title: Racial and Ethnic Digital Divides in Posting COVID-19 Content on Social Media Among US Adults: Secondary Survey Analysis

text: BACKGROUND: Public health surveillance experts are leveraging user-generated content on social media to track the spread and effects of COVID-19. However, racial and ethnic digital divides, which are disparities among people who have internet access and post on social media, can bias inferences. This bias is particularly problematic in the context of the COVID-19 pandemic because due to structural inequalities, members of racial and ethnic minority groups are disproportionately vulnerable to contracting the virus and to the deleterious economic and social effects from mitigation efforts. Further, important demographic intersections with race and ethnicity, such as gender and age, are rarely investigated in work characterizing social media users; however, they reflect additional axes of inequality shaping differential exposure to COVID-19 and its effects. OBJECTIVE: The aim of this study was to characterize how the race and ethnicity of US adults are associated with their odds of posting COVID-19 content on social media and how gender and age modify these odds. METHODS: We performed a secondary analysis of a survey conducted by the Pew Research Center from March 19 to 24, 2020, using a national probability sample (N=10,510). Respondents were recruited from an online panel, where panelists without an internet-enabled device were given one to keep at no cost. The binary dependent variable was responses to an item asking whether respondents "used social media to share or post information about the coronavirus." We used survey-weighted logistic regressions to estimate the odds of responding in the affirmative based on the race and ethnicity of respondents (white, black, Latino, other race/ethnicity), adjusted for covariates measuring sociodemographic background and COVID-19 experiences. We examined how gender (female, male) and age (18 to 30 years, 31 to 50 years, 51 to 64 years, and 65 years and older) intersected with race and ethnicity by estimating interactions. RESULTS: Respondents who identified as black (odds ratio [OR] 1.29, 95% CI 1.02-1.64; P=.03), Latino (OR 1.66, 95% CI 1.36-2.04; P<.001), or other races/ethnicities (OR 1.33, 95% CI 1.02-1.72; P=.03) had higher odds than respondents who identified as white of reporting that they posted COVID-19 content on social media. Women had higher odds of posting than men regardless of race and ethnicity (OR 1.58, 95% CI 1.39-1.80; P<.001). Among men, respondents who identified as black, Latino, or members of other races/ethnicities were significantly more likely to post than respondents who identified as white. Older adults (65 years or older) had significantly lower odds (OR 0.73, 95% CI 0.57-0.94; P=.01) of posting compared to younger adults (18-29 years), particularly among those identifying as other races/ethnicities. Latino respondents were the most likely to report posting across all age groups. CONCLUSIONS: In the United States, members of racial and ethnic minority groups are most likely to contribute to COVID-19 content on social media, particularly among groups traditionally less likely to use social media (older adults and men). The next step is to ensure that data collection procedures capture this diversity by encompassing a breadth of search criteria and social media platforms.


Covid-19: BMA demands full death in service benefits for UK doctors


title: Impact of the 2020 COVID-19 pandemic on the workload of the orthopaedic service in a busy UK district general hospital

text: INTRODUCTION: The COVID -19 outbreak has had a profound effect on the management of healthcare service provision in the UK. Orthopaedic departments have been no exception to this and have needed to adapt to the changing circumstances by releasing resources and focusing on 'essential' activity. The aim of this study is to quantify the reduction in trauma and, in addition, describe any changes in the type of referrals to the trust which may have been affected by the pandemic itself and the social distancing measures employed by the UK government. METHODS: The study was performed in a UK District Hospital which is also a Trauma Unit providing trauma and orthopaedic care to a population of 625,000 people. The trust based electronic database of trauma referrals was used to compare the numbers of, and types of referral to our trauma service during the COVID-19 pandemic and the corresponding time periods in the previous 3 years. RESULTS: The mean number of referrals per week to the service reduced by 33% in the time period following the confirmation of the outbreak as a pandemic (p<0.0001). Number of operations performed per week reduced by 26% (p = 0.001). There was no change in the number of referrals relating to domestic abuse or non-accidental injury. In addition, numbers of hip fractures, periprosthetic fractures and prosthetic joint dislocations were unchanged. There was a significant reduction in the number of referrals for simple fractures, native joint dislocations, wounds and soft tissue injuries. Within the paediatric population, similarly, a reduction in simple fracture referrals was demonstrated. DISCUSSION: An association between the outbreak of the pandemic and a reduction in referral numbers to our department has been demonstrated. The direct cause of this may be multifactorial but proposing that it is, in part, due to the social distancing measures introduced by the government is certainly conceivable. The patterns of injury would reflect this also with low energy and fragility trauma persisting whilst injuries associated with younger people have reduced. We would suggest that information such as this could be useful in healthcare planning and resource allocation in future pandemic situations.


title: Protective immunity after COVID-19 has been questioned: What can we do without SARS-CoV-2-IgG detection?

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces a severe acute respiratory syndrome that is called COVID-19. Clinical manifestations of COVID-19 include diarrhea, pneumonia, lymphopenia, exhausted lymphocytes, and pro-inflammatory cytokine production. Immunology is part of the process of clinical evolution, but there are some questions around immunity-based protection: (1) why some infected people have only mild symptoms of the disease or are asymptomatic; (2) why delayed and weak antibody responses are associated with severe outcomes; and (3) why positivity in molecular tests does not represent protective antibody IgG. Perhaps T cell responses may be the key to solving those questions. SARS-CoV-2-specific memory T cells persist in peripheral blood and may be capable of providing effective information about protective immunity. The T cells studies can be helpful in elucidating the pathways for development of vaccines, therapies, and diagnostics for COVID-19 and for filling these immunology knowledge gaps.


title: Decentralized Privacy-Preserving Proximity Tracing

text: This document describes and analyzes a system for secure and privacy-preserving proximity tracing at large scale. This system, referred to as DP3T, provides a technological foundation to help slow the spread of SARS-CoV-2 by simplifying and accelerating the process of notifying people who might have been exposed to the virus so that they can take appropriate measures to break its transmission chain. The system aims to minimise privacy and security risks for individuals and communities and guarantee the highest level of data protection. The goal of our proximity tracing system is to determine who has been in close physical proximity to a COVID-19 positive person and thus exposed to the virus, without revealing the contact's identity or where the contact occurred. To achieve this goal, users run a smartphone app that continually broadcasts an ephemeral, pseudo-random ID representing the user's phone and also records the pseudo-random IDs observed from smartphones in close proximity. When a patient is diagnosed with COVID-19, she can upload pseudo-random IDs previously broadcast from her phone to a central server. Prior to the upload, all data remains exclusively on the user's phone. Other users' apps can use data from the server to locally estimate whether the device's owner was exposed to the virus through close-range physical proximity to a COVID-19 positive person who has uploaded their data. In case the app detects a high risk, it will inform the user.


title: The effect of massage on the quality of life in patients recovering from COVID-19: A systematic review protocol

text: BACKGROUND: There is a worldwide outbreak of covid-19, and as the number of patients increases, more and more patients are recovering. Massage is used as an alternative therapy. Currently, there are no relevant articles for systematic review. METHODS: We will search the randomized controlled trials related to acupuncture therapy and postoperative anorectal diseases from inception to January 2020. The following database is our focus area: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan-Fang Database. All published randomized controlled trials in English or Chinese related to massage for COVID-19 will be included. Primary outcome asthe influence of massage on the quality of life of convalescent patients. Secondary outcomes were accompanying symptoms (such as myalgia, expectoration, stuffiness, runny nose, pharyngalgia, anhelation, chest distress, dyspnea, crackles, headache, nausea, vomiting, anorexia, diarrhea) disappear rate, negative COVID-19 results rate on 2 consecutive occasions (not on the same day), average hospitalization time, clinical curative effect, and improved quality of life. RESULTS: The results will provide a high-quality synthesis of current evidence for researchers in this subject area. CONCLUSION: The conclusion of our study will provide evidence to judge whether massage is an effective intervention on the quality of life in patients recovering. PROSPERO REGISTRATION NUMBER: CRD42020181398.


Síndrome de DRESS simulando enfermedad por coronavirus 2019-NcoV./ [DRESS syndrome simulating coronavirus 2019-NcoV disease]


title: Critical medical ecology and SARS-COV-2 in the urban environment: a pragmatic, dynamic approach to explaining and planning for research and practice

text: BACKGROUND: Practitioners and researchers in the midst of overwhelming coronavirus disease 2019 (COVID-19) outbreaks are calling for new ways of looking at such pandemics, with an emphasis on human behavior and holistic considerations. Viral outbreaks are characterized by socio-behaviorally-oriented public health efforts aimed at reducing exposure and prevention of morbidity/mortality once infected. These efforts involve different points-of-view, generally, than do those aimed to understand the virus' natural history. Rampant spread of SARS-CoV-2 infection in cities clearly signals that urban areas contain conditions favorable for rapid transmission of the virus. MAIN TEXT: The Critical Medical Ecology model is a multidimensional, multilevel way of viewing pandemics comprehensively, rooted simultaneously in microbiology and in anthropology, with shared priority for evolution, context, stressors, homeostasis, adaptation, and power relationships. Viewing COVID-19 with a Critical Medical Ecological lens suggests three important interpretations: 1) COVID-19 is equally - if not more - a socially-driven disease as much as a biomedical disease, 2) the present interventions available for primary prevention of transmission are social and behavioral interventions, and 3) wide variation in COVID-19 hospitalization/death rates is not expected to significantly be attributable to a more virulent and rapidly-evolving virus, but rather to differences in social and behavioral factors - and power dynamics - rather than (solely) biological and clinical factors. Cities especially are challenged due to logistics and volume of patients, and lack of access to sustaining products and services for many residents living in isolation. CONCLUSIONS: In the end, SARS-CoV-2 is acting upon dynamic social human beings, entangled within structures and relationships that include but extend far beyond their cells, and in fact beyond their own individual behavior. As a comprehensive way of thinking, the Critical Medical Ecology model helps identify these elements and dynamics in the context of ecological processes that create, shape, and sustain people in their multidimensional, intersecting environments.


title: The emergence of Miocene reefs in South China Sea and its resilient adaptability under varying eustatic, climatic and oceanographic conditions

text: During the Miocene, extensive carbonate deposition thrived over wide latitudinal ranges in Southeast Asia despite perturbations of the global climate and thermohaline circulation that affected the Asian continent. Nevertheless, the mechanisms of its emergence, adaptability in siliciclastic-dominated margins and demise, especially in southern South China Sea (SCS), are largely speculative and remains enigmatic along with a scarcity of constraints on paleoclimatic and palaeoceanographic conditions. Here we show, through newly acquired high-resolution geophysical data and accurate stratigraphic records based on strontium isotopic dating, the evolution of these platforms from ~15.5-9.5 Ma is initially tied to tectonics and eustasy, and ultimately, after ~9.5 Ma, to changes in the global climate patterns and consequent palaeoceanographic conditions. Our results demonstrate at least two paleodeltas that provided favourable substratum of elevated sand bars, which conditioning the emergence of the buildups that inadvertently mirrored the underlying strata. We show unprecedented evidences for ocean current fluctuations linked to the intensification of the Asian summer monsoon winds resulting in the formation of drifts and moats, which extirpated the platforms through sediment removal and starvation. This work highlights the imperative role of palaeoceanography in creating favourable niches for reefal development that can be applicable to carbonate platforms elsewhere.


title: COVID-19: Striking a Balance between Health Care Provider Safety and Patient Care in the Indian Hospital Settings

text: Background: The COVID-19 pandemic has taken its toll on the health care systems all over the world. The global shortage of resources has adversely affected the safety of healthcare personnel as well patients. This has forced the health care facilities to adopt various measures and improvisation in infection control practices, in addition to those in personnel protective equipments (PPEs) adapting to their need and their resources. Objectives: To review the literature on the infection control practices in health care facilities against COVID-19 and put forward practical solutions, in addition to personnel protective equipments that may be adopted for health care personnel and patient safety in the Indian setting. Conclusions: We are now amidst of COVID-19 pandemic and we need to focus on 'Risk reduction as much as possible'. The facilities and resources should transform to meet the challenges within the shortest time frame. The concept of patient care needs to balance with the safety of the healthcare, patient and society. This is achievable only by a combination of engineering controls, administrative controls and PPEs. It involves a lot of committed team work while managing an outbreak like COVID - 19 attached with a lot of social stigma.


COVID-19 infection at nighttime


Asthme et COVID-19: une population à risque?/ [Asthma and COVID-19: a risk population?]


title: Key points of serious adverse eventand protection of patients in ophthalmic clinical trials during novel coronavirus pneumonia outbreak/ 中华实验眼科杂志

text: The prevention and control of novel coronavirus pneumonia is the most priority recently, and various measures during the prevention and control period will have varying degrees of impact on the implement of clinical trials. However, various examinations in ophthalmological clinical trials need close contact between operators and patients, which put us at risk of cross-infection. This paper indicated some suggestions based on the criteria of clinical trials under major public health emergencies, the management of clinical trials during epidemic period including the follow-up of subjects, the treatment of epidemic serious adverse event (SAE) and the management requirements of co-sponsors, as well as the requirements and management principles for environment, subjects, examiners and inspection equipment in the process of ophthalmic clinical trials. It may be helpful to the ophthalmic clinical trial researchers and subjects during the period of novel coronavirus infection.


title: Aggregate Prevalence of Chemosensory and Sinonasal Dysfunction in SARS-CoV-2 and Related Coronaviruses

text: Much of the published literature regarding the novel coronavirus disease 2019 (COVID-19) constitutes lower respiratory system symptomatology, while there exists a paucity of data describing the complicated sequelae of the upper respiratory system, including chemosensory and/or sinonasal dysfunction. This study utilized the National Library of Medicine's PubMed/MEDLINE database to query for articles describing COVID-19, SARS-CoV-2, SARS-CoV-1, MERS-CoV, and other coronaviruses, with any mention of smell, taste, or other chemosensory or sinonasal dysfunction. Aggregate analysis demonstrated an incidence of 49.6% (n = 497 of 1002; 95% CI, 46.5%-52.7%), 47.9% (n = 480 of 1002; 95% CI, 44.8%-51.0%), and 17.9% (n = 880 of 4909; 95% CI, 16.9%-19.0%) for smell loss, taste loss, and smell or taste loss, respectively, in patients infected with SARS-CoV-2. Additionally, there were significantly higher incidences of runny nose/rhinorrhea/rhinitis and nasal congestion/obstruction/blockage in other coronaviruses as compared with SARS-CoV-2 (P < .001). Understanding these less well-characterized symptoms may help develop measures for estimating early markers of disease prevalence and/or resolution. Level of evidence: 4.


COVID-19 in Africa: the spread and response


Editor's Desk: Knowing Well, Being Well: Wellness and Weirdness: Health in the Time of COVID-19


Chronic obstructive pulmonary disease and the COVID-19 pandemic: Reciprocal challenges


Indirect effects of COVID-19 on child health care: delayed diagnosis of developmental dysplasia of the hip


Cutaneous manifestations in COVID-19: Lessons learned from current evidence


Seeking Normalcy as the Curve Flattens: Ethical Considerations for Pediatricians Managing Collateral Damage of COVID-19


Caring for Women Who Are Planning a Pregnancy, Pregnant, or Postpartum During the COVID-19 Pandemic


Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and coronavirus


Coronaviruses and Immunosuppressed Patients: The Facts During the Third Epidemic


title: A Dedicated Path to Emergent Thoracic Surgery in Covid-19 Patients: an Italian Institution Protocol

text: The outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic pointed out that the need to ensure emergent surgery in positive for infection patients is no longer hypothetical. Among emergency procedures, thoracic surgical operations are frequent. A standardized surgical pathway is mandatory in order to achieve effective and safe management of this subset of patients. We briefly present the protocol adopted by our thoracic surgery division.


A strategy targeting monocyte-macrophage differentiation to avoid pulmonary complications in SARS-Cov2 infection


title: In the response to COVID-19, we can't forget health system commitments to contraception and family planning

text: Contraceptive and family planning services and supplies are core components of essential health services, and access to these services is a fundamental human right. This standard must continue to be respected and protected as such by governments prioritizing scarce resources during this COVID-19 pandemic. But with many health systems currently focusing on the response to the pandemic, the provision of basic contraception counselling, the delivery of contraceptive products and services, and the functioning of supply chains have been disrupted.


Hydroxychloroquine in Covid-19: Does the end justify the means?


Keeping governments accountable: the COVID-19 Assessment Scorecard (COVID-SCORE)


COVID-19 Ethics and Research


title: A Case of Postoperative Covid-19 Infection After Cardiac Surgery: Lessons Learned

text: While the focus of the medical community is on the management of COVID-19 and its associated complex presentations, it is critical to recognize that patients will continue to present with other medical problems that require urgent therapeutic interventions. There is growing concern that such interventions might have an impact on the natural history of COVID-19. We present a case of a patient who presented with unstable angina and multivessel coronary artery disease for which coronary artery bypass surgery was indicated and performed. Unfortunately, he succumbed to respiratory complications attributed to COVID-19. Our experience suggests concern about adverse outcomes in patients undergoing cardiac surgery who might be infected with COVID-19. Clearly, additional investigations and experience are needed.


title: Review of Chest Radiograph Findings of COVID-19 Pneumonia and Suggested Reporting Language

text: The diagnosis of coronavirus disease 2019 (COVID-19) is confirmed by reverse transcription polymerase chain reaction. The utility of chest radiography (CXR) remains an evolving topic of discussion. Current reports of CXR findings related to COVID-19 contain varied terminology as well as various assessments of its sensitivity and specificity. This can lead to a misunderstanding of CXR reports and makes comparison between examinations and research studies challenging. With this need for consistency, we propose language for standardized CXR reporting and severity assessment of persons under investigation for having COVID-19, patients with a confirmed diagnosis of COVID-19, and patients who may have radiographic findings typical or suggestive of COVID-19 when the diagnosis is not suspected clinically. We recommend contacting the referring providers to discuss the likelihood of viral infection when typical or indeterminate features of COVID-19 pneumonia on CXR are present as an incidental finding. In addition, we summarize the currently available literature related to the use of CXR for COVID-19 and discuss the evolving techniques of obtaining CXR in COVID-19-positive patients. The recently published expert consensus statement on reporting chest computed tomography findings related to COVID-19, endorsed by the Radiological Society of North American (RSNA), the Society of Thoracic Radiology (STR), and American College of Radiology (ACR), serves as the framework for our proposal.


title: Trends and Innovations in Biosensors for COVID-19 Mass Testing

text: Fast and widespread diagnosis is crucial to fighting against the outbreak of COVID-19. This work surveys the landscape of available and emerging biosensor technologies for COVID-19 testing. Molecular diagnostic assays based on quantitative reverse transcription polymerase chain reaction are used in most clinical laboratories. However, the COVID-19 pandemic has overwhelmed testing capacity and motivated the development of fast point-of-care tests and the adoption of isothermal DNA amplification. Antigenic and serological rapid tests based on lateral-flow immunoassays suffer from low sensitivity. Advanced digital systems enhance performance at the expense of speed and the need for large equipment. Emerging technologies, including CRISPR gene-editing tools, benefit from high sensitivity and specificity of molecular diagnostics and the easy use of lateral-flow assays. DNA sequencing and sample pooling strategies are highlighted to bring out the full capacity of the available biosensor technologies and accelerate mass testing.


title: Early experience with remdesivir in SARS-CoV-2 pneumonia

text: At present, there is no definitive antiviral treatment for coronavirus disease 2019 (COVID-19). We describe our early experience with remdesivir in four critically ill COVID-19 patients. Patients received a 200 mg loading dose, followed by 100 mg daily intravenously for up to 10 days. All patients had been previously treated with other antivirals before remdesivir initiation. One patient experienced a torsade de pointes requiring cardiac resuscitation and one died due to multiple organ failure. Three patients showed biochemical signs of liver injury. Lymphocyte count increased in all patients soon after remdesivir initiation. Nasal swab SARS-CoV-2 RNA became negative in three of four patients after 3 days of therapy. We observed an in vivo virological effect of remdesivir in four critically ill, COVID-19 patients, coupled with a significant burden of adverse events. Although limited by the low number of subjects studied, our preliminary experience may be relevant for clinicians treating COVID-19.


Want to Improve Public Health Access? Let's Start with the Basics: Measuring Efficiency Correctly


title: Hyponatremia presenting with hourly fluctuating urine osmolality

text: Summary: The etiology of hyponatremia is assessed based on urine osmolality and sodium. We herein describe a 35-year-old Asian man with pulmonary tuberculosis and perforated duodenal ulcer who presented with hyponatremia with hourly fluctuating urine osmolality ranging from 100 to 600 mosmol/kg, which resembled urine osmolality observed in typical polydipsia and SIADH simultaneously. Further review revealed correlation of body temperature and urine osmolality. Since fever is a known non-osmotic stimulus of ADH secretion, we theorized that hyponatremia in this patient was due to transient ADH secretion due to fever. In our case, empiric exogenous glucocorticoid suppressed transient non-osmotic ADH secretion and urine osmolality showed highly variable concentrations. Transient ADH secretion-related hyponatremia may be underrecognized due to occasional empiric glucocorticoid administration in patients with critical illnesses. Repeatedly monitoring of urine chemistries and interpretation of urine chemistries with careful review of non-osmotic stimuli of ADH including fever is crucial in recognition of this etiology. Learning points: Hourly fluctuations in urine osmolality can be observed in patients with fever, which is a non-osmotic stimulant of ADH secretion. Repeated monitoring of urine chemistries aids in the diagnosis of the etiology underlying hyponatremia, including fever, in patients with transient ADH secretion. Glucocorticoid administration suppresses ADH secretion and improves hyponatremia even in the absence of adrenal insufficiency; the etiology of hyponatremia should be determined carefully in these patients.


A Leader's Guide to Crisis Communication: Lessons from Ebola for COVID-19


title: Hypergraph Learning for Identification of COVID-19 with CT Imaging

text: The coronavirus disease, named COVID-19, has become the largest global public health crisis since it started in early 2020. CT imaging has been used as a complementary tool to assist early screening, especially for the rapid identification of COVID-19 cases from community acquired pneumonia (CAP) cases. The main challenge in early screening is how to model the confusing cases in the COVID-19 and CAP groups, with very similar clinical manifestations and imaging features. To tackle this challenge, we propose an Uncertainty Vertex-weighted Hypergraph Learning (UVHL) method to identify COVID-19 from CAP using CT images. In particular, multiple types of features (including regional features and radiomics features) are first extracted from CT image for each case. Then, the relationship among different cases is formulated by a hypergraph structure, with each case represented as a vertex in the hypergraph. The uncertainty of each vertex is further computed with an uncertainty score measurement and used as a weight in the hypergraph. Finally, a learning process of the vertex-weighted hypergraph is used to predict whether a new testing case belongs to COVID-19 or not. Experiments on a large multi-center pneumonia dataset, consisting of 2,148 COVID-19 cases and 1,182 CAP cases from five hospitals, are conducted to evaluate the performance of the proposed method. Results demonstrate the effectiveness and robustness of our proposed method on the identification of COVID-19 in comparison to state-of-the-art methods.


title: Serological survey of SARS-CoV-2 for experimental, domestic, companion and wild animals excludes intermediate hosts of 35 different species of animals

text: The pandemic SARS-CoV-2 has been reported in 123 countries with more than 5,000 patients died from it. However, the original and intermediate hosts of the virus remain unknown. In this study, 1,914 serum samples from 35 animal species were used for detection of SARS-CoV-2-specific antibodies using double-antigen sandwich ELISA after validating its specificity and sensitivity. The results showed that no SARS-CoV-2-specific antibodies were detected in above samples which excluded the possibility of 35 animal species as intermediate host for SARS-CoV-2. More importantly, companion animals including pet dogs (including one dog the SARS-CoV-2 patient kept and two dogs which had close contact with it) and cats, street dogs and cats also showed serological negative to SARS-CoV-2, which relieved the public concerns for the pets as SARS-CoV-2 carriers.


Does a Crying Child Enhance the Risk for COVID-19 Transmission?


title: Featuring COVID-19 cases via screening symptomatic patients with epidemiologic link during flu season in a medical center of central Taiwan

text: BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CO-V-2), was first reported in Wuhan, Hubei province, China has now rapidly spread over 50 countries. For the prevention and control of infection, Taiwan Centers for Disease Control initiated testing of SARS-CoV-2 on January 24th 2020 for persons suspected with this disease. Until February 28th, 43 flu-like symptomatic patients were screened in China Medical University Hospital. METHODS: Two patients were confirmed positive for SARS-CoV-2 infection by rRT-PCR as COVID-19 patients A and B. Causative pathogens for included patients were detected using FilmArray™ Respiratory Panel. We retrospectively analyzed the clinical presentations, laboratory data, radiologic findings, and travel and exposure contact histories, of the COVID-19 patients in comparison to those with other respiratory infections. RESULTS: Through contact with Taiwan No. 19 case patient on 27th January, COVID-19 patients A and B were infected. Both patients had no identified comorbidities and developed mild illness with temporal fever, persistent cough, and lung interstitial infiltrates. Owing to the persistence of positive SARS-CoV-2 in respiratory specimen, the two COVID-19 patients are still in the isolation rooms despite recovery until 10th of March. The results of FilmArrayTM Respiratory Panel revealed 22 of the 41 non-COVID-19 patients were infected by particular pathogens. In general, seasonal respiratory pathogens are more prevalent than SARS-CoV-2 in symptomatic patients in non- COVID-19 endemic area during the flu season. Since all patients shared similar clinical and laboratory findings, expanded surveillance of detailed exposure history for suspected patients and application of rapid detection tools are highly recommended.


title: The Innate Immune System: Fighting on the Front Lines or Fanning the Flames of COVID-19?

text: The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has had devastating global impacts and will continue to have dramatic effects on public health for years to come. A better understanding of the immune response to SARS-CoV-2 will be critical for the application and development of therapeutics. The degree to which the innate immune response confers protection or induces pathogenesis through a dysregulated immune response remains unclear. In this review, we discuss what is known about the role of the innate immune system during SARS-CoV-2 infection, suggest directions for future studies, and evaluate proposed COVID-19 immunomodulating therapeutics.


Editor's presentation: Staying healthy and fighting cardiovascular disease at the time of COVID


title: Noisy three-player dilemma game: Robustness of the quantum advantage

text: Games involving quantum strategies often yield higher payoff. Here, we study a practical realization of the three-player dilemma game using the superconductivity-based quantum processors provided by IBM Q Experience. We analyze the persistence of the quantum advantage under corruption of the input states and how this depends on parameters of the payoff table. Specifically, experimental fidelity and error are observed not to be properly anti correlated, i.e., there are instances where a class of experiments with higher fidelity yields a greater error in the payoff. Further, we find that the classical strategy will always outperform the quantum strategy if corruption is higher than half.


title: [Investigation of an epidemic cluster caused by COVIDâ19 cases in incubation period in Shanghai]

text: Objective: To analyze the epidemiological characteristics of a cluster of 5 confirmed COVIDâ19 cases related with the transmission in incubation period of initial case, and find out the infection source and transmission chain.. Methods: According to "The Prevention and Control Protocol for Coronavirus Disease 2019 (Third Edition)" issued by the National Health Commission, a field epidemiological survey was conducted for the 5 cases in January 2020. Nasopharyngeal swabs and sputum samples were collected from them for the detection of 2019-nCoV by real time RT-PCR. Multi prevention and control measures were taken, such as tracking and screening close contacts, medical isolation observation, investigating the epidemiological link, analyzing transmission chain. Results: Case 1, who had common environmental exposure with other COVIDâ19 cases, got sick on 20 January, 2020 and was confirmed on 1 February. Case 2 became symptomatic on 22 January and was confirmed on 27 January. Case 3 got sick on 25 January and was confirmed on 30 January. Case 4 had illness onset on 20 January and was confirmed on 1 February. Case 5 got sick on 23 January and was confirmed on 31 January. Among the 5 cases, case 2 died and the illness of other cases were effectively controlled. After exclusion of other common exposure factors, case 1 had a 6-hour meeting with case 2 and case 3 on 19 January. Case 2 and case 3 might be infected by case 1 during the incubation period. It is the key point for epidemiological investigation. Conclusion: The epidemiological investigation indicates that the transmission might occur in the incubation period of COVID-19 case, close attention should be paid to it in future COVID-19 prevention and control.


High-flow tracheal oxygen in tracheostomised COVID-19 patients


Clinical utility of pre-transplant ophthalmic consultation for lung transplant recipients: implications in the COVID-19 pandemic era


Unique Patterns of Cardiovascular Involvement in Coronavirus Disease-2019


title: At the heart of COVID-19

text: Coronavirus disease (COVID-19) first presented in Wuhan, Hubei province, China in December 2019. Since then, it has rapidly spread across the world, and is now formally considered a pandemic. The disease does not discriminate but increasing age and the presence of comorbidities are associated with severe form of the disease and poor outcomes. Although the prevalence of COVID-19 in patients with cardiovascular disease is under-reported, there is evidence that pre-existing cardiac disease can render individuals vulnerable. It is thought that COVID-19 may have both a direct and indirect effect on the cardiovascular system; however, the primary mechanism of underlying cardiovascular involvement is still uncertain. Of particular interest is the role of angiotensin-converting enzyme 2, which is well known for its cardiovascular effects and is also considered to be important in the pathogenesis of COVID-19. With a range of different drug candidates being suggested, effective anti-virals and vaccines are an area of on-going research. While our knowledge of COVID-19 continues to rapidly expand, this review highlights recent advances in our understanding of the interaction between COVID-19 and the cardiovascular system.


Importing coronavirus disease 2019 (COVID-19) into China after international air travel


Online learning in the time of COVID-19


Ophthalmology After Coronavirus Disease 2019 (COVID-19): Transition Back to Patient Care


Development of in vitro transcribed RNA as positive control for laboratory diagnosis of SARS-CoV-2 in India


title: A contribution for the forensic odontologist's safety in the autopsy room

text: The Covid 19 pandemic we are currently facing all over the world is undoubtly an emergency condition which exposes all workers to the risks of a serious infection. The personnel working in the autoptic room is at high risk for the possible contact with infected material from corpses, splashes and aerosols diffusion, and must be always prepared to stay safe and healthy. We offer to the forensic odontologists' community a short summary of some old and new hints on the treatment of dead bodies in the autopsy room during this pandemic emergency time.


title: Mathematical modeling and prediction of COVID-19 in Moscow city and Novosibirsk region

text: The paper formulates and solves the problem of identification of unknown parameters of mathematical models of the spread of COVID-19 coronavirus infection, based on SEIR type models, based on additional information about the number of detected cases, mortality, self-isolation coefficient and tests performed for the Moscow city and the Novosibirsk Region from 03.23.2020. Within the framework of the models used, the population is divided into seven (SEIR-HCD) and five (SEIR-D) groups with similar characteristics with transition probabilities between groups depending on a specific region. Identifiability analysis of the SEIR-HCD mathematical model was carried out, which revealed the least sensitive unknown parameters to additional measurements. The tasks of refining the parameters are reduced to minimizing the corresponding target functionals, which were solved using stochastic methods (simulating annealing, differential evolution, genetic algorithm, etc.). For a different amount of tested data, a prognostic scenario for the development of the disease in the city of Moscow and the Novosibirsk region was developed, the peak is predicted the development of the epidemic in Moscow with an error of 2 days and 174 detected cases, and an analysis of the applicability of the developed models was carried out.


SARS-CoV2 entry and spread in the lymphatic drainage system of the brain


Serological characteristics of COVID-19 patients


title: Realgar (α-As4S4) Treats Myelodysplasic Syndromes through Reducing DNA Hypermethylation

text: DNA hypermethylation is an epigenetic modification that plays a critical role in the oncogenesis of myelodysplastic syndromes (MDS). Aberrant DNA methylation represses the transcription of promotors of tumor suppressor genes, inducing gene silencing. Realgar (α-As4S4) is a traditional medicine used for the treatment of various diseases in the ancient time. Realgar was reported to have efficacy for acute promyelocytic leukemia (APL). It has been demonstrated that realgar could efficiently reduce DNA hypermethylation of MDS. This review discusses the mechanisms of realgar on inhibiting DNA hypermethylation of MDS, as well as the species and metabolisms of arsenic in vivo.


title: A short, animated video to improve good COVID-19 hygiene practices: a structured summary of a study protocol for a randomized controlled trial

text: OBJECTIVES: Entertainment-education (E-E) media can improve behavioral intent toward health-related practices. In the era of COVID-19, millions of people can be reached by E-E media without requiring any physical contact. We have designed a short, wordless, animated video about COVID-19 hygiene practices-such as social distancing and frequent hand washing-that can be rapidly distributed through social media channels to a global audience. The E-E video's effectiveness, however, remains unclear. The study aims to achieve the following objectives. To: 1.Quantify people's interest in watching a short, animated video about COVID-19 hygiene (abbreviated to CoVideo).2.Establish the CoVideo's effectiveness in increasing behavioural intent toward COVID-19 hygiene.3.Establish the CoVideo's effectiveness in improving COVID-19 hygiene knowledge. TRIAL DESIGN: The present study is a multi-site, parallel group, randomized controlled trial (RCT) comparing the effectiveness of the CoVideo against an attention placebo control (APC) video or no video. The trial has an intervention arm (CoVideo), placebo arm (APC), and control arm (no video). Nested in each trial arm is a list experiment and questionnaire survey, with the following ordering. Arm 1: the CoVideo, list experiment, and questionnaire survey. Arm 2: the APC video, list experiment, questionnaire survey, and CoVideo. Arm 3: the list experiment, questionnaire survey, and CoVideo. For each list experiment, participants will be randomized to a control or treatment group. The control group will receive a list of five items and the treatment group will receive the same five items plus one item about COVID-19 hygiene. We will use the list experiment to reduce response bias associated with socially desirable answers to COVID-19 questions. The questionnaire survey will include items about the participant's age, sex, country of residence, highest education, and knowledge of COVID-19 spread. After completing the list experiment and questionnaire survey, participants in Arms 2 and 3 will receive the CoVideo to ensure post-trial access to treatment. PARTICIPANTS: This will be an online study setting. We will use Prolific Academic (ProA: https://www.prolific.co) to recruit participants and host our study on the Gorilla™ platform (www.gorilla.sc). To be eligible, participants must be between the age of 18 and 59 years (male, female, or other) and have current residence in the United States, the United Kingdom, Germany, Spain, Mexico, or France. Participants will be excluded from the study if they cannot speak English, German, French, or Spanish (since the instructions and survey questions will be available in these 4 languages only). INTERVENTION AND COMPARATOR: The intervention is an E-E video about COVID-19 hygiene (CoVideo). Developed by our co-author (MA) for Stanford Medicine, the CoVideo is animated with sound effects, and has no words, speech, or text. The CoVideo shows how the novel coronavirus is spread (airborne, physical contact) and summarizes the public's response to the COVID-19 outbreak. Key components of the CoVideo are the promotion of five hygiene practices: i) social distancing and avoiding group gatherings, ii) frequently washing hands with soap and water or sanitizer, iii) cleaning surfaces at home (e.g., kitchen counters), iv) not sharing eating utensils, and v) avoidance of stockpiling essential goods (such as toilet paper and face masks). The CoVideo, which was designed for universal reach and optimized for release on social media channels, can be viewed at https://www.youtube.com/watch?v=rAj38E7vrS8. The comparators are an APC video (Arm 2) or no video (Arm 3). The APC video is similar in style to the CoVideo; it is also animated with a duration of 2.30 minutes, has sound effects but no words, speech, or text. The video message is about how small choices become actions, which become habits, which become a way of life. It is available at https://www.youtube.com/watch?v=_HEnohs6yYw. Each list experiment will have a control list as the comparator. The control list is needed to measure the prevalence of behavioral intent toward COVID-19 hygiene. MAIN OUTCOMES: This study will measure primary and secondary outcomes related to COVID-19 hygiene. By hygiene, we mean the adoption of behaviors or practices that reduce the chances of being infected or spreading COVID-19. As our primary outcome, we will measure changes in behavioral intent toward five hygiene practices: social distancing, washing hands, cleaning household surfaces, not sharing eating utensils, and not stockpiling essential goods. As a secondary outcome, we will measure knowledge about behaviors that can prevent the spread of COVID-19. RANDOMIZATION: Using a web-based randomization algorithm, Gorilla will randomly allocate participants to the intervention (CoVideo), placebo (APC), or control (no video) arm (sequence generation) at a 1:1:1 ratio. Within each trial arm, Gorilla will randomly allocate participants at a 1:1 ratio to the control or treatment group. Items in the lists will be randomly ordered to avoid order effects. The presentation order of the list experiments will also be randomized. BLINDING: Because ProA handles the interaction between the study investigators and participants, the participants will be completely anonymous to the study investigators. The outcome measures will be self-reported and submitted anonymously. All persons in the study team will be blinded to the group allocation. NUMBERS TO BE RANDOMIZED: The Gorilla algorithm will randomize 6,700 participants to each trial arm, giving a total sample size of 20,100. TRIAL STATUS: The protocol version number is 1.0 and the date is 18 May 2020. Recruitment is expected to end by 22 June 2020. Thus far, the study investigators have recruited 2,500 participants on ProA. Of these participants, 800 have completed the study on the Gorilla platform. TRIAL REGISTRATION: The study and its outcomes were registered at the German Clinical Trials Register (www.drks.de) on May 12th, 2020, protocol number: #DRKS00021582. The study was registered before any data was collected. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


title: Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study

text: OBJECTIVES: To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN: Prospective observational study. SETTING: General paediatric department of a university hospital in Paris, France. PARTICIPANTS: 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020. MAIN OUTCOME MEASURES: The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus. RESULTS: 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home. CONCLUSIONS: The ongoing outbreak of Kawasaki-like multisystem inflammatory syndrome among children and adolescents in the Paris area might be related to SARS-CoV-2. In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry.


Unintended Consequence: Influenza plunges with public health response to COVID-19 in Singapore


18F-Fluorocholine uptake matching CT lesions in the lungs of a patient clinically cured from COVID-19 syndrome


title: Potential therapeutic use of ebselen for COVID-19 and other respiratory viral infections

text: Ebselen is an organoselenium compound exhibiting hydroperoxide- and peroxynitrite-reducing activity, acting as a glutathione peroxidase and peroxiredoxin enzyme mimetic. Ebselen reacts with a multitude of protein thiols, forming a selenosulfide bond, which results in pleiotropic effects of antiviral, antibacterial and anti-inflammatory nature. The main protease (Mpro) of the corona virus SARS-CoV-2 is a potential drug target, and a screen with over 10,000 compounds identified ebselen as a particularly promising inhibitor of Mpro (Jin, Z. et al. (2020) Nature 582, 289-293). We discuss here the reaction of ebselen with cysteine proteases, the role of ebselen in infections with viruses and with other microorganisms. We also discuss effects of ebselen in lung inflammation. In further research on the inhibition of Mpro in SARS-CoV-2, ebselen can serve as a promising lead compound, if the inhibitory effect is confirmed in intact cells in vivo. Independently of this action, potential beneficial effects of ebselen in COVID-19 are ascribed to a number of targets critical to pathogenesis, such as attenuation of inflammatory oxidants and cytokines.


title: Early vascular surgery response to the COVID-19 pandemic: Results of a nationwide survey

text: OBJECTIVE: The COVID-19 pandemic has had major implications for the United States health care system. This survey study sought to identify practice changes, to understand current personal protective equipment (PPE) use, and to determine how caring for patients with COVID-19 differs for vascular surgeons practicing in states with high COVID-19 case numbers vs in states with low case numbers. METHODS: A 14-question online survey regarding the effect of the COVID-19 pandemic on vascular surgeons' current practice was sent to 365 vascular surgeons across the country through REDCap from April 14 to April 21, 2020, with responses closed on April 23, 2020. The survey response was analyzed with descriptive statistics. Further analyses were performed to evaluate whether responses from states with the highest number of COVID-19 cases (New York, New Jersey, Massachusetts, Pennsylvania, and California) differed from those with lower case numbers (all other states). RESULTS: A total of 121 vascular surgeons responded (30.6%) to the survey. All high-volume states were represented. The majority of vascular surgeons are reusing PPE. The majority of respondents worked in an academic setting (81.5%) and were performing only urgent and emergent cases (80.5%) during preparation for the surge. This did not differ between states with high and low COVID-19 case volumes (P = .285). States with high case volume were less likely to perform a lower extremity intervention for critical limb ischemia (60.8% vs 77.5%; P = .046), but otherwise case types did not differ. Most attending vascular surgeons worked with residents (90.8%) and limited their exposure to procedures on suspected or confirmed COVID-19 cases (56.0%). Thirty-eight percent of attending vascular surgeons have been redeployed within the hospital to a vascular access service or other service outside of vascular surgery. This was more frequent in states with high case volume compared with low case volume (P = .039). The majority of vascular surgeons are reusing PPE (71.4%) and N95 masks (86.4%), and 21% of vascular surgeons think that they do not have adequate PPE to perform their clinical duties. CONCLUSIONS: The initial response to the COVID-19 pandemic has resulted in reduced elective cases, with primarily only urgent and emergent cases being performed. A minority of vascular surgeons have been redeployed outside of their specialty; however, this is more common among states with high case numbers. Adequate PPE remains an issue for almost a quarter of vascular surgeons who responded to this survey.


title: Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis

text: BACKGROUND: Early reports of COVID-19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding, is this practise justified? OBJECTIVE: To estimate the risk of the neonate becoming infected with SARS-COV-2 by mode of delivery, type of infant feeding and mother-infant interaction SEARCH STRATEGY: Two biomedical databases were searched between September 2019 - June 2020. SELECTION CRITERIA: Case reports or case series of pregnant women with confirmed COVID-19, where neonatal outcomes were reported. DATA COLLECTION AND ANALYSIS: Data was extracted on mode of delivery, infant infection status, infant feeding and mother-infant interaction. For reported infant infection a critical analysis was performed to evaluate the likelihood of vertical transmission. MAIN RESULTS: We included 49 studies which included 666 neonates and 655 women where information was provided on the mode of delivery and the infant's infection status. 28/666 (4%) neonates had confirmed COVID-19 infection postnatally. Of the 291 women who delivered vaginally, 8/292 (2.7%) neonates were positive. Of the 364 women who had a Caesarean birth, 20/374 (5.3%) neonates were positive. Of the 28 neonates with confirmed COVID-19 infection, 7 were breast fed, 3 formula fed, 1 was given expressed breast milk and in 17 neonates the method of infant feeding was not reported. CONCLUSIONS: Neonatal COVID-19 infection is uncommon, uncommonly symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or allowed contact with the mother.


Performing Structural Heart Disease Interventions During the COVID-19 Pandemic: But What Are the Downsides?


title: Incidence of COVID-19 in patients with rheumatic diseases treated with targeted immunosuppressive drugs: what can we learn from observational data?

text: OBJECTIVES: To describe the incidence and severity of coronavirus disease 2019 (COVID-19) in rheumatic patients treated with targeted synthetic or biological anti-rheumatic drugs (ts/bDMARDs) compared with the general population living in the same Italian region. METHODS: Patients followed at two referral rheumatology centres in Lombardy from 25th February to 10th April 2020 were invited to participate in a survey to detect patients with confirmed COVID-19, close contacts with known COVID-19 cases, symptoms of infection, working, behavioural and disease management changes applied to prevent the contagion. The incidence of COVID-19 in the Lombardy population was obtained from the National Institute of Statistics. Confirmed COVID-19 was defined by nasopharyngeal swab. RESULTS: The survey was circulated amongst 955 patients (531 rheumatoid arthritis, 203 psoriatic arthritis, 181 spondyloarthritis, and 40 of connective tissue diseases/vasculitides/autoinflammatory diseases; mean age 53.7 years; female: 67.4%). The rate of responders was 98.05%. The incidence of confirmed COVID-19 is consistent with the general population (0.62% vs 0.66%; p=0.92). None of the patients had severe complications or required intensive care treatment, and all of them temporarily discontinued ongoing ts/bDMARDs therapy. Almost all patients adopted precautions to prevent the contagion (90.6%) and maintained the ongoing treatment with ts/bDMARDs (93.2%). The disease activity remained stable in 89.5% of patients. CONCLUSIONS: Our results highlight the attitude from rheumatic patients to prevent the contagion while maintaining their chronic treatments. The incidence and severity of COVID-19 in patients treated with ts/bDMARDs was not significantly different from that of the general population in the same region.


title: Rapid and visual detection of 2019 novel coronavirus (SARS-CoV-2) by a reverse transcription loop-mediated isothermal amplification assay

text: OBJECTIVE: To evaluate a reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and compare it with RT-PCR. METHODS: We designed primers specific to the orf1ab and S genes of SARS-CoV-2. Total viral RNA was extracted using the QIAamp Viral RNA Mini Kit. We optimized the RT-LAMP assay, and evaluated it for its sensitivity and specificity of detection using real-time turbidity monitoring and visual observation. RESULTS: The primer sets orf1ab-4 and S-123 amplified the genes in the shortest times, the mean (±SD) times were 18 ± 1.32 min and 20 ± 1.80 min, respectively, and 63°C was the optimum reaction temperature. The sensitivities were 2 × 101 copies and 2 × 102 copies per reaction with primer sets orf1ab-4 and S-123, respectively. This assay showed no cross-reactivity with 60 other respiratory pathogens. To describe the availability of this method in clinical diagnosis, we collected 130 specimens from patients with clinically suspected SARS-CoV-2 infection. Among them, 58 were confirmed to be positive and 72 were negative by RT-LAMP. The sensitivity was 100% (95% CI 92.3%-100%), specificity 100% (95% CI 93.7%-100%). This assay detected SARS-CoV-2 in a mean (±SD) time of 26.28 ± 4.48 min and the results can be identified with visual observation. CONCLUSION: These results demonstrate that we developed a rapid, simple, specific and sensitive RT-LAMP assay for SARS-CoV-2 detection among clinical samples. It will be a powerful tool for SARS-CoV-2 identification, and for monitoring suspected patients, close contacts and high-risk groups.


title: De novo design of protein peptides to block association of the SARS-CoV-2 spike protein with human ACE2

text: The outbreak of COVID-19 has now become a global pandemic that has severely impacted lives and economic stability. There is, however, no effective antiviral drug that can be used to treat COVID-19 to date. Built on the fact that SARS-CoV-2 initiates its entry into human cells by the receptor binding domain (RBD) of its spike protein binding to the angiotensin-converting enzyme 2 (hACE2), we extended a recently developed approach, EvoDesign, to design multiple peptide sequences that can competitively bind to the SARS-CoV-2 RBD to inhibit the virus from entering human cells. The protocol starts with the construction of a hybrid peptidic scaffold by linking two fragments grafted from the interface of the hACE2 protein (a.a. 22-44 and 351-357) with a linker glycine, which is followed by the redesign and refinement simulations of the peptide sequence to optimize its binding affinity to the interface of the SARS-CoV-2 RBD. The binding experiment analyses showed that the designed peptides exhibited a significantly stronger binding potency to hACE2 than the wild-type hACE2 receptor (with -53.35 vs. -46.46 EvoEF2 energy unit scores for the top designed and wild-type peptides, respectively). This study demonstrates a new avenue to utilize computationally designed peptide motifs to treat the COVID-19 disease by blocking the critical spike-RBD and hACE2 interactions.


COVID-19: New York City pandemic notes from the first 30 days


title: Light as a potential treatment for pandemic coronavirus infections: A perspective

text: The recent outbreak of COVID-19, which continues to ravage communities with high death tolls and untold psychosocial and catastrophic economic consequences, is a vivid reminder of nature's capacity to defy contemporary healthcare. The pandemic calls for rapid mobilization of every potential clinical tool, including phototherapy-one of the most effective treatments used to reduce the impact of the 1918 "Spanish influenza" pandemic. This paper cites several studies showing that phototherapy has immense potential to reduce the impact of coronavirus diseases, and offers suggested ways that the healthcare industry can integrate modern light technologies in the fight against COVID-19 and other infections. The evidence shows that violet/blue (400-470 nm) light is antimicrobial against numerous bacteria, and that it accounts for Niels Ryberg Finsen's Nobel-winning treatment of tuberculosis. Further evidence shows that blue light inactivates several viruses, including the common flu coronavirus, and that in experimental animals, red and near infrared light reduce respiratory disorders, similar to those complications associated with coronavirus infection. Moreover, in patients, red light has been shown to alleviate chronic obstructive lung disease and bronchial asthma. These findings call for urgent efforts to further explore the clinical value of light, and not wait for another pandemic to serve as a reminder. The ubiquity of inexpensive light emitting lasers and light emitting diodes (LEDs), makes it relatively easy to develop safe low-cost light-based devices with the potential to reduce infections, sanitize equipment, hospital facilities, emergency care vehicles, homes, and the general environment as pilot studies have shown.


Mission command: applying principles of military leadership to the SARS-CoV-2 (COVID-19) crisis: more than just 'mission command'


title: Cellular Nanosponges Inhibit SARS-CoV-2 Infectivity

text: We report cellular nanosponges as an effective medical countermeasure to the SARS-CoV-2 virus. Two types of cellular nanosponges are made of the plasma membranes derived from human lung epithelial type II cells or human macrophages. These nanosponges display the same protein receptors, both identified and unidentified, required by SARS-CoV-2 for cellular entry. It is shown that, following incubation with the nanosponges, SARS-CoV-2 is neutralized and unable to infect cells. Crucially, the nanosponge platform is agnostic to viral mutations and potentially viral species, as well. As long as the target of the virus remains the identified host cell, the nanosponges will be able to neutralize the virus.


Profile of specific antibodies to SARS-CoV-2: The first report


title: Framing COVID-19: How we conceptualize and discuss the pandemic on Twitter

text: Doctors and nurses in these weeks are busy in the trenches, fighting against a new invisible enemy: Covid-19. Cities are locked down and civilians are besieged in their own homes, to prevent the spreading of the virus. War-related terminology is commonly used to frame the discourse around epidemics and diseases. Arguably the discourse around the current epidemic will make use of war-related metaphors too,not only in public discourse and the media, but also in the tweets written by non-experts of mass communication. We hereby present an analysis of the discourse around #Covid-19, based on a corpus of 200k tweets posted on Twitter during March and April 2020. Using topic modelling we first analyze the topics around which the discourse can be classified. Then, we show that the WAR framing is used to talk about specific topics, such as the virus treatment, but not others, such as the effects of social distancing on the population. We then measure and compare the popularity of the WAR frame to three alternative figurative frames (MONSTER, STORM and TSUNAMI) and a literal frame used as control (FAMILY). The results show that while the FAMILY literal frame covers a wider portion of the corpus, among the figurative framings WAR is the most frequently used, and thus arguably the most conventional one. However, we conclude, this frame is not apt to elaborate the discourse around many aspects involved in the current situation. Therefore, we conclude, in line with previous suggestions, a plethora of framing options, or a metaphor menu, may facilitate the communication of various aspects involved in the Covid-19-related discourse on the social media, and thus support civilians in the expression of their feelings, opinions and ideas during the current pandemic.


title: Estimating the number of infections and the impact of non-pharmaceutical interventions on COVID-19 in European countries: technical description update

text: Following the emergence of a novel coronavirus (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics. In response, many European countries have implemented unprecedented non-pharmaceutical interventions including case isolation, the closure of schools and universities, banning of mass gatherings and/or public events, and most recently, wide-scale social distancing including local and national lockdowns. In this technical update, we extend a semi-mechanistic Bayesian hierarchical model that infers the impact of these interventions and estimates the number of infections over time. Our methods assume that changes in the reproductive number - a measure of transmission - are an immediate response to these interventions being implemented rather than broader gradual changes in behaviour. Our model estimates these changes by calculating backwards from temporal data on observed to estimate the number of infections and rate of transmission that occurred several weeks prior, allowing for a probabilistic time lag between infection and death. In this update we extend our original model [Flaxman, Mishra, Gandy et al 2020, Report #13, Imperial College London] to include (a) population saturation effects, (b) prior uncertainty on the infection fatality ratio, (c) a more balanced prior on intervention effects and (d) partial pooling of the lockdown intervention covariate. We also (e) included another 3 countries (Greece, the Netherlands and Portugal). The model code is available at https://github.com/ImperialCollegeLondon/covid19model/ We are now reporting the results of our updated model online at https://mrc-ide.github.io/covid19estimates/ We estimated parameters jointly for all M=14 countries in a single hierarchical model. Inference is performed in the probabilistic programming language Stan using an adaptive Hamiltonian Monte Carlo (HMC) sampler.


Coronavirus vaccine developers wary of errant antibodies


title: Clinical Characteristics and Outcomes of COVID-19 Patients With a History of Stroke in Wuhan, China

text: BACKGROUND AND PURPOSE: Information on stroke survivors infected with coronavirus disease 2019 (COVID-19) is limited. The aim of this study was to describe specific clinical characteristics and outcomes of patients with COVID-19 with a history of stroke. METHODS: All the confirmed cases of COVID-19 at Tongji Hospital from January 27 to March 5, 2020, were included in our cohort study. Clinical data were analyzed and compared between patients with and without a history of stroke. RESULTS: Of the included 1875 patients with COVID-19, 50 patients had a history of stroke. The COVID-19 patients with medical history of stroke were older with more comorbidities, had higher neutrophil count, and lower lymphocyte and platelet counts than those without history of stroke. The levels of D-dimers, cardiac troponin I, NT pro-brain natriuretic peptide, and interleukin-6 were also markedly higher in patients with history of stroke. Stroke survivors who underwent COVID-19 developed more acute respiratory distress syndrome and received more noninvasive mechanical ventilation. Data from propensity-matched analysis indicated a higher proportion of patients with COVD-19 with a history of stroke were admitted to the intensive care unit requiring mechanical ventilation and were more likely to be held in the unit or die, compared with non-stroke history COVID-19 patients. CONCLUSIONS: Patients with COVID-19 with a history of stroke had more severe clinical symptoms and poorer outcomes compared with those without a history of stroke.


title: Open questions for harnessing autophagy-modulating drugs in the SARS-CoV-2 war: hope or hype?

text: At a time when the world faces an emotional breakdown, crushing our dreams, if not, taking our lives, we realize that together we must fight the war against the COVID-19 outbreak even if almost the majority of the scientific community finds itself confined at home. Every day, we, scientists, listen to the latest news with its promises and announcements. Across the world, a surge of clinical trials trying to cure or slow down the coronavirus pandemic has been launched to bring hope instead of fear and despair. One first proposed clinical trial has drawn worldwide hype to the benefit of chloroquine (CQ), in the treatment of patients infected by the recently emerged deadly coronavirus (SARS-CoV-2). We should consider this information in light of the long-standing anti-inflammatory and anti-viral properties of CQ-related drugs. Yet, none of the articles promoting the use of CQ in the current pandemic evoked a possible molecular or cellular mechanism of action that could account for any efficacy. Here, given the interaction of viruses with macroautophagy (hereafter referred to as autophagy), a CQ-sensitive anti-viral safeguard pathway, we would like to discuss the pros, but also the cons concerning the current therapeutic options targeting this process.


High prevalence of deep vein thrombosis in mechanically ventilated COVID-19 patients


The Novel Coronavirus Disease (COVID-19) Threat for Patients with Cardiovascular Disease and Cancer


title: A new era for nuclear medicine

text: The coronavirus COVID-19 pandemic is the defining global health crisis of our time. Health care systems globally are amid an unprecedented challenge. Since its emergence in December 2019 in Wuhan, China, the virus has spread to 185 countries worldwide, with more than 2.63 million cases confirmed and more than 183 thousand related deaths (as of 23/04/2020). According to current evidence, the novel coronavirus is transmitted from human-to-human mainly via respiratory droplets of different sizes, contact with bodily fluids, or from contaminated surfaces. In the context of COVID-19, airborne transmission may be possible in specific circumstances and settings in which procedures that generate aerosols are performed. The common clinical symptoms of the highly pathogenic and large-scale epidemic virus include fever, cough, fatigue, ageusia and anosmia and in some patients, gastrointestinal infection symptoms. The elderly and patients with comorbidities are susceptible to infection and prone to severe complications, which may be associated with acute respiratory distress syndrome (ARDS) and cytokines storm. Currently, there are few specific antiviral strategies, but several potent candidates of antivirals and repurposed drugs are under urgent investigation. Under these circumstances, it is critical for health care settings, including nuclear medicine departments to take infection control measures, to prevent a potential spread not just among patients but also to staff members as well as to reconsider the performance of randomized clinical trials. There have already been papers on the radiology preparedness that should be applied to radiology and nuclear medicine departments to support the care of patients with COVID-19 and maintain radiologic diagnostic and interventional support for the entirety of the hospital and healthcare system, particularly for emergencies, without jeopardizing an outbreak in the units. Since most nuclear medicine diagnostic and therapeutic interventions are non-urgent, the general guidance from the International Atomic Energy Agency (IAEA) for infection prevention and control is to postpone scheduled procedure after cautious risk assessment, with certain exceptions. Individualized approach of each case is a sine qua non of ensuring low transmission of COVID-19 as well as effective and safe management of patients admitted to nuclear medicine departments. Another major issue raised is the possible impact COVID-19 on the transport of medical radioisotopes. By the 1st of April 2020, the Euratom Supply Agency (ESA) co-chaired the European Observatory on Supply of Medical Radioisotope expressing their concerns related to the impact of COVID-19 on the supply chain and inconsequence on the availability of the most vital medical radioisotopes used in nuclear medicine. Due to the current lockdown situation, extended border controls, reductions and elimination of many commercial passenger flights, competition and cost of cargo and charter options, required appropriate additional support. The new era of nuclear medicine practice worldwide coincides with a new era for the Hellenic Society of Nuclear Medicine (HSNM) and the Hellenic Journal of Nuclear Medicine (HJNM). The founder and Editor in Chief for more than 28 consecutive years, Professor Emeritus Philip Grammaticos, resigned leaving behind a benchmark for the presidencies and editors to come. His commitment to the conservation of a high level of scientific excellence of the published papers is the legacy which we wish to maintain in the future publications. The interim Editor in Chief of the current issue, would like to express her gratitude to Professor Emeritus Philip Grammaticos for his contribution to the global scientific community as well as to the incoming Editor in Chief Konstantinos Anagnostopoulos, MD, PhD, FRCP, FESC for accepting this new role. We wholeheartedly welcome the new Editor in Chief and the new members of the Editorial Board, wishing them an active, attentive and successful mandate. Hellenic Journal of Nuclear Medicine will remain true to the set principles, values and past and prepared to cope with future challenges in the scientific and clinical setting.


title: Protein Structure and Sequence Reanalysis of 2019-nCoV Genome Refutes Snakes as Its Intermediate Host and the Unique Similarity between Its Spike Protein Insertions and HIV-1

text: As the infection of 2019-nCoV coronavirus is quickly developing into a global pneumonia epidemic, the careful analysis of its transmission and cellular mechanisms is sorely needed. In this Communication, we first analyzed two recent studies that concluded that snakes are the intermediate hosts of 2019-nCoV and that the 2019-nCoV spike protein insertions share a unique similarity to HIV-1. However, the reimplementation of the analyses, built on larger scale data sets using state-of-the-art bioinformatics methods and databases, presents clear evidence that rebuts these conclusions. Next, using metagenomic samples from Manis javanica, we assembled a draft genome of the 2019-nCoV-like coronavirus, which shows 73% coverage and 91% sequence identity to the 2019-nCoV genome. In particular, the alignments of the spike surface glycoprotein receptor binding domain revealed four times more variations in the bat coronavirus RaTG13 than in the Manis coronavirus compared with 2019-nCoV, suggesting the pangolin as a missing link in the transmission of 2019-nCoV from bats to human.


Clinical implications of COVID-19 in patients with chronic liver disease and liver tumor


title: Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal

text: BACKGROUND: Public health concern is increasing with recent rise in the number of COVID-19 cases in Nepal. To curb this pandemic, Nepal is facing some forms of lockdown, encouraging people to implement social distancing so as to reduce interactions between people which could eventually reduce the possibilities of new infection; however, it has affected the overall physical, mental, social and spiritual health of the people. METHODS: Published articles related to psychosocial effects due to COVID-19 and other outbreaks were searched and reviewed. CONCLUSION: While many countries are supporting their citizens with sophisticated health safety-nets and various relief funds, some developing countries have unique challenges with vulnerable populations and limited resources to respond to the pandemic. This review presents the consequences of pandemic and lockdown on socioeconomic, mental health and other aspects in Nepalese society.


Does prolonged propofol sedation of mechanically ventilated COVID-19 patients contribute to critical illness myopathy?


Recovery from COVID-19 following hepatitis C, human immunodeficiency virus infection, and liver transplantation


title: Blood biochemical characteristics of patients with coronavirus disease 2019 (COVID-19): a systemic review and meta-analysis

text: Objective Recently, there have been several studies on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19); however, these studies have mainly been concentrated in Wuhan, China; the sample sizes of each article were different; and the reported clinical characteristics, especially blood biochemical indices, were quite different. This study aimed to summarize the blood biochemistry characteristics of COVID-19 patients by performing a systemic review and meta-analysis of published studies. Methods Comprehensive studies were screened from PubMed, Embase, and Cochrane Library through March 11, 2020. The inclusion criteria included studies investigating the biochemical indexes of patients with COVID-19. The statistical software R3.6.3 was used for meta-analysis. Results Ten studies including 1745 COVID-19 patients met the inclusion criteria for our meta-analysis. Meta-analysis showed that 16% and 20% of patients with COVID-19 had alanine transaminase (ALT) and aspartate aminotransferase (AST) levels higher than the normal range, respectively. Thirty-four percent of patients showed albumin (ALB) levels lower than the normal range, and 6% of patients showed abnormal total bilirubin (TBil) levels. The levels of creatinine (CRE) were increased in 8% of patients. The creatine kinase (CK) level of 13% of patients exceeded the normal range, and 52% of patients had elevated lactate dehydrogenase (LDH) levels. In addition, six studies met the inclusion criteria for the systemic review evaluating the relevance between LDH levels and the severity of COVID-19, and all six studies showed a positive association between these two factors. Conclusions Some patients with COVID-19 had different degrees of blood biochemical abnormalities, which might indicate multiple organ dysfunction. Some biochemical indexes, such as abnormal ALB and LDH, could reflect the severity of the disease to a certain extent. These blood biochemical indicators should be considered in the clinical management of the disease.


title: Scenarios for a post-COVID-19 world airline network

text: The airline industry was severely hit by the COVID-19 crisis with an average demand decrease of about $64\%$ (IATA, April 2020) which triggered already several bankruptcies of airline companies all over the world. While the robustness of the world airline network (WAN) was mostly studied as an homogeneous network, we introduce a new tool for analyzing the impact of a company failure: the `airline company network' where two airlines are connected if they share at least one route segment. Using this tool, we observe that the failure of companies well connected with others has the largest impact on the connectivity of the WAN. We then explore how the global demand reduction affects airlines differently, and provide an analysis of different scenarios if its stays low and does not come back to its pre-crisis level. Using traffic data from the Official Aviation Guide (OAG) and simple assumptions about customer's airline choice strategies, we find that the local effective demand can be much lower than the average one, especially for companies that are not monopolistic and share their segments with larger companies. Even if the average demand comes back to $60\%$ of the total capacity, we find that between $46\%$ and $59\%$ of the companies could experience a reduction of more than $50\%$ of their traffic, depending on the type of competitive advantage that drives customer's airline choice. These results highlight how the complex competitive structure of the WAN weakens its robustness when facing such a large crisis.


title: ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of thyroid nodules and cancer

text: Most patients with thyroid nodules and thyroid cancer (TC) referred for diagnostic work-up and treatment are not considered at higher risk of infection from SARS-CoV-2 compared to the general population. On the other hand, healthcare resources should be spared to the maximum extent possible during a pandemic. Indeed, while thyroid nodules are very common, only a small percentage are cancerous and, in turn, most thyroid cancers are indolent in nature. Accordingly, diagnostic work-up of thyroid nodules, thyroid surgery for either benign or malignant thyroid nodules and radioiodine treatment for differentiated thyroid cancers may be safely postponed during SARS-CoV-2 pandemic. Appropriate patient counselling, however, is mandatory and red flags should be carefully identified prompting immediate evaluation and treatment as appropriate. For these selected cases diagnostic work-up (e.g. ultrasound, scintigraphy, fine-needle aspiration), surgery and radioiodine therapy may proceed despite the threat of SARS-CoV-2 infection and COVID-19, after an individual risk-benefit analysis.


Commentary: A review of long-term corneal preservation techniques: Relevance and renewed interests in the COVID-19 era


title: Automatic Detection of COVID-19 Cases on X-ray images Using Convolutional Neural Networks

text: In recent months the world has been surprised by the rapid advance of COVID-19. In order to face this disease and minimize its socio-economic impacts, in addition to surveillance and treatment, diagnosis is a crucial procedure. However, the realization of this is hampered by the delay and the limited access to laboratory tests, demanding new strategies to carry out case triage. In this scenario, deep learning models are being proposed as a possible option to assist the diagnostic process based on chest X-ray and computed tomography images. Therefore, this research aims to automate the process of detecting COVID-19 cases from chest images, using convolutional neural networks (CNN) through deep learning techniques. The results can contribute to expand access to other forms of detection of COVID-19 and to speed up the process of identifying this disease. All databases used, the codes built, and the results obtained from the models' training are available for open access. This action facilitates the involvement of other researchers in enhancing these models since this can contribute to the improvement of results and, consequently, the progress in confronting COVID-19.


title: Clinical impact of pre-admission antithrombotic therapy in hospitalized patients with COVID-19: A multicenter observational study

text: Little is still known about the clinical features associated with the occurrence of acute respiratory distress syndrome (ARDS) in hospitalized patients with Coronavirus disease 2019 (COVID-19). The aim of the present study was to describe the prevalence of pre-admission antithrombotic therapies in patients with COVID-19 and to investigate the potential association between antithrombotic therapy and ARDS, as disease clinical presentation, or in-hospital mortality. We enrolled 192 consecutive patients with laboratory-confirmed COVID-19 admitted to emergency department of five Italian hospitals. The study population was divided in two groups according to the evidence of ARDS at chest computed tomography at admission. Propensity score weighting adjusted regression analysis was performed to assess the risk ARDS at admission, and death during hospitalization, in patients treated or not with antiplatelet and anticoagulant agents. ARDS was reported in 73 cases (38 %), who showed more likely hypertension compared to those without ARDS (57.8 % vs 49.6 %; P = 0.005). Thirty-five patients (18.5 %) died during the hospitalization. Not survived COVID-19 patients showed a statistically significant increased age (77 ± 8.31 vs 65.57 ± 8.31; P = 0.001), hypertension (77.1 % vs 53.5 %; P = 0.018) and coronary artery disease prevalence (28.6 % vs 10.2 %; P = 0.009). Both unadjusted and adjusted regression analyses showed no difference in the risk of ARDS at admission, or death during hospitalization, between patients treated or not with antiplatelets or anticoagulants. Pre-admission antithrombotic therapy, both antiplatelet and anticoagulant, does not seem to show a protective effect in severe forms of COVID-19 with ARDS at presentation and rapidly evolving toward death.


Closed Total Laryngectomy During The Covid-19 Pandemic Disease


Coronavirus disease 2019 (COVID-19) pandemic: International variation of personal protective equipment (PPE) and infection prevention and control (IPC) guidelines


COVID-19 and elderly: beyond the respiratory drama


title: Pediatric COVID-19-associated rhabdomyolysis: a case report

text: COVID-19 is the illness caused by infection with the novel coronavirus SARS-CoV-2. Although myalgia is common in adults, it has not been noted as a common symptom in children. There have been a few reported cases of COVID-19-associated rhabdomyolysis in adults. This case report describes a 16-year-old boy who presented with fever, myalgias, mild shortness of breath with exertion, and dark-colored urine. COVID-19 PCR was positive. His initial creatinine kinase (CK) level was 427,656 U/L. Serum creatinine was normal for age. He was treated with isotonic intravenous fluids containing sodium bicarbonate to maintain urine output of 100-200 mL/h and urine pH > 7.0. His serum creatinine remained normal throughout the hospital stay and he was discharged on hospital day 12 with a CK of 6526 U/L. To our knowledge, no pediatric cases of COVID-19-associated rhabdomyolysis have been previously reported. Adult cases of rhabdomyolysis have been reported and a few reports have noted patients with elevated CK levels without rhabdomyolysis. Given this pediatric case of COVID-19-associated rhabdomyolysis, pediatric clinicians should be aware of this complication and manage fluids appropriately in order to prevent acute kidney injury.


Resuscitating Children with COVID-19: What the Pediatric Anesthesiologist Needs to Know


title: [Effect of convalescent plasma and immunoglobulin on patients with severe acute respiratory syndrome: a systematic review]

text: OBJECTIVE: To systematically review evidence for the effect of convalescent plasma and immunoglobulin on treatment of severe acute respiratory syndrome (SARS), and further provide advice on the treatment of coronavirus disease 2019 (COVID-19). METHODS: Clinical studies of convalescent plasma and immunoglobulin in the treatment of SARS were collected from a variety of databases such as PubMed, Cochrane Library, Web of Science, Embase, CNKI, VIP, Wanfang, and CBM from November 2002 to March 2020. Two researchers independently screened the literature, extracted the data, and assessed the risk of bias based on the national institute for health and clinical excellence case series quality scale, and systematically evaluated the results. RESULTS: A total of 10 clinical studies, including 212 patients, were eventually included. There were 4 case series studies, 5 case reports and 1 case-control study. Most studies were with low or very low quality. The systematic analysis showed that 107 patients administered convalescent plasma and 16 patients used immunoglobulin during the treatment of SARS. Forty-nine patients were definitely not treated with the above two methods, and the remaining 40 patients were not reported clearly. The treatment of convalescent plasma and immunoglobulin could both improve the symptoms and reduce the mortality (12 died), and most SARS patients got better, while 11 SARS patients who did not receive the above therapies died. CONCLUSIONS: Convalescent plasma and immunoglobulin were effective on relieving symptoms of SARS patients. However, due to low quality and lacking of control group, convalescent plasma and immunoglobulin should be used with caution to treat COVID-19 patients.


title: Guidelines: Anaesthesia in the context of COVID-19 pandemic

text: OBJECTIVES: The world is currently facing an unprecedented healthcare crisis caused by the COVID-19 pandemic. The objective of these guidelines is to produce a framework to facilitate the partial and gradual resumption of intervention activity in the context of the COVID-19 pandemic. METHODS: The group has endeavoured to produce a minimum number of recommendations to highlight the strengths to be retained in the 7 predefined areas: (1) protection of staff and patients; (2) benefit/risk and patient information; (3) preoperative assessment and decision on intervention; (4) modalities of the preanaesthesia consultation; (5) specificity of anaesthesia and analgesia; (6) dedicated circuits and (7) containment exit type of interventions. RESULTS: The SFAR Guideline panel provides 51 statements on anaesthesia management in the context of COVID-19 pandemic. After one round of discussion and various amendments, a strong agreement was reached for 100% of the recommendations and algorithms. CONCLUSION: We present suggestions for how the risk of transmission by and to anaesthetists can be minimised and how personal protective equipment policies relate to COVID-19 pandemic context.


Coronavirus diaries: to be a scientist


SARS-CoV-2 as a trigger of neurodegeneration: thinking ahead


Practical Techniques to Adapt Surgical Resident Education to the COVID-19 Era


An Italian programme for COVID-19 infection in multiple sclerosis


title: COVID-19, Australia: Epidemiology Report 4 (Reporting week ending 19:00 AEDT 22 February 2020)

text: This is the fourth epidemiological report for coronavirus disease 2019 (COVID-19), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 22 February 2020. It includes data on COVID-19 cases diagnosed in Australia, the international situation and a review of current evidence.


title: Current situation of COVID-19 in northern Cyprus

text: Background: The public health burden of the novel coronavirus disease 2019 (COVID-19) is expected to increase and urgent strict measures by decision-makers is critical for the containment of the novel coronavirus (SARS-CoV-2) outbreak worldwide. Aims: This study aimed to give a real-time analysis of COVID-19 presence in northern Cyprus. Methods: All official SARS-CoV-2 positive cases were tracked and reported in terms of the origin, nationality, and transmission routes. Preventive measures taken after the first reported case were analyzed for their effectiveness as control strategies. Results: The index case of SARS-CoV-2 in northern Cyprus was identified as a female German tourist. First local case had travel history from the United Kingdom after which local transmission occurred. Rapid and strict containment measures have currently delayed a peak in observed cases. Conclusions: Rapid implementation of social-distancing measures, good hygiene measures and travel/gathering bans in northern Cyprus has been effective in controlling the outbreak.


title: Cross-lingual Transfer Learning for COVID-19 Outbreak Alignment

text: The spread of COVID-19 has become a significant and troubling aspect of society in 2020. With millions of cases reported across countries, new outbreaks have occurred and followed patterns of previously affected areas. Many disease detection models do not incorporate the wealth of social media data that can be utilized for modeling and predicting its spread. In this case, it is useful to ask, can we utilize this knowledge in one country to model the outbreak in another? To answer this, we propose the task of cross-lingual transfer learning for epidemiological alignment. Utilizing both macro and micro text features, we train on Italy's early COVID-19 outbreak through Twitter and transfer to several other countries. Our experiments show strong results with up to 0.85 Spearman correlation in cross-country predictions.


title: Learning as We Go: An Examination of the Statistical Accuracy of COVID19 Daily Death Count Predictions

text: This paper provides a formal evaluation of the predictive performance of a model (and its various updates) developed by the Institute for Health Metrics and Evaluation (IHME) for predicting daily deaths attributed to COVID19 for each state in the United States. The IHME models have received extensive attention in social and mass media, and have influenced policy makers at the highest levels of the United States government. For effective policy making the accurate assessment of uncertainty, as well as accurate point predictions, are necessary because the risks inherent in a decision must be taken into account, especially in the present setting of a novel disease affecting millions of lives. To assess the accuracy of the IHME models, we examine both forecast accuracy as well as the predictive performance of the 95% prediction intervals provided by the IHME models. We find that the initial IHME model underestimates the uncertainty surrounding the number of daily deaths substantially. Specifically, the true number of next day deaths fell outside the IHME prediction intervals as much as 70% of the time, in comparison to the expected value of 5%. In addition, we note that the performance of the initial model does not improve with shorter forecast horizons. Regarding the updated models, our analyses indicate that the later models do not show any improvement in the accuracy of the point estimate predictions. In fact, there is some evidence that this accuracy has actually decreased over the initial models. Moreover, when considering the updated models, while we observe a larger percentage of states having actual values lying inside the 95% prediction intervals (PI), our analysis suggests that this observation may be attributed to the widening of the PIs. The width of these intervals calls into question the usefulness of the predictions to drive policy making and resource allocation.


title: Insomnia during COVID-19 pandemic and lockdown: Prevalence, severity, and associated risk factors in French population

text: In response to Voitsidis et al. (2020) published in Psychiatry Research addressing the paucity of research on insomnia during a pandemic, we obtained data from an online cross-sectional survey by documenting the prevalence of clinical insomnia and its contributing factors in a French general public sample. Participants (N = 556) completed the Insomnia Severity Index, UCLA Loneliness scale, and provided information on sociodemographics, antecedents of mental and physical health conditions, and COVID-19-related stressful life events. In our sample, 19.1% met the diagnostic criteria of clinical insomnia, which was twice lower than that reported in the study by Voitsidis et al., but close to those found among Chinese and Italian populations. We confirmed COVID-19-related worries and loneliness to be the major contributing factors to clinical insomnia, in addition to education status, being infected by the virus and pre-existing mental health illness. These findings underscore that sleep-related problems should be an important component of mental health interventions during pandemics.


title: Robust predictive model for Carriers, Infections and Recoveries (CIR): first update for CoVid-19 in Spain

text: This article reports a first update on the assesment of the model previously presented in arXiv:2003.13890v1. New available data have been used to feed the model and the comparison with real data still shows good agreement. The main novelty of the model is that it keeps track of the date of infection of a single individual and uses stochastic distributions to aggregate individuals who share the same date of infection. In addition, it uses two types of infections, mild and serious, with a different recovery time. These features are implemented in a set of differential equations which determine the number of Carriers, Infections, Recoveries, Hospitalized and Deaths.


"Abandoned" Nursing Homes Continue to Face Critical Supply and Staff Shortages as COVID-19 Toll Has Mounted


title: Clinical characteristics of IgG4-RD patients infected with COVID-19 in Hubei, China

text: OBJECTIVE: IgG4-related disease (IgG4-RD) is an immune-mediated multi-organ, chronic and progressive disease. Therefore, we conducted a study to investigate the susceptibility of COVID-19 in IgG4-RD patients in Hubei province, and to characterize the clinical manifestation of COVID-19 in IgG4-RD patients. METHODS: A follow-up system that includes over 200 IgG4-RD patients across the country during the past ten years. A total of ninety-one patients with IgG4-RD who live in Hubei, China were identified and responded to our survey. Medical history, clinical symptoms, laboratory tests, CT imaging, and treatment were obtained through a standardized data collection form, and then independently reviewed by two investigators. RESULTS: 2 of 91 cases were infected with COVID-19. Both of them were classified as moderate type. The symptoms such as fever and cough and radiologic features were similar to other COVID-19 patients. Neither of them episode recurrent of IgG4-RD nor progressed to severe or critical condition of COVID-19 under the condition of continuous oral low-dose of glucocorticoids. Besides, patient 2 took a long time for SARS-CoV-2 nucleic acid to turn negative. CONCLUSION: IgG4-RD patients may belongs to the susceptible population of COVID-19 infection, and thus need more careful personal protection. Early identification and properly treatment are very important to prevent IgG4-RD patients with COVID-19 from progression to severe condition.


The Emerging Pandemic of Coronavirus and the Urgent Need for Public Health Leadership