David Oliver: Doughnut deliveries, hospital staff, and the pandemic


Does nasal screening for Staphylococcus aureus before surgery compromise health care professional safety in the COVID-19 era?


title: Real-Time Fluorescence Imaging Using Indocyanine Green to Assess Therapeutic Effects of Near-Infrared Photoimmunotherapy in Tumor Model Mice

text: BACKGROUND: Near-infrared photoimmunotherapy (NIR-PIT) is a cancer therapy that causes an increase in tumor perfusion, a phenomenon termed the super-enhanced permeability and retention effect. Currently, in vivo treatment efficacy of NIR-PIT is observable days after treatment, but monitoring would be improved by more acute detection of intratumor change. Fluorescence imaging may detect increased tumor perfusion immediately after treatment. METHODS: In the first experiment, athymic nude mouse models bearing unilateral subcutaneous flank tumors were treated with either NIR-PIT or laser therapy only. In the second experiment, mice bearing bilateral flank tumors were treated with NIR-PIT only on the left-sided tumor. In both groups, immediately after treatment, indocyanine green was injected at different doses intravenously, and mice were monitored with the Shimadzu LIGHTVISION fluorescence imaging system for 1 hour. RESULTS: Tumor-to-background ratio of fluorescence intensity increased over the 60 minutes of monitoring in treated mice but did not vary significantly in control mice. Tumor-to-background ratio was highest in the 1 mg kg-1 and 0.3 mg kg-1 doses. In mice with bilateral tumors, tumor-to-untreated tumor ratio increased similarly. CONCLUSIONS: Acute changes in tumor perfusion after NIR-PIT can be detected by real-time fluorescence imaging.


Confusion over CPR in patients with covid-19


Novel coronavirus infection and pregnancy


Prevention and control measure to avoid cross infection during radiotherapy in coronavirus disease 2019 (COVID-19) epidemic in Wuhan, China


title: Successful treatment of coronavirus disease 2019 in a patient with asthma

text: Underlying lung disease, especially asthma, has recently been found to be associated with a higher risk of hospitalization with coronavirus disease 2019 (COVID-19) infection. Inhaled corticosteroids (ICS) are the most commonly used controller medications in patients with asthma. It is unclear whether ICS use increases the risk for severe COVID-19 infection. At the current time, asthma organizations are still recommending the continued use of ICS and other asthma medications to minimize the risk of uncontrolled asthma. However, for patients with asthma and who have recovered from COVID-19 infection, the timing of resumption of asthma therapy is equally uncertain. Pulmonary function testing and exhaled oral nitric oxide testing are aerosol-generating procedures and are currently being severely restricted at most health-care facilities. We presented a case of a patient with cough-variant asthma who developed severe COVID-19 associated acute respiratory distress syndrome with the need for intubation and prolonged mechanical ventilation. We highlighted the potential utility of using COVID-19 RNA detection as well as immunoglobulin G antibody testing to help guide the timing of resumption of asthma therapy.


[Urgent research agenda for the novel coronavirus epidemic: transmission and non-pharmaceutical mitigation strategies]


title: Are the cutaneous manifestations during or due to SARS-CoV-2 infection/COVID-19 frequent or not? Revision of possible pathophysiologic mechanisms

text: BACKGROUND: SARS-Cov-2 is a single-stranded RNA virus, a Betacoronavirus, composed of 16 non-structural proteins, with specific roles in replication of coronaviruses. The pathogenesis of COVID-19 is not yet fully understood. The virus and host factors interplay among distinct outcomes of infected patients. METHODS: Using MeSH (Medical Subject Headings) in PubMed, authors searched for articles cotaining information on COVID-19 and the skin. RESULTS: The pathophysiology of the disease is multifactorial: association with innate immune response, hypercoagulability state, lung tissue damage, neurological and/or gastrointestinal tract involvement, monocytic/macrophage activation syndrome, culminating in exaggerated cytokine secretion, called "cytokine storm", which leads to worsening and death. These systemic conditions may be associated with cutaneous lesions, that have polymorphic aspects, where at histopathological level show involvement in different skin changes. These lesions may be associated with multisystemic manifestations that could occur due to angiotensin-converting enzyme 2 receptor and transmembrane serine protease action, allowing the pulmonary infection and possibly skin manifestation. Several reports in literature show cutaneous lesions similar to chilblain, urticarial eruptions, diffuse or disseminated erythema, livedo racemosa, blue toe syndrome, retiform purpura, vesicle trunk, purpuric exanthema or exanthema with clinical aspects of symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) and others. CONCLUSIONS: This review describes the complexity of Covid-19, pathophysiological and clinical aspects, dermatological finding and other dermatological conditions associated with SARS-CoV-2 infection or COVID-19.


Detection of SARS-CoV-2 on high-touch surfaces in a clinical microbiology laboratory


Effects of COVID-19 lockdown on epidemic diseases of childhood


title: Comprehensive investigation of an in-hospital transmission cluster of a symptomatic SARS-CoV-2-positive physician among patients and healthcare workers in Germany

text: We investigated potential transmissions of a symptomatic SARS-CoV-2-positive physician in a tertiary-care hospital who worked for 15 cumulative hours without wearing a face mask. No in-hospital transmissions occurred, despite 254 contacts among patients and healthcare workers. In conclusion, exposed hospital staff continued work, accompanied by close clinical and virologic monitoring.


COVID-19 pandemic and mental health: The surgeon's role in re-engaging patients


Pivoting Research to COVID-19


Dealing with immune-mediated neuropathies during COVID-19 outbreak: practical recommendations from the task force of the Italian Society of Neurology (SIN), the Italian Society of Clinical Neurophysiology (SINC) and the Italian Peripheral Nervous System Association (ASNP)


Diabetes and Technology in the Covid-19 Pandemic Crisis


title: Chinese Public's Attention to the COVID-19 Epidemic on Social Media: Observational Descriptive Study

text: BACKGROUND: Since the coronavirus disease (COVID-19) epidemic in China in December 2019, information and discussions about COVID-19 have spread rapidly on the internet and have quickly become the focus of worldwide attention, especially on social media. OBJECTIVE: This study aims to investigate and analyze the public's attention to events related to COVID-19 in China at the beginning of the COVID-19 epidemic (December 31, 2019, to February 20, 2020) through the Sina Microblog hot search list. METHODS: We collected topics related to the COVID-19 epidemic on the Sina Microblog hot search list from December 31, 2019, to February 20, 2020, and described the trend of public attention on COVID-19 epidemic-related topics. ROST Content Mining System version 6.0 was used to analyze the collected text for word segmentation, word frequency, and sentiment analysis. We further described the hot topic keywords and sentiment trends of public attention. We used VOSviewer to implement a visual cluster analysis of hot keywords and build a social network of public opinion content. RESULTS: The study has four main findings. First, we analyzed the changing trend of the public's attention to the COVID-19 epidemic, which can be divided into three stages. Second, the hot topic keywords of public attention at each stage were slightly different. Third, the emotional tendency of the public toward the COVID-19 epidemic-related hot topics changed from negative to neutral, with negative emotions weakening and positive emotions increasing as a whole. Fourth, we divided the COVID-19 topics with the most public concern into five categories: the situation of the new cases of COVID-19 and its impact, frontline reporting of the epidemic and the measures of prevention and control, expert interpretation and discussion on the source of infection, medical services on the frontline of the epidemic, and focus on the worldwide epidemic and the search for suspected cases. CONCLUSIONS: Our study found that social media (eg, Sina Microblog) can be used to measure public attention toward public health emergencies. During the epidemic of the novel coronavirus, a large amount of information about the COVID-19 epidemic was disseminated on Sina Microblog and received widespread public attention. We have learned about the hotspots of public concern regarding the COVID-19 epidemic. These findings can help the government and health departments better communicate with the public on health and translate public health needs into practice to create targeted measures to prevent and control the spread of COVID-19.


U.S. 'Warp Speed' vaccine effort comes out of the shadows


title: Modelos SIR modificados para la evoluci\'on del COVID19

text: We study the SIR epidemiological model, with a variable contagion rate, applied to the evolution of COVID19 in Cuba. It is highlighted that an increase in the predictive character depends on understanding the dynamics for the temporal evolution of the rate of contagion $\beta^*$. A semi-empirical model for this dynamics is formulated, where reaching $\beta^*\approx0$ due to isolation is achieved after the mean duration of the disease $\tau=1/\gamma$, in which the number of infected in the confined families has decreased. It is considered that $\beta^*(t)$ should have an abrupt decrease on the day of initiation of confinement and decrease until canceling at the end of the interval $\tau$. The analysis describes appropriately the infection curve for Germany. The model is applied to predict an infection curve for Cuba, which estimates a maximum number of infected as less than 2000 in the middle of May, depending on the rigor of the isolation. This is suggested by the ratio between the daily detected cases and the total. We consider the ratio between the observed and real infected cases (k) less than unity. The low value of k decreases the maximum obtained when $\beta^*-\gamma>0$. The observed evolution is independent of k in the linear region. The value of $\beta^*$ is also studied by time intervals, adjusting to the data of Cuba, Germany and South Korea. We compare the extrapolation of the evolution of Cuba with the contagion rate until 16.04.20 with that obtained by a strict quarantine at the end of April. This model with variable $\beta^*$ correctly describes the observed infected evolution curves. We emphasize that the desired maximum of the SIR infected curve is not the maximum standard with constant $\beta^*$, but one achieved due to quarantine when $\tilde R_0=\beta^*/\gamma<1$. For the countries controlling the epidemic the maxima are in the region in which SIR equations are linear.


COVID-19 Related Oral Manifestations, Early Disease Features?


title: AACR Calls on Congress to Take Immediate Action against COVID-19 and Protect Patients with Cancer during the Pandemic

text: On March 30, 2020, the AACR Board of Directors provided a letter to the U.S. Congressional leadership on behalf of its members in response to the COVID-19 public health emergency.


COVID-19: How Can Rural Community Pharmacies Respond to the Outbreak?


title: Resuming hip and knee arthroplasty after COVID-19: ethical implications for well-being, safety and the economy

text: Reinstating elective hip and knee arthroplasty services presents significant challenges. We need to be honest about the scale of the obstacles ahead and realise that the health challenges and economic consequences of the COVID-19 pandemic are potentially devastating. We must also prepare to make difficult ethical decisions about restarting elective hip and knee arthroplasty. These decisions should be based on the existing evidence-base, reliable data, the recommendations of experts, and regional circumstances.


Corticosteroids in diabetes patients infected with COVID-19


To-go medications as a means to treat discharged emergency department patients during COVID-19


title: [Thoughts on the reform of preventive medicine education in the context of new medicine]

text: Talent training is the core and foundation of public health system construction. Shortage of talents in the field of disease prevention and public health exposed by COVID-19 pandemic highlights the importance of developing preventive medical education. This article analyzes the challenges of medical education in the dilemma of "separation of medical treatment and prevention", and the new requirements for preventive medical education in the construction of New Medicine under the Healthy China strategy. Four aspects including stepping up the resource allocation and investment, educating responsible public health professionals, the education of all medical students who implement the core competence of public health, and the establishment of a continuing education system for preventive medicine have been considered. A series of specific suggestions are put forward including the establishment of a full-chain closed-loop research system to support the cultivation of top-notch innovative public health talents, strengthening the assessment of core public health capabilities for clinical medical professional admission, formulating a "medical and preventive integration" training program for primary health personnel, and implementing "combination of peace and war" public health personnel reserve system, with the purpose of providing reference for the reform and development of preventive medical education in China.


Correlation between travellers departing from Wuhan before the Spring Festival and subsequent spread of COVID-19 to all provinces in China


title: Correlation between travellers departing from Wuhan before the Spring Festival and subsequent spread of COVID-19 to all provinces in China ;Journal of Travel Medicine ;Oxford Academic

text: Highlight We found a strong correlation between travel volumes departing from Wuhan, Hubei Province before the Spring Festival and the extent of amplification of the outbreak of COVID-19 in China in 2020, with 100 top cities Almost 70% of exportations were within cities in Hubei province


title: Commentary: Challenges to Achieve Conceptual Clarity in the Definition of Pandemics

text: From a scientific standpoint, the world is more prepared than ever to respond to infectious disease outbreaks; paradoxically, globalization and air travel, antimicrobial resistance, the threat of bioterrorism, and newly emerging pathogens driven by ecological, socioeconomic, and environmental factors, have increased the risk of global epidemics.1,2,3 Following the 2002-2003 severe acute respiratory syndrome (SARS), global efforts to build global emergency response capabilities to contain infectious disease outbreaks were put in place.4,5,6 But the recent H1N1, Ebola, and Zika global epidemics have shown unnecessary delays and insufficient coordination in response efforts.7,8,9,10 In a thoughtful and compelling essay,11 Thana C. de Campos argues that greater clarity in the definition of pandemics would probably result in more timely effective emergency responses, and pandemic preparedness. In her view, a central problem is that the definition of pandemics is based solely on disease transmission across several countries, and not on spread and severity together, which conflates two very different situations: emergency and nonemergency disease outbreaks. A greater emphasis on severity, such that pandemics are defined as severe and rapidly spreading infectious disease outbreaks, would make them "true global health emergencies," allowing for priority resource allocation and effective collective actions in emergency response efforts. Sympathetic to the position taken by de Campos, here I highlight some of the challenges in the definition of severity during an infectious disease outbreak.


title: Related Health Factors of Psychological Distress During the COVID-19 Pandemic in Spain

text: Measures to prevent and contain the COVID-19 health crisis include population confinement, with the consequent isolation and interruption of their usual activities. The aim of the study is to analyse psychological distress during the COVID-19 pandemic. For this, a cross-sectional observational study with a sample of 4180 people over the age of 18 during quarantine was developed. Variables considered were sociodemographic variables, physical symptoms, health conditions, COVID-19 contact history and psychological adjustment. The data were collected through a self-developed questionnaire and the General Health Questionnaire (GHQ-12). Bivariate analyses were performed, including Chi-Squared test and Student's T-test. Predictive ability was calculated through logistic regression. Results obtained showed a high level of psychological distress (72.0%), with a higher percentage in women and people of lower middle age. Statistically significant differences were found in the variable working situation (χ² = 63.139, p ≤ 0.001, V = 0.123) and living with children under the age of 16 (χ² = 7.393, p = 0.007, V = 0.042). The predictive variables with the highest weight were sex (OR = 1.952, 95% IC = (1.667, 2.286)), presence of symptoms (OR = 1.130, 95% CI = (1.074, 1.190)), and having had close contact with an individual with confirmed COVID-19 (OR = 1.241, 95% CI = (1.026, 1.500)). These results could enrich prevention interventions in public health and, in particular, in mental health in similar pandemic situations.


Características y resultados de una serie de 59 pacientes con neumonía grave por COVID-19 ingresados en UCI./ Características y resultados de una serie de 59 pacientes con neumonía grave por COVID-19 ingresados en UCI./ Characteristics and results of a series of 59 patients with severe pneumonia due to COVID-19 admitted in the ICU


Covid-19: retired doctors could be asked to return to work, says Hancock


Essais cliniques en période de pandémie : garantir la sécurité des patients et maintenir l'accès à l'innovation./ [Clinical trials during pandemic crisis: How to ensure safety and maintain access to innovation]


Understanding the Impact of COVID-19 on Latino Sexual Minority Men in a US HIV Hot Spot


title: Coronaviruses fusion with the membrane and entry to the host cell

text: Coronaviruses (CoVs) are positive-strand RNA viruses with the largest genome among all RNA viruses. They are able to infect many host, such as mammals or birds. Whereas CoVs were identified 1930s, they became known again in 2003 as the agents of the Severe Acute Respiratory Syndrome (SARS). The spike protein is thought to be essential in the process of CoVs entry, because it is associated with the binding to the receptor on the host cell. It is also involved in cell tropism and pathogenesis. Receptor recognition is the crucial step in the infection. CoVs are able to bind a variety of receptors, although the selection of receptor remains unclear. Coronaviruses were initially believed to enter cells by fusion with the plasma membrane. Further studies demonstrated that many of them involve endocytosis through clathrin-dependent, caveolae-dependent, clathrin-independent, as well as caveolae-independent mechanisms. The aim of this review is to summarise current knowledge about coronaviruses, focussing especially on CoVs entry into the host cell. Advances in understanding coronaviruses replication strategy and the functioning of the replicative structures are also highlighted. The development of host-directed antiviral therapy seems to be a promising way to treat infections with SARS-CoV or other pathogenic coronaviruses. There is still much to be discovered in the inventory of pro- and anti-viral host factors relevant for CoVs replication. The latest pandemic danger, originating from China, has given our previously prepared work even more of topicality.


COVID-19 and obesity


title: Regression Approach for Modeling COVID-19 Spread and its Impact On Stock Market

text: The paper studies different regression approaches for modeling COVID-19 spread and its impact on the stock market. The logistic curve model was used with Bayesian regression for predictive analytics of the coronavirus spread. The impact of COVID-19 was studied using regression approach and compared to other crises influence. In practical analytics, it is important to find the maximum of coronavirus cases per day, this point means the estimated half time of coronavirus spread in the region under investigation. The obtained results show that different crises with different reasons have different impact on the same stocks. It is important to analyze their impact separately. Bayesian inference makes it possible to analyze the uncertainty of crisis impacts.


title: Neutrophil to lymphocyte ratio as prognostic and predictive factor in patients with coronavirus disease 2019: A retrospective cross-sectional study

text: This retrospective study was designed to explore whether neutrophil to lymphocyte ratio (NLR) is a prognostic factor in patients with coronavirus disease 2019 (COVID-19). A cohort of patients with COVID-19 admitted to the Tongren Hospital of Wuhan University from 11 January 2020 to 3 March 2020 was retrospectively analyzed. Patients with hematologic malignancy were excluded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count. NLR values were measured at the time of admission. The primary outcome was all-cause in-hospital mortality. A multivariate logistic analysis was performed. A total of 1004 patients with COVID-19 were included in this study. The mortality rate was 4.0% (40 cases). The median age of nonsurvivors (68 years) was significantly older than survivors (62 years). Male sex was more predominant in nonsurvival group (27; 67.5%) than in the survival group (466; 48.3%). NLR value of nonsurvival group (median: 49.06; interquartile range [IQR]: 25.71-69.70) was higher than that of survival group (median: 4.11; IQR: 2.44-8.12; P < .001). In multivariate logistic regression analysis, after adjusting for confounding factors, NLR more than 11.75 was significantly correlated with all-cause in-hospital mortality (odds ratio = 44.351; 95% confidence interval = 4.627-425.088). These results suggest that the NLR at hospital admission is associated with in-hospital mortality among patients with COVID-19. Therefore, the NLR appears to be a significant prognostic biomarker of outcomes in critically ill patients with COVID-19. However, further investigation is needed to validate this relationship with data collected prospectively.


Could the decrease in the endothelial nitric oxide (NO) production and NO bioavailability be the crucial cause of COVID-19 related deaths?


Diagnostic and prognostic values of cutaneous manifestations in COVID-19


title: COVID-19 human challenge studies: ethical issues

text: COVID-19 poses an extraordinary threat to global public health and an effective vaccine could provide a key means of overcoming this crisis. Human challenge studies involve the intentional infection of research participants and can accelerate or improve vaccine development by rapidly providing estimates of vaccine safety and efficacy. Human challenge studies of low virulence coronaviruses have been done in the past and human challenge studies with severe acute respiratory syndrome coronavirus 2 have been proposed. These studies of coronaviruses could provide considerable benefits to public health; for instance, by improving and accelerating vaccine development. However, human challenge studies of severe acute respiratory syndrome coronavirus 2 in particular might be controversial, in part, for ethical reasons. The ethical issues raised by such studies thus warrant early consideration involving, for example, broad consultation with the community. This Personal View provides preliminary analyses of relevant ethical considerations regarding human challenge studies of severe acute respiratory syndrome coronavirus 2, including the potential benefits to public health and to participants, the risks and uncertainty for participants, and the third-party risks (ie, to research staff and the wider community). We argue that these human challenge studies can reasonably be considered ethically acceptable insofar as such studies are accepted internationally and by the communities in which they are done, can realistically be expected to accelerate or improve vaccine development, have considerable potential to directly benefit participants, are designed to limit and minimise risks to participants, and are done with strict infection control measures to limit and reduce third-party risks.


Covid-19 could widen mental health inequalities for a generation, warns charity


title: Report of the first cases of mother and infant infections with 2019 novel coronavirus in Xinyang City Henan Province/ 中华传染病杂志

text: Objective@#To report the first case of a neonatal pneumonia with 2019-nCoV infection, and the experience of successfully diagnosis and treatment in late pregnancy woman with novel coronavirus pneumonia (critical type) in Xinyang city.@*Methods@#The successfully diagnosis and treatment of a woman with 38 weeks singleton pregnancy complicated with novel coronavirus pneumonia (critical type), and a case of neonatal pneumonia with 2019-nCoV infection were retrospectively analyzed.@*Results@#A single male was successfully delivered at 38-week gestation of his mother by cesarean section under third level protection in operation room. The delivery woman was diagnosed with 2019-nCoV infection at day 2 of delivery. Dyspnea and severe hypoxemia soon developed, and invasive mechanical ventilation was given. After active rescue and treatment, the delivery woman had been taken off line successfully and the condition was stable. Pharyngeal swab specimen of the neonate was sent for examination 3 days after birth, and was positive for novel coronavirus nucleic acid by fluorescence reverse transcript polymerase chain reaction.@*Conclusion@#2019-nCoV may be transmitted vertically from mother to child.


title: Quarantine Vehicle Scheduling for Transferring High-Risk Individuals in Epidemic Areas

text: In a large-scale epidemic outbreak, there can be many high-risk individuals to be transferred for medical isolation in epidemic areas. Typically, the individuals are scattered across different locations, and available quarantine vehicles are limited. Therefore, it is challenging to efficiently schedule the vehicles to transfer the individuals to isolated regions to control the spread of the epidemic. In this paper, we formulate such a quarantine vehicle scheduling problem for high-risk individual transfer, which is more difficult than most well-known vehicle routing problems. To efficiently solve this problem, we propose a hybrid algorithm based on the water wave optimization (WWO) metaheuristic and neighborhood search. The metaheuristic uses a small population to rapidly explore the solution space, and the neighborhood search uses a gradual strategy to improve the solution accuracy. Computational results demonstrate that the proposed algorithm significantly outperforms several existing algorithms and obtains high-quality solutions on real-world problem instances for high-risk individual transfer in Hangzhou, China, during the peak period of the novel coronavirus pneumonia (COVID-19).


Coping With COVID-19: Learning From Past Pandemics to Avoid Pitfalls and Panic


Perioperative personal protective equipment stewardship (POPPiES)


COVID 19 vaccination lessons from Japanese anti-HPV vaccination lobby


Vesicular drug-delivery systems as theranostics in COVID-19


Have We Passed the Peak? The COVID-19 Plastic Surgery Webinar Pandemic


title: Safety model for chest drainage in pandemic by COVID-19

text: Over one million cases of the SARS-CoV-2 virus have been confirmed worldwide, with the death toll exceeding 50,000 people. An important issue to be addressed concerns the exposure of health professionals to this new virus. The first reports from Wuhan province, China, described infection rates of up to 29% among healthcare professionals before the use of personal protective equipment (PPE) was fully regulated. There are several protocols on the correct use of PPE during aerosol-generating procedures. However, there is no specific guidance on how to proceed in cases of need for chest tubes in patients with positive COVID-19 active air leak. The objective of this work is to assist surgeons of the most diverse specialties during the chest drainage of a patient with COVID-19 and to avoid a risk of contamination to the professional and the environment.


title: Rhinologic Practice Special Considerations During COVID-19: Visit Planning, Personal Protective Equipment, Testing, and Environmental Controls

text: As rhinologists return to practice amid SARS-CoV-2, special considerations are warranted given the unique features of their subspecialty. Rhinologist manipulation of nasal tissue, proximity, and frequent aerosol-generating procedures (AGPs) create high risk for infection transmission. There are 4 areas of special consideration to mitigate risk: (1) previsit planning for risk stratification/mitigation, (2) appropriate personal protective equipment, (3) preprocedural testing, and (4) environmental controls. During previsit planning, risk factors of the patient and procedures are considered. High-risk AGPs are identified by duration, proximity, manipulation of high-viral load tissue, and use of powered instrumentation. Appropriate personal protective equipment includes selection of respiratory and eye protection. COVID-19 testing can screen for asymptomatic carriers prior to high-risk procedures; however, alternative testing methods are required in rhinologic patients not eligible for nasopharyngeal testing due to nasal obstruction or skull base defects. Last, AGPs in rhinologic practices require considerations of room air handling and environmental controls.


title: Coinfección entre dengue y COVID-19: Necesidad de abordaje en zonas endémicas./ [Coinfection between dengue and covid-19: need for approach in endemic zones.]

text: The impact caused by the 2019 coronavirus disease (COVID-19) in different parts of the world, currently reaches 745, 308 infected and 35,307 deaths according to the latest reports. In this context, in our country, an area of ââepidemiological relevance is the Peruvian Amazon, due to the distribution of endemic diseases such as metaxemic diseases (Dengue, Malaria, among others), where the problem increases due to the COVID infection. -19 can lead to false positives in Dengue screening tests. Thus leading to a delay in the diagnosis of COVID-19 infection and further spread of the virus, since in most cases of Dengue there are no warning signs and treatment is ambulatory. This article seeks to express an opinion on the need to address cases of coinfection between Dengue and Covid-19 in endemic areas.


Covid-19: Health needs of sex workers are being sidelined, warn agencies


Care for patients with rheumatic diseases during COVID-19 pandemic: A position statement from APLAR


title: COVID-19-Pandemie: strukturierte Erweiterung von Beatmungskapazitäten mithilfe von Heimrespiratoren./ [COVID-19 pandemic: structured expansion of ventilation capacities using home respirators]

text: Due to the current COVID-19 pandemic there is a need for a rapid increase in intensive care and ventilation capacities. Delivery times for additional intensive care respirators are currently not foreseeable. An option to increase ventilation capacities not only for COVID-19, but for all patients requiring mechanical ventilation is to use home respirators. Home respirators are turbine respirators, so they can usually be operated without high-pressure oxygen connections and can therefore also be used in areas outside the classical intensive care medical infrastructure. Due to their limited technical features, home respirators are not suitable for the treatment of severely affected patients but can be used for weaning after respiratory improvement, which means that intensive care respirators are available again more quickly. Respiratory therapists are specially trained nurses or therapists in the field of out of hospital ventilation and can independently use home ventilation respirators, for example for weaning in the intensive care unit. Thus, they relieve intensive care nursing staff in the pandemic. Due to the COVID-19 pandemic medical students from the Oldenburg University are currently being trained in operating home respirators to provide basic support in the hospital if necessary.


Does pandemic justify the use of hydroxychloroquine for treatment and prevention of COVID-19 in India?


An innovative endotracheal tube clamp for use in COVID-19


title: Caring for patients with diabetes during COVID-19 pandemic: Important considerations for pharmacists

text: The current pandemic of the COVID-19 infection, coupled with the increased global burden of diabetes, has imposed significant challenges to the healthcare providers in providing effective and sustained care to patients with diabetes during the ongoing pandemic. It is, therefore, important for healthcare providers to understand and follow the recommended changes in the delivery of care, lifestyle modifications, and pharmacotherapy to ensure optimal care to the patients during and post-pandemic era. This commentary aims to discuss the impact of COVID-19 on diabetes care and the important considerations for pharmacists during this pandemic.


title: Dinucleotide repeats in coronavirus SARS-CoV-2 genome: evolutionary implications

text: The ongoing global pandemic of infection disease COVID-19 caused by the 2019 novel coronavirus (SARS-COV-2, formerly 2019-nCoV) presents critical threats to public health and the economy since it was identified in China, December 2019. The genome of SARS-CoV-2 had been sequenced and structurally annotated, yet little is known of the intrinsic organization and evolution of the genome. To this end, we present a mathematical method for the genomic spectrum, a kind of barcode, of SARS-CoV-2 and common human coronaviruses. The genomic spectrum is constructed according to the periodic distributions of nucleotides, and therefore reflects the unique characteristics of the genome. The results demonstrate that coronavirus SARS-CoV-2 exhibits dinucleotide TT islands in the non-structural proteins 3, 4, 5, and 6. Further analysis of the dinucleotide regions suggests that the dinucleotide repeats are increased during evolution and may confer the evolutionary fitness of the virus. The special dinucleotide regions in the SARS-CoV-2 genome identified in this study may become diagnostic and pharmaceutical targets in monitoring and curing the COVID-19 disease.


ACEi and ARB with COVID-19


Managing patients with cancer in the COVID-19 era


SLE patients are not immune to covid-19: importance of sending the right message across


title: BCG versus COVID-19: impact on urology

text: PURPOSE: To search for evidence base for using BCG in the fight against COVID-19 and the possible impact of these clinical trials on urology practice. METHODS: A literature review about the basis of the ongoing clinical trials using BCG against COVID-19, as well as the use of BCG in urology and if there are any implications of these trials on our practice. RESULTS: Based on data from some epidemiological studies, there are some current clinical trials on the use BCG as a possible prophylactic vaccine against SARS CoV-2 which can affect urology practice. Urologists are already struggling with the global shortage of BCG which can be even more aggravated by such trials. In addition, if the ongoing trials proved the efficacy of BCG as a prophylaxis against COVID-19, this may open the door to more urological research opportunities to question the possibility that intra-vesical BCG, given its systemic immunologic effect, may have been protective to this subgroup of urological patients. CONCLUSION: The ongoing clinical trials using BCG against COVID-19 can affect our urology practice. We need to stay vigilant to such impacts: BCG shortage and possible new chances for urology research work.


House Calls for Stem Cell Transplants During the COVID-19 Pandemic


Oral erosions and petechiae during SARS-CoV-2 infection


title: The impact of COVID-19 on the UK fresh food supply chain

text: The resilience of the food supply chain is a matter of critical importance, both for national security and broader societal well bring. COVID19 has presented a test to the current system, as well as means by which to explore whether the UK's food supply chain will be resilient to future disruptions. In the face of a growing need to ensure that food supply is more environmentally sustainable and socially just, COVOD19 also represents an opportunity to consider the ability of the system to innovative, and its capacity for change. The purpose of this case based study is to explore the response and resilience of the UK fruit and vegetable food supply chain to COVID19, and to assess this empirical evidence in the context of a resilience framework based on the adaptive cycle. To achieve this we reviewed secondary data associated with changes to retail demand, conducted interviews with 23 organisations associated with supply to this market, and conducted four video workshops with 80 organisations representing half of the UK fresh produce community. The results highlight that, despite significant disruption, the retail dominated fresh food supply chain has demonstrated a high degree of resilience. In the context of the adaptive cycle, the system has shown signs of being stuck in a rigidity trap, as yet unable to exploit more radical innovations that may also assist in addressing other drivers for change. This has highlighted the significant role that innovation and R&D communities will need to play in enabling the supply chain to imagine and implement alternative future states post COVID.


Professional Obligations of Clinicians and Institutions in Pediatric Care Settings During a Public Health Crisis: A Review


Timely research papers about COVID-19 in China


Liver injury in COVID-19: Diagnosis and associated factors


title: Standard versus hypofractionated intensity-modulated radiotherapy for prostate cancer: assessing the impact on dose modulation and normal tissue effects when using patient-specific cancer biology

text: Hypofractionation of prostate cancer radiotherapy achieves tumour control at lower total radiation doses, however, increased rectal and bladder toxicities have been observed. To realise the radiobiological advantage of hypofractionation whilst minimising harm, the potential reduction in dose to organs at risk was investigated for biofocused radiotherapy. Patient-specific tumour location and cell density information were derived from multiparametric imaging. Uniform-dose plans and biologically-optimised plans were generated for a standard schedule (78 Gy/39 fractions) and hypofractionated schedules (60 Gy/20 fractions and 36.25 Gy/5 fractions). Results showed that biologically-optimised plans yielded statistically lower doses to the rectum and bladder compared to isoeffective uniform-dose plans for all fractionation schedules. A reduction in the number of fractions increased the target dose modulation required to achieve equal tumour control. On average, biologically-optimised, moderately-hypofractionated plans demonstrated 16.3% (p-value:0.01) and 16.0% (p-value:0.04) reduction in rectal and bladder dose compared with standard fractionation. The tissue-sparing effect was more pronounced in extreme hypofractionation with mean reduction in rectal and bladder dose of 37.4% (p-value:<0.01) and 46.8% (p-value:0.02), respectively. This study suggests that the ability to utilise patient-specific tumour biology information will provide greater incentive to employ hypofractionation in the treatment of localised prostate cancer with radiotherapy. However, to exploit the radiobiological advantages given by hypofractionation, greater attention to geometric accuracy is required due to increased sensitivity to treatment uncertainties.


COVID-19: response plan for International Medical Assistance companies


Pandemic panic and anxiety in developing countries. Embracing One Health offers practical strategies in management of COVID-19 for Africa


title: Oculoplastic surgery practice during the COVID-19 novel coronavirus pandemic: experience sharing from Hong Kong

text: At present, all parts of the world are hit hard by COVID-19. The first confirmed case of COVID-19 in the territory of Hong Kong was announced on January 23, 2020. Since then, oculoplastic surgeons in Hong Kong have been taking every measure to protect all healthcare workers and patients from contracting the disease. This paper aims to share the experiences of and measures taken by local oculoplastic surgeons in combating COVID-19. Three main aspects are discussed, namely clinical, administrative, and training and educational. We hope our experiences would provide reference to fellow oculoplastic colleagues in other parts of the world in fighting this COVID-19 pandemic.


Secondary Impact of the COVID-19 Pandemic on Patients With Heart Failure


Loss of Smell and Taste in 2013 European Patients With Mild to Moderate COVID-19


title: Mortality burden from seasonal influenza in Chongqing, China, 2012-2018

text: Purpose: To estimate influenza-associated excess mortality rates (EMRs) in Chongqing from 2012 to 2018.Methods: We obtained weekly mortality data for all-cause and four underlying causes of death (circulatory and respiratory disease (CRD), pneumonia and influenza (P&I), chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IDH)), and influenza surveillance data, from 2012 to 2018. A negative-binomial regression model was used to estimate influenza-associated EMRs in two age groups (<65 years and ≥65 years).Results: It was estimated that an annual average of 10025 influenza-associated deaths occurred in Chongqing, corresponding to 5.2% of all deaths. The average EMR for all-cause death associated with influenza was 33.5 (95% confidence interval (CI): 31.5-35.6) per 100 000 persons, and in separate cause-specific models we attributed 24.7 (95% CI: 23.3-26.0), 0.8 (95% CI: 0.7-0.8), 8.5 (95% CI: 8.1-9.0) and 5.0 (95% CI: 4.7-5.3) per 100 000 persons EMRs to CRD, P&I, COPD and IDH, respectively. The estimated EMR for influenza B virus was 20.6 (95% CI: 20.3-21.0), which was significantly higher than the rates of 5.3 (95% CI: 4.5-6.1) and 7.5 (95% CI: 6.7-8.3) for A(H3N2) and A(H1N1) pdm09 virus, respectively. The estimated EMR was 152.3 (95% CI: 136.1-168.4) for people aged ≥65 years, which was significantly higher than the rate for those aged <65 years (6.8, 95% CI: 6.3-7.2).Conclusions: Influenza was associated with substantial EMRs in Chongqing, especially among elderly people. Influenza B virus caused a relatively higher excess mortality impact compared with A(H1N1)pdm09 and A(H3N2). It is advisable to optimize future seasonal influenza vaccine reimbursement policy in Chongqing to curb disease burden.


Clinical placements for medical students in the time of COVID-19


title: Reasons and solutions for 'false positive results' of 2019 Novel Coronavirus-specific antibodies detection

text: Assays of specific immunoglobulin M (IgM) and immunoglobulin G (IgG) have been supplemented in 'diagnosis and treatment guidelines of Novel Coronavirus pneumonia' (7th edition) issued by National Health Commission of the People’s Republic of China as an auxiliary evidence to diagnose Novel Coronavirus pneumonia However, the false positive results is a major problem in the application of antibody assays The factors causing the false positive results were analyzed and the ways were discussed to reduce the false positive results The false positive results of antibody assays can be reduced, but they cannot be fully resolved Antibody assays are valuable criteria for the diagnosis of suspected cases with negative nucleic acid results only if at least two dynamic tests are used


Improper Solid Waste Management Increases Potential for COVID-19 Spread in Developing Countries


Reply to: "Reporting of all cardiac medications and their outcome in COVID-19"


title: Comparison of hydroxychloroquine, lopinavir/ritonavir, and standard of care in critically ill patients with SARS-CoV-2 pneumonia: an opportunistic retrospective analysis

text: BACKGROUND: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak is spreading worldwide. To date, no specific treatment has convincingly demonstrated its efficacy. Hydroxychloroquine and lopinavir/ritonavir have potential interest, but virological and clinical data are scarce, especially in critically ill patients. METHODS: The present report took the opportunity of compassionate use and successive drug shortages to compare the effects of two therapeutic options, lopinavir/ritonavir and hydroxychloroquine, as compared to standard of care only. The primary outcomes were treatment escalation (intubation, extra-corporeal membrane oxygenation support, or renal replacement therapy) after day 1 until day 28. Secondary outcomes included ventilator-free days at day 28, mortality at day 14 and day 28, treatment safety issues and changes in respiratory tracts, and plasma viral load (as estimated by cycle threshold value) between admission and day 7. RESULTS: Eighty patients were treated during a 4-week period and included in the analysis: 22 (28%) received standard of care only, 20 (25%) patients received lopinavir/ritonavir associated to standard of care, and 38 (47%) patients received hydroxychloroquine and standard of care. Baseline characteristics were well balanced between the 3 groups. Treatment escalation occurred in 9 (41%), 10 (50%), and 15 (39%) patients who received standard of care only, standard of care and lopinavir/ritonavir, and standard of care and hydroxychloroquine, respectively (p = 0.567). There was no significant difference between groups regarding the number of ventilator-free days at day 28 and mortality at day 14 and day 28. Finally, there was no significant change between groups in viral respiratory or plasma load between admission and day 7. CONCLUSION: In critically ill patients admitted for SARS-CoV-2-related pneumonia, no difference was found between hydroxychloroquine or lopinavir/ritonavir as compared to standard of care only on the proportion of patients who needed treatment escalation at day 28. Further randomized controlled trials are required to demonstrate whether these drugs may be useful in this context.


title: Changes in food choice following restrictive measures due to Covid-19

text: BACKGROUND AND AIMS: Following the Covid-19 proliferation beyond the borders of China at the beginning of 2020, containment measures have been taken by different countries around the globe. Citizens were forced to stay at home. The aim of this study is twofold. First, we will provide an analysis of food consumption in Italy during the emergency from a social stance. Secondly, we will consider the risks in relation to health of these food product choices. METHODS AND RESULT: This analysis is based on IRi's data on consumption trends (percentage increase in sales in value) during the first period of the spread of coronavirus, from 23rd of February through the 29th of March, 2020. The sample includes 10 769 stores. There was an increase in the consumption of pasta, flour, eggs, long-life milk and frozen foods, in comparison to a reduction of fresh food goods. The sales of snacks have dropped in relation to the production of homemade bread, pizza and cakes. CONCLUSION: The increase in the consumption of some types of food is linked with their symbolic value and its tendency to carry on at home some external socialization habits. But be careful: these habits are not always healthy.


title: Uric Acid Elevation by Favipiravir, an Antiviral Drug

text: In light of the recent pandemic, favipiravir (Avigan®), a purine nucleic acid analog and antiviral agent approved for use in influenza in Japan, is being studied for the treatment of coronavirus disease 2019 (COVID-19). Increase in blood uric acid level is a frequent side effect of favipiravir. Here, we discussed the mechanism of blood uric acid elevation during favipiravir treatment. Favipiravir is metabolized to an inactive metabolite M1 by aldehyde oxidase and xanthine oxidase, and excreted into urine. In the kidney, uric acid handling is regulated by the balance of reabsorption and tubular secretion in the proximal tubules. Favipiravir and M1 act as moderate inhibitors of organic anion transporter 1 and 3 (OAT1 and OAT3), which are involved in uric acid excretion in the kidney. In addition, M1 enhances uric acid reuptake via urate transporter 1 (URAT1) in the renal proximal tubules. Thus, favipiravir is thought to decrease uric acid excretion into urine, resulting in elevation of uric acid levels in blood. Elevated uric acid levels were returned to normal after discontinuation of favipiravir, and favipiravir is not used for long periods of time for the treatment of viral infection. Thus, the effect on blood uric acid levels was subclinical in most studies. Nevertheless, the adverse effect of favipiravir might be clinically important in patients with a history of gout, hyperuricemia, kidney function impairment (in which blood concentration of M1 increases), and where there is concomitant use of other drugs affecting blood uric acid elevation.


Prise en charge des cancers oculaires en période épidémique de Covid-19./ [Management of ocular cancer during COVID-19 pandemic]


Minimizing pharmacotherapy-related healthcare worker exposure to SARS-CoV-2


title: Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions

text: The outbreak of a novel coronavirus disease (COVID-19, caused by the 2019-nCoV infection) in December 2019 is one of the most severe public health emergencies since the founding of People's Republic of China in 1949. Healthcare personnel (HCP) nationwide are facing heavy workloads and high risk of infection, especially those who care for patients in Hubei Province. Sadly, as of February 20, 2020, over two thousand COVID-19 cases are confirmed among HCP from 476 hospitals nationwide, with nearly 90% of them from Hubei Province. Based on literature search and interviews with some HCP working at Wuhan, capital city of Hubei, we have summarized some of the effective measures taken to reduce infection among HCP, and also made suggestions for improving occupational safety during an infectious disease outbreak. The experience and lessons learned should be a valuable asset for international health community to contain the ongoing COVID-19 epidemic around the world.


title: Novel Drugs Targeting the SARS-CoV-2/COVID-19 Machinery

text: Like other human pathogenic viruses, coronavirus SARS-CoV-2 employs sophisticated macromolecular machines for viral host cell entry, genome replication and protein processing. Such machinery encompasses SARS-CoV-2 envelope spike (S) glycoprotein required for host cell entry by binding to the ACE2 receptor, viral RNA-dependent RNA polymerase (RdRp) and 3-chymotrypsin-like main protease (3Clpro/Mpro). Under the pressure of the accelerating COVID-19 pandemic caused by the outbreak of SARSCoV- 2 in Wuhan, China in December 2019, novel and repurposed drugs were recently designed and identified for targeting the SARS-CoV-2 reproduction machinery, with the aim to limit spread of SARS-CoV-2 and morbidity and mortality of the COVID-19 pandemic.


title: Poverty levels, societal and individual heterogeneities explain the SARS-CoV-2 pandemic growth in Latin America

text: Latin America is experiencing severe impacts of the SARS-CoV-2 pandemic, but poverty and weak public health institutions hamper gathering the kind of refined data needed to inform classical SEIR models of epidemics. We present an alternative approach that draws on advances in statistical ecology and conservation biology to enhance the value of sparse data in projecting and ameliorating epidemics. Our approach, leading to what we call a Stochastic Epidemic Gompertz model, with few parameters can flexibly incorporate heterogeneity in transmission within populations and across time. We demonstrate that poverty has a large impact on the course of the pandemic, across fourteen Latin American countries, and show how our approach provides flexible, time-varying projections of disease risk that can be used to refine public health strategies.


title: Modeling indoor-level non-pharmaceutical interventions during the COVID-19 pandemic: a pedestrian dynamics-based microscopic simulation approach

text: Mathematical modeling of epidemic spreading has been widely adopted to estimate the threats of epidemic diseases (i.e., the COVID-19 pandemic) as well as to evaluate epidemic control interventions. The indoor place is considered to be a significant epidemic spreading risk origin, but existing widely-used epidemic spreading models are usually limited for indoor places since the dynamic physical distance changes between people are ignored, and the empirical features of the essential and non-essential travel are not differentiated. In this paper, we introduce a pedestrian-based epidemic spreading model that is capable of modeling indoor transmission risks of diseases during people's social activities. Taking advantage of the before-and-after mobility data from the University of Maryland COVID-19 Impact Analysis Platform, it's found that people tend to spend more time in grocery stores once their travel frequencies are restricted to a low level. In other words, an increase in dwell time could balance the decrease in travel frequencies and satisfy people's demand. Based on the pedestrian-based model and the empirical evidence, combined non-pharmaceutical interventions from different operational levels are evaluated. Numerical simulations show that restrictions on people's travel frequency and open-hours of indoor places may not be universally effective in reducing average infection risks for each pedestrian who visit the place. Entry limitations can be a widely effective alternative, whereas the decision-maker needs to balance the decrease in risky contacts and the increase in queue length outside the place that may impede people from fulfilling their travel needs.


title: P-Values in a Post-Truth World

text: The role of statisticians in society is to provide tools, techniques, and guidance with regards to how much to trust data. This role is increasingly more important with more data and more misinformation than ever before. The American Statistical Association recently released two statements on p-values, and provided four guiding principles. We evaluate their claims using these principles and find that they failed to adhere to them. In this age of distrust, we have an opportunity to be role models of trustworthiness, and responsibility to take it.


New approaches to cancer care in a COVID-19 world


Re: From the frontlines of COVID-19-how prepared are we as obstetricians? A commentary


Surgical management of bone and soft tissue sarcomas and skeletal metastases during the COVID-19 pandemic


title: COVID-19: CADD to the rescue

text: The recent outbreak of the deadly COVID-19 disease, being caused by the novel coronavirus (SARS-CoV-2), has put the world on red alert as it keeps spreading and recording more fatalities. Research efforts are being carried out to curtail the disease from spreading as it has been declared as of global health emergency. Hence, there is an exigent need to identify and design drugs that are capable of curing the infection and hinder its continual spread across the globe. Herein, a computer-aided drug design tool known as the virtual screening method was used to screen a database of 44 million compounds to find compounds that have the potential to inhibit the surface glycoprotein responsible for virus entry and binding. The consensus scoring approach selected three compounds with promising physicochemical properties and favorable molecular interactions with the target protein. These selected compounds can undergo lead optimization to be further developed as drugs that can be used in treating the COVID-19 disease.


One-house one-person testing: Strategical plan to limit COVID-19 spread in stage three in the developing world


title: Epidemiological and clinical features of 200 hospitalized patients with corona virus disease 2019 outside Wuhan, China: A descriptive study

text: BACKGROUND: The recent outbreak of coronavirus disease 2019 (COVID-19) has spread worldwide, with especially severe epidemics occurring in cities across China. OBJECTIVES: To report the epidemiological and clinical futures of the 200 patients infected with COVID-19 in Yichang, Hubei Province, China. STUDY DESIGN: 200 patients confirmed with COVID-19 in a designated hospital in Yichang from Jan 30 to Feb 8, 2020 were investigated retrospectively. The epidemiological data and clinical characteristics were collected. The data between the ICU patients and non-ICU patients were compared. The patients were followed up till Feb 26, 2020. RESULTS: Of the 200 hospitalized patients with COVID-19, 98 (49.0 %) were male, and the mean age was 55 years. Eighty-seven (43.5 %) had no linkage to Wuhan or contact history. Familial clustering was found in 34 patients. Sixtyfive (32.5 %) suffered from chronic diseases. The common symptoms included fever (171[85.5 %]), cough (116[58.0 %]), and fatigue (64[32 %]). Most patients had lymphopenia. One hundred and seventy-two (86 %) patients showed typical imaging findings of viral pneumonia. Most patients received antiviral, antibiotic, and corticosteroid treatment. Compared with the non-ICU patients, 29 (14.5 %) patients in the ICU were older and more likely to show dyspnea and complications including ARDS. As of Feb 26, 15 (51.7 %) patients in the ICU had died. CONCLUSIONS: The COVID-19 infection was of clustering onset and can cause severe respiratory disease and even death. The mortality of ICU patients with COVID-19 was considerably high.


Can the 2019 Novel Coronavirus Cause Parkinson's Disease?


title: Early Warnings: The Lessons of COVID-19 for Public Health Climate Preparedness

text: The early 2020 response to COVID-19 revealed major gaps in public health systems around the world as many were overwhelmed by a quickly-spreading new coronavirus. While the critical task at hand is turning the tide on COVID-19, this pandemic serves as a clarion call to governments and citizens alike to ensure public health systems are better prepared to meet the emergencies of the future, many of which will be climate-related. Learning from the successes as well as the failures of the pandemic response provides some guidance. We apply several recommendations of a recent World Health Organization Policy Brief on COVID-19 response to 5 key areas of public health systems - governance, information, services, determinants, and capacity - to suggest early lessons from the coronavirus pandemic for climate change preparedness. COVID-19 has demonstrated how essential public health is to well-functioning human societies and how high the economic cost of an unprepared health system can be. This pandemic provides valuable early warnings, with lessons for building public health resilience.


SARS-CoV-2 infection in a highly experienced person living with HIV


Efficacy, safety and cost-effectiveness of hydroxychloroquine in children with COVID-19: A call for evidence


Trials of anti-tumour necrosis factor therapy for COVID-19 are urgently needed


Importation and Human-to-Human Transmission of a Novel Coronavirus in Vietnam


title: How do we recover from COVID-19? Helping diabetes teams foresee and prepare for the psychological harms

text: The scale of the COVID-19 pandemic is entirely unprecedented. However, as depicted in Fig. 1, evidence from previous large-scale disasters indicates that following a first wave of admissions and deaths from COVID-19, there are likely to be subsequent waves of people with acute care needs worsened by delayed hospital treatment, and people with long-term conditions whose routine care has been disrupted [1]. People with diabetes are likely to constitute a large proportion of those with acute second- and third-wave care needs, and in many cases, management of their condition may also have been negatively affected by lockdown.


Nowruz travelers and the COVID-19 pandemic in Iran


title: Coronavirus Disease (COVID-19) in Kidney and Liver Transplant Patients: A Single-Center Experience

text: OBJECTIVES: The novel 2019 coronavirus (COVID-19) was first described in December 2019 in Wuhan, China and subsequently announced as a pandemic on March 12, 2020. In several studies, solid-organ transplant recipients were reported to have higher risk for COVID-19. Here, we aimed to determine the frequency of COVID-19 in our kidney and liver transplant patients. MATERIALS AND METHODS: Our study included 583 transplant patients who were admitted to our outpatient transplant clinics and emergency departments between March 1 and May 1, 2020. Seventy-four of them were liver transplant recipients (46 male, 28 female, of which 14 were pediatric and 60 were adult patients) and 509 of them were kidney transplant recipients (347 male, 162 female, of which 16 were pediatric and 493 were adult patients). We retrospectively evaluated demographic characteristics, currently used immunosuppressant treatment, present complaints, treatment and diagnosis of comorbid diseases, and results of COVID-19 tests. RESULTS: Of 583 transplant recipients, 538 were seen in our outpatient transplant clinics and 45 were seen in our emergency departments. Of these, 18 patients who had had cough and fever were evaluated by respiratory clinic doctors, and nasopharyngeal swab samples were taken. One kidney transplant recipient had a positive COVID-19 test; he was followed with home isolation. He received treatment with hydroxychloroquine (400 mg/day). The other 17 patients had negative tests. There were no mortalities due to COVID-19. CONCLUSIONS: Transplant patients also got affected during the COVID-19 pandemic. According to the data of our centers, this effect is not much more different from the normal population. We recommend that transplant recipients should be warned in terms of personal hygiene and should be closely monitored by organ transplant centers. If there is an indication for hospitalization, they should be followed in an isolated unit, with no aggressive changes made to immunosuppressive doses unless necessary.


title: Finding equipoise: CEPI revises its equitable access policy

text: Launched at Davos in January 2017 with funding from sovereign investors and philanthropic institutions, the Coalition for Epidemic Preparedness Innovations (CEPI) is an innovative partnership between public, private, philanthropic, and civil organisations whose mission is to stimulate, finance and co-ordinate vaccine development against diseases with epidemic potential in cases where market incentives fail. As of December 2019, CEPI has committed to investing up to $706 million in vaccine development. This includes 19 vaccine candidates against its priority pathogens (Lassa fever virus, Middle East respiratory syndrome coronavirus, Nipah virus, Chikungunya, Rift Valley fever) and three vaccine platforms to develop vaccines against Disease X, a novel or unanticipated pathogen. As an entity largely supported by public funds, ensuring equitable access to vaccines whose development it supports in low- and middle-income countries is CEPI's primary focus. CEPI developed an initial equitable access policy shortly after its formation, with key stakeholders expressing strong views about its content and prescriptive nature. The CEPI board instructed that it be revisited after a year. This paper describes the process of revising the policy, and how key issues were resolved. CEPI will continue to take an iterative, rather than prescriptive, approach to its policy-one that reflects the needs of multiple stakeholders and ensures it can meet its equitable access goals.


title: The Urban-Rural Disparity in the Status and Risk Factors of Health Literacy: A Cross-Sectional Survey in Central China

text: Health literacy is the ability of individuals to access, process, and understand health information to make decisions regarding treatment and their health on the whole; it is critical to maintain and improve public health. However, the health literacy of urban and rural populations in China has been little known. Thus, this study aims to assess the status of health literacy and explore the differences of its possible determinants (e.g., socio-economic factors) among urban and rural populations in Henan, China. A cross-sectional study, 78,646 participants were recruited from a populous province in central China with a multi-stage random sampling design. The Chinese Resident Health Literacy Scale was adopted to measure the health literacy of the respondents. In the participants, the level of health literacy (10.21%) in central China was significantly lower than the national average, and a big gap was identified between urban and rural populations (16.92% vs. 8.09%). A noticeable difference was reported in different aspects and health issues of health literacy between urban and rural populations. The health literacy level was lower in those with lower levels of education, and a significant difference was identified in the level of health literacy among people of different ages and occupations in both urban and rural areas. Note that in rural areas, as long as residents educated, they all had higher odds to exhibit basic health literacy than those uneducated; in rural areas, compared with those aged 15 to 24 years, residents aged 45 to 54 years (OR = 0.846,95% CI (0.730, 0.981)), 55 to 64 years (OR = 0.716,95% CI (0.614, 0.836)) and above 65 years (OR = 0.679, 95% CI (0.567, 0.812)) were 84.6%, 71.6%, and 67.9%, respectively, less likely to exhibit basic health literacy. Considering the lower health literacy among rural residents compared with their urban counterparts, a reorientation of the health policy-making for Chinese rural areas is recommended. This study suggests that urban-rural disparity about health literacy risk factors should be considered when implementing health literacy promotion intervention.


title: Genomic Epidemiology and its importance in the study of the COVID-19 pandemic

text: Not available.


title: Pharmacological perspective: glycyrrhizin may be an efficacious therapeutic agent for COVID-19

text: Coronavirus disease 2019 (COVID-19) caused by the previously unknown pathogen, severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) is now a global pandemic. There are no vaccines or specific treatments against this new virus; therefore, there is an urgent need to advance novel therapeutic interventions for COVID-19. Glycyrrhizin is a triterpene saponin with various biological functions and pharmacological effects. This brief article discusses the therapeutic potential of glycyrrhizin for the treatment of COVID-19 from the perspective of its pharmacological action, including binding angiotensin-converting enzyme II (ACE2), downregulating proinflammatory cytokines, inhibiting the accumulation of intracellular reactive oxygen species (ROS), inhibiting thrombin, inhibiting the hyperproduction of airway exudates, and inducing endogenous interferon.


title: COVID-19: médicos, gastroenterología y emociones

text: La enfermedad por coronavirus (COVID-19) se convirtió en una pandemia con implicaciones clínicas y emo-cionales, a veces invisibles para los gastroenterólogos Aunque morir es parte de la vida, el riesgo para algunos médicos puede ser mayor Específicamente, los gastroenterólogos nos vemos afectados por el temor a reiniciar nuestras consultas y procedimientos endoscópicos En medio de un mar de información incluso con contradicciones entre diferentes expertos, seguir los lineamientos de las Asociaciones Colombianas del Aparato Digestivo podría ayudar a tranquilizar a los médicos y pacientes Aunque las patologías seguirán apareciendo, el miedo de la población a contagiarse puede generar consecuencias como el retraso en el tratamiento de un cáncer de vías digestivas El autocuidado físico mediante estrategias de protección y el cuidado emocional son clave para ayudar a nuestro sistema inmunológico Adaptarnos a funcionar en medio de la pandemia por medio de la teleorientación en plataformas digitales es una forma creativa de disminuir la angustia colectiva (AU)


title: Class A G Protein-Coupled Receptor Antagonist Famotidine as a Therapeutic Alternative Against SARS-CoV2: An In Silico Analysis

text: The pandemic associated with Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV2) and its disease named COVID-19 challenged the scientific community to discover effective therapeutic solutions in a short period. Repurposing existing drugs is one viable approach that emphasizes speed during these urgent times. Famotidine, a class A G protein-coupled receptor antagonist used for the treatment of gastroesophageal reflux was recently identified in an in silico screening. Additionally, a recent retrospective clinical report showed that the treatment with famotidine provided a good outcome in patients infected with SARS-CoV2. A clinical trial testing effectiveness of famotidine in combination with hydroxychloroquine is currently ongoing in the United States (US). In the 1990s, famotidine was described as an antiviral agent against human immunodeficiency virus (HIV). Interestingly, some HIV protease inhibitors are presently being used against SARS-CoV2. However, it is not clear if famotidine could be effective against SARS-CoV2. Thus, by using a computational analysis, we aimed to examine if the antiviral effect of famotidine could be related to the inhibition of proteases involved in the virus replication. Our results showed that famotidine could interact within the catalytic site of the three proteases associated with SARS-CoV2 replication. However, weak binding affinity of famotidine to these proteases suggests that a successful famotidine therapy could likely be achieved only in combination with other antiviral drugs. Finally, analysis of famotidine's pharmacokinetic parameters indicated that its effect against SARS-CoV2 infection could be reached only upon intravenous administration. This work will contribute to the pharmacological knowledge of famotidine as an antiviral agent against SARS-CoV2.


The War We Call COVID-19: A Letter From the Front in New York


title: ß-sitosterol ameliorates influenza A virus-induced proinflammatory response and acute lung injury in mice by disrupting the cross-talk between RIG-I and IFN/STAT signaling

text: ß-Sitosterol (24-ethyl-5-cholestene-3-ol) is a common phytosterol Chinese medical plants that has been shown to possess antioxidant and anti-inflammatory activity. In this study we investigated the effects of ß-sitosterol on influenza virus-induced inflammation and acute lung injury and the molecular mechanisms. We demonstrate that ß-sitosterol (150-450 µg/mL) dose-dependently suppresses inflammatory response through NF-κB and p38 mitogen-activated protein kinase (MAPK) signaling in influenza A virus (IAV)-infected cells, which was accompanied by decreased induction of interferons (IFNs) (including Type I and III IFN). Furthermore, we revealed that the anti-inflammatory effect of ß-sitosterol resulted from its inhibitory effect on retinoic acid-inducible gene I (RIG-I) signaling, led to decreased STAT1 signaling, thus affecting the transcriptional activity of ISGF3 (interferon-stimulated gene factor 3) complexes and resulting in abrogation of the IAV-induced proinflammatory amplification effect in IFN-sensitized cells. Moreover, ß-sitosterol treatment attenuated RIG-I-mediated apoptotic injury of alveolar epithelial cells (AEC) via downregulation of pro-apoptotic factors. In a mouse model of influenza, pre-administration of ß-sitosterol (50, 200 mg·kg-1·d-1, i.g., for 2 days) dose-dependently ameliorated IAV-mediated recruitment of pathogenic cytotoxic T cells and immune dysregulation. In addition, pre-administration of ß-sitosterol protected mice from lethal IAV infection. Our data suggest that ß-sitosterol blocks the immune response mediated by RIG-I signaling and deleterious IFN production, providing a potential benefit for the treatment of influenza.


title: Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19

text: Since December 2019, novel coronavirus infected pneumonia emerged in Wuhan city and rapidly spread throughout China. In severe novel coronavirus pneumonia cases, the number of platelets, their dynamic changes during the treatment, platelet-to-lymphocyte ratio (PLR) were a concern. We sought to describe the platelet feature of these cases. Single-center case series of the 30 hospitalized patients with confirmed coronavirus disease (COVID)-19 in Huizhou municipal central hospital from January 2020 to February 2020 were retrospectively analyzed. Demographic, clinical, blood routine results, other laboratory results, and treatment data were collected and analyzed. Outcomes of severe patients and nonsevere patients were compared. Univariate analysis showed that: age, platelet peaks, and PLR at peak platelet were the influencing factors in severe patients, multivariate analysis showed that the PLR value at peak platelet during treatment was an independent influencing factor in severe patients. The average hospitalization day of patients with platelet peaks during treatment was longer than those without platelet peaks (P < .05). The average age of patients with platelet peaks during treatment was older than those without platelet peaks (P < .05). The patients with significantly elevated platelets during treatment had longer average hospitalization days. And the higher PLR of patients during treatment had longer average hospitalization days. Single-center case series of the 30 hospitalized patients with confirmed COVID-19 in Huizhou Municipal Central Hospital, presumed that the number of platelets and their dynamic changes during the treatment may have a suggestion on the severity and prognosis of the disease. The patient with markedly elevated platelets and longer average hospitalization days may be related to the cytokine storm. The PLR of patients means the degree of cytokine storm, which might provide a new indicator in the monitoring in patients with COVID-19.


Human monoclonal antibodies block the binding of SARS-CoV-2 spike protein to angiotensin converting enzyme 2 receptor


title: CoViD-19 and stress in the pandemic: "sanity is not statistical"

text: CoViD-19 pandemic is causing serious consequences on mental health, consequences that are considered that bad that World Health Organization has affirmed that mental health defence is priority in this particular moment of development of pandemic. In light of this alertness, what we are interested in approaching in this work, is the specific stress condition caused by pandemic, which underlies and precedes the described classification of diseases and which is going towards an increase in the entire world, including . The stress caused by pandemic is a new condition in comparison with what is known in clinical practice and with what is included in the classification of mental disorder. The ongoing stress condition and the mixture of different types of unconventional stress, which not only hits the present but also disrupts the future, create an entirely new form of clinical condition given by pandemic.


title: A Framework for Sustainable Contact Tracing and Exposure Investigation for Large Health Systems

text: Contact tracing is a cornerstone of communicable disease containment and involves identifying, quarantining, and monitoring contacts of infected people. Although contact tracing is a known evidence-based strategy in the community setting, the COVID-19 pandemic highlighted the challenges to implementing labor-intensive contact tracing in the occupational setting of large health care systems and hospitals, the epicenter of the pandemic. We present a framework for feasible, scalable COVID-19 contact tracing in a large multistate health system in the United States employing approximately 69,000 health care personnel. The framework is shared with sufficient details to allow adoption or adaptation by other health systems. Continuous enhancement, optimization, and evaluation of the framework are ongoing.


The role of phylogenetic analysis in clarifying the infection source of a COVID-19 patient


COVID-19 Infection May Cause Clozapine Intoxication: Case Report and Discussion


Reducing hand recontamination of healthcare workers during COVID-19


title: Review and Prospect of Pathological Features of Corona Virus Disease

text: Abstract: Since 2003, coronavirus has caused multiple major public health events that resulted in global epidemics, such as severe acute respiratory syndrome ï¼SARSï¼, Middle East respiratory syndrome ï¼MERSï¼ and corona virus disease 2019 ï¼COVID-19ï¼. Especially since COVID-19 outbroke in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. But so far, the pathological diagnosis of COVID-19 has been relatively deficientï¼ it is still confined to the pathological findings of punctured organs, and the majority of medical workers have poor awareness of its pathological characteristics. The COVID-19, as same as SARS and MERS, is caused by coronaviruses and can cause viral pneumonia. They have certain similarities. This article comprehensively reviews the pathological features observed in the autopsies of the aforementioned three diseases, in order to provide reference to the analysis of pathological changes of COVID-19.


COVID-19 and fat embolism: a hypothesis to explain the severe clinical outcome in people with obesity


title: Successful use of tPA for thrombolysis in COVID related ARDS: a case series

text: We describe successful usage of low dose Tissue plasminogen activator (tPA) (30-50 mg) in three COVID19 critically ill patients, who were in worsening respiratory failure in-spite of being on therapeutic anticoagulation. All patients had respiratory rate > 40; FiO2 > 0.7(on NIV); PiO2/FiO2 ratio < 100 and D-dimer>1000 ng/ml. C.T. Pulmonary Angiography could not be done in these patients due to poor general condition, but 2D echo was normal and none of the patients was in shock. So there was no conventional indication of thrombolysis in these patients, yet after thrombolysis, we saw dramatic changes in oxygenation. All patients became off oxygen within 3-7 days and were discharged within 2 weeks. The whole idea was to prevent intubation, since mortality rates are very high in intubated COVID19 patients. tPA is associated with <1% risk of fatal bleed. In this unprecedented pandemic with high mortality rates, thrombolysis could be an effective and safe option in carefully selected critically ill patients of COVID19.


Development of Telemedicine Infrastructure at an LGBTQ+ Clinic to Support HIV Prevention and Care in Response to COVID-19, Providence, RI


title: Overcoming the bottleneck to widespread testing: a rapid review of nucleic acid testing approaches for COVID-19 detection

text: The current COVID-19 pandemic presents a serious public health crisis, and a better understanding of the scope and spread of the virus would be aided by more widespread testing. Nucleic-acid-based tests currently offer the most sensitive and early detection of COVID-19. However, the "gold standard" test pioneered by the U.S. Centers for Disease Control and Prevention takes several hours to complete and requires extensive human labor, materials such as RNA extraction kits that could become in short supply, and relatively scarce qPCR machines. It is clear that a huge effort needs to be made to scale up current COVID-19 testing by orders of magnitude. There is thus a pressing need to evaluate alternative protocols, reagents, and approaches to allow nucleic-acid testing to continue in the face of these potential shortages. There has been a tremendous explosion in the number of papers written within the first weeks of the pandemic evaluating potential advances, comparable reagents, and alternatives to the "gold-standard" CDC RT-PCR test. Here we present a collection of these recent advances in COVID-19 nucleic acid testing, including both peer-reviewed and preprint articles. Due to the rapid developments during this crisis, we have included as many publications as possible, but many of the cited sources have not yet been peer-reviewed, so we urge researchers to further validate results in their own laboratories. We hope that this review can urgently consolidate and disseminate information to aid researchers in designing and implementing optimized COVID-19 testing protocols to increase the availability, accuracy, and speed of widespread COVID-19 testing.


Care for the psychological status of frontline medical staff fighting against COVID-19


Covid-19: Drug firms warn stockpiles have been eroded amid fears of no deal Brexit


In Reply: Challenges in interpreting the diagnostic performance of symptoms to predict COVID-19 status: the case of anosmia


title: Multiple assays in a real-time RT-PCR SARS-CoV-2 panel can mitigate the risk of loss of sensitivity by new genomic variants during the COVID-19 outbreak

text: OBJECTIVES: In this study, five SARS-CoV-2 PCR assay panels were evaluated against the accumulated genetic variability of the virus to assess the effect on sensitivity of the individual assays. DESIGN OR METHODS: As of week 21, 2020, the complete set of available SARS-CoV-2 genomes from GISAID and GenBank databases were used in this study. SARS-CoV-2 primer sequences from publicly available panels (WHO, CDC, NMDC, and HKU) and QIAstat-Dx were included in the alignment, and accumulated genetic variability affecting any oligonucleotide annealing was annotated. RESULTS: A total of 11,627 (34.38%) genomes included single mutations affecting annealing of any PCR assay. Variations in 8,773 (25.94%) genomes were considered as high risk, whereas additional 2,854 (8.43%) genomes presented low frequent single mutations and were predicted to yield no impact on sensitivity. In case of the QIAstat-Dx SARS-CoV-2 Panel, 99.11% of the genomes matched with a 100% coverage all oligonucleotides, and critical variations were tested in vitro corroborating no loss of sensitivity. CONCLUSIONS: This analysis stresses the importance of targeting more than one region in the viral genome for SARS-CoV-2 detection to mitigate the risk of loss of sensitivity due to the unknown mutation rate during this SARS-CoV-2 outbreak.


SARS-CoV-2: Environment and spread: An annotated selection of World Wide Web sites relevant to the topics in environmental microbiology


title: COVID-19 pandemic-a focused review for clinicians

text: BACKGROUND: The COVID-19 pandemic caused by SARS-CoV-2 remains a significant issue for global health, economics and society. A wealth of data has been generated since its emergence in December 2019, and it is vital for clinicians to keep up with this data from across the world at a time of uncertainty and constantly evolving guidelines and clinical practice. OBJECTIVES: Here we provide an update for clinicians on the recent developments in the virology, diagnostics, clinical presentation, viral shedding, and treatment options for COVID-19 based on current literature. SOURCES: We considered published peer-reviewed papers and non-peer-reviewed pre-print manuscripts on COVID19 and related aspects with an emphasis on clinical management aspects. CONTENT: We describe the virological characteristics of SARS-CoV-2 and the clinical course of COVID-19 with an emphasis on diagnostic challenges, duration of viral shedding, severity markers and current treatment options. IMPLICATIONS: The key challenge in managing COVID-19 remains patient density. However, accurate diagnosis as well as early identification and management of high-risk severe cases are important for many clinicians. For improved management of cases, there is a need to understand test probability of serology, qRT-PCR and radiological testing, and the efficacy of available treatment options that could be used in severe cases with a high risk of mortality.


title: Epidemiologia da COVID-19: comparação entre boletins epidemiológicos

text: Introdução: Para o enfrentamento da pandemia da COVID-19 preconiza-se o isolamento social e acompanhamento epidemiológico da evolução do número de casos dessa doença Objetivo: avaliar a taxa de incidência e sua distribuição epidemiológica por idade, sexo, fator de risco e letalidade por meio de dados secundários de fontes oficiais de informações sobre o episódio pandêmico no país registrado no DATASUS e nos boletins epidemiológicos do Ministério da Saúde Método: Pesquisa descritiva conduzida com base em dados secundários extraídos dos boletins epidemiológicos 06, 09 e 14 do MS sobre a COVID-19 Resultados: A maior parte dos casos está concentrada na região Sudeste Dentre o total de óbitos a maioria apresentava pelo menos um fator de risco A cardiopatia foi a principal comorbidade e a maioria dos indivíduos tinha 60 anos ou mais, com predominância do sexo masculino Conclusão: São necessários mais estudos clínicos e epidemiológicos para esclarecer as melhores formas de prevenção e de intervenção às vítimas acometidas pelo SARS-CoV-2 para reduzir a ocorrência de novos casos e óbitos relacionados a esse vírus Introduction: To cope with the COVID-19 pandemic is necessary social isolation and epidemiological monitoring of the evolution of the number of cases of this disease Objective: to evaluate the incidence rate and its epidemiological distribution by age, sex, risk factor and lethality using secondary data from official sources of information about the pandemic episode in the country registered in DATASUS and in the epidemiological bulletins of the Ministry of Health Method: Descriptive research conducted based on secondary data extracted from the epidemiological bulletins 06,09 and 14of the MS on COVID-19 Results: Most of the cases are concentrated in the Southeast region Among the total deaths, the majority had at least one risk factor Heart disease was the main associated comorbidity, most of the individuals were 60 years old or older and the male predominated Conclusion: More clinical and epidemiological studies are needed to clarify the best forms of prevention and intervention for victims of SARS-CoV-2 to reduce the occurrence of new cases and deaths related to this virus (AU)


COVID-19 disease in New York City pediatric hematology and oncology patients


Potential Unconventional Medicines for the Treatment of SARS-CoV-2


title: Management of chronic rhinosinusitis with steroid nasal irrigations: a viable non-surgical alternative in the COVID-19 Era

text: BACKGROUND: High-dose, high-volume steroid nasal irrigations (NSI) have been incorporated into the medical management of recalcitrant CRS, primarily following surgical intervention. The objective of this study was to evaluate the role of NSI as a preoperative management and to identify the percentage of patients who ultimately underwent ESS for recalcitrant CRS despite being on NSI. METHODS: Retrospective chart review of patients presenting with CRS who underwent a trial of NSI for at least six weeks. Pre-irrigation and post-irrigation outcomes measured included Lund-Mackay scores (LMS), SNOT-22 scores, and whether or not the patient underwent ESS. RESULTS: Of the 90 patients who underwent NSI, 32 patients underwent ESS, while 58 patients had a significant enough improvement in symptoms to avoid ESS. The likelihood of decision for surgery did not differ between the mometasone and budesonide groups (p=0.3094), comorbid asthma status (p=0.3585), smoking status (p=0.2256), polyp status (p=0.7288), or history of prior ESS (p=0.5803). SNOT scores significantly improvement following NSI in the group of patients that did not go on to ESS (p<0.0001) and in the group that did (p<0.0001). LMS also improved following NSI, but this was only statistically significant in the patients that ultimately went on to ESS (p=0.0102). CONCLUSIONS: After a trial of NSI, 64.4% of patients with CRS no longer met candidacy for ESS and had a significant improvement in SNOT-22 scores. This supports the use of nasal steroid irrigations in the medical management of CRS with and without surgical intervention and with and without nasal polyposis. This article is protected by copyright. All rights reserved.


title: Management of COVID-19 Outbreak in Argentina: The Beginning

text: The aim of this study was to analyze the impact coronavirus disease 2019 (COVID-19) had in Argentina during its initial stage, identify the measures taken to try to mitigate its impact, and briefly compare it with the influenza A H1N1 pandemic in 2009. This is a descriptive study. Pandemics constitute a serious problem to global health with a major impact on the affected countries' populations. The recent COVID-19 outbreak represents one of the most important viral pandemics lately. It reached Argentina 64 days after the first case was identified in China. Since then, several measures were taken by the Argentinian government to try to mitigate its impact in this initial stage. An updated report of the current situation and its management in different countries is of vital importance regarding global health issues and may serve for feedback and decision-making.


Antimicrobial stewardship interventions to minimize healthcare worker exposure to SARS-CoV-2


Discrepancy in reports of COVID-19 onset of symptoms: are faulty data being collected?


title: Letter to the editor: efficacy of different methods of combination regimen administrations including dexamethasone, intravenous immunoglobulin, and interferon-beta to treat critically ill COVID-19 patients: a structured summary of a study protocol for a randomized controlled trial

text: OBJECTIVES: There is little information about Coronavirus Disease 2019 (COVID-19) management for critically ill patients. Most of these patients develop acute respiratory distress syndrome (ARDS) due to excessive inflammatory response and the ensuing cytokine storm. Anti-inflammatory drugs including corticosteroids can be used to effectively reduce the effect of this cytokine storm and lung damage. However, corticosteroids can have side effects, so simultaneous administration of immunoglobulin (IV-IG) and interferon-beta can help manage treatment using corticosteroids. Therefore, we designed a trial to test our hypothesis that early administration of dexamethasone in combination with IV-IG and interferon-beta can reduce the effect of the cytokine storm in critically ill patients COVID-19. TRIAL DESIGN: A phase two multi-center randomized controlled trial (RCT) with three parallel arms (1:1:1 ratio). PARTICIPANTS: They will be hospitalized patients with severe COVID-19 who have positive RT-PCR test and have blood oxygen saturation levels (SpO2) less than 90% and respiratory rate higher than 24 per minute or have involvement of more than 50% of their lung when viewed using computed tomography (CT)-scan. The age range of patients will be 18-70 years old. EXCLUSION CRITERIA: the need for intubation; allergy, intolerance, or contraindication to any study drug including dexamethasone, IV-IG, and interferon-beta; pregnancy or lactation; known HIV positive or active hepatitis B or C. The study will be conducted in several hospitals of the Golestan province, Iran. INTERVENTION AND COMPARATOR: The study subjects will be randomly allocated to three treatment arms: two experimental groups (two arms: Intervention 1 and Intervention 2) and one Control Group, which will be matched for age and sex using frequency matching method. Each eligible patient in the control arm will receive the standard treatment for COVID-19 based on WHO guidelines and the Ministry of the Health and Medical Education (MOHME) of Iran. Each patient in the Intervention Group 1 will receive the standard treatment for COVID-19 and dexamethasone, at the first 24 hours' time of admission. The intervention begins with the administration of dexamethasone based on the SpO2 levels. If the level of SpO2 does not improve after 24 hours, IV-IG (400 mg/kg once daily for 5 days) and interferon-beta (7 doses every other day) will be prescribed along with dexamethasone administration. In Intervention Group 2, the administration of dexamethasone will be started within the first 24 hours' time of admission and will be continued for 48-72 hours and then the SpO2 level will be checked. Then, if the level of SpO2 has not improved after that time, IV-IG and interferon-beta will be prescribed as the same dosage as Group 1. If the percentages of the SpO2 level are between 85 and 90/ 80 and 85/ 75 and 80/ less than 75, the dosages will be 4 mg every 12 hours/ 4 mg every 8 hours/ 8 mg every 12 hours/ 8 mg every 8 hours, respectively. According to the WHO recommendation, all participants will have the best available supportive care with full monitoring. MAIN OUTCOMES: Primary: An increase in the SpO2 level to reach more than 90% in each case, which will be assessed by the oximeter. Secondary: The duration of hospital stays; intubation status and the percentage of patients who are free of mechanical ventilation; the mortality rates during hospitalization and one month after the admission time. RANDOMISATION: Participants will be allocated into either control or intervention groups with a 1:1:1 allocation ratio using a computer random number generator to generate a table of random numbers for simple randomization. BLINDING (MASKING): The project's principal investigator (PI) is unblinded. However, the PI will not analyse the data and interpret the results. An unblinded researcher (a pharmacist) will cover the drug's bottles with aluminium foil and prepare them interventions and control drugs in a syringe with a code so that patients are blinded. This person will have no patients contact. The staff and nurses, caring for the patients, will be unblinded for each study group due to the nature of this study. The staff that take outcome measurements will be blinded. The laboratory technicians will also be blinded as well as the statistical team. These study statisticians will have access to coded data and will analyse the data labelled as group X, group Y, and group Z. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): The target sample size will be 105 critically ill COVID-19 patients, who will be allocated randomly to the three trial arms with 35 patients in each group. TRIAL STATUS: Recruitment is ongoing. The study began on April 18 2020 and will be completed June 19 2020. This summary describes protocol version 1; April 2 2020. TRIAL REGISTRATION: https://www.irct.ir/. Identifier: IRCT20120225009124N4 version 1; Registration date: April 2 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting the dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The full protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines.


Serotonin syndrome in two COVID-19 patients treated with lopinavir/ritonavir


title: FDG PET/CT in a Patient With Mantle Cell Lymphoma and COVID-19: Typical Findings

text: A 52-year-old woman with no medical history was admitted on March 18, 2020, presenting since 3 days asthenia, abdominal pain, and dry cough but no fever. Adenomegalies, splenomegaly, leukocytosis, and elevated LDH suggested mature lymphoproliferation. Considering the current health context, an RT-PCR testing for COVID-19 (coronavirus disease 2019) was performed and found to be positive. Early chest CT showed no sign of pulmonary infection but multiple adenomegalies. An F-FDG PET/CT performed 5 days later to assess the extent of the hemopathy revealed the apparition of FDG-avid bilateral ground glass and subpleural curvilinear opacities suggesting COVID-19-associated pneumopathy.


title: A nation-wide survey on emotional and psychological impacts of COVID-19 social distancing

text: OBJECTIVE: Social distancing is crucial in order to flatten the curve of COVID-19 virus spreading. Isolation, scarcity of resources and the lack of social contacts may have produced a negative impact on people's emotions and psychological well-being. This study aims to explore the reasons and the ways through which social distancing generates negative emotions in individuals who experienced the lockdown. To a larger extent, the objective is to check the existence of relations between negative emotions and the satisfaction of basic needs. MATERIALS AND METHODS: In Italy 140,656 online interviews were collected from March 22 to April 2, 2020. Data analysis was carried out using mono and bivariate statistical analysis, K-means clustering and the Principal Components Analysis (PCA). The parameters for the identification of six clusters were: the intensity of the respondent's basic emotions and the layers of Maslow's hierarchy of needs. RESULTS: The majority of people involved in an emergency situation, implying a collapse of social contacts, experience some kind of emotional reactions. In our study, we found a correlation between basic emotions and Maslow's hierarchy of needs. In times of crisis, the most basic needs are the physiological ones. Fear, anger and sadness are predominant in all population groups; anger and disgust mainly appear when people are exposed to the risk of not being able to meet subsistence needs, thus perceiving a lack of economic security. CONCLUSIONS: The well-known Maslow's theory of human needs seems to fit well with the outbreak of negative emotions in the context of COVID-19. This study demonstrates the existence of links between negative emotions and primary needs that mainly refer to the first three levels of Maslow's pyramid. As a result of COVID-19 worldwide pandemic, many people have been sucked into the bottom layers of the pyramid. This change in individual basic needs has triggered a relevant transformation in individual emotional status and a shift towards negative emotions.


Upper airway symptoms in coronavirus disease 2019 (COVID-19)


Correction for Dietz et al., "2019 Novel Coronavirus (COVID-19) Pandemic: Built Environment Considerations To Reduce Transmission"