title: Targeting the gut-lung microbiota axis by means of a high-fibre diet and probiotics may have anti-inflammatory effects in COVID-19 infection

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1 is a 2019 novel coronavirus, which only in the European area has led to more than 300,000 cases with at least 21,000 deaths. This manuscript aims to speculate that the manipulation of the microbial patterns through the use of probiotics and dietary fibers consumption may contribute to reduce inflammation and strengthen the immune system response in COVID-19 infection. The reviews of this paper are available via the supplemental material section.


title: Neuro-rehabilitation service during COVID-19 pandemic: Best practices from UK

text: This paper provides the context of COVID-19 outbreak with special reference to hospital-based neurorehabilitation services in the UK and transferrable lessons for similar services globally. While the COVID-19 pandemic has created numerous challenges at all levels and forced us to confront our own vulnerabilities as individuals, teams, services, communities and on the global stage, it has also simultaneously offered us opportunities for transformation. Converting catastrophe into opportunity requires creativity, diligence, innovation, strategy and vision. This reflection serves to identify the challenges we encountered, the solutions we applied and the opportunities that we have taken. In the wake of an information avalanche, service and clinical practice challenge, service capacity challenge and above all, a unique and timely reminder of our own humanity and the inter-connectedness and fragility of human societies, we have endeavoured to identify and describe some crucial leadership facets, which are supporting our journey through this global health crisis.


Haemostasis in Times of COVID-19


COVID-19 Preparedness in Nursing Homes in the Midst of the Pandemic


title: Complex Immune Dysregulation in Covid-19 Patients with Severe Respiratory Failure

text: Proper management of COVID-19 mandates better understanding of disease pathogenesis The sudden clinical deterioration 7-8 days after initial symptom onset suggests that severe respiratory failure (SRF) in COVID-19 is driven by a unique pattern of immune dysfunction We studied immune responses of 54 COVID-19 patients, 28 of whom had SRF All SRF patients displayed either macrophage activation syndrome (MAS) or very low human leukocyte antigen (HLA)-DR expression accompanied by profound depletion of CD4-lymphocytes, CD19- lymphocytes and natural killer cells TNFα and IL-6 production by circulating monocytes was sustained, a pattern distinct from bacterial sepsis or influenza SARS-CoV-2 patient plasma inhibited HLA-DR expression, and this was partially restored by the IL-6 blocker Tocilizumab;off-label Tocilizumab treatment of patients was accompanied by increase in circulating lymphocytes Thus, the unique pattern of immune dysregulation in severe COVID-19 is characterized by IL-6-mediated low HLA-DR expression and lymphopenia, associated with sustained cytokine production and hyper-inflammation


Mechanisms of stroke and the role of anticoagulants in COVID-19


title: Epidemic spreading model of COVID-19

text: We study Susceptible-Exposed-Asymptomatic-Infectious-Recovered (SEAIR) epidemic spreading model inspired by two characteristics of the infectiousness of COVID-19: delayed start and its appearance before onset of symptoms, or even with total absence of them. The model is theoretically analyzed in continuous-time compartmental version and discrete-time version on random regular graphs and complex networks. We show analytically that there are relationships between the epidemic thresholds and the equations for the susceptible populations at the endemic equilibrium in all three versions, which hold when the epidemic is weak. We provide theoretical arguments that eigenvector centrality of a node approximately determines its risk to become infected.


Early experience in the COVID-19 pandemic from a vascular surgery unit in a Singapore tertiary hospital


Overzealous hand hygiene during the COVID 19 pandemic causing an increased incidence of hand eczema among general population


title: Spatial and temporal analysis of varroosis from 2005 to 2018

text: This paper describes the global distribution and temporal trend of Varroa spp. during 13 years (2005-2018) using the information retrieved from the OIE World Animal Health Information Database (WAHIS). During the period of study 53.4% of the countries reported the presence of the mite at least once. Countries were classified in five categories: 22% as Enzootic, 18% as Epizootic, 9% as Free, 12% and 26% respectively as disease Present or Absent at least once since 2005. Twelve percent of the countries were not able to provide any information on the presence of the disease. The average percentage of countries reporting the disease present was stable along the study, but it was observed a statistically significant increasing trend in the number of outbreaks reported per year. The number of outbreaks were different among the climate regions. Based on the seasonality analysis, the second semester of each year was the period characterized by the highest number of outbreaks reported.


The role of physical and rehabilitation medicine in the COVID-19 pandemic: The clinician's view


title: On the Inhibition of COVID-19 Protease by Indian Herbal Plants: An In Silico Investigation

text: COVID-19 has quickly spread across the globe, becoming a pandemic. This disease has a variable impact in different countries depending on their cultural norms, mitigation efforts and health infrastructure. In India, a majority of people rely upon traditional Indian medicine to treat human maladies due to less-cost, easier availability and without any side-effect. These medicines are made by herbal plants. This study aims to assess the Indian herbal plants in the pursuit of potential COVID-19 inhibitors using in silico approaches. We have considered 18 extracted compounds of 11 different species of these plants. Our calculated lipophilicity, aqueous solubility and binding affinity of the extracted compounds suggest that the inhibition potentials in the order; harsingar>aloe vera>giloy>turmeric>neem>ashwagandha>red onion>tulsi>cannabis>black pepper. On comparing the binding affinity with hydroxychloroquine, we note that the inhibition potentials of the extracts of harsingar, aloe vera and giloy are very promising. Therefore, we believe that these findings will open further possibilities and accelerate the works towards finding an antidote for this malady.


COVID-19: a plea to protect the older population


Covid-19 and public health


title: The important role of polysaccharides from a traditional Chinese medicine-Lung Cleansing and Detoxifying Decoction against the COVID-19 pandemic

text: The new coronavirus pneumonia, named COVID-19 by the World Health Organization, has become a pandemic. It is highly pathogenic and reproduces quickly. There are currently no specific drugs to prevent the reproduction and spread of COVID-19. Some traditional Chinese medicines, especially the Lung Cleansing and Detoxifying Decoction (Qing Fei Pai Du Tang), have shown therapeutic effects on mild and ordinary COVID-19 patients. Polysaccharides are important ingredients in this decoction. This review summarizes the potential pharmacological activities of polysaccharides isolated by hot water extraction from Lung Cleansing and Detoxifying Decoction, which is consistent with its production method, to provide the theoretical basis for ongoing research on its application.


title: South Korea's responses to stop the COVID-19 pandemic

text: BACKGROUND: South Korea's aggressive responses to the coronavirus disease 2019 (COVID-19) have greatly slowed the epidemic without regional lockdowns. METHODS: The Korean Centers for Disease Control and Prevention's daily briefings were thoroughly reviewed. Information about hospital countermeasures and government coordination was collected via telephone interviews with 4 infection control team leaders, 1 emergency department nurse, and 1 infectious disease physician in Korea. RESULTS: After the 2015 Middle East Respiratory Syndrome outbreak, the government and hospitals prepared for the inevitable outbreak of emerging infectious diseases by reforming the epidemic preparedness system. As a result, COVID-19 diagnostic test kits were quickly developed, enabling extensive early detection of potential cases. Other key steps were tracking cases, finding exposed individuals, coordinating case assignments with health care facilities, and selective clinic screenings for visitors' entering hospitals with mandatory mask wearing. Consequently, after overcoming the initial peak of the outbreak, which was related to a religious group, Korea has been able to maintain daily new cases at around 100 and to less than 50 daily cases in the second week of April. CONCLUSIONS: To counter the COVID-19 pandemic, which may persist, long-term, sustained response strategies must be prepared along with coordination between government and health systems.


title: Relapsing viral keratoconjunctivitis in COVID-19: a case report

text: BACKGROUND: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, many studies have reported the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the conjunctival sac of patients infected with this virus, with several patients displaying symptoms of viral conjunctivitis. However, to our best knowledge, there is no in-depth report on the course of patients with COVID-19 complicated by relapsing viral conjunctivitis or keratoconjunctivitis. CASE PRESENTATION: A 53-year-old man confirmed with COVID-19 developed symptoms of viral conjunctivitis in the left eye approximately 10 days after the onset of COVID-19. The results of a nucleic acid test were positive for SARS-CoV-2 in the conjunctival sac of the left eye. The symptoms were relieved 6 days after treatment. However, the patient was subsequently diagnosed with viral keratoconjunctivitis in both eyes 5 days after the symptoms in the left eye were satisfactorily relieved. The disease progressed rapidly, with spot staining observed at the periphery of the corneal epithelium. Although SARS-CoV-2 could not be detected in conjunctival secretions, the levels of inflammatory factors, such as interleukin-6, were increased in both eyes. Both eyes were treated with glucocorticoids, and symptoms were controlled within 5 days. There was no recurrence. CONCLUSIONS: In this case report, the pathogenesis, clinical manifestations, treatment, and outcome of a case with COVID-19 complicated by relapsing viral keratoconjunctivitis is described, and the involvement of topical cytokine surge in the pathogenesis of COVID-19 as it relates to viral keratoconjunctivitis is reported.


title: Effect of coronavirus infection on the human heart: A scoping review

text: BACKGROUND: The global coronavirus disease 2019 pandemic has highlighted the importance of understanding the cardiovascular implications of coronavirus infections, with more severe disease in those with cardiovascular co-morbidities, and resulting cardiac manifestations such as myocardial injury, arrhythmias, and heart failure. DESIGN: A systematic review of the current knowledge on the effects of coronavirus infection on the cardiovascular system in humans was performed and results were summarized. METHODS: Databases such as MEDLINE, EMBASE, CENTRAL, Scopus, Web of Science, ClinicalTrials.gov, Chinese Knowledge Resource Integrated Database and Chinese Clinical Trial Registry were searched on 20 March 2020. RESULTS: In total, 135 studies were included, involving severe acute respiratory syndrome, Middle East respiratory syndrome, coronavirus disease 2019 and other coronaviruses. Most were case reports, case series and cohort studies of poor to fair quality. In post-mortem examinations of subjects who died from infection, around half had virus identified in heart tissues in severe acute respiratory syndrome, but none in Middle East respiratory syndrome and coronavirus disease 2019. Cardiac manifestations reported include tachycardia, bradycardia, arrhythmias, and myocardial injury, secondary to both systemic infection and treatment. Cardiac injury and arrhythmias are more prevalent in coronavirus disease 2019, and elevated cardiac markers are associated with intensive care unit admission and death. In severe acute respiratory syndrome, Middle East respiratory syndrome, and coronavirus disease 2019, comorbidities such as hypertension, diabetes mellitus, and heart disease are associated with intensive care unit admission, mechanical ventilation, and mortality. There were cases of misdiagnosis due to overlapping presentations of cardiovascular diseases and coronavirus infections, leading to hospital spread and delayed management of life-threatening conditions. CONCLUSION: This review highlighted the ways in which coronaviruses affect cardiovascular function and interacts with pre-existing cardiovascular diseases.


title: People with Suspected COVID-19 Symptoms Were More Likely Depressed and Had Lower Health-Related Quality of Life: The Potential Benefit of Health Literacy

text: The coronavirus disease 2019 (COVID-19) epidemic affects people's health and health-related quality of life (HRQoL), especially in those who have suspected COVID-19 symptoms (S-COVID-19-S). We examined the effect of modifications of health literacy (HL) on depression and HRQoL. A cross-sectional study was conducted from 14 February to 2 March 2020. 3947 participants were recruited from outpatient departments of nine hospitals and health centers across Vietnam. The interviews were conducted using printed questionnaires including participants' characteristics, clinical parameters, health behaviors, HL, depression, and HRQoL. People with S-COVID-19-S had a higher depression likelihood (OR, 2.88; p < 0.001), lower HRQoL-score (B, -7.92; p < 0.001). In comparison to people without S-COVID-19-S and low HL, those with S-COVID-19-S and low HL had 9.70 times higher depression likelihood (p < 0.001), 20.62 lower HRQoL-score (p < 0.001), for the people without S-COVID-19-S, 1 score increment of HL resulted in 5% lower depression likelihood (p < 0.001) and 0.45 higher HRQoL-score (p < 0.001), while for those people with S-COVID-19-S, 1 score increment of HL resulted in a 4% lower depression likelihood (p = 0.004) and 0.43 higher HRQoL-score (p < 0.001). People with S-COVID-19-S had a higher depression likelihood and lower HRQoL than those without. HL shows a protective effect on depression and HRQoL during the epidemic.


title: COVID-19 and the elderly: insights into pathogenesis and clinical decision-making

text: The elderly may represent a specific cluster of high-risk patients for developing COVID-19 with rapidly progressive clinical deterioration. Indeed, in older individuals, immunosenescence and comorbid disorders are more likely to promote viral-induced cytokine storm resulting in life-threatening respiratory failure and multisystemic involvement. Early diagnosis and individualized therapeutic management should be developed for elderly subjects based on personal medical history and polypharmacotherapy. Our review examines the pathogenesis and clinical implications of ageing in COVID-19 patients; finally, we discuss the evidence and controversies in the management in the long-stay residential care homes and aspects of end-of-life care for elderly patients with COVID-19.


title: Hypertension, the renin-angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19

text: Systemic arterial hypertension (referred to as hypertension herein) is a major risk factor of mortality worldwide, and its importance is further emphasized in the context of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection referred to as COVID-19. Patients with severe COVID-19 infections commonly are older and have a history of hypertension. Almost 75% of patients who have died in the pandemic in Italy had hypertension. This raised multiple questions regarding a more severe course of COVID-19 in relation to hypertension itself as well as its treatment with renin-angiotensin system (RAS) blockers, e.g. angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). We provide a critical review on the relationship of hypertension, RAS, and risk of lung injury. We demonstrate lack of sound evidence that hypertension per se is an independent risk factor for COVID-19. Interestingly, ACEIs and ARBs may be associated with lower incidence and/or improved outcome in patients with lower respiratory tract infections. We also review in detail the molecular mechanisms linking the RAS to lung damage and the potential clinical impact of treatment with RAS blockers in patients with COVID-19 and a high cardiovascular and renal risk. This is related to the role of angiotensin-converting enzyme 2 (ACE2) for SARS-CoV-2 entry into cells, and expression of ACE2 in the lung, cardiovascular system, kidney, and other tissues. In summary, a critical review of available evidence does not support a deleterious effect of RAS blockers in COVID-19 infections. Therefore, there is currently no reason to discontinue RAS blockers in stable patients facing the COVID-19 pandemic.


A Re-analysis in Exploring the Association between Temperature and COVID-19 Transmissibility: An Ecological Study with 154 Chinese Cities


Challenges Estimating Total Lives Lost in COVID-19 Decisions: Consideration of Mortality Related to Unemployment, Social Isolation, and Depression


title: Active case finding with case management: the key to tackling the COVID-19 pandemic

text: COVID-19 was declared a pandemic by WHO on March 11, 2020, the first non-influenza pandemic, affecting more than 200 countries and areas, with more than 5·9 million cases by May 31, 2020. Countries have developed strategies to deal with the COVID-19 pandemic that fit their epidemiological situations, capacities, and values. We describe China's strategies for prevention and control of COVID-19 (containment and suppression) and their application, from the perspective of the COVID-19 experience to date in China. Although China has contained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and nearly stopped indigenous transmission, a strong suppression effort must continue to prevent re-establishment of community transmission from importation-related cases. We believe that case finding and management, with identification and quarantine of close contacts, are vitally important containment measures and are essential in China's pathway forward. We describe the next steps planned in China that follow the containment effort. We believe that sharing countries' experiences will help the global community manage the COVID-19 pandemic by identifying what works in the struggle against SARS-CoV-2.


Recommendations for Metabolic and Bariatric Surgery During the COVID-19 Pandemic from IFSO


title: Treatment concerns for psychiatric symptoms in patients with COVID-19 with or without psychiatric disorders

text: Many psychiatric patients have been infected with COVID-19, and patients with COVID-19 may develop psychiatric symptoms after treatment with antiviral drugs. Given the tolerability and minimal P450 interactions, antidepressants (i.e., citalopram, escitalopram etc.), antipsychotics (i.e., olanzapine) and valproate can be considered to be safe in combination with antiviral drugs.


title: Aberrant Expression of Syndecan-1 in Cervical Cancers

text: Syndecan-1, is a transmembrane heparan/chondroitin sulfate proteoglycan necessary for cell-cell and cell-matrix interactions. Its decreased level on the cell surface correlates with poor prognosis in several tumor types. Aberrant stromal localization of syndecan-1 is also considered an unfavorable prognostic factor in various human malignancies. In the presented work the question was addressed if changes in syndecan-1 expression are related to the prognosis of cervical cancer. Immunohistochemistry for syndecan-1 extracellular domain was performed on surgical specimens of primary cervical cancer. To follow the communication between tumor cells and stromal fibroblasts, their mono-and co-cultures were studied, detecting the expression of syndecan-1, smooth muscle actin, vimentin, and desmin. Immunohistochemistry of tumorous specimens revealed that while cell surface syndecan-1 expression was reduced on cancer cells, it appeared on the surface of tumor-associated fibroblasts. Until year 7, the cohort with high cell surface syndecan-1 expression had significantly longer survival. No difference in the same time-period could be detected when stromal syndecan-1 expression was analyzed. In vitro analysis revealed, that tumor cells can induce syndecan-1 expression on fibroblast, and fibroblasts showed that fibroblast-like cells are built by two cell types: (a) syndecan-1 positive, cytokeratin negative real fibroblasts, and (b) syndecan-1 and cytokeratin positive epithelial-mesenchymal transformed tumor cells. Syndecan-1 on the surface of cancer cells appears to be a positive prognostic marker. Although syndecan-1 positive fibroblasts promote tumor cell proliferation in vitro, we failed to detect their cancer promoting effect in vivo.


title: Covid-19 in a patient with multiple sclerosis treated with natalizumab: May the blockade of integrins have a protective role?

text: The disease caused by the new coronavirus SARS-CoV-2 (COVID-19) is currently spread worldwide . Recent data supports SARS-CoV-2 may use integrins to enter human cells. Therefore, anti-integrins therapies might be an alternative against the infection . Natalizumab, approved for Multiple Sclerosis (MS) treatment, acts blocking α4-integrin. We report a MS patient treated with natalizumab who develops COVID-19, with excellent recovery and repeated negative results in 5 consecutive microbiological studies. We postulate this may be due to the blockade of integrins induced by natalizumab.


title: COVID-19: Melatonin as a potential adjuvant treatment

text: This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology. This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients. Additional experiments and clinical studies are required to confirm this speculation.


Mental health of medical workers in Pakistan during the pandemic COVID-19 outbreak


title: Fish as bioindicators: coal and mercury pollution in Colombia's ecosystems

text: Mining in Colombia affects 488,672 ha (298,391 in coal mining and 190,281 in gold mining). However, Colombia has insufficient studies on mining and its repercussions, which limits estimates of mining impacts on ecosystems and the human population. Due to the rise of mining activities in Colombia, the negative impacts generated by coal and Hg will also continue to increase. This review analyzes national information levels on coal and Hg in island/coastal/marine as well as freshwater ecosystems and human groups using fishery resources as a framework. This is because fish are the main source of animal protein in marine coastal-island and mainland communities. Here, 15 of 32 Colombian departments have records on total mercury (THg) in water, sediments, fish, and human communities. Around 205 ton/year of mercury is discharged into the ecosystem. In human hair for example (15.3 to 50.15 µg/g), mercury exceeds the international maximum levels allowed (ILA) and the national standard (5.0 µg/g). Mercury levels in freshwater fish show 3.3 µg/g of THg and levels in marine and coastal-island fish are 1.2 µg/g THg exceeding the ILA (0.5 µg/g) standard for fish that will be consumed. Carnivorous species have a THg between 0.04 and 2.55 µg/g suggesting bioaccumulation and magnification of heavy metals. These findings were then compared with available international information.


Bildediagnostikk av pasienter med covid-19./ Bildediagnostikk av pasienter med covid-19./ Diagnostic imaging of COVID-19 patients


The ultrasound guided triage: a new tool for prehospital management of COVID-19 pandemic


How do children spread the coronavirus? The science still isn't clear


title: Sampling and detection of corona viruses in air: A mini review

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a strain of coronaviruses that causes coronavirus disease 2019 (COVID-19). In these days, the spread of the SARS-CoV-2 virus through the air has become a controversial topic among scientists. Various organizations provide standard methods for monitoring biological agents in the air. Nevertheless, there has been no standard recommended method for sampling and determination of viruses in air. This manuscript aimed at reviewing published papers for sampling and detection of corona viruses, especially SARS-Cov-2 as a global health concern. It was found that SARS-Cov 2 was present in some air samples that were collected from patient's rooms in hospitals. This result warrants its airborne transmission potential. However, due to the fact that in the most reviewed studies, sampling was performed in the patient's room, it seems difficult to discriminate whether it is airborne or is transmitted through respiratory droplets. Moreover, some other disrupting factors such as patient distance from the sampler, using protective or oxygen masks by patients, patient activities, coughing and sneezing during sampling time, air movement, air conditioning, sampler type, sampling conditions, storage and transferring conditions, can affect the results. About the sampling methods, most of the used samplers such as PTFE filters, gelatin filers and cyclones showed suitable performance for trapping SARS-Co and MERS-Cov viruses followed by PCR analysis.


title: Effect of the COVID-19 pandemic on anxiety among children with cystic fibrosis and their mothers

text: BACKGROUND: We aimed to evaluate anxiety among children with cystic fibrosis (CF) and their mothers related to the COVID-19 pandemic. METHODS: A total of 45 patients with CF and their mothers were enrolled in the study together with 90 age-matched healthy children and their mothers as a control group. The State and Trait Anxiety Inventory (STAI) was administered by teleconference with children aged 13 to 18 years old and their mothers. The STAI for children was administered with children aged 9 to 12 years. Results were compared with age-matched healthy children and their mothers. The relationship between anxiety scores of children with CF and their mothers was evaluated by comparing with clinical data of children with CF. At the conclusion of the teleconference, mothers were asked whether their anxiety had changed as a result of the interview. RESULTS: It was found that healthy children aged 13 to 18 years had higher state anxiety scores than age-matched children with CF. Mothers of children with CF had higher trait anxiety scores, especially those of children aged 0 to 12 years, than mothers of healthy children (P < .05). For mothers of children with CF, state anxiety scores were higher among those whose children had chronic Pseudomonas infection (P < .05). Most mothers of children with CF stated that their anxiety decreased following the interview. CONCLUSION: The COVID-19 pandemic may increase anxiety among mothers of children with CF as well those with healthy children. However, COVID-19 had no effect on the anxiety of children with CF. Informing parents of children with CF about COVID-19 by teleconference may decrease anxiety.


Onco-gynecologic surgery in the COVID-19 era: Risks and precautions-A position paper from FRANCOGYN, SCGP, SFCO, and SFOG


Policies on the use of respiratory protection for hospital health workers to protect from coronavirus disease (COVID-19)


title: Analyzing COVID-19 pandemic for unequal distribution of tests, identified cases, deaths, and fatality rates in the top 18 countries

text: BACKGROUND AND AIMS: COVID-19 pandemic has affected various countries differently due to variance in demographics, income level, health infrastructure, government response, control and enforcement, and cultural traits of different populations. This study aims to identify significant factors behind the unequal distribution of identified cases and deaths in different countries. Our study's objective is comparative analysis and identification of relations between the spread of COVID-19 pandemic, population characteristics, and government response. METHODS: The top 18 countries worst hit by COVID-19 cases were identified. The data metrics, such as the number of cases, deaths, fatality rates, tests, average life expectancy, and population, were collected and consolidated. RESULTS: Countries with significant percentage of the older population are vulnerable to a high number of deaths due to COVID-19. Developed countries have higher per capita testing, whereas testing is less intensive in developing/underdeveloped countries. There is a consensus among health experts that COVID-19 has higher fatality rates for people above 60, however, with further age, this increases exponentially. Countries with higher life expectancy are also high-income countries, and the best course of action would be to provide specialized support to self-isolate for people of ages 75 and above. CONCLUSION: The behaviour of disease occurring at a large scale and interaction with different populations is studied to understand and differentiate the factors and measures that successfully inhibited the pandemic. The study benchmarks different countries based on their performance and efforts against the pandemic and provides some useful insights on the efficiency of their governance and potential to improve & ramp up their programs. The economic status and existing healthcare infrastructure as they are the key factors in determining the country's ability to contain and minimize the losses from this pandemic.


title: Preface: How far has Neotropical Ichthyology progressed in twenty years?

text: Studies on the diversity, taxonomy, phylogeny, and biogeography of Neotropical Fishes have thrived over the twenty years that have elapsed since the first symposium on their phylogeny and classification in Porto Alegre, Brazil. Here, we review recent advances in the study of Neotropical fishes and assess the known diversity of freshwater species in that region. 6,255 valid freshwater species have been discovered in the Neotropics so far, and we estimate that over 9,000 species will be known when the inventory is complete. We also summarize the events of the second Symposium on Phylogeny and Classification of Neotropical Fishes that took place last year in Londrina, Brazil. Along with invited talks on the biodiversity of all major groups of Neotropical fishes, a series of presentations on the development of fish collections, and numerous contributed talks, the meeting included a special session to honor Dr. Richard Vari, who was one of the most prolific and beloved members of our community.(AU)


title: Persistent infection and pancytopenia associated with ferret systemic coronaviral disease in a domestic ferret

text: Ferret systemic coronaviral disease (FSCD) is a well-established cause of mortality in domestic ferrets. We describe herein novel findings in a case of FSCD that was diagnosed and medically managed following virus detection by immunohistochemical (IHC) staining of surgical biopsy samples. Hematologic changes in this ferret suggested spread of the virus to the bone marrow, which was confirmed by IHC staining of a postmortem sample. Genotyping of the virus indicated that the virus grouped with alphacoronaviruses and was most closely related to ferret enteric coronavirus (FRECV) MSU-2. Our clinical case demonstrates that a FRECV MSU-2-like ferret coronavirus associated previously with the enteric pathotype may cause systemic disease, including bone marrow involvement causing persistent pancytopenia.


(In)Segurança alimentar no contexto da pandemia por SARS-CoV-2./ (In)Segurança alimentar no contexto da pandemia por SARS-CoV-2./ Food (in)security in Brazil in the context of the SARS-CoV-2 pandemic


Delivering high-quality vascular care by telehealth during the COVID-19 pandemic


title: Arbitrarily sparse spectra for self-affine spectral measures

text: Given an expansive matrix $R\in M_d({\mathbb Z})$ and a finite set of digit $B$ taken from $ {\mathbb Z}^d/R({\mathbb Z}^d)$. It was shown previously that if we can find an $L$ such that $(R,B,L)$ forms a Hadamard triple, then the associated fractal self-affine measure generated by $(R,B)$ admits an exponential orthonormal basis of certain frequency set $\Lambda$, and hence it is termed as a spectral measure. In this paper, we show that if #$B<|\det (R)|$, not only it is spectral, we can also construct arbitrarily sparse spectrum $\Lambda$ in the sense that its Beurling dimension is zero.


title: Erratum: COVID-19, Australia: Epidemiology Report 15 (Reporting week to 23:59 AEST 3 May 2020)

text: An error in data processing resulted in the tabulation of incorrect crude case fatality rate values, for age groups of 50-59 and above, in Table 5 (Crude Case Fatality Rate of all cases and hospitalised cases, by age group) as originally published in the COVID-19 (Australia) epidemiology report 14. The table below provides the corrected values.


Blockade of SARS-CoV-2 infection by recombinant soluble ACE2


Isolating children is not the answer to COVID-19


title: Infection with SARS-CoV-2 causes abnormal laboratory results of multiple organs in patients

text: AIM: To evaluate the clinical value of abnormal laboratory results of multiple organs in patients with coronavirus disease 2019 (COVID-2019) and to help clinicians perform correct treatment. RESULTS: Elevated neutrophil-to-LYM ratio (NLR), D-dimer(D-D), interleukin (IL)-6, IL-10, IL-2, interferon-Y, and age were significantly associated with the severity of illness. However, significant and sustained decreases were observed in the LYM subset (p<0.05). D-D, T cell counts, and cytokine levels in severe COVID-19 patients who survived the disease gradually recovered at later time points to levels that were comparable to those of mild cases. Second, D-D increased from 0.5 to 8, and the risk ratio increased from 2.75 to 55, eventually leading to disseminated intravascular coagulation. Moreover, the acute renal function damage occurred earlier than abnormal heart and liver functions (p<0.05). CONCLUSIONS: The degrees of lymphopenia and proinflammatory cytokine storm were higher in severe COVID-19 patients than in mild cases. The degree was associated with the disease severity. Advanced age, NLR, D-D, and cytokine levels may serve as useful prognostic factors for the early identification of severe COVID-19 cases. METHODS: Peripheral blood samples were collected from 93 confirmed COVID-19 patients. The samples were examined for lymphocyte (LYM) subsets by flow cytometry and cytokine profiles by specific immunoassays. The receiver operating characteristic curve was applied to determine the best diagnostic thresholds for laboratory results, and principal component analysis was used to screen the major risk factors. The prognostic values were assessed using the Kaplan-Meier curve and univariate and multivariate COX regression models.


Whole nucleocapsid protein of SARS-CoV-2 may cause false positive results in serological assays


title: Medically unexplained symptoms in the times of Covid-19 pandemic: a case-report

text: In early 2020, a novel coronavirus (SARS-CoV-2) leading to a potentially fatal condition was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread worldwide becoming a pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the psychological impact that COVID-19 may have, especially on vulnerable individuals with pre-existing mental health conditions. Somatic symptom disorder (SSD) is characterized by a dysfunctional preoccupation with physical symptoms leading to excessive and unnecessary healthcare utilization. Despite being quite common, such condition remains underrecognized. We report a detailed clinical case of a 16 years old adolescent, who presented with a history suggestive of COVID-19 infection and associated psychological distress. Despite testing negative for the presence of SARS-CoV-2, his extreme and persisting health preoccupations required an inpatient admission to the Child and Adolescent Neuropsychiatric Unit. He responded rapidly to a low dose of antipsychotic and an antidepressant. Based on his medical history and current presentation, he received a diagnosis of SSD. When COVID-19-like symptoms occur, we highlight the importance of differentially diagnosing a possible exacerbation of a pre-existing SSD, triggered by fear of being infected. This may help preventing further burden to the healthcare system.


COVID-19 Non-Essential Surgery Restrictions and Spine Surgery: A German Experience


title: Attempting to understand the spread of SARS-CoV-2: Associations between the number of cases in regions and selected economic and geographic parameters

text: We present in this work some results from analysing the spread of Covid-19 in different countries and regions around the world and the potential relations with climate, geographical location, and GDP. While the situation remains dynamic, we believe this analysis has the potential to uncover certain underlying trends. We primarily intend the results to drive further, more detailed analysis of the relevant data by other researchers that would help us gather a better understanding of the situation, aiding our preparedness. Our observations show that countries in high latitudes, with temperate and/or continental climate, and with reasonably"open"economies are the most vulnerable to this outbreak.


Pharmacist-driven education for solid organ transplant recipients in the COVID-19 era


Covid-19: Sweden should have done more, says architect of country's strategy


title: COVID-19 in adult patients with CHD: a matter of anatomy or comorbidities?

text: Little is know about COVID-19 outcome in specific populations such as Adult congenital heart disease (ACHD) patients. We report three cases of adult patients with similar underlying disease with completely different clinical severity at the time of COVID-19 infection. The patient with the most severe clinical course was obese and diabetic, suggesting that COVID-19 mortality and morbidity in Adult congenital heart disease patients might be independent of anatomic complexity.


title: Patient-Reported GI Outcomes in Patients With Anal Cancer Receiving Modern Chemoradiation

text: PURPOSE: Among patients with anal cancer, chemoradiotherapy is often associated with toxicities that diminish quality of life. We describe the GI-related patient-reported outcomes (PROs) of patients with anal cancer receiving chemoradiotherapy to improve patient-physician communication. METHODS: We prospectively followed patients with nonmetastatic squamous cell carcinoma of the anal canal who received definitive chemoradiotherapy. Patients completed the bowel subdomain of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire before treatment and at 4 subsequent timepoints. We used the paired Wilcoxon test to compare EPIC scores at different times. RESULTS: The study included 21 patients; median age was 57 years. Most patients (52%) had T2 and either N0 or N1 disease (81%). Most patients (91%) received chemotherapy with cisplatin-fluorouracil and either intensity-modulated radiotherapy or volumetric modulated arc therapy. Compared with the patients' median overall summary score at baseline (66), their median score at 1 week (82) was higher (P = .009), whereas their median score at 5 weeks (54) was lower (P = .025). The patients' median overall summary score at baseline and at 3 months did not differ (P = .919). Three months after radiotherapy, most patients reported minimal adverse effects compared with baseline. CONCLUSION: The GI-related PROs of patients with anal cancer tend to fluctuate during radiotherapy but return to baseline by 3 months, at which time most patients report few or no residual adverse effects. We provide a clear timeline of GI acute toxicity using sequential PRO measurements that will improve patient-physician communication regarding expectations for cancer treatment.


Prevention of endothelial dysfunction and thrombotic events in COVID-19 patients with familial hypercholesterolemia


Awaiting the "catharsis"


title: Management of ST-Elevation Myocardial Infarction in the COVID-19 Era: The Role of Thrombosis and Anticoagulation Strategy

text: Cardiac manifestations of COVID-19 include myocarditis, demand ischemia, myocardial infarction and arrhythmias with prothrombotic state being a major underlying pathogenetic mechanism In this report we present a case of a 57-year-old, otherwise healthy, woman who presented with chest pain and nausea and was found to have an inferior wall ST-elevation myocardial infarction (STEMI) in the setting of an active COVID-19 infection Angiography revealed tortuous coronary arteries with a 100% right coronary artery occlusion with high thrombus burden and normal left coronary system In light of the available literature regarding the pro-thrombotic effects of this novel corona virus, we continued full dose anticoagulation with Enoxaparin after the cardiac catheterization and transitioned to rivaroxaban and we also continued the patient on dual antiplatelet therapy prior to discharge


Authoritarianism, outbreaks, and information politics


USC referrals


Covid-19: The inside story of the RECOVERY trial


title: Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019

text: BACKGROUND: The clinical presentation of European patients with mild-to-moderate COVID-19 infection is still unknown. OBJECTIVE: To study the clinical presentation of COVID-19 in Europe. METHODS: Patients with positive diagnosis of COVID-19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analysing the relationship between outcomes. RESULTS: A total of 1,420 patients completed the study (962 females, 30.7% of healthcare workers). The mean age of patients was 39.17 ± 12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by 45.4%. The mean duration of COVID-19 symptoms of mild-to-moderate cured patients was 11.5 ± 5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild-to-moderate COVID-19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients. CONCLUSION: The clinical presentation of mild-to-moderate COVID-19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild-to-moderate COVID-19 that needs to be recognized as such by the WHO.


title: A case of Covid-19 patient with acute limb ischemia and heparin resistance

text: Heparin resistance is an uncommon phenomenon defined as the need for high dose unfractionated heparin (UFH) of more than 35,000 IU/day to achieve the target activated partial thromboplastin time ratio or the failure to achieve the desired activated clotting time after a full UFH dose. This rare phenomenon is being more commonly observed in Covid-19 patients in a hypercoagulable state. We describe a Covid-19 patient confirmed by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay, with acute limb ischemia, who developed heparin resistance. The patient was managed by the departments of Vascular Surgery, Anesthesia and Intensive Care, and the Coagulation Service and Thrombosis Research from San Raffaele Scientific Institute, Milan, Italy.


Rethinking high-risk groups in COVID-19


title: Flattening the emotional distress curve: A behavioral health pandemic response strategy for COVID-19

text: This article proposes a framework for managing the behavioral health impacts of the COVID-19 global pandemic. This framework aligns and should be integrated with an existing public health pandemic intervals model. It includes six phases of a behavioral health pandemic response strategy: preplanning, response readiness, response mobilization, intervention, continuation, and amelioration. The ways behavioral health specialists can capitalize on their competence in the leadership, prevention, education, service, research, and advocacy domains within each behavioral health pandemic response phase are articulated. Behavioral health expertise can help ensure a more comprehensive, effective pandemic response that facilitates the flattening of the curve of disease spread, along with the corresponding emotional distress curve. A case illustration, the Caring Communities (CC) initiative, is offered as an exemplar of action steps in the leadership, prevention, education, service, research, and advocacy domains that behavioral health professionals can take within each of the behavioral health pandemic response phases. Key CC action steps include providing support groups, offering virtual wellness breaks, participating in educational outreach, creating and disseminating wellness guides, launching and leading a virtual behavioral health clinic for health care staff, participating in behavioral health research and program evaluation, and engaging in advocacy initiatives aimed at improving behavioral health care and addressing and reducing health disparities. Finally, recommendations for optimizing behavioral health contributions to future pandemic responses are proffered. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


COVID-19 pneumonia in Taiwan


title: Common trends in the epidemic of Covid-19 disease

text: The discovery of SARS-CoV-2, the responsible virus for the Covid-19 epidemic, has sparked a global health concern with many countries affected. Developing models that can interpret the epidemic and give common trend parameters are useful for prediction purposes by other countries that are at an earlier phase of the epidemic; it is also useful for future planning against viral respiratory diseases. One model is developed to interpret the fast-growth phase of the epidemic and another model for an interpretation of the entire data set. Both models agree reasonably with the data. It is shown by the first model that during the fast phase, the number of new infected cases depends on the total number of cases by a power-law relation with a scaling exponent equal to 0.82. The second model gives a duplication time in the range 1 to 3 days early in the start of the epidemic, and another parameter alpha = 0.1-0.5) that deviates the progress of the epidemic from an exponential growth. Our models may be used for data interpretation and for guiding predictions regarding this disease, e.g. the onset of the maximum in the number of new cases.


title: Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy

text: BACKGROUND: National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited. METHODS: All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated. RESULTS: Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56-75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5-11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60-99), with median PaO2/FiO2 ratio, 267 (IQR 184-314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4-16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. CONCLUSION: In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.


title: Rapid reviews for rapid decision-making during the coronavirus disease (COVID-19) pandemic, Norway, 2020

text: In response to urgent needs for updated evidence for decision-making on various aspects related to coronavirus disease (COVID-19), the Norwegian Institute of Public Health established a rapid review team. Using simplified processes and shortcuts, this team produces summary reviews on request within 1-3 days that inform advice provided by the institute. All reviews are published with explicit messages about the risk of overlooking key evidence or making misguided judgements by using such rapid processes.


title: A Human Pluripotent Stem Cell-based Platform to Study SARS-CoV-2 Tropism and Model Virus Infection in Human Cells and Organoids

text: SARS-CoV-2 has caused the COVID-19 pandemic. There is an urgent need for physiological models to study SARS-CoV-2 infection using human disease-relevant cells. COVID-19 pathophysiology includes respiratory failure but involves other organ systems including gut, liver, heart, and pancreas. We present an experimental platform comprised of cell and organoid derivatives from human pluripotent stem cells (hPSCs). A Spike-enabled pseudo-entry virus infects pancreatic endocrine cells, liver organoids, cardiomyocytes, and dopaminergic neurons. Recent clinical studies show a strong association with COVID-19 and diabetes. We find that human pancreatic beta cells and liver organoids are highly permissive to SARS-CoV-2 infection, further validated using adult primary human islets and adult hepatocyte and cholangiocyte organoids. SARS-CoV-2 infection caused striking expression of chemokines, as also seen in primary human COVID-19 pulmonary autopsy samples. hPSC-derived cells/organoids provide valuable models for understanding the cellular responses of human tissues to SARS-CoV-2 infection and for disease modeling of COVID-19.


title: Extended ORF8 Gene Region Is Valuable in the Epidemiological Investigation of Severe Acute Respiratory Syndrome-Similar Coronavirus

text: Severe acute respiratory syndrome coronavirus (SARS-CoV) was discovered as a novel pathogen in the 2002-2003 SARS epidemic. The emergence and disappearance of this pathogen have brought questions regarding its source and evolution. Within the genome sequences of 281 SARS-CoVs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and SARS-related CoVs (SARSr-CoVs), a ~430 bp genomic region (from 27 701 bp to 28 131 bp in AY390556.1) with regular variations was investigated. This ~430 bp region overlaps with the ORF8 gene and is prone to deletions and nucleotide substitutions. Its complexity suggested the need for a new genotyping method for coronaviruses related to SARS-similar coronaviruses (SARS-CoV, SARSr-CoV, and SARS-CoV-2). Bat SARSr-CoV presented 3 genotypes, of which type 0 is only seen in bat SARSr-CoV, type I is present in SARS in the early phase, and type II is found in all SARS-CoV-2. This genotyping also shows potential usage in distinguishing the SARS-similar coronaviruses from different hosts and geographic areas. This genomic region has important implications for predicting the epidemic trend and studying the evolution of coronavirus.


title: Exploring Stress Coping Strategies of Frontline Emergency Health Workers dealing Covid-19 in Pakistan: A Qualitative Inquiry

text: BACKGROUND: The COVID-19 outbreak has gravely impacted the physical and psychological health of people. As the outbreak is ongoing, it is crucial to equip the emergency healthcare workers (HCWs) to be medically and psychologically prepared. OBJECTIVE: To examine the psychological impact of COVID-19 on emergency HCWs and to understand how they are dealing with COVID-19 pandemic, their stress coping strategies or protective factors, and challenges while dealing with COVID-19 patients. METHOD: Using a framework thematic analysis approach, 15 frontline emergency HCWs directly dealing with COVID-19 patients from 2 April to 25 April 2020. The semi-structured interviews were conducted face-to-face or by telephone. Data were analysed using thematic analysis. RESULTS: Findings highlighted first major theme of stress coping, including, limiting media exposure, limited sharing of Covid-19 duty details, religious coping, just another emergency approach, altruism, and second major theme of Challenges includes, psychological response and noncompliance of public/denial by religious scholar. CONCLUSION: Participants practiced and recommended various coping strategies to deal with stress and anxiety emerging from COVID-19 pandemic. Media was a was reported to be a principal source of raising stress and anxiety among the public. Religious coping as well as their passion to serve humanity and country were the commonly employed coping strategies.


title: Spacematch: Using environmental preferences to match occupants to suitable activity-based workspaces

text: The activity-based workspace (ABW) paradigm is becoming more popular in commercial office spaces. In this strategy, occupants are given a choice of spaces to do their work and personal activities on a day-to-day basis. This paper shows the implementation and testing of the Spacematch platform that was designed to improve the allocation and management of ABW. An experiment was implemented to test the ability to characterize the preferences of occupants to match them with suitable environmentally-comfortable and spatially-efficient flexible workspaces. This approach connects occupants with a catalog of available work desks using a web-based mobile application and enables them to provide real-time environmental feedback. In this work, we tested the ability for this feedback data to be merged with indoor environmental values from Internet-of-Things (IoT) sensors to optimize space and energy use by grouping occupants with similar preferences. This paper outlines a case study implementation of this platform on two office buildings. This deployment collected 1,182 responses from 25 field-based research participants over a 30-day study. From this initial data set, the results show that the ABW occupants can be segmented into specific types of users based on their accumulated preference data, and matching preferences can be derived to build a recommendation platform.


title: Comparative pathogenesis of COVID-19, MERS, and SARS in a nonhuman primate model

text: The current pandemic coronavirus, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), was recently identified in patients with an acute respiratory syndrome, coronavirus disease 2019 (COVID-19). To compare its pathogenesis with that of previously emerging coronaviruses, we inoculated cynomolgus macaques with SARS-CoV-2 or Middle East respiratory syndrome (MERS)-CoV and compared the pathology and virology with historical reports of SARS-CoV infections. In SARS-CoV-2-infected macaques, virus was excreted from nose and throat in the absence of clinical signs and detected in type I and II pneumocytes in foci of diffuse alveolar damage and in ciliated epithelial cells of nasal, bronchial, and bronchiolar mucosae. In SARS-CoV infection, lung lesions were typically more severe, whereas they were milder in MERS-CoV infection, where virus was detected mainly in type II pneumocytes. These data show that SARS-CoV-2 causes COVID-19-like disease in macaques and provides a new model to test preventive and therapeutic strategies.


title: Income security during periods of ill health: a scoping review of policies, practice and coverage in low-income and middle-income countries

text: The COVID-19 pandemic is a reminder that insufficient income security in periods of ill health leads to economic hardship for individuals and hampers disease control efforts as people struggle to stay home when sick or advised to observe quarantine. Evidence on income security during periods of ill health is growing but has not previously been reviewed as a full body of work concerning low-income and middle-income countries (LMICs). We performed a scoping review to map the range, features, coverage, protective effects and equity of policies that aim to provide income security for adults whose ill health prevents them from participating in gainful work. A total of 134 studies were included, providing data from 95% of LMICs. However, data across the majority of these countries were severely limited. Collectively the included studies demonstrate that coverage of contributory income-security schemes is low, especially for informal and low-income workers. Meanwhile, non-contributory schemes targeting low-income groups are often not explicitly designed to provide income support in periods of ill health, they can be difficult to access and rarely provide sufficient income support to cover the needs of eligible recipients. While identifying an urgent need for more research on illness-related income security in LMICs, this review concludes that scaling up and diversifying the range of income security interventions is crucial for improving coverage and equity. To achieve these outcomes, illness-related income protection must receive greater recognition in health policy and health financing circles, expanding our understanding of financial hardship beyond direct medical costs.


Impact of Anti-TNF and Thiopurines medications on the development of COVID-19 in patients with inflammatory bowel disease: A Nationwide VA cohort study


Human antibodies can neutralize SARS-CoV-2


All eyes on Coronavirus-What do we need to know as ophthalmologists


title: Personal prophylaxis against COVID-19: A compilation of evidence based recommendations

text: The year 2020 started with a report about a cluster of pneumonia cases from Wuhan, China, that were later identified to be caused by the novel coronavirus. By March 11, this outbreak was designated as a pandemic by World Health Organization. So far, it has affected 213 countries and territories around the world. It is an infectious disease (R0: 2.2 to 3.3) with confirmed human-to-human transmission. The high morbidity and mortality attributed to viral infection has overwhelmed the health systems of most countries across the globe. As of now, there is no confirmed treatment or vaccine against COVID-19. The current pharmacological management relies only on supportive care. Therefore, only non-pharmacological approaches are left to protect people from infection. Established preventive methods against infection include dodging the exposure from the virus, which will break the chain of transmission and prevent further human-to-human spread. In the present paper, we discuss the various non-pharmacological approaches that have to be adopted at the personal or community level and by the healthcare providers to win against this virus.


Going global - Travel and the 2019 novel coronavirus


[Ten hot issues on diagnosis and treatment of breast cancer under the outbreak of novel coronavirus pneumonia]


title: Measure what matters: Counts of hospitalized patients are a better metric for health system capacity planning for a reopening

text: OBJECTIVE: Responding to the COVID-19 pandemic requires accurate forecasting of health system capacity requirements using readily available inputs. We examined whether testing and hospitalization data could help quantify the anticipated burden on the health system given shelter-in-place (SIP) order. MATERIALS AND METHODS: 16,103 SARS-CoV-2 RT-PCR tests were performed on 15,807 patients at Stanford facilities between March 2 and April 11, 2020. We analyzed the fraction of tested patients that were confirmed positive for COVID-19, the fraction of those needing hospitalization, and the fraction requiring ICU admission over the 40 days between March 2nd and April 11th 2020. RESULTS: We find a marked slowdown in the hospitalization rate within ten days of SIP even as cases continued to rise. We also find a shift towards younger patients in the age distribution of those testing positive for COVID-19 over the four weeks of SIP. The impact of this shift is a divergence between increasing positive case confirmations and slowing new hospitalizations, both of which affects the demand on health systems. CONCLUSION: Without using local hospitalization rates and the age distribution of positive patients, current models are likely to overestimate the resource burden of COVID-19. It is imperative that health systems start using these data to quantify effects of SIP and aid reopening planning.


Rising evidence for neurological involvement in COVID-19 pandemic


title: Group testing as a strategy for the epidemiologic monitoring of COVID-19

text: Sample pooling consists in combining samples from multiple individuals into a single pool that is then tested using a unique test-kit. A positive test means that at least one individual within the pool is infected. Here, we propose an analysis and applications of sample pooling to the epidemiologic monitoring of COVID-19. We first introduce a model of the RT-qPCR process used to test for the presence of virus in a sample and construct a statistical model for the viral load in a typical infected individual inspired by the clinical data from Jones et. al. (2020). We then propose a method for the measure of the prevalence in a population, based on group testing, taking into account the increased number of false negatives associated with this method. Finally, we present an application of sample pooling for the prevention of epidemic outbreak in closed connected communities (e.g. nursing homes).


title: Gender differences in patients with COVID-19: a narrative review

text: In December 2019 a novel coronavirus emerged in Wuhan, China causing many cases of severe pneumonia. World Health Organization (WHO) named this disease Coronavirus Disease 2019 (COVID-19). The infection has rapidly spread across China to many other countries, and on March 12, 2020 the WHO declared pandemic outbreak of COVID-19. As of May 16, 2020, COVID-19 has been diagnosed in more than 4,490,000 patients, associated to 305,976 deaths worldwide; in Italy 224,760 COVID-19 cases have been reported with 31,763 deaths. The main routes of transmission are respiratory droplets and direct contact with infected people, so numerous prevention strategies are employed to mitigate the spread of disease, including social distancing and isolation. The aim of this narrative review is to underline gender differences in epidemiology, etiopathogenesis, risk factors, clinical presentation, diagnosis, prognosis and mortality of patients infected with SARS-CoV-2. Currently data on the sex indicators for admitted or deceased patients are only available, but there is no analysis about other gender indicators. The data considered in our study are the only currently available in the literature, but it is appropriate to implement a specific analysis with all gender indicators to identify appropriate strategies. Moreover, the evaluation of a health service efficiency is a key element to define gender outcomes. Knowing the gender differences in COVID-19 outbreak would be a fundamental tool to understand the effects of a health emergency on individuals and communities as well as to carry out effective and equitable policies, public health measures and targeted solutions.


Anestesiología y los anestesiólogos en la COVID-19./ Anestesiología y los anestesiólogos en la COVID-19./ Anesthesiology and the Anesthesiologists at COVID-19


Chest Radiograph Features Predict a Favorable Outcome in Patients with COVID-19


title: High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study

text: PURPOSE: Little evidence of increased thrombotic risk is available in COVID-19 patients. Our purpose was to assess thrombotic risk in severe forms of SARS-CoV-2 infection. METHODS: All patients referred to 4 intensive care units (ICUs) from two centers of a French tertiary hospital for acute respiratory distress syndrome (ARDS) due to COVID-19 between March 3rd and 31st 2020 were included. Medical history, symptoms, biological data and imaging were prospectively collected. Propensity score matching was performed to analyze the occurrence of thromboembolic events between non-COVID-19 ARDS and COVID-19 ARDS patients. RESULTS: 150 COVID-19 patients were included (122 men, median age 63 [53; 71] years, SAPSII 49 [37; 64] points). Sixty-four clinically relevant thrombotic complications were diagnosed in 150 patients, mainly pulmonary embolisms (16.7%). 28/29 patients (96.6%) receiving continuous renal replacement therapy experienced circuit clotting. Three thrombotic occlusions (in 2 patients) of centrifugal pump occurred in 12 patients (8%) supported by ECMO. Most patients (> 95%) had elevated D-dimer and fibrinogen. No patient developed disseminated intravascular coagulation. Von Willebrand (vWF) activity, vWF antigen and FVIII were considerably increased, and 50/57 tested patients (87.7%) had positive lupus anticoagulant. Comparison with non-COVID-19 ARDS patients (n = 145) confirmed that COVID-19 ARDS patients (n = 77) developed significantly more thrombotic complications, mainly pulmonary embolisms (11.7 vs. 2.1%, p < 0.008). Coagulation parameters significantly differed between the two groups. CONCLUSION: Despite anticoagulation, a high number of patients with ARDS secondary to COVID-19 developed life-threatening thrombotic complications. Higher anticoagulation targets than in usual critically ill patients should therefore probably be suggested.


title: Technology-based management of neurourology patients in the COVID-19 pandemic: Is this the future? A report from the International Continence Society (ICS) institute

text: Coronavirus disease-2019 (COVID-19) pandemic significantly altered our daily life as well as our professional practice. COVID-19 has disrupted our lives both professionally and personally. We know the urological management in a neurogenic patient needs to be tailored to the individual circumstances, this is even more pertinent during these uncertain times. International Continence Society is the premier international organization in functional urology. Lately, it has established an institute to facilitate teaching and training opportunities all over the world. The School of Neurourology teamed with the School of Modern Technology and set up a Webinar-"How to manage the neuro-urological patients in the current pandemic." This was set up as a case-based discussion to deliberate the management of our patients in the present climate and examine the role of modern technology in overcoming the current barriers.


RAAS blockers in hypertension posing a higher risk toward the COVID-19


title: 'Your country needs you': the ethics of allocating staff to high-risk clinical roles in the management of patients with COVID-19

text: As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are 'fit for reallocation' have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated.


title: Lack of antiviral activity of darunavir against SARS-CoV-2

text: OBJECTIVES: Given the high need and the absence of specific antivirals for treatment of COVID-19 (the disease caused by severe acute respiratory syndrome-associated coronavirus-2 [SARS-CoV-2]), human immunodeficiency virus (HIV) protease inhibitors are being considered as therapeutic alternatives. METHODS: Prezcobix/Rezolsta is a fixed-dose combination of 800 mg of the HIV protease inhibitor darunavir (DRV) and 150 mg cobicistat, a CYP3A4 inhibitor, which is indicated in combination with other antiretroviral agents for the treatment of HIV infection. There are currently no definitive data on the safety and efficacy of DRV/cobicistat for the treatment of COVID-19. The in vitro antiviral activity of darunavir against a clinical isolate from a patient infected with SARS-CoV-2 was assessed. RESULTS: DRV showed no antiviral activity against SARS-CoV-2 at clinically relevant concentrations (EC50 > 100 µM). Remdesivir, used as a positive control, demonstrated potent antiviral activity (EC50 = 0.38 µM). CONCLUSIONS: Overall, the data do not support the use of DRV for the treatment of COVID-19.


title: A simple method for detection of a novel coronavirus (SARS-CoV-2) using one-step RT-PCR followed by restriction fragment length polymorphism

text: A novel coronavirus associated with acute respiratory disease (named SARS-CoV-2) is recently identified in Wuhan city, China, spread rapidly worldwide. Early identification of this novel coronavirus by molecular tools is critical for surveillance and control of the epidemic outbreak. We aimed to establish a simple method for the detection of SARS-CoV-2 in differentiating with SARS-CoV. Primers of our in-house reverse transcription polymerase chain reaction (RT-PCR) assays were designed to target conserved regions of the RdRP gene and E gene, selected restriction enzymes EcoRI, Tsp45I, and AluI to distinguish between SARS-CoV-2 and SARS-CoV. In this report, a 396-bp fragment of the RdRp gene and 345-bp fragment of the E gene were amplified by one-step RT-PCR. Enzyme Tsp45I cuts the RdRP-amplified product of SARS-CoV-2 generating three fragments of 45, 154, and 197 bp, but it did not cut the amplicon of SARS-CoV. In contrast, the amplified product of SARS-CoV was digested with EcoRI producing two fragments of 76 and 320 bp, whereas the amplicon of SARS-CoV-2 was undigested by Tsp45I help to distinguish clearly SARS-CoV-2 from SARS-CoV on gel electrophoresis. In addition, AluI cut the amplicon of the E gene of SARS-CoV-2 generating two fragments of 248 and 97 bp without cutting to SARS-CoV. The accuracy of the assay was confirmed by sequencing and phylogenetic analysis. When evaluated on clinical samples showed a high sensitivity of 95%, specificity of our assay was 100% and clinical performance for detection of SARS-CoV-2 in comparison with other reference assays. In conclusion, in the present study, we successfully developed a simple method for molecular detection of SARS-CoV-2 in differentiating with SARS-CoV.


title: A Simple Method for Detection of a Novel Coronavirus (SARS-CoV-2) using One-step RT-PCR followed by Restriction Fragment Length Polymorphism

text: BACKGROUND: A novel coronavirus associated with acute respiratory disease (named SARS-CoV-2) is recently identified in Wuhan city, China, spread rapidly worldwide. An early identification of this novel coronavirus by molecular tools is critical for surveillance and control of the epidemic outbreak. OBJECTIVES: We aimed to establish a simple method for detection of SARS-CoV-2 in differentiating with SARS-CoV. STUDY DESIGN: Primers of our in-house RT-PCR assays were designed to target conserved regions of the RdRP gene and E gene, selected restriction enzymes EcoRI, Tsp45I and AluI to distinguish between SARS-CoV-2 and SARS-CoV. RESULTS AND DISCUSSIONS: In this report, a 396 bp fragment of the RdRp gene and 345 bp fragment of the E gene were amplified by one-step RT-PCR. Enzyme Tsp45I cuts the RdRP amplified product of SARS-CoV-2 generating 3 fragments of 45, 154 and 197 bp, but it did not cut the amplicon of SARS-CoV. In contrast, the amplified product of SARS-CoV was digested with EcoRI producing 2 fragments of 76 and 320 bp, whereas, the amplicon of SARS-CoV-2 was undigested by Tsp45I help to distinguish clearly SARS-CoV-2 from SARS-CoV on gel electrophoresis. In addition, AluI cut the amplicon of the E gene of SARS-CoV-2 generating 2 fragments of 248 and 97 bp without cutting to SARS-CoV. Accuracy of assay was confirmed by sequencing and phylogenetic analysis. When evaluated on clinical samples showed a high sensitivity of 95%, specificity of our assay was 100% and clinical performance for detection of SARS-CoV-2 in comparison with other reference assays. In conclusion, the present study, we successfully developed a simple method for molecular detection of SARS-CoV-2 in differentiating with SARS-CoV. This article is protected by copyright. All rights reserved.


title: COVID-19 Anxiety

text: Growing concerns about anxiety associated with COVID-19 have led to recommendations for effective self-care, and greater availability of mental health treatment. At the same time, existential concerns raised by the pandemic suggest the importance of religious resources, as seen in research into the experience of patients dealing with advanced cancer.


title: Using influenza surveillance networks to estimate state-specific prevalence of SARS-CoV-2 in the United States

text: Detection of SARS-CoV-2 infections to date has relied heavily on RT-PCR testing. However, limited test availability, high false-negative rates, and the existence of asymptomatic or sub-clinical infections have resulted in an under-counting of the true prevalence of SARS-CoV-2. Here, we show how influenza-like illness (ILI) outpatient surveillance data can be used to estimate the prevalence of SARS-CoV-2. We found a surge of non-influenza ILI above the seasonal average in March 2020 and showed that this surge correlated with COVID-19 case counts across states. If 1/3 of patients infected with SARS-CoV-2 in the US sought care, this ILI surge would have corresponded to more than 8.7 million new SARS-CoV-2 infections across the US during the three-week period from March 8 to March 28, 2020. Combining excess ILI counts with the date of onset of community transmission in the US, we also show that the early epidemic in the US was unlikely to have been doubling slower than every 4 days. Together these results suggest a conceptual model for the COVID-19 epidemic in the US characterized by rapid spread across the US with over 80% infected patients remaining undetected. We emphasize the importance of testing these findings with seroprevalence data and discuss the broader potential to use syndromic surveillance for early detection and understanding of emerging infectious diseases.


Antimicrobial resistance in the age of COVID-19


title: Ethical guidelines for deliberately infecting volunteers with COVID-19

text: Global fatalities related to COVID-19 are expected to be high in 2020-2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase II and phase III trials could take less long to conduct if they used human challenge methods-that is, deliberately infecting participants with COVID-19 following inoculation. This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approval processes so that they are in place when applications for trials are made.


title: Diabetes and covid-19: more than the sum of two morbidities

text: The coronavirus disease 2019 (covid-19) pandemic has caused a public health emergency worldwide. Risk, severity and mortality of the disease have been associated with non-communicable chronic diseases, such as diabetes mellitus. Accumulated evidence has caused great concern in countries with high prevalence of this morbidity, such as Brazil. This text shows the picture of diabetes in Brazil, followed by epidemiological data and explanatory hypothesis for the association between diabetes and covid-19. We emphasized how the burden of these two morbidities in a middle-income country has aggravated this pandemic scenario. The comprehension of this association and biological plausibility may help face this pandemic and future challenges.


title: Olfactory dysfunction in the COVID-19 outbreak

text: The first cases of coronavirus 2019 (COVID-19) occurred in Wuhan, China, and rapidly become a public health emergency of international proportions. The disease may cause mild-to-severe acute respiratory syndrome (SARS) and is caused by a SARS-CoV-2 coronavirus infection. The clinical manifestations of COVID-19 include fever, dry cough, fatigue, sputum production, shortness of breath, sore throat, and headache. This article is a narrative review with the aim of analyzing the current literature on postviral olfactory dysfunction (OD) related to SARS-CoV-2 pandemics. Since the initial anecdotal reports from China, international reports on COVID-19 patients have been increasing, describing a 5% to 85% range of loss of smell. To date, the literature is widely heterogeneous regarding the loss of smell; therefore, we advise home isolation measures and/or social distancing, and to carry out diagnostic tests for SARS-CoV-2 when possible in those patients with sudden and severe loss of smell who cannot be promptly evaluated.


title: A Guide to COVID-19: a global pandemic caused by the novel coronavirus SARS-CoV-2

text: The emergence of the SARS-CoV-2 strain of the human coronavirus has thrown the world into the midst of a new pandemic. In the human body, the virus causes COVID-19, a disease characterized by shortness of breath, fever, and pneumonia, which can be fatal in vulnerable individuals. SARS-CoV-2 has characteristics of past human coronaviruses, with close genomic similarities to SARS-CoV, the virus that causes the disease SARS. Like these related coronaviruses, SARS-CoV-2 is transmitted through the inhalation of droplets and interaction with contaminated surfaces. Across the world, laboratories are developing candidate vaccines for the virus - with vaccine trials underway in the United States and the United Kingdom - and considering various drugs for possible treatments and prophylaxis. Here, we provide an overview of SARS-CoV-2 by analyzing its virology, epidemiology, and modes of transmission while examining the current progress of testing procedures and possible treatments through drugs and vaccines.


Potential pitfalls of routine SARS-CoV-2 serology for mass screening


Invisible spread of SARS-CoV-2 - Authors' reply


title: Research methodology and characteristics of journal articles with original data, preprint articles and registered clinical trial protocols about COVID-19

text: BACKGROUND: The research community reacted rapidly to the emergence of COVID-19. We aimed to assess characteristics of journal articles, preprint articles, and registered trial protocols about COVID-19 and its causal agent SARS-CoV-2. METHODS: We analyzed characteristics of journal articles with original data indexed by March 19, 2020, in World Health Organization (WHO) COVID-19 collection, articles published on preprint servers medRxiv and bioRxiv by April 3, 2010. Additionally, we assessed characteristics of clinical trials indexed in the WHO International Clinical Trials Registry Platform (WHO ICTRP) by April 7, 2020. RESULTS: Among the first 2118 articles on COVID-19 published in scholarly journals, 533 (25%) contained original data. The majority was published by authors from China (75%) and funded by Chinese sponsors (75%); a quarter was published in the Chinese language. Among 312 articles that self-reported study design, the most frequent were retrospective studies (N = 88; 28%) and case reports (N = 86; 28%), analyzing patients' characteristics (38%). Median Journal Impact Factor of journals where articles were published was 5.099. Among 1088 analyzed preprint articles, the majority came from authors affiliated in China (51%) and were funded by sources in China (46%). Less than half reported study design; the majority were modeling studies (62%), and analyzed transmission/risk/prevalence (43%). Of the 927 analyzed registered trials, the majority were interventional (58%). Half were already recruiting participants. The location for the conduct of the trial in the majority was China (N = 522; 63%). The median number of planned participants was 140 (range: 1 to 15,000,000). Registered intervention trials used highly heterogeneous primary outcomes and tested highly heterogeneous interventions; the most frequently studied interventions were hydroxychloroquine (N = 39; 7.2%) and chloroquine (N = 16; 3%). CONCLUSIONS: Early articles on COVID-19 were predominantly retrospective case reports and modeling studies. The diversity of outcomes used in intervention trial protocols indicates the urgent need for defining a core outcome set for COVID-19 research. Chinese scholars had a head start in reporting about the new disease, but publishing articles in Chinese may limit their global reach. Mapping publications with original data can help finding gaps that will help us respond better to the new public health emergency.


title: Dermatological diseases presented before COVID-19: Are patients with psoriasis and superficial fungal infections more vulnerable to the COVID-19?

text: Recent studies have focused on the comorbid conditions of the COVID-19. According to the current studies, numerous diseases including lung disease, cardiovascular disease and immunosuppression appear to be at higher risk for severe forms of the COVID-19. To date, there are no data in the literature on the comorbid dermatologic diseases and COVID-19. We tried to analyze the previous dermatological comorbidity of 93 patients with COVID-19 (51 males, 42 females) who presented to the dermatology outpatient clinics for the last 3 years. The most common dermatologic diseases in patients with COVID-19 who have dermatologic diseases for the last 3 years were superficial fungal infections (24, 25.8%), seborrheic dermatitis (11, 11.8%), actinic keratosis (10, 10.8%), psoriasis (6, 6.5%), and eczema (6, 6.5%), respectively. In addition, the number of COVID-19 patients who presented to dermatology in the last 3 months was 17 (11 men, 6 women). The median age of these patients was 58 (minimum 18, maximum 80) years, and the most common dermatologic diseases before diagnosed COVID-19 were superficial fungal infections (5, 25%), psoriasis (4, 20%), and viral skin diseases (3, 15%). The possible similarity between cutaneous and mucosal immunity and immunosuppression suggests that patients with some dermatologic diseases especially superficial fungal infections and psoriasis may be more vulnerable to the COVID-19.


Letter: Neurosurgery at war with the COVID-19 pandemic: patient's management from an African neurosurgical center


Anticipating and curtailing the cardiometabolic toxicity of social isolation and emotional stress in the time of COVID-19


title: Altered cytokine levels and immune responses in patients with SARS-CoV-2 infection and related conditions

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic in early 2020. The infection has been associated with a wide range of clinical symptoms. In the severely affected patients, it has caused dysregulation of immune responses including over-secretion of inflammatory cytokines and imbalances in the proportion of naïve helper T cells, memory helper T cells and regulatory T cells. Identification of the underlying mechanism of such aberrant function of immune system would help in the prediction of disease course and selection of susceptible patients for more intensive cares. In the current review, we summarize the results of studies which reported alterations in cytokine levels and immune cell functions in patients affected with SARS-CoV-2 and related viruses.


title: Renin-angiotensin system inhibitors in management of hypertension during the COVID-19 pandemic

text: COVID-19, which is caused by the single-stranded RNA severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has introduced significant therapeutic dilemmas in several areas. One of these is concern regarding the use of renin-angiotensin system (RAS) inhibitors. Dysfunction of the RAS has been observed in COVID-19 patients, but whether RAS inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type-1 receptor blockers (ARBs), are associated with improved or worse clinical outcomes, remains unclear. RAS inhibitors are currently widely used in the treatment of hypertension. Emerging data suggest an increased association and a heightened mortality in patients of COVID-19 with co-morbidities such as hypertension, coronary heart disease, and diabetes mellitus, particularly in the elderly. Therefore, several recently published research papers have focused on the management of hypertension during the COVID-19 pandemic, as this co-morbidity was found to be the most common in patients with coronavirus infections. SARS-CoV-2 viral surface protein is known to attach angiotensin converting enzyme-2 (ACE-2) on the cell membrane to facilitate viral entry into the cytoplasm. While the SARS-CoV-2 viral load remains the highest in upper respiratory tract of COVID-19 patients, it has also been reported in multiple sites in COVID-19, and patients not infrequently require the Intensive Care Units (ICU) admission. However, despite the theoretical concerns of possible increased ACE2 expression by RAS blockade, there is no evidence that RAS inhibitors are harmful during COVID-19 infection, and indeed they have been shown to be beneficial in some animal studies. In this review we summarise the pathophysiology of the interaction between RAS, ACEIs/ARBs inhibitors and COVID-19, and conclude, on the basis of current data, that RAS blockade should be maintained during the current coronavirus pandemic.


Children are protected against SARS-CoV-2 infection


title: The COVID-19 pandemic and Thailand: A psychologist's viewpoint

text: This commentary describes the current situation of the COVID-19 pandemic in Thailand and the effects of the pandemic on mental health of Thais as well as potential strategies for dealing with the spread of COVID-19 in Thailand. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Respiratory support for adult patients with COVID-19

text: The COVID-19 pandemic is creating unique strains on the healthcare system. While only a small percentage of patients require mechanical ventilation and ICU care, the enormous size of the populations affected means that these critical resources may become limited. A number of non-invasive options exist to avert mechanical ventilation and ICU admission. This is a clinical review of these options and their applicability in adult COVID-19 patients. Summary recommendations include: (1) Avoid nebulized therapies. Consider metered dose inhaler alternatives. (2) Provide supplemental oxygen following usual treatment principles for hypoxic respiratory failure. Maintain awareness of the aerosol-generating potential of all devices, including nasal cannulas, simple face masks, and venturi masks. Use non-rebreather masks when possible. Be attentive to aerosol generation and the use of personal protective equipment. (3) High flow nasal oxygen is preferred for patients with higher oxygen support requirements. Non-invasive positive pressure ventilation may be associated with higher risk of nosocomial transmission. If used, measures special precautions should be used reduce aerosol formation. (4) Early intubation/mechanical ventilation may be prudent for patients deemed likely to progress to critical illness, multi-organ failure, or acute respiratory distress syndrome (ARDS).


I Never Thought I Had "Moral Courage," until COVID-19 Happened.


title: Severe Acute Respiratory Syndrome Coronavirus 2 among Asymptomatic Workers Screened for Work Resumption, China

text: After the outbreak in Wuhan, China, we assessed 29,299 workers screened for severe acute respiratory syndrome coronavirus 2 by reverse transcription PCR. We noted 18 (0.061%) cases of asymptomatic infection; 13 turned negative within 8.0 days, and 41 close contacts tested negative. Among 6 contacts who had serologic tests, none were positive.


Time to consider histologic pattern of lung injury to treat critically ill patients with COVID-19 infection


title: Overcoming Challenges Resulting From COVID-19: New York State's Creating Healthy Schools and Communities Initiative

text: "Upstream" interventions that increase access or reduce barriers to healthy foods and opportunities for physical activity - referred to as policy, systems, or environmental strategies - are central to encouraging and supporting healthy behaviors that prevent chronic disease at a population level. However, they are complex and challenging to execute, especially during coronavirus disease 2019 (COVID-19), and efforts to build practitioner capacity are warranted. In this commentary, we describe a user or human-centered design (HCD) capacity-building approach to support practitioners in accomplishing the goals of the New York State Creating Healthy Schools and Communities (CHSC) initiative. This approach has been especially helpful during COVID-19, as it enables support to be responsive to practitioners' constantly changing needs. Given that CHSC is a project specific to New York State and that the efforts of the Obesity Prevention Center for Excellence were tailored to obesity prevention, more research and evaluations should be conducted to better understand how the use of HCD could support practitioners addressing other complex public health issues in the United States.


title: Positive results for patients with COVID-19 discharged form hospital in Chongqing, China

text: BACKGROUND: Since December 2019, over 80,000 patients with coronavirus disease 2019 (COVID-19) have been confirmed in China. With the increasing number of recovered patients, more attention should be paid to the follow-up of these patients. METHODS: In the study, 576 patients with COVID-19 discharged from hospital in Chongqing, China from January 24, 2020, to March 10, 2020 were evaluated by viral nucleic acid tests for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) to determine if they could be released from quarantine. Among the 576 patients, 61 patients (10.6%) had positive RT-PCR test results of SARS-CoV-2. We aimed to analyze the demographics, clinical characteristics and treatment of 61 patients. RESULTS: These positive patients were characterized by older age, chronic medical illness and mild conditions. 38 (62.3%) patients who were asymptomatic without abnormalities on chest radiographs were found in the positive with COVID-19. Also, they showed positive results of stool or sputum specimens with negative results of nasal and pharyngeal swab specimens. The median duration of positive result of SARS-CoV-2 was varied from 3 days to 35 days in the patients discharged from hospital with no family member infection. CONCLUSIONS: Multi-site screening of SARS-CoV-2 including nasal and pharyngeal swabs, stool and sputum specimens could be considered to improve the diagnosis, treatment and infection control in patients with COVID-19. Our findings provide the important information and clinical evidence for the improved management of patients recovered from COVID-19.


title: Functional Role of Dietary Intervention to Improve the Outcome of COVID-19: A Hypothesis of Work

text: BACKGROUND: On the 31 December 2019, the World Health Organization (WHO) was informed of a cluster of cases of pneumonia of unknown origin detected in Wuhan City, Hubei Province, China. The infection spread first in China and then in the rest of the world, and on the 11th of March, the WHO declared that COVID-19 was a pandemic. Taking into consideration the mortality rate of COVID-19, about 5-7%, and the percentage of positive patients admitted to intensive care units being 9-11%, it should be mandatory to consider and take all necessary measures to contain the COVID-19 infection. Moreover, given the recent evidence in different hospitals suggesting IL-6 and TNF-α inhibitor drugs as a possible therapy for COVID-19, we aimed to highlight that a dietary intervention could be useful to prevent the infection and/or to ameliorate the outcomes during therapy. Considering that the COVID-19 infection can generate a mild or highly acute respiratory syndrome with a consequent release of pro-inflammatory cytokines, including IL-6 and TNF-α, a dietary regimen modification in order to improve the levels of adiponectin could be very useful both to prevent the infection and to take care of patients, improving their outcomes.


"MoRPHEE" fighting COVID-19


title: Renin-Angiotensin System Inhibition in Cardiovascular Patients at the Time of COVID19: Much Ado for Nothing? A Statement of Activity from the Directors of the Board and the Scientific Directors of the Italian Society of Hypertension

text: Cardiovascular diseases, in particular hypertension, as well as the cardiovascular treatment with Renin-Angiotensin System inhibitors such as Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs), are claimed once again as mechanisms of Severe Acute Respiratory Syndrome (SARS) during the COVID-19 outbreak due to Cov-2 epidemics. In vitro studies are available to support the eventual role of ACE inhibitors and ARBs in both the promotion and antagonism of the disease. The available literature, indeed, presents contrasting results, all concentrated in experimental models. Evidence in humans is lacking that those mechanisms are actually occurring in the present COVID-19 outbreak. Here we present the reasoned statement of the Italian Society of Hypertension to maintain ongoing antihypertensive treatments. Furthermore, the Italian Society of Hypertension presents its own initiative to investigate the issue using an online questionnaire to collect relevant data in human disease.


Eating disorders and obesity (ED&O) in the COVID-19 storm


title: Covid-19 in Diabetes Patients in Ukraine: Lessons for Doctors and Patients

text: World Health Organization recognized coronavirus disease 2019 (COVID-19) as a pandemic on 11 March 2020. The first case of COVID-19 in Ukraine was confirmed on 3 March 2020 in Chernivtsi and the first lethal case was reported on 13 March 2020. As of 22 April 2020 6592 cases of COVID-19 have been reported in Ukraine, among these cases 174 caused death (2.64% lethality), 467 patients (7.08% of cases) have recovered. The feature of COVID-19 pandemics in Ukraine is that the age of patients is lower (50-59 years old, 40-49 years old and 30-39 years old) than in China and other European countries. Another feature of COVID-19 epidemiology in Ukraine is that virus cause disease in women (56.0%) more often than in men (44.0%). But there are more male patients in other countries. Although there are more male deaths (51.7%) than female (48.3%) in Ukraine. Deaths have occurred in 30-49 years old patients (14%), in 50-69 years old patients (48%), in 70 years old and older patients (38%). 85% of all deaths were over 50 years of age. 79% of patients who died from COVID-19 had severe cardiovascular diseases, diabetes mellitus, neoplasms, renal diseases, respiratory disorders and obesity. In total, co-morbidities (one or several) have been cardiovascular diseases (74%), diabetes mellitus (22%), lungs diseases (9%), neoplasms (8%), renal diseases (7%). In this article we analyzed epidemiology and causes of negative influence of diabetes mellitus on COVID-19 progress in world and Ukraine. We also made recommendations on prophylaxis and patients treatment in cases of COVID-19 and diabetes mellitus co-morbidity.