82 were RT-PCR positive. Median patients' age was 38 years, 53.5% were male, and 93.7% were from the first week after symptom onset. Overall sensitivity and specificity were 93.9% (CI95% 86.5-97.4) and 100% (CI95% 92.1-100), respectively, with a diagnostic accuracy of 96.1% and Kappa coefficient of 0.9. Sensitivity was significantly higher in samples with high viral loads. CONCLUSIONS: The evaluated RDT showed a high sensitivity and specificity in samples mainly obtained during the first week of symptoms and with high viral loads, despite the use of a non-validated sample material. The assay has the potential to become an important tool for early diagnosis of SARS-CoV-2, particularly in situations with limited access to molecular methods.


title: Characteristics of patients with coronavirus disease (COVID-19) confirmed using an IgM-IgG antibody test

text: Coronavirus disease (COVID-19), caused by a novel betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly developed into a pandemic since it was first reported in December 2019. Nucleic acid testing is the standard method for the diagnosis of viral infections. However, this method reportedly has a low positivity rate. To increase the sensitivity of COVID-19 diagnoses, we developed an IgM-IgG combined assay and tested it in patients with suspected SARS-CoV-2 infection. In total, 56 patients were enrolled in this study and SARS-CoV-2 was detected by using both IgM-IgG antibody and nucleic acid tests. Clinical and laboratory data were collected and analyzed. Our findings suggest that patients who develop severe illness might experience longer virus exposure times and develop a more severe inflammatory response. The IgM-IgG test is an accurate and sensitive diagnostic method. A combination of nucleic acid and IgM-IgG testing is a more sensitive and accurate approach for diagnosis and early treatment of COVID-19.


Utility of hyposmia and hypogeusia for the diagnosis of COVID-19


title: History is repeating itself: Probable zoonotic spillover as the cause of the 2019 novel Coronavirus Epidemic

text: Pathogen transmission from a vertebrate animal to a human, also known as zoonotic spillover, represents a global public health burden, which while associated with multiple outbreaks, still remains a poorly understood phenomenon. Coronaviruses, like influenza viruses, circulate in nature in various animal species. Alpha-coronaviruses and beta-coronaviruses can infect mammals and gamma-coronaviruses and delta-coronaviruses tend to infect birds, but some of them can also be transmitted to mammals. Although still preliminary, current data suggest that bats are the most probable initial source of the current 2019 novel CoV (2019nCoV) outbreak, that begun on December 2019 in Wuhan, China, apparently spreading from a "wet market" to multiple cities and provinces in China. This epidemic of 2019nCoV, already reaching more than 6,000 cases to-day (end of January 2020) (>90% in China), will not be the last one linked to zoonotic spillover events.


History is repeating itself: Probable zoonotic spillover as the cause of the 2019 novel coronavirus epidemic


The COVID-19 pandemic requires a unified global response


Breaking Bad News via Telemedicine: A New Challenge at Times of an Epidemic


title: Implicaciones hepáticas en la pandemia por COVID-19

text: La infección generada por el coronavirus, denominado SARS-CoV-2, llamada coronavirus disease 2019(COVID-19), surgió en China a finales de diciembre de 2019 Actualmente ha sido categorizada como una pandemia por la Organización Mundial de la Salud (OMS) Se han documentado alteraciones de pruebas hepáticas, sin embargo, los estudios se han enfocado en los efectos cardíacos, pulmonares y renales de esta infección La alteración de pruebas hepáticas en el contexto de COVID-19 puede ser consecuencia de hepatitis viral, toxicidad farmacológica, inflamación o choque También se considera como un marcador de pronóstico y gravedad de la enfermedad El impacto de la infección por SARS-CoV-2 en pacientes con enfer-medad hepática preexistente o receptores de trasplante hepático no es claro, y se plantean distintas hipótesis sobre mayor o menor riesgo de enfermedad grave y de descompensación de la enfermedad de base (AU)The infection generated by the novel coronavirus SARS-CoV-2, named Coronavirus Disease 2019 (COVID-19) emerged late December of 2019 in China It is currently categorized as a pandemic by the World Health Organization Studies have focused on cardiac, pulmonary, and renal effects of this infection, but liver test abnormalities have also been documented This alteration may be a consequence of viral hepatitis, phar-macological toxicity, inflammation, or shock It is also considered a marker of prognosis and severity of the disease The impact of SARS-CoV-2 infection in patients with pre-existing liver disease or liver transplant recipients is unclear, and different hypotheses exist regarding the higher or lower risk of severe disease and decompensation of the underlying disease


title: Precautions for Operating Room Team Members During the COVID-19 Pandemic

text: BACKGROUND: The novel coronavirus SARS-CoV-2 (COVID-19) can infect healthcare workers. We developed an institutional algorithm to protect operating room team members during the COVID-19 pandemic and rationally conserve personal protective equipment (PPE). STUDY DESIGN: An interventional platform (operating room, interventional suite, and endoscopy) PPE taskforce was convened by the hospital and medical school leadership and tasked with developing a common algorithm for PPE use, to be used throughout the interventional platform. In conjunction with our infectious disease experts, we developed our guidelines based on potential patterns of spread, risk of exposure, and conservation of PPE. RESULTS: A decision tree algorithm describing our institutional guidelines for precautions for operating room team members was created. This algorithm is based on urgency of operation, anticipated viral burden at the surgical site, opportunity for a procedure to aerosolize virus, and likelihood a patient could be infected based on symptoms and testing. CONCLUSIONS: Despite COVID-19 being a new threat, we have shown that by developing an easy-to-follow decision tree algorithm for the interventional platform teams, we can ensure optimal health care worker safety.


Straining the System: Novel Coronavirus (COVID-19) and Preparedness for Concomitant Disasters


Acral edema during the COVID-19 pandemic


Precision medicine for COVID-19: a call for better clinical trials


Clinically significant portal hypertension in cirrhosis patients with COVID-19: Clinical characteristics and outcomes


Clinically significant portal hypertension in cirrhosis patients with COVID-19: clinical characteristics and outcomes


title: Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019

text: BACKGROUND: The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated. METHODS: A total of 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n=535) collected during the hospitalization were tested for total antibodies (Ab), IgM and IgG against SARS-CoV-2. The dynamics of antibodies with the disease progress was analyzed. RESULTS: Among 173 patients, the seroconversion rate for Ab, IgM and IgG was 93.1%, 82.7% and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might due to the lack of blood samples at the later stage of illness. The median seroconversion time for Ab, IgM and then IgG were day-11, day-12 and day-14, separately. The presence of antibodies was <40% among patients within 1-week since onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM) and 79.8% (IgG) since day-15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day-7 to 45.5% (25/55) during day 15-39. Combining RNA and antibody detections significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (p<0.001), even in early phase of 1-week since onset (p=0.007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (p=0.006). CONCLUSIONS: The antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.


title: Risk estimation of the SARS-CoV-2 acute respiratory disease outbreak outside China

text: BACKGROUND: On December 31, 2019, the World Health Organization was alerted to the occurrence of cases of pneumonia in Wuhan, Hubei Province, China, that were caused by an unknown virus, which was later identified as a coronavirus and named the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to estimate the reproductive number of SARS-CoV-2 in the Hubei Province and evaluate the risk of an acute respiratory coronavirus disease (COVID-19) outbreak outside China by using a mathematical model and stochastic simulations. RESULTS: We constructed a mathematical model of SARS-CoV-2 transmission dynamics, estimated the rate of transmission, and calculated the reproductive number in Hubei Province by using case-report data from January 11 to February 6, 2020. The possible number of secondary cases outside China was estimated by stochastic simulations in various scenarios of reductions in the duration to quarantine and rate of transmission. The rate of transmission was estimated as 0.8238 (95% confidence interval [CI] 0.8095-0.8382), and the basic reproductive number as 4.1192 (95% CI 4.0473-4.1912). Assuming the same rate of transmission as in Hubei Province, the possibility of no local transmission is 54.9% with a 24-h quarantine strategy, and the possibility of more than 20 local transmission cases is 7% outside of China. CONCLUSION: The reproductive number for SARS-CoV-2 transmission dynamics is significantly higher compared to that of the previous SARS epidemic in China. This implies that human-to-human transmission is a significant factor for contagion in Hubei Province. Results of the stochastic simulation emphasize the role of quarantine implementation, which is critical to prevent and control the SARS-CoV-2 outbreak outside China.


Early tocilizumab treatment could improve survival among COVID-19 patients


title: Concerns and Fears of Indian Dentists on Professional Practice During the Coronavirus Disease-2019 (COVID-19) Pandemic

text: The Coronavirus disease-2019 (COVID-19) pandemic, due to the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) was declared a public health emergency of international concern by the World Health Organization on 30th of January 2020 (World Health Organization, 2020). The first case of COVID-19 was reported in India on the same day, and at the time of writing, on 20th May 2020, India has reported over 106,000 patients, with over 3,300 related deaths. The country is under a state of lockdown since 25th March, 2020, and over 600 health care providers have been infected.


Concerns and fears of Indian dentists on professional practice during the coronavirus disease 2019 (COVID-19) pandemic


Untapped potential: More US labs could be providing tests for coronavirus


SARS-CoV-2 and COVID-19: What are our options? Where should we focus our attention on to find new drugs and strategies?


title: [The risk and prevention of bio-aerosol transmission in dental clinics]

text: Corona virus disease 2019 (COVID-19) has become a Public Health Emergency of International Concern since its outbreak, and whether COVID-19 can transmit by aerosol remains controversial The problem of bio-aerosol transmission in the relatively confined dental clinics has aroused wide attention in the field of dentistry This review provided a most updated summary on the relation between bio-aerosols and dental clinics, which included the microorganisms in bio-aerosols, the bio-aerosol transmission and the sources testing methods, temporal and spatial distribution of dental bio-aerosols and summarized how to reduce the exposure to bio-aerosols in dental clinics


title: Contaminação microbiológica da ração e água fornecida a frangos em granja avícola da cidade de Januária, MG

text: A qualidade da água e das rações são fatores importantes para o desempenho da atividade avícola. A cadeia de produção de frangos pode proporcionar variadas fontes de contaminação, incluindo a ração e a água utilizada. O presente estudo teve como objetivo avaliar a incidência de indicadores de contaminação microbiológica em ração e água fornecida a frangos de corte em uma granja avícola do município de Januária-MG. Foram realizadas análises microbiológicas da água e ração fornecidas aos frangos, avaliando a contagem de bactérias coliformes totais, coliformes a 45°C e enterobactérias. A elevada contagem de coliformes totais e coliformes a 45°C na água e na ração, assim como, a elevada contagem de enterobactérias na ração pode representar a possibilidade da presença de bactérias patogênicas e consequente risco à saúde dos consumidores das aves comercializadas pela granja pesquisada.(AU)


title: Current pharmacological treatments for SARS-COV-2: A narrative review

text: The novel coronavirus, later identified as SARS-CoV-2, originating from Wuhan in China in November 2019, quickly spread around the world becoming a pandemic. Despite the knowledge of previous coronaviruses, such as those responsible for the SARS and MERS-CoV epidemic, there is no drug or prophylaxis treatment to this day. The rapid succession of scientific findings on SARS-CoV-2 provides a significant number of potential drug targets. Nevertheless, at the same time, the high quantity of clinical data, generated by a large number of rapidly infected people, require accurate tests regarding effective medical treatments. Several in vitro and in vivo studies were rapidly initiated after the outbreak of the pandemic COVID-19. Initial clinical studies revealed the promising potential of remdesivir that demonstrated a powerful and specific in vitro antiviral activity for COVID-19. Promising effects appear to be attributable to hydroxychloroquine. Remdesivir and hydroxychloroquine are being tested in ongoing randomized trials. In contrast, oseltamivir was not effective and corticosteroids are not currently recommended. However, few data from ongoing clinical trials are identifying low molecular weight heparins, innate immune system stimulating agents, and inflammatory modulating agents as potential effective agents. The authors assume that the current pandemic will determine the need for a systematic approach based on big data analysis for identifying effective drugs to defeat SARS-Cov-2. This work is aimed to be a general reference point and to provide an overview as comprehensive as possible regarding the main clinical trials in progress at the moment.


COVID-19 in the community


Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond


Universal screening for SARS-CoV-2 in asymptomatic obstetric patients in Tokyo, Japan


title: Adapting to the Coronavirus Disease 2019 Pandemic in New York City

text: The coronavirus disease 2019 has and continues to overwhelm the medical establishment in New York City. It has moved faster and had rates of mortality higher than what were initially forecast. All departments within large hospital systems have had to learn lessons and adapt in real time to the crisis. We share our experience and what we have learned as it pertains to this pandemic and hope that it aides, guides, and influences other departments of physical medicine and rehabilitation regarding their potential roles and areas of growth during this time.


The Rheumatology Community responds to the COVID-19 pandemic: the establishment of the COVID-19 global rheumatology alliance


title: Dietary Choices and Habits during COVID-19 Lockdown: Experience from Poland

text: The outbreak of coronavirus disease (COVID-19) in late December 2019 in China, which later developed into a pandemic, has forced different countries to implement strict sanitary regimes and social distancing measures. Globally, at least four billion people were under lockdown, working remotely, homeschooling children, and facing challenges coping with quarantine and the stressful events. The present cross-sectional online survey of adult Poles (n = 1097), conducted during a nationwide quarantine, aimed to assess whether nutritional and consumer habits have been affected under these conditions. Over 43.0% and nearly 52% reported eating and snacking more, respectively, and these tendencies were more frequent in overweight and obese individuals. Almost 30% and over 18% experienced weight gain (mean ± SD 3.0 ± 1.6 kg) and loss (-2.9 ± 1.5 kg), respectively. Overweight, obese, and older subjects (aged 36-45 and >45) tended to gain weight more frequently, whereas those with underweight tended to lose it further. Increased BMI was associated with less frequent consumption of vegetables, fruit, and legumes during quarantine, and higher adherence to meat, dairy, and fast-foods. An increase in alcohol consumption was seen in 14.6%, with a higher tendency to drink more found among alcohol addicts. Over 45% of smokers experienced a rise in smoking frequency during the quarantine. The study highlights that lockdown imposed to contain an infectious agent may affect eating behaviors and dietary habits, and advocates for organized nutritional support during future epidemic-related quarantines, particularly for the most vulnerable groups, including overweight and obese subjects.


title: Variance of Longest Run Duration in a Random Bitstring

text: We continue an earlier study, starting with unconstrained $n$-bitstrings, focusing now less on average behavior and more on uncertainty. The interplay between $\bullet$ longest runs of 0s and of 1s, when bitstrings are multus $\bullet$ longest runs of 0s and bitsums (# of 1s), when bitstrings are solus $\\$ is examined. While negative correlations approach zero as $n \rightarrow \infty$ in the former (for clumped 1s), the limit is evidently nonzero in the latter (for separated 1s). Similar analysis is possible when both 0s and 1s are clumped (bimultus), and when 0s are clumped but 1s are separated (persolus). Our methods are experimentally-based.


All that's fit to preprint


title: Pandemie post-normali. Perché CoViD-19 richiede un nuovo approccio alla scienza./ [Post-Normal Pandemics: why CoViD-19 requires a new approach to science.]

text: In addressing pandemics, science has never seemed more needed and useful, while at the same time limited and powerless. The existing contract between science and society is falling apart. A new covenant is urgently needed to navigate the days ahead.


title: Passengers' destinations from China: low risk of Novel Coronavirus (2019-nCoV) transmission into Africa and South America

text: Novel Coronavirus (2019-nCoV [SARS-COV-2]) was detected in humans during the last week of December 2019 at Wuhan city in China, and caused 24 554 cases in 27 countries and territories as of 5 February 2020. The objective of this study was to estimate the risk of transmission of 2019-nCoV through human passenger air flight from four major cities of China (Wuhan, Beijing, Shanghai and Guangzhou) to the passengers' destination countries. We extracted the weekly simulated passengers' end destination data for the period of 1-31 January 2020 from FLIRT, an online air travel dataset that uses information from 800 airlines to show the direct flight and passengers' end destination. We estimated a risk index of 2019-nCoV transmission based on the number of travellers to destination countries, weighted by the number of confirmed cases of the departed city reported by the World Health Organization (WHO). We ranked each country based on the risk index in four quantiles (4th quantile being the highest risk and 1st quantile being the lowest risk). During the period, 388 287 passengers were destined for 1297 airports in 168 countries or territories across the world. The risk index of 2019-nCoV among the countries had a very high correlation with the WHO-reported confirmed cases (0.97). According to our risk score classification, of the countries that reported at least one Coronavirus-infected pneumonia (COVID-19) case as of 5 February 2020, 24 countries were in the 4th quantile of the risk index, two in the 3rd quantile, one in the 2nd quantile and none in the 1st quantile. Outside China, countries with a higher risk of 2019-nCoV transmission are Thailand, Cambodia, Malaysia, Canada and the USA, all of which reported at least one case. In pan-Europe, UK, France, Russia, Germany and Italy; in North America, USA and Canada; in Oceania, Australia had high risk, all of them reported at least one case. In Africa and South America, the risk of transmission is very low with Ethiopia, South Africa, Egypt, Mauritius and Brazil showing a similar risk of transmission compared to the risk of any of the countries where at least one case is detected. The risk of transmission on 31 January 2020 was very high in neighbouring Asian countries, followed by Europe (UK, France, Russia and Germany), Oceania (Australia) and North America (USA and Canada). Increased public health response including early case recognition, isolation of identified case, contract tracing and targeted airport screening, public awareness and vigilance of health workers will help mitigate the force of further spread to naïve countries.


title: Performance of the nasal photoplethysmographic index as an analgesic index during surgery under general anaesthesia

text: In a previous study, we developed a new analgesic index using nasal photoplethysmography (nasal photoplethysmographic index, NPI) and showed that the NPI was superior to the surgical pleth index (SPI) in distinguishing pain above numerical rating scale 3. Because the NPI was developed using data obtained from conscious patients with pain, we evaluated the performance of NPI in comparison with the SPI and the analgesia nociception index (ANI) in patients under general anaesthesia with target-controlled infusion of propofol and remifentanil. The time of nociception occurrence was defined as when the signs of inadequate anaesthesia occurred. The median values of NPI, SPI, and ANI for 1 minute from the time of the sign of inadequate anaesthesia were determined as the value of each analgesic index that represents inadequate anaesthesia. The time of no nociception was determined as 2 minutes before the onset of skin incision, and the median value for 1 minute from that time was defined as the baseline value. In total, 81 patients were included in the analysis. NPI showed good performance in distinguishing inadequate anaesthesia during propofol-remifentanil based general anaesthesia. NPI had the highest value in terms of area under the receiver operating characteristic curve, albeit without statistical significance (NPI: 0.733, SPI: 0.722, ANI: 0.668). The coefficient of variations of baseline values of NPI, SPI, and ANI were 27.5, 47.2, and 26.1, respectively. Thus, the NPI was effective for detecting inadequate anaesthesia, showing similar performance with both indices and less baseline inter-individual variability than the SPI.


title: Pregnancy and COVID-19: a systematic review of maternal, obstetric and neonatal outcomes

text: BACKGROUND: There is limited information related to COVID-19 in pregnancy. OBJECTIVES: Evaluate the impact of COVID-19 during pregnancy. Search strategy: Searches were systematically carried out in PubMed, Scopus database and WHO database. Selection criteria: Studies with information related to the effects of COVID-19 in pregnancy, concerning maternal, obstetric, and neonatal outcomes were included. Data collection and analysis: Data were extracted for systematic review following PRISMA guidelines. CARE and STROBE were used to evaluate the quality of data. Main Results: A total of 8 studies involving 95 pregnant women and 51 neonates were included. Overall, the quality was considered good in four studies, moderate in three and poor in one. Among pregnant women, 26% had a history of epidemiological exposure to SARS-CoV-2. The most common symptoms presented were fever (55%), cough (38%) and fatigue (11%). In 50 deliveries, 94% were cesarean sections and 35% were preterm births. Of the 51 neonates, 20% had low birth weight and 1 tested positive for Sars-CoV-2. There was 1 neonatal death, not related to the viral infection, and no cases of severe neonatal asphyxia. CONCLUSIONS: The information compiled in this systematic review may help healthcare providers administer the best possible care.


title: Developing and testing a measure of COVID-19 organizational support of healthcare workers - results from Peru, Ecuador, and Bolivia

text: During the COVID-19 pandemic, healthcare workers are facing high workloads with resource constraints and risk of virus exposure, and healthcare organizations need to support their healthcare workers to reduce their anxiety. Based on a recent 8-point framework of COVID-19 specific organization support, we devised a measure of COVID-19 Organizational Support (COVID-OS). We tested the new measure with 712 healthcare workers in Bolivia, Ecuador, and Peru and found the new measure formed three factors to predict healthcare workers' anxiety and life satisfaction during the COVID-19 pandemic. We call for further studies to test COVID-OS in other countries and settings.


Continuing Professional Development in the Era of COVID-19


title: Thoughts and Advices on Performing Procedures in Surgery During the Outbreak of Novel Coronavirus Pneumonia/ 中山大学学报(医学科学版)

text: @#Since the outbreak of novel coronavirus pneumonia（coronavirus disease 2019，COVID- 19）in 2019，it has had a serious impact on the normal work and life of the people because of its strong infectivity，high susceptibility，long incubation period and diversified clinical manifestations. In this epidemic situation，clinicians should master the clinical manifestations and epidemiological characteristics of novel coronavirus pneumonia ，comply with the diagnosis and treatment guidelines of novel coronavirus pneumonia，carry out the diagnosis and treatment classification of surgical diseases well，reasonably select surgical methods；while optimizing the process of diagnosis，treatment and nursing，the protective measures should be taken according to different risk grades.


Academic Community's Efforts to Guide the Fight Against Coronavirus Disease 2019 (COVID-19) Epidemic in Korea


title: Artificial Intelligence Distinguishes COVID-19 from Community Acquired Pneumonia on Chest CT

text: Background Coronavirus disease has widely spread all over the world since the beginning of 2020. It is desirable to develop automatic and accurate detection of COVID-19 using chest CT. Purpose To develop a fully automatic framework to detect COVID-19 using chest CT and evaluate its performances. Materials and Methods In this retrospective and multi-center study, a deep learning model, COVID-19 detection neural network (COVNet), was developed to extract visual features from volumetric chest CT exams for the detection of COVID-19. Community acquired pneumonia (CAP) and other non-pneumonia CT exams were included to test the robustness of the model. The datasets were collected from 6 hospitals between August 2016 and February 2020. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity and specificity. Results The collected dataset consisted of 4356 chest CT exams from 3,322 patients. The average age is 49±15 years and there were slightly more male patients than female (1838 vs 1484; p-value=0.29). The per-exam sensitivity and specificity for detecting COVID-19 in the independent test set was 114 of 127 (90% [95% CI: 83%, 94%]) and 294 of 307 (96% [95% CI: 93%, 98%]), respectively, with an AUC of 0.96 (p-value<0.001). The per-exam sensitivity and specificity for detecting CAP in the independent test set was 87% (152 of 175) and 92% (239 of 259), respectively, with an AUC of 0.95 (95% CI: 0.93, 0.97). Conclusions A deep learning model can accurately detect COVID-19 and differentiate it from community acquired pneumonia and other lung diseases.


title: [Preliminary clinical study of direct renin inhibitor aliskiren in the treatment of severe COVID-19 patients with hypertension]

text: Objective: To explore the feasibility of direct renin inhibitor aliskiren for the treatment of severe patients of COVID-19 with hypertension. Methods: A retrospective case analysis of effectiveness and safety of aliskiren treatment to lower blood pressure in three severe and one critically ill patients of COVID-19 with hypertension. Results: Four patients, two males and two females, with an average age of 78 years (66-87 years), were referred to hospital mainly because of respiratory symptoms. Three cases were confirmed by 2019-nCoV nucleic acid and antibody detection (severe type), and one with cardiac insufficiency was clinically determined (critically ill type). The previous diagnosis of hypertension was clear. Two patients took calcium channel antagonist (CCB), one patient took angiotensin converting enzyme inhibitor (ACEI), and one patient took angiotensin II receptor antagonist (ARB). After admission, ACEI or ARB were discontinued, one patient with heart failure patient was treated by aliskiren combined with diuretic; 3 patients were treated with aliskiren combined with CCB. Two patients were stopped to use CCB due to low blood pressure after 1 to 2 weeks of using CCB and aliskiren. On the basis of comprehensive therapy combined with antiviral and oxygenation treatment, aliskiren antihypertensive treatment was taken for three to four weeks. The blood pressure control of four patients was satisfactory and there was no complaint of discomfort. The condition improved, and all patients had reached the discharge standard and were discharged. Conclusion: Our preliminary clinical data shows that aliskiren's antihypertensive therapy is effective and safe for severe COVID-19 patients complicated with hypertension. Further clinical aliskiren therapy study is required with more COVID-19 patients..


Child Health and Delivery of Care During the COVID-19 Pandemic and Beyond


title: Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

text: PURPOSE OF REVIEW: Coronavirus disease of 2019 (COVID-19) is a cause of significant morbidity and mortality worldwide. While cardiac injury has been demonstrated in critically ill COVID-19 patients, the mechanism of injury remains unclear. Here, we review our current knowledge of the biology of SARS-CoV-2 and the potential mechanisms of myocardial injury due to viral toxicities and host immune responses. RECENT FINDINGS: A number of studies have reported an epidemiological association between history of cardiac disease and worsened outcome during COVID infection. Development of new onset myocardial injury during COVID-19 also increases mortality. While limited data exist, potential mechanisms of cardiac injury include direct viral entry through the angiotensin-converting enzyme 2 (ACE2) receptor and toxicity in host cells, hypoxia-related myocyte injury, and immune-mediated cytokine release syndrome. Potential treatments for reducing viral infection and excessive immune responses are also discussed. COVID patients with cardiac disease history or acquire new cardiac injury are at an increased risk for in-hospital morbidity and mortality. More studies are needed to address the mechanism of cardiotoxicity and the treatments that can minimize permanent damage to the cardiovascular system.


title: Advances in Collaborative Filtering and Ranking

text: In this dissertation, we cover some recent advances in collaborative filtering and ranking. In chapter 1, we give a brief introduction of the history and the current landscape of collaborative filtering and ranking; chapter 2 we first talk about pointwise collaborative filtering problem with graph information, and how our proposed new method can encode very deep graph information which helps four existing graph collaborative filtering algorithms; chapter 3 is on the pairwise approach for collaborative ranking and how we speed up the algorithm to near-linear time complexity; chapter 4 is on the new listwise approach for collaborative ranking and how the listwise approach is a better choice of loss for both explicit and implicit feedback over pointwise and pairwise loss; chapter 5 is about the new regularization technique Stochastic Shared Embeddings (SSE) we proposed for embedding layers and how it is both theoretically sound and empirically effectively for 6 different tasks across recommendation and natural language processing; chapter 6 is how we introduce personalization for the state-of-the-art sequential recommendation model with the help of SSE, which plays an important role in preventing our personalized model from overfitting to the training data; chapter 7, we summarize what we have achieved so far and predict what the future directions can be; chapter 8 is the appendix to all the chapters.


title: Learning from a Pandemic

text: The Covid-19 pandemic has highlighted connections between health and social structural phenomena that have long been recognized in bioethics but have never really been front and center-not just access to health care, but fundamental conditions of living that affect public health, from income inequality to political and environmental conditions. In March, as the pandemic spread globally, the field's traditional focus on health care and health policy, medical research, and biotechnology no longer seemed enough. The adequacy of bioethics seemed even less certain after the killing of George Floyd, whose homicide showed in an especially agonizing way how social institutions are in effect (and often intentionally) designed to make the lives of black people go poorly and end early. Whether bioethics needs to be expanded, redirected, and even reconceived is at the heart of the May-June 2020 issue of the Hastings Center Report, which is devoted to questions provoked by and lessons emerging during this pandemic.


title: Overdose and risk factors for coronavirus disease 2019

text: BACKGROUND: There have been significant efforts to respond to the two public health emergencies of coronavirus disease 2019 (COVID-19) and overdose in British Columbia (BC), Canada. The purpose of this study was to quantify the prevalence of known risk factors associated with mortality due to COVID-19 for persons who have had a non-fatal overdose during 2015-2017 in comparison to persons who have not had an overdose. METHODS: Data were extracted from the BC Provincial Overdose Cohort which includes a 20 % random sample of BC residents and persons who have had a non-fatal overdose in BC from January 2015 to December 2017. Chi-square tests and logistic regression were used to compare risk factors by overdose history. RESULTS: Persons who had a non-fatal overdose were significantly more likely to have three (chronic pulmonary disease, diabetes, coronary heart disease) of the four known chronic conditions associated with the development of severe illness due to COVID-19 compared to persons who did not have a previous non-fatal overdose event. CONCLUSION: Persons who had an overdose were more likely to have several chronic conditions associated with the development of severe illness due to COVID-19. The increased likelihood of having these risk factors is reflective of the social and health inequities experienced by persons who have a history of overdose.


The #ASRASpring20 conference was canceled due to COVID-19 but the science survives and thrives


title: Soluble Urokinase Plasminogen Activator Receptor: A Biomarker for Predicting Complications and Critical Care Admission of COVID-19 Patients

text: The novel coronavirus infection has spread worldwide, causing a wide spectrum of clinical manifestations. Most patients develop moderate clinical illness, but a substantial number will experience severe pneumonia, which may rapidly progress to acute respiratory distress syndrome and multiple organ failure. In this population, soluble urokinase plasminogen activator receptor (suPAR) could serve as a quick triage test and independent marker of clinical severity, hospital and intensive care unit admission, complications, and mortality.


Inpatient care for dermatological patients during SARS-CoV-2 - a case report from Portugal


title: The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study

text: Epicardial adipose tissue (EAT) is associated with cardiovascular risk. The longitudinal change in EAT volume (EATv) and density (EATd), and potential modulators of these parameters, has not been described. We prospectively recruited 90 patients with non-obstructive coronary atherosclerosis on baseline computed tomography coronary angiography (CTCA) performed for suspected coronary artery disease to undergo a repeat research CTCA. EATv in millilitres (mL) and EATd in Hounsfield units (HU) were analysed and multivariable regression analysis controlling for traditional cardiovascular risk factors (CVRF) performed to assess for any predictors of change. Secondary analysis was performed based on statin therapy. The median duration between CTCA was 4.3years. Mean EATv increased at follow-up (72 ± 33 mL to 89 ± 43 mL, p < 0.001) and mean EATd decreased (baseline -76 ± 6 HU vs. -86 ± 5 HU, p < 0.001). There were no associations between baseline variables of body mass index, age, sex, hypertension, hyperlipidaemia, diabetes or smoking on change in EATv or EATd. No difference in baseline, follow-up or delta EATv or EATd was seen in patients with (60%) or without baseline statin therapy. In this select group of patients, EATv consistently increased and EATd consistently decreased at long-term follow-up and these changes were independent of CVRF, age and statin use. Together with the knowledge of strong associations between EAT and cardiac disease, these findings may suggest that EAT is an independent parameter rather than a surrogate for cardiovascular risk.


Extracorporeal membrane oxygenation in COVID-19