title: Risk factors for mortality in patients with Coronavirus Disease 2019 (COVID-19) in Bolivia: An analysis of the first 107 confirmed cases

text: The present study is aimed to assess the risk factors for mortality in the first 107 rRT-PCR confirmed cases of SARS-CoV-2 infections in Bolivia. For this observational, retrospective and cross-sectional study, the epidemiological data records were collected from the Hospitals and the Ministry of Health of Bolivia, obtaining the clinical and epidemiological data of the COVID-19 cases that were laboratory-diagnosed during March 2-29, 2020. Samples were tested by rRT-PCR to SARS-CoV-2 at the Laboratory of the National Center of Tropical Diseases (CENETROP), following the protocol Charite, Berlin, Germany. The odds ratio (OR) with respective 95% confidence interval (95%CI) for mortality as dependent variable was calculated. When we comparatively analyzed survivors and non-survivors in this first group of 107 cases in Bolivia, we found that at bivariate analyses, age (±60 years old), hypertension, chronic heart failure, diabetes, and obesity, as well as the requirement of ICU, were significantly exposure variables associated with death. At the multivariate analysis (logistic regression), two variables remained significantly associated, age, ±60 years-old (OR=9.4, 95%CI 1.8-104.1) and hypertension (OR=3.3, 95%CI 1.3-6.3). As expected, age and comorbidities, particularly hypertension, were independent risk factors for mortality in Bolivia in the first 107 cases group. More further studies are required to better define risk factors and preventive measures related to COVID-19 in this and other Latin American countries.


Postmortem Examination in Two Cases of Death Related to 2019-nCoV Infection and the Experience of On-site Protection


title: SARS-CoV-2 SPIKE PROTEIN: an optimal immunological target for vaccines

text: COVID-19 has rapidly spread all over the world, progressing into a pandemic. This situation has urgently impelled many companies and public research institutes to concentrate their efforts on research for effective therapeutics. Here, we outline the strategies and targets currently adopted in developing a vaccine against SARS-CoV-2. Based on previous evidence and experience with SARS and MERS, the primary focus has been the Spike protein, considered as the ideal target for COVID-19 immunotherapies.


Hypertension and predisposition to infection: an important issue during this global pandemic


title: [Expression analysis of 2019-nCoV related ACE2 and TMPRSS2 in eye tissues]

text: Objective: Angiotensin converting enzyme 2 (ACE2) and Transmembrane serine protease 2 (TMPRSS2) are the key proteins for 2019-nCoV entry into host cells. To evaluate the potential infection risk of 2019-nCoV on ocular surface, we compared ACE2 and TMPRSS2 expression among different eye tissues. Methods: Experimental article. Thirty mice were assigned to male, female, aging, diabetic and non-diabetic groups, with 6 mice in each group. Real-time PCR was performed to quantify ACE2 and TMPRSS2 gene expression in conjunctiva, cornea, lacrimal gland, iris, lens, retina, lung, heart, kidney, and liver from male mice. Immunohistochemistry staining was applied to visualize the distribution of the two proteins in different mice tissues, and in human corneal and conjunctival sections. Published transcriptome datasets were extracted to generate the expression comparasion of ACE2 and TMPRSS2 between human conjunctival and corneal tissues, and results were analyzed with Mann-Whitney U test. Female mice, aging mice, STZ-induced diabetic mice, diabetic group control mice were also subjected to ACE2 expression analysis. Results were analyzed using Student's t-test. Results: The expression of ACE2 and TMPRSS2 genes were the highest in conjunctiva among all the six mice eye tissues explored. The expression of these two genes in conjunctiva were lower than that in kidney and lung. ACE2 and TMPRSS2 shared similar expression pattern with the staining concentrated in corneal epithelium, conjunctival epithelium and lacrimal gland serous cells. The expression levels of ACE2 showed sex-difference. Female mice had lower ACE2 in conjunctiva and cornea than male mice, with the expression levels taking only 43% (t=3.269, P=0.031) and 63% (t=4.080, P=0.015) of that in the male conjunctiva and cornea, respectively. Diabetic mice expressed more ACE2 in conjunctiva (1.21-fold, P>0.05) and lacrimal gland (1.10-fold, P>0.05) compared with the control group. No significant difference on ACE2 expression was found between the aging and young adult mice. The expression level of human conjunctiva ACE2 and TMPRSS2 were significantly higher than that in the cornea (P=0.007), with 5.74-fold and 12.84-fold higher in the conjunctiva than in the corneal epithelium cells, which resembled the situation in mice. Conclusion: The observation of high-level ACE2 and TMPRSS2 expression in conjunctiva among the 6 eye tissues examined suggests that conjunctiva serves as an infection target tissue of 2019-nCoV. (Chin J Ophthalmol, 2020, 56:).


COVID-19 pandemic planning: considerations for radiation oncology medical physics


COVID-19: the risk of respiratory techniques in healthcare workers


title: Structure, photodynamic reaction and DNA photocleavage properties of a nitrosyl iron-sulfur cluster (Me4N)2[Fe2S2(NO)4]: A DFT calculation and experimental study

text: Density functional theory calculations were performed on the structure of the nitrosyl iron-sulfur cluster (Me4N)2[Fe2S2(NO)4]. The IR spectra were assigned and the electronic ground-state properties in different solvents were analyzed. Dynamic conversion of [Fe2S2(NO)4]2- was analyzed quantitatively using the time-resolved IR spectra in different solvents. Photo irradiation and polarity of solvent obviously affect the reaction rates, which are faster in CH3CN and CH3OH than those in DMSO and water. The calculated orbital energies of HOMOs are higher and those of LUMO-HOMO gap are smaller in CH3CN and CH3OH than those in DMSO and water, which is consistent with the reaction rate and explains the experimental observation. Moreover, the photo-induced nitric oxide (NO) release and cluster conversion was identified using EPR spectra. The photocleavage of pBR322 DNA was observed, both NO and oxygen related free radicals play key roles in the process. The study provides an effective method to monitor the photodynamic reactions for better understanding of the physiological activity of nitrosyl iron-sulfur clusters.


title: High Incidence of Barotrauma in Patients with COVID-19 Infection on Invasive Mechanical Ventilation

text: Background We observed a high number of patients with COVID-19 pneumonia who had barotrauma related to invasive mechanical ventilation at our institution. Purpose To determine if the rate of barotrauma in patients with COVID-19 infection was greater than other patients requiring invasive mechanical ventilation at our institution. Methods In this retrospective study, clinical and imaging data of patients seen between 03/01/2020 and 04/06/2020 who tested positive for COVID-19 and experienced barotrauma associated with invasive mechanical ventilation were compared to patients without COVID-19 infection during the same period. Historical comparison was made to barotrauma rates of patients with acute respiratory distress syndrome (ARDS) from 02/01/2016 to 02/01/2020 at our institution. Comparison of patient groups was performed using categorical or continuous statistical testing as appropriate with multivariable regression analysis. Patient survival was assessed using Kaplan-Meier curves analysis. Results 601 patients with COVID-19 infection underwent invasive mechanical ventilation (63 ± 15 years, 71% men). There were 89/601 (15%) patients with one or more barotrauma events, for a total of 145 barotrauma events (24% overall events) (95% CI 21-28%). During the same period, 196 patients without COVID-19 infection (64 ± 19 years, 52% male) with invasive mechanical ventilation had 1 barotrauma event (.5% 95% CI, 0-3%, p<.001 vs. the group with COVID-19 infection). Of 285 patients with ARDS over the prior 4 years on invasive mechanical ventilation (68 ± 17 years, 60% men), 28 patients (10%) had 31 barotrauma events, with overall barotrauma rate of 11% (95% CI 8-15%, p<.001 vs. the group with COVID-19 infection). Barotrauma is an independent risk factor for death in COVID-19 (OR=2.2, p=.03), and is associated with longer hospital length of stay (OR=.92, p<.001). Conclusion Patients with COVID-19 infection and invasive mechanical ventilation had a higher rate of barotrauma than patients with ARDS and patients without COVID-19 infection.


Challenges to the prevention of COVID-19 spread in slums of Bangladesh


title: Handling uncertainty and ambiguity in the COVID-19 pandemic

text: The 2019 novel coronavirus outbreak is unprecedented. Yet some look to ready-made models to address it. This creates confusion about more adaptive responses that reflect an uncertain and ambiguous context. Those assessing associated mental health challenges must be wary of overdiagnosis. Handling the pandemic well, requires engaging the public as mature partners. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Practical insights for paediatric otolaryngology surgical cases and performing microlaryngobronchoscopy during the COVID-19 pandemic

text: Paediatric otolaryngology practice involves examining and operating in anatomical locations with high levels of aerosol generation and transmission of COVID-19 to treating clinicians, especially from the asymptomatic patient populations including children. During the COVID-19 pandemic all emergent otolaryngological conditions affecting the airway, oral, and nasal cavities should be managed medically where possible and any operating deferred. We present guidelines for operating on paediatric otolaryngological patients when necessary during the COVID-19 pandemic, and incorporate experience gathered during microlaryngobronchoscopy on a COVID-19 positive infant at our institution.


Integrated Infection Control Strategy to Minimize Hospital-Acquired Infection During Outbreak of Coronavirus Disease 2019 Among ED Health Care Workers


title: Near-term pregnant women's attitude toward, concern about and knowledge of the COVID-19 pandemic

text: Background: COVID-19 is a novel type of the coronavirus family with an incompletely described clinical course. Little is known about the psychological aspects, particularly for vulnerable populations including pregnant women.Objectives: To understand the attitude, concerns, and knowledge of the non-infected pregnant women toward the COVID-19 outbreak in order to constitute base data for detailed counseling and to develop targeted messages.Patients and methods: This cross-sectional survey research presented analysis of prospectively collected data yielded at a single tertiary "Coronavirus Pandemic Hospital" referral center for a ten days period following the first confirmed death due to the COVID-19 pandemic in Turkey. Non-infected women with a confirmed pregnancy over 30th gestational week were consecutively included. A patient-reported non-validated questionnaire formed by the expert committee that includes 15 specific questions was used. Non-infected, pregnant women over 30th gestational week who applied to the outpatient clinic were consecutively included. A total of 213 women were enrolled, 37 were excluded: 7 for being in the first trimester, 3 were illiterate, and 27 were Syrian refugees having difficulties in translation.Results: A total of 172 pregnant women were included. Overall, four women refused to participate to the survey (1.9%). The mean age was 27.5 ± 5.3 years. Median gestational week and parity were 35 ± 11 weeks and 1 ± 2, respectively. Pregnant women were observed to trust the authorities (65%) and the healthcare staff (92.4%), and their respect was increased (82.5%) during the outbreak. Majority of the women (87.2%) comply with the self-quarantine rules. Half of the women (52%) reported that they felt vulnerable and predominantly were concerned (80%). Approximately one-third of the women constantly keep thinking that they may get infected (35.5%) or they might get infected during/following the delivery or their baby might get infected after being born (42%). Half of the women (50%) were reported that they either had no idea about or think the breastfeeding is not safe during the outbreak. About 45% of the women were confused or had doubts about if the mode of delivery may be affected by the pandemic. Greater part of the participants does not know if COVID-19 might cause birth defects (76%) or preterm birth (64.5%). Counseling flow keys helping pregnant women to overcome misleads, regarding the COVID-19 outbreak is proposed.Conclusions: Non-infected pregnant women with a viable pregnancy at near term were observed to have positive attitude and compliance toward the COVID-19 outbreak and frontline healthcare staff; increased concern and vulnerability; and restricted knowledge about the pregnancy-related outcomes. While the clinical evidence was growing rapidly, this data may guide obstetricians and midwives to perceive what accurate information should be provided to the pregnant women.


Asymptomatic and symptomatic SARS-CoV-2 infections in close contacts of COVID-19 patients: a seroepidemiological study


Paediatric and adult critical care medicine: joining forces against Covid-19


title: Dental Care and Oral Health under the Clouds of COVID-19

text: KNOWLEDGE TRANSFER STATEMENT: This commentary provides a timely evidence-based overview on the impact of COVID-19 on dental care and oral health and identifies gaps in protection of patients and staff in dental settings. Oral symptoms are prominent before fever and cough occur. Dental professionals may play an important role in early identification and diagnosis of patients with COVID-19.


title: D3Targets-2019-nCoV: a webserver for predicting drug targets and for multi-target and multi-site based virtual screening against COVID-19

text: A highly effective medicine is urgently required to cure coronavirus disease 2019 (COVID-19). For the purpose, we developed a molecular docking based webserver, namely D3Targets-2019-nCoV, with two functions, one is for predicting drug targets for drugs or active compounds observed from clinic or in vitro/in vivo studies, the other is for identifying lead compounds against potential drug targets via docking. This server has its unique features, (1) the potential target proteins and their different conformations involving in the whole process from virus infection to replication and release were included as many as possible; (2) all the potential ligand-binding sites with volume larger than 200 Å3 on a protein structure were identified for docking; (3) correlation information among some conformations or binding sites was annotated; (4) it is easily to be updated, and is accessible freely to public (https://www.d3pharma.com/D3Targets-2019-nCoV/index.php). Currently, the webserver contains 42 proteins [20 severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) encoded proteins and 22 human proteins involved in virus infection, replication and release] with 69 different conformations/structures and 557 potential ligand-binding pockets in total. With 6 examples, we demonstrated that the webserver should be useful to medicinal chemists, pharmacologists and clinicians for efficiently discovering or developing effective drugs against the SARS-CoV-2 to cure COVID-19.


title: Correction to: Nuclear medicine services after COVID-19: gearing up back to normality

text: The authors P. Orellana and N. El-Haj were inadvertently deleted in the original paper.


Covid-19 : que sait-on des patients admis en soins intensifs ?


Recent Findings on Cardiovascular Safety With the Use of Chloroquine and Hydroxychloroquine for COVID-19


title: Using the Nursing Interventions Classification to identify nursing interventions in free text nursing documentation in adult psychiatric outpatient care setting Surgical Training During and After COVID-19: A Joint Trainee and Trainers Manifesto

text: AIMS AND OBJECTIVES: To identify and describe nursing interventions in patient documentation in adult psychiatric outpatient setting, and to explore the potential for using the Nursing Interventions Classification in documentation in this setting BACKGROUND: Documentation is an important part of nurses'work, and in the psychiatric outpatient care setting it can be time-consuming Only very few research reports are available on nursing documentation in this care setting METHODS: A qualitative analysis of secondary data consisting of nursing documentation for 79 patients in four outpatient units (years 2016 - 2017) The data consisted of 1150 free text entries describing a contact or an attempted contact with 79 patients, their family members or supporting networks and 17 nursing care summaries Deductive and inductive content analysis was used SRQR-guideline was used for reporting RESULTS: We identified 71 different nursing interventions, 64 of which are described in the Nursing Interventions Classification Surveillance and Care-Coordination were the most common interventions The analysis revealed two perspectives which challenge the use of the classification: the problem of overlapping interventions and the difficulty of naming group-based interventions CONCLUSION: There is an urgent need to improve patient documentation in the adult psychiatric outpatient care setting, and standardized nursing terminologies such as the Nursing Interventions Classification could be a solution to this However, the problems of overlapping interventions and naming group-based interventions, suggests that the classification needs to be further developed before it can fully support the systematic documentation of nursing interventions in the psychiatric outpatient care setting RELEVANCE TO CLINICAL PRACTICE: This study describes possibilities of using a systematic nursing language to describe the interventions nurses use in the adult psychiatric outpatient setting It also describes problems in the current free text based documentation


Antagonizing the renin-angiotensin-aldosterone system in the era of COVID-19


COVID-19 in persons with multiple sclerosis treated with ocrelizumab - A pharmacovigilance case series


Invited commentary on "Optimizing response in surgical systems during and after COVID-19 pandemic: Lessons from China and the UK - Perspective. Int J Surg, 2020, May 4, Epub ahead of print"


Invited commentary on "Optimizing response in surgical systems during and after COVID-19 pandemic: Lessons from China and the UK - Perspective. Int J Surg, 2020, May 4, Epub ahead of print" Hyperactive Delirium Requires More Aggressive Management in Patie


title: The Effect of the COVID-19 Pandemic on Smoking Cessation Success

text: The coronavirus pandemic first started in Wuhan, China, in December 2019 and affected the whole world. In our country, new measures to be taken were announced after the first case was seen on March 11, 2020. In this study, patients who admitted to the smoking cessation clinic in 2018 and followed up by phone, regarding smoking cessation status in 2019 were questioned for their smoking cessation status after the coronavirus pandemic in 2020. In this descriptive study, the patients who applied to the smoking cessation outpatient clinic in 2018 were questioned regarding their smoking cessation status after 1 year and after the pandemic. It was investigated whether coronapandemia had an effect on smoking cessation. The data were evaluated by using SPSS 22 software. A value of p < 0.05 was considered significant. A total of 357 individuals with a median of Fagerström score of 7.0 were included in the study. Seventy-one (19.9%) of the subjects used nicotine tape, 268 (75.1%) used varenicline, and 18 (5.0%) used both. When the success of those who quit smoking before pandemic and those who quit smoking after pandemic were compared, a statistically significant relationship was found (p < 0.001). In our study, the rate of smoking cessation after 1 year was 23.7%, and the most common side effects were psychiatric complaints, whereas the rate of smoking cessation during the pandemic period was 31.1%. In order to increase the rate of smoking cessation, which is an important public health problem, more counseling should be provided, during the pandemic period.


A suspicious role of interferon in the pathogenesis of SARS-CoV-2 by enhancing expression of ACE2


title: Managing COVID-19 disease in pediatric patients

text: Children are less likely to be infected with SARS-CoV-2 than adults and often have a milder course of COVID-19 disease and a lower case fatality rate. Children account for an estimated 1% to 5% of those diagnosed with COVID-19. Even so, preschool-aged children, infants, and children with underlying health conditions may still be at risk for severe disease and complications. Unique aspects of COVID-19 presentation and disease course in children and possible vertical transmission to newborns from COVID-19-positive mothers are discussed.


COVID-19 in pregnancy


title: Knowledge of and attitudes toward COVID-19 among parents of child dental patients during the outbreak

text: The aim of this study was to evaluate the knowledge of and attitudes toward coronavirus disease 2019 (COVID-19) among the parents of child dental patients in Shenzhen during the outbreak. A structured questionnaire containing 10 questions was used, and each question had 2 or 3 possible answers. The parents of children (aged 0-14 years) who visited the dental department of our hospital last year were eligible to participate in this study. A total of 148 parents were interviewed by telephone in February 2020 by research staff. A total of 94.59% of the parents said they paid high attention to COVID-19 and explained it to their children; 66.22% thought the dental department environment was more dangerous than other public places; 91.89% believed the dental department had a higher risk of virus infection; and 83.78% said they would take their children to a dental department if the children had a severe toothache. Approximately 81.08% of the parents expressed confidence after we informed them about the preventive measures taken in the dental department to ensure safe treatment for their children. In conclusion, all parents were concerned about COVID-19, and most of them had talked about it with their children often. In addition, a considerable percentage of them would not take their children to the dental department even if they had severe dental pain and thought that the dental environment could be more dangerous than other environments. More information about this topic should be delivered to this population.


title: Death, loss and community-Perspectives from children, their parents and older adults on intergenerational community-based arts initiatives in Sweden

text: Studio DöBra is a community-based initiative in which children (9 y/o) and older adults (mostly 80+) engaged with topics related to dying, death and loss through shared arts activities (e.g. collage, sculpture, games). In an ageing society, Sweden's end-of-life (EoL) care is increasingly professionalised and specialised, but there is little community involvement. One goal of Studio DöBra was therefore to support community engagement with EoL-related topics. Another goal was to create opportunities for interaction between children and older adults as there are few intergenerational meeting places. Two iterations of Studio DöBra were developed (2016, 2018) in different Swedish cities, utilising a community-based participatory research approach. Project groups comprised first author MK and representatives of community organisations such as meeting places for older adults, after-school centres and artistic organisations. Each iteration engaged eight children and eight older adults in a series of five workshops. This article investigates how children and older adults motivate their participation, their experiences of participating and ways in which they were affected by participation. We also investigate how parents reflect on their child's participation in Studio DöBra. Older adults, children and their parents were interviewed after each Studio DöBra. An inductive qualitative process guided by interpretive description was used to analyse the transcripts. Findings indicate that participants acted as individuals with agency in connecting across generations and in creating spaces for engaging with EoL-topics, not only in Studio DöBra but also in their social networks. Participants reflected on a changing sense of community through new intergenerational connections and social activities, and expressed a desire to maintain these. However, participants indicated sustainability challenges related to lacking agency in maintaining these spaces and sense of intergenerational community, as they rely on support from community organisations.


title: Mood of India During Covid-19 -- An Interactive Web Portal Based on Emotion Analysis of Twitter Data

text: The severe outbreak of Covid-19 pandemic has affected many countries across the world, and disrupted the day to day activities of many people. During such outbreaks, understanding the emotional state of citizens of a country could be of interest to various organizations to carry out tasks and to take necessary measures. Several studies have been performed on data available on various social media platforms and websites to understand the emotions of people against many events, inclusive of Covid-19, across the world. Twitter and other social media platforms have been bridging the gap between the citizens and government in various countries and are of more prominence in India. Sentiment Analysis of posts on twitter is observed to accurately reveal the sentiments. Analysing real time posts on twitter in India during Covid-19, could help in identifying the mood of the nation. However, most of the existing studies related to Covid-19, on twitter and other social media platforms are performed on data posted during a specific interval. We are not aware of any research that identifies emotional state of India on a daily basis. Hence, we present a web portal that aims to display mood of India during Covid-19, based on real time twitter data. This portal also enables users to select date range, specific date and state in India to display mood of people belonging to the specified region, on the specified date or during the specified date range. Also, the number of Covid-19 cases and mood of people at specific cities and states on specific dates is visualized on the country map. As of May 6 2020, the web portal has about 194370 tweets, and each of these tweets are classified into seven categories that include six basic emotions and a neutral category. A list of Trigger Events are also specified, to allow users to view the mood of India on specific events happening in the country during Covid-19.


Changing admission patterns in paediatric emergency departments during the COVID-19 pandemic


Firearm Industry Groups Are Using COVID-19 to Expand Gun Rights


Three children who recovered from novel coronavirus 2019 pneumonia


Decreased "WBC*LYM" was observed in SARS-CoV-2-infected patients from a fever clinic in Wuhan


Resilience and Covid-19


Disinfection of N95 respirators by ionized hydrogen peroxide during pandemic coronavirus disease 2019 (COVID-19) due to SARS-CoV-2


title: An evolving crisis

text: Insights into how viruses change over time can help us cope with this pandemic and avoid future ones, says Jonathan R. Goodman.


Curcumin as a potential treatment for COVID-19


Preparing for Pandemics: RNA Vaccines at the Forefront


title: Diabetes and COVID-19: Global and Regional Perspectives

text: The coronavirus disease-2019 (COVID-19) has been designated as a highly contagious infectious disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) since December 2019, when an outbreak of pneumonia cases emerged in Wuhan, China. The COVID-19 pandemic has led to a global health crisis, devastating the social, economic and political aspects of life. Many clinicians, health professionals, scientists, organizations, and governments have actively defeated COVID-19 and shared their experiences of the SARS-CoV2. Diabetes is one of the major risk factors for fatal outcomes from COVID-19. Patients with diabetes are vulnerable to infection because of hyperglycemia; impaired immune function; vascular complications; and comorbidities such as hypertension, dyslipidemia, and cardiovascular disease. In addition, angiotensin-converting enzyme 2 (ACE2) is a receptor for SARS-CoV-2 in the human body. Hence, the use of angiotensin-directed medications in patients with diabetes requires attention. The severity and mortality from COVID-19 was significantly higher in patients with diabetes than in those without. Thus, the patients with diabetes should take precautions during the COVID-19 pandemic. Therefore, we review the current knowledge of COVID-19 including the global and regional epidemiology, virology, impact of diabetes on COVID-19, treatment of COVID-19, and standard of care in the management of diabetes during this critical period.


Opening editorial: Telepsychology: Research, training, practice, and policy


Sleep apnoea management in Europe during the COVID-19 pandemic: data from the European Sleep Apnoea Database (ESADA)


title: From Prediction to Prescription: AI-Based Optimization of Non-Pharmaceutical Interventions for the COVID-19 Pandemic

text: Several models have been developed to predict how the COVID-19 pandemic spreads, and how it could be contained with non-pharmaceutical interventions (NPIs) such as social distancing restrictions and school and business closures. This paper demonstrates how evolutionary AI could be used to facilitate the next step, i.e. determining most effective intervention strategies automatically. Through evolutionary surrogate-assisted prescription (ESP), it is possible to generate a large number of candidate strategies and evaluate them with predictive models. In principle, strategies can be customized for different countries and locales, and balance the need to contain the pandemic and the need to minimize their economic impact. While still limited by available data, early experiments suggest that workplace and school restrictions are the most important and need to be designed carefully. It also demonstrates that results of lifting restrictions can be unreliable, and suggests creative ways in which restrictions can be implemented softly, e.g. by alternating them over time. As more data becomes available, the approach can be increasingly useful in dealing with COVID-19 as well as possible future pandemics.


title: Repurposing of clinically approved drugs for treatment of coronavirus disease 2019 in a 2019-novel coronavirus-related coronavirus model

text: BACKGROUND: Medicines for the treatment of 2019-novel coronavirus (2019-nCoV) infections are urgently needed. However, drug screening using live 2019-nCoV requires high-level biosafety facilities, which imposes an obstacle for those institutions without such facilities or 2019-nCoV. This study aims to repurpose the clinically approved drugs for the treatment of coronavirus disease 2019 (COVID-19) in a 2019-nCoV-related coronavirus model. METHODS: A 2019-nCoV-related pangolin coronavirus GX_P2V/pangolin/2017/Guangxi was described. Whether GX_P2V uses angiotensin-converting enzyme 2 (ACE2) as the cell receptor was investigated by using small interfering RNA (siRNA)-mediated silencing of ACE2. The pangolin coronavirus model was used to identify drug candidates for treating 2019-nCoV infection. Two libraries of 2406 clinically approved drugs were screened for their ability to inhibit cytopathic effects on Vero E6 cells by GX_P2V infection. The anti-viral activities and anti-viral mechanisms of potential drugs were further investigated. Viral yields of RNAs and infectious particles were quantified by quantitative real-time polymerase chain reaction (qRT-PCR) and plaque assay, respectively. RESULTS: The spike protein of coronavirus GX_P2V shares 92.2% amino acid identity with that of 2019-nCoV isolate Wuhan-hu-1, and uses ACE2 as the receptor for infection just like 2019-nCoV. Three drugs, including cepharanthine (CEP), selamectin, and mefloquine hydrochloride, exhibited complete inhibition of cytopathic effects in cell culture at 10 µmol/L. CEP demonstrated the most potent inhibition of GX_P2V infection, with a concentration for 50% of maximal effect [EC50] of 0.98 µmol/L. The viral RNA yield in cells treated with 10 µmol/L CEP was 15,393-fold lower than in cells without CEP treatment ([6.48â±â0.02]â×â10vs. 1.00â±â0.12, tâ=â150.38, Pâ<â0.001) at 72 h post-infection (p.i.). Plaque assays found no production of live viruses in media containing 10 µmol/L CEP at 48 h p.i. Furthermore, we found CEP had potent anti-viral activities against both viral entry (0.46â±â0.12, vs.1.00â±â0.37, tâ=â2.42, Pâ<â0.05) and viral replication ([6.18â±â0.95]â×â10vs. 1.00â±â0.43, tâ=â3.98, Pâ<â0.05). CONCLUSIONS: Our pangolin coronavirus GX_P2V is a workable model for 2019-nCoV research. CEP, selamectin, and mefloquine hydrochloride are potential drugs for treating 2019-nCoV infection. Our results strongly suggest that CEP is a wide-spectrum inhibitor of pan-betacoronavirus, and further study of CEP for treatment of 2019-nCoV infection is warranted.


Impact of COVID-19 pandemic on patients with large-vessel vasculitis in Italy: a monocentric survey


A chaotic and stressed environment for 2019-nCoV suspected, infected and other people in India: Fear of mass destruction and causality


title: Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study

text: BACKGROUND: Different degrees of disorders are reported in respiratory function, physical function and psychological function in patients with corona virus disease 2019 (COVID-19), especially in elderly patients. With the experience of improved and discharged COVID-19 patients, timely respiratory rehabilitation intervention may improve prognosis, maximize functional preservation and improve quality of life (QoL), but there lacks of studies worldwide exploring the outcome of this intervention. OBJECTIVE: To investigate the effects of 6-week respiratory rehabilitation training on respiratory function, QoL, mobility and psychological function in elderly patients with COVID-19. METHODS: This paper reported the findings of an observational, prospective, quasi-experimental study, which totally recruited 72 participants, of which 36 patients underwent respiratory rehabilitation and the rest without any rehabilitation intervention. The following outcomes were measured: pulmonary function tests including plethysmography and diffusing lung capacity for carbon monoxide (DLCO), functional tests (6-min walk distance test), Quality of life (QoL) assessments (SF-36 scores), activities of daily living (Functional Independence Measure, FIM scores), and mental status tests (SAS anxiety and SDS depression scores). RESULTS: After 6 weeks of respiratory rehabilitation in the intervention group, there disclosed significant differences in FEV1(L), FVC(L), FEV1/FVC%, DLCO% and 6-min walk test. The SF-36 scores, in 8 dimensions, were statistically significant within the intervention group and between the two groups. SAS and SDS scores in the intervention group decreased after the intervention, but only anxiety had significant statistical significance within and between the two groups. CONCLUSIONS: Six-week respiratory rehabilitation can improve respiratory function, QoL and anxiety of elderly patients with COVID-19, but it has little significant improvement on depression in the elderly.


Living through a pandemic - A time for clarity, courage and truth


Going viral: doctors must tackle fake news in the covid-19 pandemic


Presumed COVID-19 Index Case on Diamond Princess cruise ship and Evacuees to Hong Kong


Risk of neuropsychiatric disorders in offspring of COVID-19-infected pregnant women and nutritional intervention


Prone CPR: A novel and cost-free solution to ensuring adequate chest compressions


title: Surgical Practice in the Current COVID-19 Pandemic: A Rapid Systematic Review

text: The coronavirus disease (COVID-19) outbreak started in Wuhan, China, in December 2019, and evolved into a global problem in a short period. The pandemic has led to many social and health-care challenges. In this context, surgery is an area that is facing the need for many adaptations. In this systematic literature review, we analyzed different perspectives concerning this situation, aiming to provide recommendations that could guide surgeons and entities toward screening, elective and emergency surgeries, decision making, and operating room management. A computerized search in PubMed, Scopus, and Scientific Electronic Library Online (SciELO) for relevant literature up to April 4, 2020, was performed. Articles were included if they were related to surgery dynamics in the context of the COVID-19 pandemic. Of the 281 articles found in our initial search and 15 articles from alternative sources, 39 were included in our review after a systematic evaluation. Concerning preoperative testing for severe acute respiratory syndrome coronavirus 2 infection, 29 (74.4%) articles recommended some kind of screening. Another major suggestion was postponing all (or at least selected) elective operations (29 articles, 74.4%). Several additional recommendations with respect to surgical practice or surgical staff were also assessed and discussed, such as performing laparoscopic surgeries and avoiding the use of electrocauterization. On the basis of the current literature, we concluded that any surgery that can be delayed should be postponed. COVID-19 screening is strongly recommended for all surgical cases. Moreover, surgical staff should be reduced to the essential members and provided with institutional psychological support.


Un mundo, una salud: la epidemia por el nuevo coronavirus COVID-19./ Un mundo, una salud: la epidemia por el nuevo coronavirus COVID-19./ One world, one health: The novel coronavirus COVID-19 epidemic


Plastics recycling after the global pandemic: resurgence or regression?


For Ebola in the Democratic Republic of the Congo, the end will have to wait


title: Network structure of COVID-19 spread and the lacuna in India's testing strategy

text: We characterize the network of COVID-19 spread in India and find that the transmission rate is 0.43, with daily case growth driven by individuals who contracted the virus abroad. We explore the question of whether this represents exponentially decaying dynamics or is simply an artefact of India's testing strategy. Testing has largely been limited to individuals travelling from high-risk countries and their immediate contacts, meaning that the network reflects positive identifications from a biased testing sample. Given generally low levels of testing and an almost complete absence of testing for community spread, there is significant risk that we may be missing out on the actual nature of outbreak. India still has an apparently low current caseload, with possibly a small window of time to act, and should therefore aggressively and systematically expand random testing for community spread, including for asymptomatic cases. This will help understand true transmission characteristics and plan appropriately for the immediate future.


title: The impact of the COVID-19 outbreak on the medico-legal and human rights of psychiatric patients

text: The COVID-19 pandemic has raised significant concerns for population mental health and the effective provision of mental health services in the light of increased demands and barriers to service delivery [1]. Particular attention is being directed toward the possible neuropsychiatric sequelae of both COVID-19 and of the stringent societal mitigation steps deployed by national governments, concerns that are informed by historical increases in the incidence of psychotic disorders following influenza pandemics [2]. However, so far there has been scant attention paid to other important areas of psychiatry during COVID-19, including medico-legal aspects and human rights. In this paper, we discuss the legal implications for psychiatry of the COVID-19 pandemic and report a novel situation in which psychiatric patients may experience diminution of their statutory protections. We believe that this represents a paradigm shift in psychiatric care and that the consideration of the fundamental rights of psychiatric patients as "less important" than infection control measures compel mental health professionals to "advocate for patients and their caregivers" in this time of crisis [1].


title: Clinical flexible needle puncture path planning based on particle swarm optimization

text: BACKGROUND AND OBJECTIVE: Percutaneous puncture with flexible needle has important value in clinical application for its low trauma and flexible path. However, it is difficult to guarantee accuracy and avoid obstacles in puncture process. Therefore, developing a viable path planning method is particularly important. In this research, the bending deformation law of flexible needles during puncture was studied and the puncture path was planned to provide a feasible method for clinical application of flexible needles. METHODS: According to the researchs that have been conducted, the path of the flexible needle in the tissue could be considered as a circular arc stitching. This research studied the calculation method of arc radius and obtained its actual value by the puncture experiments. Based on the arc model, the spatial transformation method of three-dimensional path planning was studied. In addition, a simplified particle swarm optimization (PSO) was applied into the process of path planning by changing the central angle of arc and the rotation angle of the needle body. RESULTS: The results of Experiment 1 showed that the path radius of the flexible needle pierced into gelatin prosthesis was influenced by four parameters, which were needle diameter, tip angle, puncture speed and the weight ratio of gelatin powder. As the needle diameter and tip angle increased, the radius of needle path tended to increase, but when the puncture speed and gelatin mass ratio increased, the radius of needle path decreased. The results of Experiment 2 showed that the distances of needle tip apart from target point were 3.2 mm (barrier-free experiments) and 1.8 mm (obstacle experiments). CONCLUSIONS: This research links the intelligent algorithm with the flexible needle puncture tissue process, which has high value in future clinical application. By setting the correct boundary conditions and parameters, the flexible needle can be planned to reach the target point accurately.


Open science takes on the coronavirus pandemic


COVID-19: A United Kingdom National Health Service cardiology perspective


Commentary: Pandemic deployment and surgical soldiership


title: Commentary: COVID in Care Homes-Challenges and Dilemmas in Healthcare Delivery

text: The COVID-19 pandemic has disproportionately affected care home residents internationally, with 19-72% of COVID-19 deaths occurring in care homes. COVID-19 presents atypically in care home residents and up to 56% of residents may test positive whilst pre-symptomatic. In this article, we provide a commentary on challenges and dilemmas identified in the response to COVID-19 for care homes and their residents. We highlight the low sensitivity of PCR testing and the difficulties this poses for blanket screening and isolation of residents. We discuss quarantine of residents and the potential harms associated with this. Personal Protective Equipment (PPE) supply for care homes during the pandemic has been suboptimal and we suggest that better integration of procurement and supply is required. Advance care planning has been challenged by the pandemic and there is a need to for healthcare staff to provide support to care homes with this. Finally, we discuss measures to implement augmented care in care homes, including treatment with oxygen and subcutaneous fluids, and the frameworks which will be required if these are to be sustainable. All of these challenges must be met by healthcare, social care and government agencies if care home residents and staff are to be physically and psychologically supported during this time of crisis for care homes.


title: COVID-19 and tuberculosis in South Africa: A dangerous combination

text: There has been much speculation during the past week about the catastrophe that awaits once coronavirus disease 2019 (COVID-19) establishes itself in the poorest communities of South Africa (SA) and, importantly, in informal settlements. Evidence to date suggests that COVID-19 is efficiently passed from infected individuals via large droplets and hard-surface fomites.


COVID-19 im Alter  eine komplexe Herausforderung : Corona-Pandemie 2020./ [COVID-19 in older adults - a complex challenge]


title: Suboptimal biological sampling as a probable cause of false-negative COVID-19 diagnostic test results

text: False-negative SARS-CoV-2 test results can negatively impact the clinical and public health response to COVID-19. We used droplet digital PCR (ddPCR) to demonstrate that human DNA levels, a stable molecular marker of sampling quality, were significantly lower in samples from 40 confirmed or suspected COVID-19 cases that yielded negative diagnostic test results (i.e. suspected false-negative test results) compared to a representative pool of 87 specimens submitted for COVID-19 testing. Our results support suboptimal biological sampling as a contributor to false-negative COVID-19 test results and underscore the importance of proper training and technique in the collection of nasopharyngeal specimens.


title: Canadian children's and youth's adherence to the 24-h movement guidelines during the COVID-19 pandemic: A decision tree analysis

text: BACKGROUND: The purpose of this study was to use decision tree modeling to generate profiles of children and youth who were more or less likely to meet the Canadian 24-h movement guidelines during the COVID-19 outbreak. METHODS: Data for this study were from a nationally representative sample of 1472 Canadian parents (Meanageâ¯=â¯45.12, SDâ¯=â¯7.55) of children (5-11 years old) or youth (12-17 years old). Data were collected in April 2020 via an online survey. Survey items assessed demographic, behavioral, social, microenvironmental, and macroenvironmental characteristics. Four decision trees of adherence and nonadherence to all movement recommendations were combined, and each individual movement recommendation (physical activity, screen time, and sleep) were generated. RESULTS: Results revealed specific combinations of adherence and nonadherence characteristics. Characteristics associated with adherence to the recommendation(s) included high parental perceived capability to restrict screen time, being a boy, increases in children's and youth's outdoor physical activity/sport since the COVID-19 outbreak began, having parents younger than 43 years old (for adherence to screen-time recommendation), having no to little change in sleep duration since the COVID-19 outbreak began, and having parents older than 35 years of age (for adherence to the sleep recommendation). Characteristics associated with nonadherence to the recommendations included low parental perceived capability to restrict screen time, decreases in children's and youth's outdoor physical activity/sport since the COVID-19 outbreak began, primary residences located in all provinces except Quebec, low parental perceived capability to support children's sleep, and increases in sleep duration since the COVID-19 outbreak began. CONCLUSION: Our results show that specific characteristics interact to contribute to (non)adherence to the movement behavior recommendations. Results highlight the importance of targeting parents' perceived capability for the promotion of children's and youth's movement behaviors during challenging times of the COVID-19 pandemic, paying particular attention to enhancing parental perceived capability to restrict screen time.


COVID-19 pandemic: guidance for nuclear medicine departments


title: The role of asymptomatic class, quarantine and isolation in the transmission of COVID-19

text: We formulate a deterministic epidemic model for the spread of Corona Virus Disease (COVID-19). We have included asymptomatic, quarantine and isolation compartments in the model, as studies have stressed upon the importance of these population groups on the transmission of the disease. We calculate the basic reproduction number [Formula: see text] and show that for [Formula: see text] the disease dies out and for [Formula: see text] the disease is endemic. Using sensitivity analysis we establish that [Formula: see text] is most sensitive to the rate of quarantine and isolation and that a high level of quarantine needs to be maintained as well as isolation to control the disease. Based on this we devise optimal quarantine and isolation strategies, noting that high levels need to be maintained during the early stages of the outbreak. Using data from the Wuhan outbreak, which has nearly run its course we estimate that [Formula: see text] which while in agreement with other estimates in the literature is on the lower side.


title: Optimally Robust Kalman Filtering at Work: AO-, IO-, and Simultaneously IO- and AO- Robust Filters

text: We take up optimality results for robust Kalman filtering from Ruckdeschel[2001,2010] where robustness is understood in a distributional sense, i.e.; we enlarge the distribution assumptions made in the ideal model by suitable neighborhoods, allowing for outliers which in our context may be system-endogenous/propagating or -exogenous/non-propagating, inducing the somewhat conflicting goals of tracking and attenuation. Correspondingly, the cited references provide optimally-robust procedures to deal with each type of outliers separately, but in case of IO-robustness does not say much about the implementation. We discuss this in more detail in this paper. Most importantly, we define a hybrid filter combining AO- and IO-optimal ones, which is able to treat both types of outliers simultaneously, albeit with a certain delay. We check our filters at a reference state space model, and compare the results with those obtained by the ACM filter Martin and Masreliez[1977], Martin[1979] and non-parametric, repeated-median based filters Fried et al.[2006,2007].


title: Special Communication: Evaluation and Treatment of Thoracic Outlet Syndrome During the Global Pandemic Due to SARS-CoV-2 and COVID-19

text: The global SARS-CoV-2/COVID-19 pandemic has required a reduction in non-emergency treatment for a variety of disorders. This report summarizes conclusions of an international multidisciplinary consensus group assembled to address evaluation and treatment of patients with thoracic outlet syndrome (TOS), a group of conditions characterized by extrinsic compression of the neurovascular structures serving the upper extremity. The following recommendations were developed in relation to the 3 defined types of TOS (neurogenic, venous, and arterial) and 3 phases of pandemic response (preparatory, urgent with limited resources, and emergency with complete diversion of resources): (1) In-person evaluation and treatment for neurogenic TOS (interventional or surgical) is generally postponed during all pandemic phases, with telephone/telemedicine visits and at-home physical therapy exercises recommended when feasible. (2) Venous TOS presenting with acute upper extremity deep vein thrombosis (Paget-Schroetter syndrome) is managed primarily with anticoagulation, with percutaneous interventions for venous TOS (thrombolysis) considered in early phases (I and II) and surgical treatment delayed until pandemic conditions resolve. Catheter-based interventions may also be considered for selected patients with central subclavian vein obstruction and threatened hemodialysis access in all pandemic phases, with definitive surgical treatment postponed. (3) Evaluation and surgical treatment for arterial TOS should be reserved for limb-threatening situations, such as acute upper extremity ischemia or acute digital embolization, in all phases of pandemic response. In late pandemic phases surgery should be restricted to thrombolysis or brachial artery thromboembolectomy, with more definitive treatment delayed until pandemic conditions resolve.


Effect of extended use N95 respirators and eye protection on personal protective equipment (PPE) utilization during SARS-CoV-2 outbreak in Singapore


title: Targeting SARS-CoV-2: a systematic drug repurposing approach to identify promising inhibitors against 3C-like proteinase and 2'-O-ribose methyltransferase

text: The recent pandemic associated with SARS-CoV-2, a virus of the Coronaviridae family, has resulted in an unprecedented number of infected people. The highly contagious nature of this virus makes it imperative for us to identify promising inhibitors from pre-existing antiviral drugs. Two druggable targets, namely 3C-like proteinase (3CLpro) and 2'-O-ribose methyltransferase (2'-O-MTase) were selected in this study due to their indispensable nature in the viral life cycle. 3CLpro is a cysteine protease responsible for the proteolysis of replicase polyproteins resulting in the formation of various functional proteins, whereas 2'-O-MTase methylates the ribose 2'-O position of the first and second nucleotide of viral mRNA, which sequesters it from the host immune system. The selected drug target proteins were screened against an in-house library of 123 antiviral drugs. Two promising drug molecules were identified for each protein based on their estimated free energy of binding (ΔG), the orientation of drug molecules in the active site and the interacting residues. The selected protein-drug complexes were then subjected to MD simulation, which consists of various structural parameters to equivalently reflect their physiological state. From the virtual screening results, two drug molecules were selected for each drug target protein [Paritaprevir (ΔG = -9.8 kcal/mol) & Raltegravir (ΔG = -7.8 kcal/mol) for 3CLpro and Dolutegravir (ΔG = -9.4 kcal/mol) and Bictegravir (ΔG = -8.4 kcal/mol) for 2'-OMTase]. After the extensive computational analysis, we proposed that Raltegravir, Paritaprevir, Bictegravir and Dolutegravir are excellent lead candidates for these crucial proteins and they could become potential therapeutic drugs against SARS-CoV-2. Communicated by Ramaswamy H. Sarma.


Clinical features and outcomes of COVID-19 in patients with rheumatic diseases treated with biological and synthetic targeted therapies


title: Essential Role of Patient Blood Management in a Pandemic: A Call for Action

text: The World Health Organization (WHO) has declared coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a pandemic. Global health care now faces unprecedented challenges with widespread and rapid human-to-human transmission of SARS-CoV-2 and high morbidity and mortality with COVID-19 worldwide. Across the world, medical care is hampered by a critical shortage of not only hand sanitizers, personal protective equipment, ventilators, and hospital beds, but also impediments to the blood supply. Blood donation centers in many areas around the globe have mostly closed. Donors, practicing social distancing, some either with illness or undergoing self-quarantine, are quickly diminishing. Drastic public health initiatives have focused on containment and "flattening the curve" while invaluable resources are being depleted. In some countries, the point has been reached at which the demand for such resources, including donor blood, outstrips the supply. Questions as to the safety of blood persist. Although it does not appear very likely that the virus can be transmitted through allogeneic blood transfusion, this still remains to be fully determined. As options dwindle, we must enact regional and national shortage plans worldwide and more vitally disseminate the knowledge of and immediately implement patient blood management (PBM). PBM is an evidence-based bundle of care to optimize medical and surgical patient outcomes by clinically managing and preserving a patient's own blood. This multinational and diverse group of authors issue this "Call to Action" underscoring "The Essential Role of Patient Blood Management in the Management of Pandemics" and urging all stakeholders and providers to implement the practical and commonsense principles of PBM and its multiprofessional and multimodality approaches.


COVID-19 and vascular surgery at a central London teaching hospital


title: Cytokine release syndrome and the prospects for immunotherapy with COVID-19. Part 2: The role of interleukin 1

text: Interleukin 1 (IL-1) is a potential target of therapy in COVID-19 during the severe respiratory-inflammatory phase ("cytokine release syndrome"), when pulmonary macrophages are hyperactivated, releasing IL-1 and other cytokines. Preliminary evidence indicates that anakinra and canakinumab, drugs that block the action of IL-1 and have a good safety profile, improve the outcomes of patients with COVID-19 cytokine release syndrome. Results from large, randomized clinical trials are pending.


Age-related difference in the rate of coronavirus disease 2019 mortality in women versus men


title: Necessity of Pharmacist-driven non-prescription telehealth consult services in the era of COVID-19

text: Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.


title: Associations of Early COVID-19 Cases in San Francisco with Domestic and International Travel

text: In early-to-mid March 2020, 20 of 46 (43%) COVID-19 cases at a tertiary care hospital in San Francisco, California were travel-related. Cases were significantly associated with travel to Europe or New York (odds ratio 32.9). Viral genomes recovered from 9 of 12 (75%) cases co-clustered with lineages circulating in Europe.


The association between laryngopharyngeal reflux and COVID-19 is still not demonstrated


Waste Not, Want Not: Re-Usability of N95 Masks


Addressing potential impact of COVID-19 pandemic on physical and mental health of elite athletes


title: [Emelt szintu szervtámogató és életfenntartó kezelések kritikus állapotú COVID19-fertozött betegeken]/ Organ replacement therapy and life-supporting treatment modalities in critically ill COVID-19 patients

text: In critically ill COVID-19 patients, the failure of the cardiorespiratory system can be due to one of the following: (1) cytokine storm, haemophagocytosis  septic shock, (2) unmanageable hypoxemia, (3) isolated organ failure or as part of multi-organ failure. Herein we give an overview of the therapeutic options for treating or preventing these disease states. In recent years, CytoSorb-haemoperfusion to remove cytokines has shown promising results in the treatment of septic shock. Inhalational nitric oxide (iNO), inhalational epoprostenol and veno-venous extracorporeal membrane oxygenation (ECMO) are options in severe hypoxemia that is unresponsive to conventional mechanical ventilation. Renal failure is a frequent component of the multi-organ failure usually seen with disease progression and necessitates starting one of the available continuous renal replacement modalities. Orv Hetil. 2020; 161(17): 704709.


title: COVID-19 Infection Fatality Rate Associated with Incidence-A Population-Level Analysis of 19 Spanish Autonomous Communities

text: Previous studies have found large variations in the COVID-19 infection fatality rate (IFR). This study hypothesized that IFR would be influenced by COVID-19 epidemic intensity. We tested the association between epidemic intensity and IFR using serological results from a recent large SARS-CoV-2 serosurvey (N = 60,983) in 19 Spanish regions. The infection fatality rate for Spain as a whole was 1.15% and varied between 0.13% and 3.25% in the regions (median 1.07%, IQR 0.69-1.32%). The IFR by region was positively associated with SARS-CoV-2 seroprevalence (rho = 0.54; p = 0.0162), cases/100,000 (rho = 0.75; p = 0.002), hospitalizations/100,000 (rho = 0.78; p = 0.0001), mortality/100,000 (rho = 0.77; p = 0.0001) and case fatality rate (rho = 0.49; p = 0.0327). These results suggest that the SARS-CoV-2 IFR is not fixed. The Spanish regions with more rapid and extensive spread of SARS-CoV-2 had higher IFRs. These findings are compatible with the theory that slowing the spread of COVID-19 down reduces the IFR and case fatality rate via preventing hospitals from being overrun, and thus allowing better and lifesaving care.


title: The differential expression of the ACE2 receptor across ages and gender explains the differential lethality of SARS-Cov-2 and suggests possible therapy

text: The fatality rate of SARS-Cov-2 escalates with age and is larger in men than women. I show that these variations are strongly correlated with the levels of the ACE2 protein in the lungs but surprisingly, despite ACE2 is the viral receptor, higher levels lead to lower fatality. This behaviour is consistent with a previous mathematical model that predicts that the speed of viral progression in the organism has a maximum and then declines with the receptor level. SARS-Cov-2 degrades ACE2 and thus worsens lung injury, causes vasoconstriction, thrombotic problems, and exacerbated inflammatory response. I developed a mathematical model based on the influence of ACE2 on viral propagation and on the negative effects of its degradation. The model fits SARS-CoV-2 fatality rate across age and gender with high accuracy ($r^2>0.9$). Rescaling the model parameters with the binding rates of the spike proteins of SARS-CoV and SARS-CoV-2 allows predicting the fatality rate of SARS-CoV across age and gender, in particular its higher severity for young patients, thus linking the molecular and epidemiological levels. These results support the suggestion that drugs that enhance the expression of ACE2, such as ACE inhibitors and angiotensin receptor blockers, constitute a promising therapy against the most adverse effects of CoViD-19. Furthermore, ACE2 is a candidate prognostic factor for detecting population that needs stronger protection.


Novel coronavirus, poor quarantine, and the risk of pandemic


title: A Tool to Early Predict Severe Corona Virus Disease 2019 (COVID-19) : A Multicenter Study using the Risk Nomogram in Wuhan and Guangdong, China

text: BACKGROUND: Due to no reliable risk stratification tool for severe coronavirus disease 2019 (COVID-19) patients at admission, we aimed to construct an effective model for early identification of cases at high risk of progression to severe COVID-19. METHODS: In this retrospective three-centers study, 372 non-severe COVID-19 patients during hospitalization were followed for more than 15 days after admission. Patients who deteriorated to severe or critical COVID-19 and patients who kept non-severe state were assigned to the severe and non-severe group, respectively. Based on baseline data of the two groups, we constructed a risk prediction nomogram for severe COVID-19 and evaluated its performance. RESULTS: The training cohort consisted of 189 patients, while the two independent validation cohorts consisted of 165 and 18 patients. Among all cases, 72 (19.35%) patients developed severe COVID-19. We found that old age, and higher serum lactate dehydrogenase, C-reactive protein, the coefficient of variation of red blood cell distribution width, blood urea nitrogen, direct bilirubin, lower albumin, are associated with severe COVID-19. We generated the nomogram for early identifying severe COVID-19 in the training cohort (AUC 0.912 [95% CI 0.846-0.978], sensitivity 85.71%, specificity 87.58%); in validation cohort (0.853 [0.790-0.916], 77.5%, 78.4%). The calibration curve for probability of severe COVID-19 showed optimal agreement between prediction by nomogram and actual observation. Decision curve and clinical impact curve analysis indicated that nomogram conferred high clinical net benefit. CONCLUSION: Our nomogram could help clinicians to early identify patients who will exacerbate to severe COVID-19, which will enable better centralized management and early treatment of severe patients.


title: Future prospects

text: This chapter addresses limitations to current 21-cm signal detection instruments, being related to the instrument, environment, signal processing or science, and what lies beyond the current horizon for 21-cm science, especially in the 2030s and beyond. We address how to overcome current challenges and drive the field forward, not only approaching a detection of the 21-cm signal but to a full characterisation of its parameterspace, in particular, probing an increasingly larger volume of k-modes (spatially and in redshifts). We also will shortly touch upon the kinds of questions that could drive such future endeavours.


title: Can nanotechnology help in the fight against COVID-19?

text: INTRODUCTION: The current COVID-19 pandemic caused by the SARS-CoV-2 virus demands the development of strategies not only to detect or inactivate the virus, but to treat it (therapeutically and prophylactically). COVID-19 is not only a critical threat for the population with risk factors, but also generates a dramatic economic impact in terms of morbidity and the overall interruption of economic activities. AREAS COVERED: Advanced materials are the basis of several technologies that could diminish the impact of COVID-19: biosensors might allow early virus detection, nanosized vaccines are powerful agents that could prevent viral infections, and nanosystems with antiviral activity could bind the virus for inactivation or destruction upon application of an external stimulus. Herein all these methods are discussed under the light of cutting-edge technologies and the previously reported prototypes targeting enveloped viruses similar to SARS-CoV-2. This analysis was derived from an extensive scientific literature search (including pubmed) performed on April 2020. EXPERT OPINION: Perspectives on how biosensors, vaccines, and antiviral nanosystems can be implemented to fight COVID-19 are envisioned; identifying the approaches that can be implemented in the short term and those that deserve long term research to cope with respiratory viruses-related pandemics in the future.


Management of IBD during the COVID-19 outbreak: resetting clinical priorities


title: Covid-19, Mental Health and Psychological First Aid

text: Crises such as the global pandemic of Covid-19 (coronavirus) elicit a range of responses from individuals and societies adversely affecting physical and emotional well-being. This article provides an overview of factors elicited in response to Covid-19 and their impact on immunity, physical health, mental health and wellbeing. Certain groups, such as individuals with mental illness, are especially vulnerable, so it is important to maximise the supports available to this population and their families during the pandemic. More broadly, the World Health Organization recommends "Psychological First Aid" as a useful technique that can help many people in a time of crisis.


title: Panique et pandémie : revue de la littérature sur les liens entre le trouble panique et l'épidémie à SARS-CoV-2./ [Panic and pandemic: Review of the literature on the links between panic disorder and the SARS-CoV-2 epidemic]

text: Although the "panic" word has been abundantly linked to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic in the press, in the scientific literature very few studies have considered whether the current epidemic could predispose to the onset or the aggravation of panic attacks or panic disorder. Indeed, most studies thus far have focused on the risk of increase and aggravation of other psychiatric disorders as a consequence of the SARS-CoV-2 epidemic, such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Yet, risk of onset or aggravation of panic disorder, especially the subtype with prominent respiratory symptoms, which is characterized by a fear response conditioning to interoceptive sensations (e.g., respiratory), and hypervigilance to these interoceptive signals, could be expected in the current situation. Indeed, respiratory symptoms, such as coughs and dyspnea, are among the most commonly associated with the SARS-CoV-2 (59-82% and 31-55%, respectively), and respiratory symptoms are associated with a poor illness prognosis. Hence given that some etiological and maintenance factors associated with panic disorder - i.e., fear conditioning to abnormal breathing patterns attributable or not to the COVID-19 (coronavirus disease 2019), as well as hypervigilance towards breathing abnormalities - are supposedly more prevalent, one could expect an increased risk of panic disorder onset or aggravation following the COVID-19 epidemic in people who were affected by the virus, but also those who were not. In people with the comorbidity (i.e., panic disorder or panic attacks and the COVID-19), it is particularly important to be aware of the risk of hypokalemia in specific at-risk situations or prescriptions. For instance, in the case of salbutamol prescription, which might be overly used in patients with anxiety disorders and COVID-19, or in patients presenting with diarrhea and vomiting. Hypokalemia is associated with an increased risk of torsade de pointe, thus caution is required when prescribing specific psychotropic drugs, such as the antidepressants citalopram and escitalopram, which are first-line treatments for panic disorder, but also hydroxyzine, aiming at anxiety reduction. The results reviewed here highlight the importance of considering and further investigating the impact of the current pandemic on the diagnosis and treatment of panic disorder (alone or comorbid with the COVID-19).


GI symptoms as early signs of COVID-19 in hospitalised Italian patients


David Oliver: What the pandemic measures reveal about ageism


title: Examining the impact of COVID-19 on stress and coping strategies in individuals with disabilities and chronic conditions

text: PURPOSE/OBJECTIVE: This study aimed to describe the perceived stress levels and coping mechanisms related to COVID-19, and whether coping is related to well-being in people with self-reported chronic conditions and disabilities. Research Method/Design: A cross-sectional survey design was implemented. The total number of participants were 269 individuals with self-reported disabilities and chronic conditions (Mage = 39.37, SDage = 12.18). We examined the relationship between perceived stress and coping strategies related to COVID-19, and which COVID-19 coping strategies were associated with well-being after controlling for demographic and psychological characteristics. RESULTS: Correlation analyses demonstrated that perceived stress related to COVID-19 was positively associated with coping strategies including self-distraction, denial, substance use, behavioral disengagement, venting, planning, religion, and self-blame. Further, hierarchical regression results demonstrated that active coping, denial, use of emotional support, humor, religion, and self-blame were associated with participants' well-being after controlling for demographic and psychological characteristics. CONCLUSIONS/IMPLICATIONS: This exploratory study findings suggest that measuring and quantifying COVID-19 related stress and coping strategies in individuals with chronic conditions and disabilities can help clinicians and researchers understand potential effects of COVID-19 among people with chronic conditions and disabilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Contamination of filtering face piece 3 masks with SARS-COV-2 during endotracheal intubation


title: Pneumococcal co-infection in Covid-19 patients

text: We would like to report our experience of 2 patients co-infected with Streptococcus pneumoniae (S. pneumoniae) and coronavirus disease 2019 (Covid-19) in the United Kingdom. This article is protected by copyright. All rights reserved.


title: The link between Vitamin D and Covid-19: distinguishing facts from fiction

text: Vitamin D is produced in the skin under the influence of UVB-light from the sun or obtained via the diet by eating fatty fish, enriched dairy products or supplements. Vitamin D is known to support a healthy bone and severe deficiency may lead to osteomalacia or the rickets, which still occur in poor areas of the world. In addition, vitamin D support key functions in many organs, including the brain, muscle and the immune systems (Holick, 2007). In fact, the vitamin D receptor (VDR) is expressed in most cell types and may activate somewhere between 200-500 genes, many related to the immune system.


title: WRKY genes family study reveals tissue-specific and stress-responsive TFs in wild potato species

text: Wild potatoes, as dynamic resource adapted to various environmental conditions, represent a powerful and informative reservoir of genes useful for breeding efforts. WRKY transcription factors (TFs) are encoded by one of the largest families in plants and are involved in several biological processes such as growth and development, signal transduction, and plant defence against stress. In this study, 79 and 84 genes encoding putative WRKY TFs have been identified in two wild potato relatives, Solanum commersonii and S. chacoense. Phylogenetic analysis of WRKY proteins divided ScWRKYs and SchWRKYs into three Groups and seven subGroups. Structural and phylogenetic comparative analyses suggested an interspecific variability of WRKYs. Analysis of gene expression profiles in different tissues and under various stresses allowed to select ScWRKY045 as a good candidate in wounding-response, ScWRKY055 as a bacterial infection triggered WRKY and ScWRKY023 as a multiple stress-responsive WRKY gene. Those WRKYs were further studied through interactome analysis allowing the identification of potential co-expression relationships between ScWRKYs/SchWRKYs and genes of various pathways. Overall, this study enabled the discrimination of WRKY genes that could be considered as potential candidates in both breeding programs and functional studies.


title: Multisystem Inflammatory Syndrome in U.S. Children and Adolescents

text: BACKGROUND: Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome. METHODS: We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms. RESULTS: We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores ≥2.5) were documented in 15 patients (8%), and Kawasaki's disease-like features were documented in 74 (40%). Most patients (171 [92%]) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%). CONCLUSIONS: Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents. (Funded by the Centers for Disease Control and Prevention.).


title: Isolated olfactory cleft involvement in SARS-CoV-2 infection: prevalence and clinical correlates

text: PURPOSE: Smell alterations are a symptom of COVID-19 and have been associated with olfactory cleft mucosal thickening (OCMT). Although their pathogenesis is unclear, evidences link them to viral neuroinvasive potential. This study aims at estimating the prevalence of OCMT in CT scans of COVID-19 patients and investigating its clinical correlates. METHODS: In a single-institution retrospective cross-sectional study, we included all patients hospitalized for COVID-19 undergoing head CT scan for any reason. Exclusion criteria were history of recent head trauma or chronic rhinosinusitis; opacification > 2 mm in any sinonasal space other than the olfactory cleft; CT performed during/after invasive ventilation or feeding via nasogastric tube. We recorded the prevalence of OCMT and related it to age, sex, need for invasive ventilation during hospital stay, outcome, length of hospital stay, diffusion of lung SARS-CoV-19 lesions and outcome. RESULTS: 63 eligible patients were identified (39 male, 24 female; median age 77.82 ± 17.77 years). OCMT was identified in 16 patients (25.4%; 95% CI 15.3-37.9%). Patients with OCMT had longer hospital stays (median 16 ± 4 vs. 9 ± 14.5 days, p = .009, Mann-Whitney U test) and required invasive ventilation more frequently than patients without mucosal thickening (OR 4.89, 95% CI 0.96-24.89, p = .063, Fisher's test). No other difference was observed. CONCLUSION: OCMT affects nearly one in four patients hospitalized for COVID-19. It is associated with a worse disease course irrespective of age, sex and diffusion of lung lesions, although with no direct effect on survival.


title: Zero tolerance for complacency by government of West African countries in the face of the COVID-19

text: A novel Coronavirus (SARS-CoV-2) causing a cluster of respiratory infections (Coronavirus Disease 2019, COVID-19) first discovered in Wuhan, China, is responsible for a new illness that has been found to affect the lungs and airways of patients with associated symptoms of fever, cough and shortness of breath. In the light of few cases recorded so far in West Africa there is tendency for complacency. The region needs to make strategic plans based on available evidence to enable them effectively deal with this rapidly evolving pandemic. At this very moment countries like China, Italy, France, Spain, Iran, UK and many others are witnessing sustained and intensive community transmission of this virus and increasing numbers of severe disease and death particularly among elderly patients with other comorbidities. The reality of the seriousness of this pandemic is alarming. Government of member states of ECOWAS need to prepare themselves by building capacity as well as implement evidenced-based steps to mitigate this rapidly evolving pandemic by testing persons presenting with symptoms (fever, cough and shortness of breath), isolating and treating those found positive, tracing and quarantining contacts, implementing social distancing as well as optimizing human and material endowment to allow healthcare workers offer safe quality clinical care for affected patients to prevent secondary infection among healthcare workers.


text: A novel Coronavirus (SARS-CoV-2) causing a cluster of respiratory infections (Coronavirus Disease 2019, COVID-19) first discovered in Wuhan, China is responsible for a new illness that has been found to affect the lungs and airways of patients with associated symptoms of fever, cough and shortness of breath. In the light of few cases recorded so far in West Africa there is tendency for complacency. The region needs to make strategic plans based on available evidence to enable them effectively deal with this rapidly evolving pandemic. At this very moment countries like China, Italy, France, Spain, Iran, UK and many others are witnessing sustained and intensive community transmission of this virus and increasing numbers of severe disease and death particularly among elderly patients with other comorbidities. The reality of the seriousness of this pandemic is alarming. Government of member states of ECOWAS need to prepare themselves by building capacity as well as implement evidenced-based steps to mitigate this rapidly evolving pandemic by testing persons presenting with symptoms (fever, cough and shortness of breath), isolating and treating those found positive, tracing and quarantining contacts, implementing social distancing as well as optimizing human and material endowment to allow healthcare workers offer safe quality clinical care for affected patients to prevent secondary infection among healthcare workers.


title: A Brief Telephone Severity Scoring System and Therapeutic Living Centers Solved Acute Hospital-Bed Shortage during the COVID-19 Outbreak in Daegu, Korea

text: With the epidemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, the number of infected patients was rapidly increasing in Daegu, Korea. With a maximum of 741 new patients per day in the city as of February 29, 2020, hospital-bed shortage was a great challenge to the local healthcare system. We developed and applied a remote brief severity scoring system, administered by telephone for assigning priority for hospitalization and arranging for facility isolation ("therapeutic living centers") for the patients starting on February 29, 2020. Fifteen centers were operated for the 3,033 admissions to the COVID-19 therapeutic living centers. Only 81 cases (2.67%) were transferred to hospitals after facility isolation. We think that this brief severity scoring system for COVID-19 worked safely to solve the hospital-bed shortage. Telephone scoring of the severity of disease and therapeutic living centers could be very useful in overcoming the shortage of hospital-beds that occurs during outbreaks of infectious diseases.


title: Critical care transport in the time of COVID-19

text: Critical care transport organizations are nimble, operationally focused institutions that can aid in managing crises. Ornge provides air ambulance and critical care transport services to Ontario. From 12 bases, Ornge operates four PC-12 Next Generation fixed wing (FW) aircraft, eight AW-139 rotary wing (RW) aircraft, and four critical care land ambulances (CCLA) on a 24/7 basis. Ornge also contracts with private air carriers to provide lower acuity air ambulance services. Ornge performs over 20,000 patient-related transports annually. We discuss Ornge's approach to preparing for the coronavirus disease 2019 (COVID-19) pandemic, and identify potential unconventional roles.


The Role of Nuclear Medicine for COVID-19: Time to Act Now


title: Epidemiological and clinical characteristics of novel coronavirus infection in children: Thoughts on the diagnostic criteria of suspected cases outside Hubei Province/ 中国小儿急救医学

text: Objective@#To improve the diagnostic criteria of suspected cases through investigating the epidemiological and clinical manifestations of confirmed cases of new-type coronavirus infection in children.@*Methods@#We retrospective analyzed the epidemiological and clinical manifestations of 6 children with new coronavirus infection diagnosed in Chongqing Three Gorges Central Hospital from February 3, 2020 to February 15, 2020 . Compared with the diagnostic criteria of suspected cases,we summarized the problems encountered in the application of this standard in clinical work and try to put forward Suggestions for improvement.@*Results@#Among the 6 children with confirmed cases: 5 males and 1 female; 3 from Hubei Province and 3 from Wanzhou ; 6 cases of clustered onset of the family; Visiting nature: 3 cases of suspected case income, 3 cases of community or outpatient screening . Three cases with fever and / or respiratory symptoms, one of which had symptoms of diarrhea; all children's blood routine and lymphocyte counts were within the normal range; chest CT imaging except for cases No. 1 and No. 5 were in line with typical new coronavirus pneumonia signs. In addition, the remaining 3 patients had abnormal imaging but did not have the characteristics of new coronavirus pneumonia, and 1 case was normal. Comparison results:Only case 1 of all cases fully met the diagnostic criteria, and the remaining cases did not meet the diagnostic criteria of early suspected cases.@*Conclusion@#In order to improve the accuracy and practicality of the diagnosis of suspected cases in children, it is recommended to refine and standardize the diagnostic criteria of some suspected cases.


title: Melanoma defies 'lockdown': ongoing detection during Covid-19 in central London

text: The COVID-19 pandemic has presented significant challenges for Dermatology services, particularly the diagnosis and management of malignant melanoma (MM). Early detection and definitive surgical treatment are key to improving MM prognosis, and in England there is a suspected skin cancer referral pathway that facilitates specialist Dermatology assessment within two weeks. Here, we describe the impact of COVID-19 on MM detection, based on data from the a Dermatology Department in central London.


title: Potential Factors Influencing Repeated SARS Outbreaks in China

text: Within last 17 years two widespread epidemics of severe acute respiratory syndrome (SARS) occurred in China, which were caused by related coronaviruses (CoVs): SARS-CoV and SARS-CoV-2. Although the origin(s) of these viruses are still unknown and their occurrences in nature are mysterious, some general patterns of their pathogenesis and epidemics are noticeable. Both viruses utilize the same receptor-angiotensin-converting enzyme 2 (ACE2)-for invading human bodies. Both epidemics occurred in cold dry winter seasons celebrated with major holidays, and started in regions where dietary consumption of wildlife is a fashion. Thus, if bats were the natural hosts of SARS-CoVs, cold temperature and low humidity in these times might provide conducive environmental conditions for prolonged viral survival in these regions concentrated with bats. The widespread existence of these bat-carried or -released viruses might have an easier time in breaking through human defenses when harsh winter makes human bodies more vulnerable. Once succeeding in making some initial human infections, spreading of the disease was made convenient with increased social gathering and holiday travel. These natural and social factors influenced the general progression and trajectory of the SARS epidemiology. However, some unique factors might also contribute to the origination of SARS in Wuhan. These factors are discussed in different scenarios in order to promote more research for achieving final validation.


War economy and the COVID-19 pandemic: Inequalities in stimulus packages as an additional challenge for health systems


[Suggestions from ophthalmic experts on eye protection during the novel coronavirus pneumonia epidemic]


title: Effect of vibration on insertion force and deflection of bioinspired needle in tissues

text: The design of surgical needles used in biopsy procedures have remained fairly standard despite the increase in complexity of surgeries. Higher needle insertion forces and deflection can increase tissue damage and decrease biopsy sample integrity. To overcome these drawbacks, we present a novel bioinspired approach to reduce insertion forces and minimize needle-tip deflection. It is well known from the literature, design of bioinspired surgical needles results in decreasing insertion forces and needle-tip deflection from the needle insertion path. This technical note studies the influence of vibration on bioinspired needle to further reduce insertion forces and needle-tip deflection. Bioinspired needle geometrical parameters such as barb shapes and geometries were analyzed to determine the best design parameters. Static and dynamic (vibration) needle insertion tests were performed to determine the maximum insertion forces and to estimate needle-tip deflection. Our results show that introducing vibration on the bioinspired needle insertion can reduce the maximum insertion force by up to 50%. It was also found that the needle-tip deflection is decreased by 47%.


title: Clinical characteristics of COVID-19 in children: Are they similar to those of SARS?

text: Although the number of SARS-CoV-2 infections has been rising amid the current pandemic of COVID-19, the low infection rate of SARS-CoV-2 in children has been low. By examining the clinical data available in the public domain, the present work clarifies the clinical presentations in children with COVID-19 in China. Statistical significance tests and adjusted odds ratios estimation were performed on the children (age below 18) and adults (age 18 or above) cohorts in China. SARS-CoV and SARS-CoV-2 shared similar clinical features. Lower respiratory tract infection was less prominent in children as evidenced by the relatively low prevalence in chest pain/discomfort and dyspnea. Similar to SARS, younger children had a less aggressive clinical course, compared with adolescents. While fewer symptoms were observed in children compared to adults, there is not yet sufficient evidence to conclude shorter hospital stay in children.


title: The Laboratory Diagnosis of COVID-19-- Frequently-Asked Questions

text: Diagnostic testing has played and will continue to play a major role in the COVID-19 pandemic. The ability to detect the SARS-CoV-2 coronavirus in respiratory secretions is essential to determine when an individual is infected and potentially infectious to others. Viral detection is used for the identification, management and isolation of individual patients. Viral detection is also used to determine when the virus has entered a community and how rapidly it is spreading. As communities attempt to re-open following periods of shutdown, the detection of both SARS-CoV-2 and specific antibodies recognizing the virus will become increasingly important as a means to assess infection and immunity in individuals and communities. Here we discuss questions commonly asked by clinicians about COVID-19 diagnostic testing.


title: A Novel and Reliable Deep Learning Web-Based Tool to Detect COVID-19 Infection from Chest CT-Scan

text: The corona virus is already spread around the world in many countries, and it has taken many lives. Furthermore, the world health organization (WHO) has announced that COVID-19 has reached the global epidemic stage. Early and reliable diagnosis using chest CT-scan can assist medical specialists in vital circumstances. In this work, we introduce a computer aided diagnosis (CAD) web service to detect COVID- 19 online. One of the largest public chest CT-scan databases, containing 746 participants was used in this experiment. A number of well-known deep neural network architectures consisting of ResNet, Inception and MobileNet were inspected to find the most efficient model for the hybrid system. A combination of the Densely connected convolutional network (DenseNet) in order to reduce image dimensions and Nu-SVM as an anti-overfitting bottleneck was chosen to distinguish between COVID-19 and healthy controls. The proposed methodology achieved 90.80% recall, 89.76% precision and 90.61% accuracy. The method also yields an AUC of 95.05%. Ultimately a flask web service is made public through ngrok using the trained models to provide a RESTful COVID-19 detector, which takes only 39 milliseconds to process one image. The source code is also available at https://github.com/KiLJ4EdeN/COVID_WEB. Based on the findings, it can be inferred that it is feasible to use the proposed technique as an automated tool for diagnosis of COVID-19.


Protecting children in low-income and middle-income countries from COVID-19


Stroke Health Care Use and COVID-19


title: Evaluation of Activation and Inflammatory Activity of Myeloid Cells During Pathogenic Human Coronavirus Infection

text: Innate immune cells play a vital role in mounting an effective host response to a variety of pathogen challenges. Myeloid cells such as neutrophils and monocyte-macrophages are major innate leukocytes that orchestrate protective immunity to viral lung infections. However, a dysregulated cytokine response can promote excessive infiltration and robust pro-inflammatory activity of neutrophils and monocyte-macrophages, leading to fatal disease. Following virus infection, the beneficial or deleterious role of infiltrating neutrophils and monocyte-macrophages is determined largely by their ability to secrete inflammatory cytokines and chemokines. A majority of studies use the total number of infiltrating cells and their activation status as measures to demonstrate their role during an infection. Consequently, the ability of neutrophils and Inflammatory Monocyte Macrophages (IMMs) to secrete inflammatory cytokines and chemokines, and its correlation with the disease severity, is not well defined. In this chapter, we report useful markers to identify lung infiltrating innate immune cells and define their activation status. We also describe a simple method to measure intracellular cytokine production to evaluate the inflammatory activity of neutrophils and IMMs in a mouse model of human coronavirus infection.


La farmacia hospitalaria en tiempos de COVID-19./ Hospital pharmacy in COVID-19


title: Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV

text: Since 2002, beta coronaviruses (CoV) have caused three zoonotic outbreaks, SARS-CoV in 2002-2003, MERS-CoV in 2012, and the newly emerged SARS-CoV-2 in late 2019. However, little is currently known about the biology of SARS-CoV-2. Here, using SARS-CoV-2 S protein pseudovirus system, we confirm that human angiotensin converting enzyme 2 (hACE2) is the receptor for SARS-CoV-2, find that SARS-CoV-2 enters 293/hACE2 cells mainly through endocytosis, that PIKfyve, TPC2, and cathepsin L are critical for entry, and that SARS-CoV-2 S protein is less stable than SARS-CoV S. Polyclonal anti-SARS S1 antibodies T62 inhibit entry of SARS-CoV S but not SARS-CoV-2 S pseudovirions. Further studies using recovered SARS and COVID-19 patients' sera show limited cross-neutralization, suggesting that recovery from one infection might not protect against the other. Our results present potential targets for development of drugs and vaccines for SARS-CoV-2.


title: Identification of a novel dual-target scaffold for 3CLpro and RdRp proteins of SARS-CoV-2 using 3D-similarity search, molecular docking, molecular dynamics and ADMET evaluation

text: The new SARS-CoV-2 coronavirus is the causative agent of the COVID-19 pandemic outbreak that affected whole the world with more than 6 million confirmed cases and over 370,000 deaths. At present, there are no effective treatments or vaccine for this disease, which constitutes a serious global health crisis. As the pandemic still spreading around the globe, it is of interest to use computational methods to identify potential inhibitors for the virus. The crystallographic structures of 3CLpro (PDB: 6LU7) and RdRp (PDB 6ML7) were used in virtual screening of 50000 chemical compounds obtained from the CAS Antiviral COVID19 database using 3D-similarity search and standard molecular docking followed by ranking and selection of compounds based on their binding affinity, computational techniques for the sake of details on the binding interactions, absorption, distribution, metabolism, excretion, and toxicity prediction; we report three 4-(morpholin-4-yl)-1,3,5-triazin-2-amine derivatives; two compounds (2001083-68-5 and 2001083-69-6) with optimal binding features to the active site of the main protease and one compound (833463-19-7) with optimal binding features to the active site of the polymerase for further consideration to fight COVID-19. The structural stability and dynamics of lead compounds at the active site of 3CLpro and RdRp were examined using molecular dynamics (MD) simulation. Essential dynamics demonstrated that the three complexes remain stable during simulation of 20 ns, which may be suitable candidates for further experimental analysis. As the identified leads share the same scaffold, they may serve as promising leads in the development of dual 3CLpro and RdRp inhibitors against SARS-CoV-2.Communicated by Ramaswamy H. Sarma.


Assessment of QT Intervals in a Case Series of Patients With Coronavirus Disease 2019 (COVID-19) Infection Treated With Hydroxychloroquine Alone or in Combination With Azithromycin in an Intensive Care Unit


title: [What we learned from SARS may provide important insights into understanding and management of coronavirus disease 2019]

text: The rapid spread of the coronavirus disease 2019 (COVID-19) has become a global threat. But the pathogenesis and treatment of the disease are not clear yet. Virological researches revealed close relationship between 2019-nCoV and SARS-CoV. The experience and knowledge we gained from severe acute respiratory syndrome (SARS), especially with regard to the time course of viral replication, host immune response and clinical progression of the patient, may provide important insights into understanding and management of COVID-19. Clinical deterioration accompanied by decreasing viral load in the second week after symptom onset was noted both in SARS and COVID-19, suggesting that the lung damage at this phase is more related to excessive host immune response rather than uncontrolled viral replication.


Universal Masking in Hospitals in the Covid-19 Era


Taking a Second Look at Neoadjuvant Endocrine Therapy for the Treatment of Early Stage Estrogen Receptor Positive Breast Cancer During the COVID-19 Outbreak