title: Detection of Coronavirus (COVID-19) Associated Pneumonia based on Generative Adversarial Networks and a Fine-Tuned Deep Transfer Learning Model using Chest X-ray Dataset

text: The COVID-19 coronavirus is one of the devastating viruses according to the world health organization. This novel virus leads to pneumonia, which is an infection that inflames the lungs' air sacs of a human. One of the methods to detect those inflames is by using x-rays for the chest. In this paper, a pneumonia chest x-ray detection based on generative adversarial networks (GAN) with a fine-tuned deep transfer learning for a limited dataset will be presented. The use of GAN positively affects the proposed model robustness and made it immune to the overfitting problem and helps in generating more images from the dataset. The dataset used in this research consists of 5863 X-ray images with two categories: Normal and Pneumonia. This research uses only 10% of the dataset for training data and generates 90% of images using GAN to prove the efficiency of the proposed model. Through the paper, AlexNet, GoogLeNet, Squeeznet, and Resnet18 are selected as deep transfer learning models to detect the pneumonia from chest x-rays. Those models are selected based on their small number of layers on their architectures, which will reflect in reducing the complexity of the models and the consumed memory and time. Using a combination of GAN and deep transfer models proved it is efficiency according to testing accuracy measurement. The research concludes that the Resnet18 is the most appropriate deep transfer model according to testing accuracy measurement and achieved 99% with the other performance metrics such as precision, recall, and F1 score while using GAN as an image augmenter. Finally, a comparison result was carried out at the end of the research with related work which used the same dataset except that this research used only 10% of original dataset. The presented work achieved a superior result than the related work in terms of testing accuracy.


title: COVID 19 pandemic: Mental health challenges of internal migrant workers of India

text: COVID- 19, a biomedical disease has serious physical and tremendous mental health implications as the rapidly spreading pandemic. One of the most vulnerable, but neglected, an occupational community of internal migrant workers is prone for development of psychological ill-effects due to double whammy impact of COVID-19 crisis and concomitant adverse occupational scenario. Permutations and combinations of the factors viz susceptibility for new viral infections, potential to act as vectors of transmission of infection, high prevalence of pre-existing physical health morbidities such as occupational pneumoconiosis, tuberculosis, HIV infections, pre-existing psychological morbidities, adverse psychosocial factors like absence of family support and caretaker during the crisis, their limitations to follow the rules and regulations of personal safety during the COVID 19 crisis, social exclusion, and inability to timely access the psychiatric services; all give rise to the peri-traumatic psychological distress to internal migrant workers. Superadded, is the blow of financial constraints due to loss of work, absence or suspension of occupational safety and health-related basic laws with associated occupational hazards, which make this occupational group highly vulnerable for the development of psychological illnesses. We attempt to draw the attention of mental health professionals, general medical practitioners and occupational health policymakers to the various, interrelated and interdependent predisposing and causative factors for the development of psychological ill-effects amongst internal migrant workers with the interventions needed to address it, from an occupational health perspective angle.


title: Comparative gross encephalon morphology in Callichthyidae (Teleostei: Ostariophysi: Siluriformes)

text: Callichthyidae comprises the subfamilies Callichthyinae and Corydoradinae, both of which are morphologically distinct and monophyletic. Although there is consensus regarding the monophyly of the family, the relationships of about 80% of its species, currently included in the genus Corydoras, remain poorly known. Despite the vast amount of osteological information for Teleostei, knowledge regarding the phylogenetic implications of encephalon anatomy is sparse and represents a poorly explored source of potential characters. The present study aims to describe the encephalon morphology in members of the Callichthyidae in order to propose new characters that may help address phylogenetic questions regarding this group. In addition to representatives of Callichthyidae, specimens belonging to the Nematogenyidae, Trichomycteridae, Scoloplacidae, Astroblepidae and Loricariidae were dissected for comparative purposes. Head dissection revealed information on the structure of the medulla spinalis, rhombencephalon, mesencephalon, diencephalon and telencephalon. The conditions observed on the encephalons examined suggest that representatives of Callichthyidae have great taste perception and processing, while Corydoradinae stand out for visual acuity and Callichthyinae for mechanoreception processing subunits. Our results also indicate that the encephalon has important features for systematic studies of the family bringing greater resolution to current phylogenetic hypotheses.(AU)


title: ENDOCRINOLOGY IN THE TIME OF COVID-19: Diagnosis and management of gestational diabetes mellitus

text: The COVID-19 pandemic has required rapid transformation and adaptation of healthcare services. Women with gestational diabetes mellitus (GDM) are one of the largest high-risk groups accessing antenatal care. In reformulating the care offered to those with GDM, there is a need to balance the sometimes competing requirement of lowering the risk of direct viral transmission against the potential adverse impact of service changes. We suggest pragmatic options for screening of GDM in a pandemic setting based on blood tests, and risk calculators applied to underlying risk factors. Alternative models for antenatal care provision for women with GDM, including targeting high-risk groups, early lifestyle interventions and remote monitoring are provided. Testing options and their timing for postpartum screening in women who had GDM are also considered. Our suggestions are only applicable in a pandemic scenario, and usual guidelines and care pathways should be re-implemented as soon as possible and appropriate.


Silent circulation of coronaviruses in pigs


title: Rapid reconstruction of SARS-CoV-2 using a synthetic genomics platform

text: Reverse genetics has been an indispensable tool to gain insights into viral pathogenesis and vaccine development. The genomes of large RNA viruses, such as those from coronaviruses, are cumbersome to clone and manipulate in Escherichia coli owing to the size and occasional instability of the genome1-3. Therefore, an alternative rapid and robust reverse-genetics platform for RNA viruses would benefit the research community. Here we show the full functionality of a yeast-based synthetic genomics platform to genetically reconstruct diverse RNA viruses, including members of the Coronaviridae, Flaviviridae and Pneumoviridae families. Viral subgenomic fragments were generated using viral isolates, cloned viral DNA, clinical samples or synthetic DNA, and these fragments were then reassembled in one step in Saccharomyces cerevisiae using transformation-associated recombination cloning to maintain the genome as a yeast artificial chromosome. T7 RNA polymerase was then used to generate infectious RNA to rescue viable virus. Using this platform, we were able to engineer and generate chemically synthesized clones of the virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)4, which has caused the recent pandemic of coronavirus disease (COVID-19), in only a week after receipt of the synthetic DNA fragments. The technical advance that we describe here facilitates rapid responses to emerging viruses as it enables the real-time generation and functional characterization of evolving RNA virus variants during an outbreak.


It's not all about COVID-19: pneumocystis pneumonia in the era of a respiratory outbreak


Implementing clinical pharmacy services in France: One of the key points to minimise the effect of the shortage of pharmaceutical products in anaesthesia or intensive care units?


Psychological preparedness for the COVID-19 pandemic, perspectives from India


Radiology-pathology Correlation in Recovered COVID-19, Demonstrating Organizing Pneumonia


title: Retrospective detection of SARS-CoV-2 in hospitalized patients with influenza-like illness

text: Since the first report of the coronavirus disease (COVID-19) in late December 2019, the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now widely spread to more than 187 countries and regions. However, it is unclear whether there has been cryptic transmission before these early officially confirmed cases, we therefore retrospectively screened for the SARS-CoV-2 RNA in 1271 nasopharyngeal swab samples, as well as the prevalence of IgM, IgG, and total antibodies against SARS-CoV-2 in 357 matched serum samples collected from hospitalized patients with influenza-like illness between 1 December 2018 and 31 March 2020 in Shanghai Ruijin Hospital. The onset date of the earliest COVID-19 case in this study was 25 January 2020. Before this time point, the presence of SARS-CoV-2 was not observed, which limited the possibility that SARS-CoV-2 has already spread among the population before the large-scale outbreak. Additionally, among 6662 patients with influenza-like illness from 1 December 2017 to 31 March 2020, the overall number of patients positive for influenza and other respiratory viruses during the COVID-19 period decreased significantly when compared with that in the same period of the last two years, reflecting that public health interventions can effectively control the spread of common respiratory viruses.


title: Organization of a radiotherapy service during the COVID-19 epidemic: Experience of Regional Center of Oncology of Agadir, Morocco

text: This study proposes organization of the activity of a radiotherapy service during the pandemic COVID-19 period. Reliable circuits for staff as well as for patients are installed and treatment protocols are adapted to the current COVID-19 situation. Several scenarios are proposed to deal with any subsequent pandemic situation.


title: Community health workers for pandemic response: a rapid evidence synthesis

text: INTRODUCTION: Coronavirus disease (COVID-19), affects 213 countries or territories globally. We received a request from National Health Systems Resource Centre, a public agency in India, to conduct rapid evidence synthesis (RES) on community health workers (CHWs) for COVID-19 prevention and control in 3 days. METHODS: We searched PubMed, websites of ministries (n=3), public agencies (n=6), multilateral institutions (n=3), COVID-19 resource aggregators (n=5) and preprints (n=1) (without language restrictions) for articles on CHWs in pandemics. Two reviewers screened the records independently with a third reviewer resolving disagreements. One reviewer extracted data with another reviewer cross-checking it. A framework on CHW performance in primary healthcare not specific to pandemic was used to guide data extraction and narrative analysis. RESULTS: We retrieved 211 records and finally included 36 articles. Most of the evidence was from low-and middle-income countries with well-established CHW programmes. Evidence from CHW programmes initiated during pandemics and for CHW involvement in pandemic response in high-income countries was scant. CHW roles and tasks change substantially during pandemics. Clear guidance, training for changed roles and definition of what constitutes essential activities (ie, those that must to be sustained) is required. Most common additional activities during pandemics were community awareness, engagement and sensitisation (including for countering stigma) and contact tracing. CHWs were reported to be involved in all aspects of contact tracing - this was reported to affect routine service delivery. CHWs have often been stigmatised or been socially ostracised during pandemics. Providing PPE, housing allowance, equal training opportunities, transportation allowance, improving salaries (paid on time and for a broad range of services) and awards in high-profile public events contributed to better recruitment and retention. We also created inventories of resources with guiding notes on guidelines for health workers (n=24), self-isolation in the community (n=10) and information, education and counselling materials on COVID-19 (n=16). CONCLUSIONS: CHWs play a critical role in pandemics. It is important to ensure role clarity, training, supportive supervision, as well as their work satisfaction, health and well-being. More implementation research on CHWs in pandemics is required.


Postnatal SARS-CoV-2 infection and immunological reaction: A prospective family cohort study


A woman with fever and cough: coronavirus disease 2019


title: Proteinase-activated receptor 1 (PAR1): A target for repurposing in the treatment of COVID-19?

text: In the search to rapidly identify effective therapies that will mitigate the morbidity and mortality of COVID-19, attention has been directed towards the repurposing of existing drugs. Candidates for repurposing include drugs that target COVID-19 pathobiology, including agents that alter angiotensin signaling. Recent data indicate that key findings in COVID-19 patients include thrombosis and endothelitis. Activation of PAR1 (Proteinase-activated receptor 1), in particular by the serine protease thrombin, is a critical element in platelet aggregation and coagulation. PAR1 activation also impacts on the actions of other cell types involved in COVID-19 pathobiology, including endothelial cells, fibroblasts and pulmonary alveolar epithelial cells. Vorapaxar is an approved inhibitor of PAR1, used for treatment of patients with myocardial infarction or peripheral arterial disease. Here, we discuss evidence implying a possible beneficial role for vorapaxar in the treatment of COVID-19 patients and in addition, other as-yet non-approved antagonists of PAR1 and PAR4.


title: Cutaneous side effects of hydroxychloroquine in health care workers in a COVID referral hospital - implications for clinical practice

text: The utility of hydroxychloroquine for the prophylaxis and treatment of alarmingly rising COVID-19 infection has been widely explored in several studies. However, its cutaneous adverse effects among health care workers and COVID patients taking prophylactic doses has not been reported. We report cases of palmoplantar among health care workers who were on prophylactic doses of hydroxychloroquine and their management with cetirizine and methylprednisolone.


Impact of COVID-19 lockdown on routine immunisation in Karachi, Pakistan


title: Comparison of In Vitro Inactivation of SARS CoV-2 with Hydrogen Peroxide and Povidone-Iodine Oral Antiseptic Rinses

text: PURPOSE: To evaluate the in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with hydrogen peroxide (H2 O2 ) and povidone-iodine (PVP-I) oral antiseptic rinses at clinically recommended concentrations and contact times. MATERIALS AND METHODS: SARS-CoV-2, USA-WA1/2020 strain virus stock was prepared prior to testing by growing in Vero 76 cells. The culture media for prepared virus stock was minimum essential medium (MEM) with 2% fetal bovine serum (FBS) and 50 µg/mL gentamicin. Test compounds consisting of PVP-I oral rinse solutions and H2 O2 aqueous solutions were mixed directly with the virus solution so that the final concentration was 50% of the test compound and 50% of the virus solution. Thus PVP-I was tested at concentrations of 0.5%, 1.25% and 1.5%, and H2 O2 was tested at 3% and 1.5% concentrations to represent clinically recommended concentrations. Ethanol and water were evaluated in parallel as standard positive and negative controls. All samples were tested at contact periods of 15 seconds and 30 seconds. Surviving virus from each sample was then quantified by standard end-point dilution assay and the log reduction value of each compound compared to the negative control was calculated. RESULTS: After the 15-second and 30-second contact times, PVP-I oral antiseptic rinse at all 3 concentrations of 0.5%, 1.25% and 1.5% completely inactivated SARS-CoV-2. The H2 O2 solutions at concentrations of 1.5% and 3.0% showed minimal viricidal activity after 15 seconds and 30 seconds of contact time. CONCLUSIONS: SARS-CoV-2 virus was completely inactivated by PVP-I oral antiseptic rinse in vitro, at the lowest concentration of 0.5 % and at the lowest contact time of 15 seconds. Hydrogen peroxide at the recommended oral rinse concentrations of 1.5% and 3.0% was minimally effective as a viricidal agent after contact times as long as 30 seconds. Therefore, preprocedural rinsing with diluted PVP-I in the range of 0.5% to 1.5% may be preferred over hydrogen peroxide during the COVID-19 pandemic. This article is protected by copyright. All rights reserved.


title: Efficacy of a novel SARS-CoV-2 detection kit without RNA extraction and purification

text: Rapid detection of SARS-CoV-2 is critical for the diagnosis of coronavirus disease 2019 (COVID-19) and preventing the spread of the virus. A novel "2019 Novel Coronavirus Detection Kit (nCoV-DK)" halves detection time by eliminating the steps of RNA extraction and purification. We evaluated concordance between the nCoV-DK and direct PCR. The virus was detected in 53/71 (74.6%) and 55/71 (77.5%) by the direct PCR and nCoV-DK, respectively, with overall concordance rate of 94.4%: 95.2% in nasopharyngeal swab, 95.5% in saliva, and 85.7% in sputum. The nCoV-DK effectively detects SARS-CoV-2 in all types of the samples including saliva, while reducing time required for detection, labor, and risk of human error.


Covid-19: Doctors and nurses donate samples to study disease


Exposure to media and fear and worry about COVID-19


The first case of acquired hemophilia A associated with SARS-CoV-2 infection


A Critical COVID Metric: Your ED Staff Infection Rate


Reflections on the COVID-19 Pandemic


title: Association between Angiotensin-Converting Enzyme Inhibitors and Lung Cancer-A Nationwide, Population-Based, Propensity Score-Matched Cohort Study

text: BACKGROUND: Direct evidence of lung cancer risk in Asian users of angiotensin-converting enzyme inhibitors (ACEIs) is lacking. METHODS: The ACEI cohort comprised 22,384 patients aged ≥ 18 years with a first prescription of ACEI. The comparison angiotensin receptor blocker (ARB) cohort consisted of age-, sex- and comorbidity-matched patients at a ratio of 1:1. The primary outcome was the incidence of lung cancer, which was evaluated using a proportional hazard model. RESULTS: The overall incidence rates of lung cancer in the ACEI and ARB cohorts were 16.6 and 12.2 per 10,000 person-years, respectively. The ACEI cohort had a significantly higher risk of lung cancer than the ARB cohort (adjusted hazard ratio [aHR]. = 1.36; 95% confidence interval [CI]. = 1.11-1.67). Duration-response and dose-response analyses revealed that compared with patients who did not receive ACEIs, patients who received ACEIs for more than 45 days per year (aHR = 1.87; 95% CI = 1.48-2.36) and patients who received more than 540 defined daily doses of ACEIs per year (aHR =1.80; 95% CI = 1.43--2.27) had a significantly higher risk of lung cancer. The cumulative incidence of lung cancer was also significantly higher in the ACEI cohort than in the ARB cohort (log-rank test, p = 0.002). CONCLUSIONS: ACEI use is associated with an increased risk of lung cancer compared with ARB use. Patients using ARBs have a significantly lower risk of lung cancer than non-ARB users.


title: [Disinfection guideline of public transport during COVID-19 outbreak]

text: This guideline is applicable to the infection prevention and control of staffs and travelers on public transport during COVID-19 outbreak.


title: Lung involvement in patients with coronavirus disease-19 (COVID-19): a retrospective study based on quantitative CT findings

text: Purpose: To explore lung involvement in patients with coronavirus disease-19 (COVID-19) using quantitative computed tomography (QCT). Methods: A total of 52 patients with COVID-19 who were admitted to three hospitals in China from January 23, 2020 to February 1, 2020 were retrospectively analyzed using QCT. The accuracy of QCT segmentation was assessed. The relationship between the time from symptom onset to initial CT and QCT parameters acquired on the initial CT were explored. Results: First, the ability of QCT to detect and segment lesions was investigated and it was unveiled that results of segmentation of the majority of cases (42/52) were satisfactory and for 8 out of 52 patients, the images depicted lesions with miss-segmentation; besides, 2 out of 52 cases had negative finding on chest CT achieved by both radiologists and QCT. QCT-related parameters showed to have a relationship with the time from symptom onset to initial CT. In the early-stage (0-3 days), the percentage of lung involvement was 4%, with a mean density of - 462 ± 99 HU. The peak density of lesions appeared at the range of - 500 to - 700 HU on density histogram. In the intermediate-stage (4-6 days), the mean percentage of lung involvement noticeably increased compared with that in early stage (7%, p < 0.05). In late stage (7-14 days), the percentage of lung involvement decreased to 5%. The mean density of lesions was the highest (- 430 ± 80), and heterogeneity density distribution showed a dual-peak on density histogram. Conclusion: COVID-19 can be promptly detected by QCT. In addition, the QCT-related parameters can highly facilitate assessment of pulmonary involvement.


Correction to Lancet Infect Dis 2020; published online March 27. https://doi.org/10.1016/S1473-3099(20)30200-0


title: Digital technology can revolutionize mental health services delivery: The COVID-19 crisis as a catalyst for change

text: The unprecedented COVID-19 crisis presents an imperative for mental health care systems to make digital mental health interventions a routine part of care. Already because of COVID-19, many therapists have rapidly moved to using telehealth in place of in-person contact. In response to this shift, Waller and colleagues compiled a series of expert recommendations to help clinicians pivot to delivering teletherapy to address eating disorders during COVID-19. However, numerous barriers still impede widespread adoption and implementation of digital interventions. In this commentary, we aim to extend the recommendations for clinicians offered by Waller and colleagues by presenting a roadmap of the systems- and policy-level requirements that are needed. We advocate for addressing barriers associated with training, licensing, safety, privacy, payment, and evaluation, as these factors have greatly limited use of these promising interventions. We also indicate that longer-term goals should include introducing truly innovative digital mental health practices, such as stepped-care models and simultaneously providing preventive and self-management services in addition to clinical services, into the health care system. Now is the time to catalyze change and comprehensively address the barriers that have prevented widespread delivery of these efficacious digital services to the millions of people who would benefit.


Accurate Statistics on COVID-19 Are Essential for Policy Guidance and Decisions


Management of Gynaecological oncology diseases during COVID-19 global pandemic


Taste and Smell Dysfunction in COVID-19 Patients


title: COVID-19 Pandemic and Telephone Triage before Attending Medical Office: Problem or Opportunity?

text: During the COVID-19 emergency, the medical operating protocols have been largely modified for reducing any type of contamination risk, for working in a safe way and for making the patient feel in a safe environment. Telemedicine, smart phones and apps could represent important devices for the community, in order to prevent virus trasmission and to perform quick diagnosis and management at medical offices. This manuscript could be useful for clinicians with regard to the current state of the effectiveness of the telephone triage in this COVID-19 epidemic period. Therefore, it could be an important starting point for future perspectives about telemedicine and virtual patient management.


Orthopedics in the Era of COVID-19


Personal protective equipment during the COVID-19 pandemic: a reply


The ethics of neuro-oncology in the era of COVID-19: Lessons to be learned


Challenges of Neurosurgery Education During the Coronavirus Disease 2019 (COVID-19) Pandemic: A U.S. Perspective


Lessons from the crucible of crisis


title: COVID-19, Australia: Epidemiology Report 9 (Reporting week to 23:59 AEDT 29 March 2020)

text: This is the ninth epidemiological report for coronavirus disease 2019 (COVID-19), reported in Australia as at 23:59 Australian Eastern Daylight Time [AEDT] 29 March 2020. It includes data on COVID-19 cases diagnosed in Australia, the international situation and a review of current evidence.


Culture counts: The diverse effects of culture and society on mental health amidst COVID-19 outbreak in Australia


title: Fast and Accurate Forecasting of COVID-19 Deaths Using the SIkJ$\alpha$ Model

text: Forecasting the effect of COVID-19 is essential to design policies that may prepare us to handle the pandemic. Many methods have already been proposed, particularly, to forecast reported cases and deaths at country-level and state-level. Many of these methods are based on traditional epidemiological model which rely on simulations or Bayesian inference to simultaneously learn many parameters at a time. This makes them prone to over-fitting and slow execution. We propose an extension to our model SIkJ$\alpha$ to forecast deaths and show that it can consider the effect of many complexities of the epidemic process and yet be simplified to a few parameters that are learned using fast linear regressions. We also present an evaluation of our method against seven approaches currently being used by the CDC, based on their two weeks forecast at various times during the pandemic. We demonstrate that our method achieves better root mean squared error compared to these seven approaches during majority of the evaluation period. Further, on a 2 core desktop machine, our approach takes only 3.18s to tune hyper-parameters, learn parameters and generate 100 days of forecasts of reported cases and deaths for all the states in the US. The total execution time for 184 countries is 11.83s and for all the US counties ($>$ 3000) is 101.03s.


Seven days in medicine: 13-19 May 2020


Adalimumab for treatment of hidradenitis suppurativa during the COVID-19 pandemic: Safety considerations


title: Mathematical modeling of the spread of the coronavirus disease 2019 (COVID-19) taking into account the undetected infections. The case of China

text: In this paper we develop a mathematical model for the spread of the coronavirus disease 2019 (COVID-19). It is a new Î¸-SEIHRD model (not a SIR, SEIR or other general purpose model), which takes into account the known special characteristics of this disease, as the existence of infectious undetected cases and the different sanitary and infectiousness conditions of hospitalized people. In particular, it includes a novel approach that considers the fraction Î¸ of detected cases over the real total infected cases, which allows to study the importance of this ratio on the impact of COVID-19. The model is also able to estimate the needs of beds in hospitals. It is complex enough to capture the most important effects, but also simple enough to allow an affordable identification of its parameters, using the data that authorities report on this pandemic. We study the particular case of China (including Chinese Mainland, Macao, Hong-Kong and Taiwan, as done by the World Health Organization in its reports on COVID-19), the country spreading the disease, and use its reported data to identify the model parameters, which can be of interest for estimating the spread of COVID-19 in other countries. We show a good agreement between the reported data and the estimations given by our model. We also study the behavior of the outputs returned by our model when considering incomplete reported data (by truncating them at some dates before and after the peak of daily reported cases). By comparing those results, we can estimate the error produced by the model when identifying the parameters at early stages of the pandemic. Finally, taking into account the advantages of the novelties introduced by our model, we study different scenarios to show how different values of the percentage of detected cases would have changed the global magnitude of COVID-19 in China, which can be of interest for policy makers.


title: Rapid Deployment of Home PACS Workstations to Enable Social Distancing in the Coronavirus Disease (COVID-19) Era

text: OBJECTIVE. Social distancing is considered an effective mitigation strategy for coronavirus disease (COVID-19), and remote interpretation of radiologic studies is one approach to social distancing within the radiology department. We describe the rapid deployment of home workstations to achieve social distancing in the radiology department at the University of Alabama at Birmingham. CONCLUSION. Transitioning from on-site interpretation to remote interpretation requires a careful balancing of hospital and departmental finances, engineering choices, and educational and philosophical workflow issues.


Cardiac surgery and COVID-19: Response to the letter to the editor


Psoriasis health care in the time of the coronavirus pandemic: insights from dedicated centers in Sardinia (Italy)


Histological findings in chilblain lupus-like COVID lesions: in search of an answer to understand their aetiology


title: Histological findings in chilblain-lupus like COVID lesions: in search of an answer to understand their etiology

text: We read with great interest the article by Piccolo et al1 . describing chilblain-like lesions (CLL) on feet and hands during the COVID-19 Pandemic. They mention the rate of association to autoimmune conditions was very low, which led the to exclude a note autoimmune disorder as main cause of CLL. Here, we hypothesize the possible relationship between the development of these lesions and immune-chained phenomena following viral infection in a certain group of patients.


Caring for Miners During the Coronavirus Disease-2019 (COVID-19) Pandemic


title: Imaging Coccygeal Trauma and Coccydynia

text: The coccygeal region has complex anatomy, much of which may contribute to or be the cause of coccyx region pain (coccydynia). This anatomy is well depicted at imaging, and management is often dictated by what structures are involved. Coccydynia is a common condition that is known to be difficult to evaluate and treat. However, imaging can aid in determining potential causes of pain to help guide management. Commonly, coccydynia (coccygodynia) occurs after trauma and appears with normal imaging features at static neutral radiography, but dynamic imaging with standing and seated lateral radiography may reveal pathologic coccygeal motion that is predictive of pain. In addition, several findings seen at cross-sectional imaging in patients with coccydynia can point to a source of pain that may be subtle and easily overlooked. Radiology can also offer a role in management of coccygeal region pain with image-guided pain management procedures such as ganglion impar block. In addition to mechanical coccyx pain, a host of other conditions involving the sacrococcygeal region may cause coccydynia, which are well depicted at imaging. These include neoplasm, infection, crystal deposition, and cystic formations such as pilonidal cyst. The authors review a variety of coccydynia causes, their respective imaging features, and common management strategies.©RSNA, 2020.


title: Human Interaction Smart Subsystem-Extending Speech-Based Human-Robot Interaction Systems with an Implementation of External Smart Sensors

text: This paper presents a more detailed concept of Human-Robot Interaction systems architecture. One of the main differences between the proposed architecture and other ones is the methodology of information acquisition regarding the robot's interlocutor. In order to obtain as much information as possible before the actual interaction took place, a custom Internet-of-Things-based sensor subsystems connected to Smart Infrastructure was designed and implemented, in order to support the interlocutor identification and acquisition of initial interaction parameters. The Artificial Intelligence interaction framework of the developed robotic system (including humanoid Pepper with its sensors and actuators, additional local, remote and cloud computing services) is being extended with the use of custom external subsystems for additional knowledge acquisition: device-based human identification, visual identification and audio-based interlocutor localization subsystems. These subsystems were deeply introduced and evaluated in this paper, presenting the benefits of integrating them into the robotic interaction system. In this paper a more detailed analysis of one of the external subsystems-Bluetooth Human Identification Smart Subsystem-was also included. The idea, use case, and a prototype, integration of elements of Smart Infrastructure systems and the prototype implementation were performed in a small front office of the Weegree company as a decent test-bed application area.


title: COVID-19 in Malta: The mental health impact

text: The COVID-19 pandemic has had a devastating impact on health, economies, and other societal pillars. The Maltese archipelago has also been affected by this viral threat. Due to Malta's characteristics as one of the smallest islands in Europe, the picture, which shall be portrayed in this article, may have some unique features, especially in terms of mental health and societal well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Audio Interview: Making Decisions about Covid-19 Testing and Treatment for Your Patients


Multisystem Inflammatory Syndrome in Children in COVID-19 Pandemic


title: The impact of the COVID-19 pandemic on the mental health of healthcare professionals

text: INTRODUCTION: Healthcare professionals (HPs) have been confronted by unprecedented traumatic experiences during the COVID-19 pandemic, especially in countries that had not experienced similar epidemic outbreaks in recent years. AIM: To analyze the impact of the COVID-19 pandemic on the mental health of HPs. METHOD: We comprehensively reviewed the studies published in MEDLINE (PubMed), Web of Science and Google Scholar between December 2019 and May 2020. RESULTS: Most studies report a high prevalence of anxiety and depressive symptoms among HPs that can be associated with: a) COVID-19 exposure; b) epidemiological issues; c) material resources; d) human resources; and e) personal factors. The role of certain variables, before, during and after the pandemic, remains unexplored. Longitudinal studies will help elucidate which factors are associated with a higher risk of developing long-lasting negative effects. Qualitative studies may contribute to understanding the influence of individual and social narratives in HPs' distress. CONCLUSION: A deeper analysis on the individual, institutional, political and socio-cultural factors, meanings and values influencing HPs distress and resilience during the COVID-19 pandemic is needed.


title: Androgen sensitivity gateway to COVID-19 disease severity

text: In this communication, we present arguments for androgen sensitivity as a likely determinant of COVID-19 disease severity. The androgen sensitivity model explains why males are more likely to develop severe symptoms while children are ostensibly resistant to infection. Further, the model explains the difference in COVID-19 mortality rates among different ethnicities. Androgen sensitivity is determined by genetic variants of the androgen receptor. The androgen receptor regulates transcription of the transmembrane protease, serine 2 (TMPRSS2), which is required for SARS-CoV-2 infectivity. TMPRSS2 primes the Spike protein of the virus, which has two consequences: diminishing viral recognition by neutralizing antibodies and activating SARS-CoV-2 for virus-cell fusion. Genetic variants that have been associated with androgenetic alopecia, prostate cancer, benign prostatic hyperplasia and polycystic ovary syndrome could be associated with host susceptibility. In addition to theoretical epidemiological and molecular mechanisms, there are reports of high rates of androgenetic alopecia of from hospitalized COVID-19 patients due to severe symptoms. Androgen sensitivity is a likely determinant of COVID-19 disease severity. We believe that the evidence presented in this communication warrants the initiation of trials using anti-androgen agents.


SARS-CoV-2 pandemic and the need for transplant-oriented trials


Demystifying pulmonary vascular complications in severe coronavirus disease-19 pneumonia (COVID-19) in the light of clinico-radiologic-pathologic correlation


title: COVID-19 multisystem inflammatory syndrome in three teenagers with confirmed SARS-CoV-2 infection

text: Coronavirus disease 2019 (COVID-19) is generally a relatively mild illness in children. An emerging disease entity coined as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) has been reported recently, but is very rare and only affects a very small minority of children. Here we describe the clinical presentations and outcomes of three teenagers with serologically-confirmed SARS-CoV-2 infection admitted to a pediatric intensive care unit for PIMS-TS. Although their initial presentations were very similar, their COVID-19-related disease varied in severity.


title: Post-travel screening of symptomatic and asymptomatic travelers

text: Until last year, terrorism, economic instability, poverty and natural disasters were considered the major threats to humans globally. Infectious diseases were seen as a minor problem. This, however, changed in 2020 when the global COVID-19 pandemic broke out and a new danger emerged. The latest events generated a lot of discussion on health hazards associated with international tourism and uncontrolled spread of pathogens across the borders. The major health problems of travelers to developing countries with harsh environmental conditions and endemic infectious diseases include gastrointestinal disorders, dermatoses, respiratory infections and fevers of unknown origin. A medical interview by an experienced physician is the foundation of the post-travel screening process both in symptomatic and asymptomatic travelers; the interview should focus on identifying exposure to risk factors (endemic infectious diseases, failure to adopt disease prevention measures, consumption of food or water from unsafe sources, insect bites, animal bites, travelling in large groups, unsafe sex with casual partners). While physical examination (identification of abnormalities) and diagnostic tests (identification of pathogens) can be useful for detecting illnesses and asymptomatic infections as well as assessing the general health condition of a patient, including his immune system. The aim of the article is to provide information on the post-travel screening process in symptomatic and asymptomatic travelers who have returned from areas with harsh climate conditions and low sanitation standards.


Fasting blood glucose predicts the occurrence of critical illness in COVID-19 patients: a multicenter retrospective cohort study


title: Providing uninterrupted care during COVID-19 pandemic: experience from Beijing Tiantan Hospital

text: BACKGROUND: The COVID-19 pandemic has already stressed the healthcare system in the world. Many hospitals have been overwhelmed by the large number of patients with COVID-19. Due to the shortage of equipment and personnel and the highly contagious nature of COVID-19, many other healthcare services are on hold. However, at Beijing Tiantan Hospital, a rapid response system has been in place so that routine care is not interrupted. We, therefore, would like to share our hospital-wide prevention and management policy during this pandemic to help other healthcare systems to function in this crisis. METHOD: Tiantan hospital is one of the leading neuroscience institutions in the world. With 1650 beds, its annual inpatient admission exceeds 30 000 patients. Its COVID-19 rapid response policy was reviewed for its functionality. RESULTS: There are nine key components of this policy: an incident management system; a comprehensive infection prevention and control, outpatient triage and flow system; a designated fever clinic; patient screening and administration; optimised surgical operations, enhanced nucleic acid testing; screening of returning employees; and a supervision and feedback system. In addition, a specific protocol was designed for treating patients with acute stroke. CONCLUSION: A comprehensive policy is helpful to protect the employee from infection and to provide quality and uninterrupted care to all who need these, including patients with acute ischaemic stroke.


title: A large number of COVID-19 interventional clinical trials were registered soon after the pandemic onset: a descriptive analysis

text: BACKGROUND AND OBJECTIVE: There is a pressing need for evidence-based interventions to address the devastating clinical and public health effects of the coronavirus disease 2019 (COVID-19) pandemic. The number of registered trials related to COVID-19 is increasing by the day. The objective of this study was to describe the characteristics of the currently registered interventional clinical trials related to COVID-19. METHODS: We searched the World Health Organization's International Clinical Trials Registry Platform on May 15th, 2020. We included any entry that is related to COVID-19. We abstracted and then descriptively analyzed the following characteristics of the registered trials: study design, status, phase, primary endpoints, experimental interventions, and geographic location among other qualifiers. RESULTS: We identified 1,308 eligible registered trials. Most trials were registered with ClinicalTrials.gov (n = 703; 53.7%) and the Chinese Clinical Trial Registry (n = 291; 22.2%). The number of participants to be enrolled across these trials was 734,657, with a median of 110 participants per trial. The most commonly studied intervention category was pharmacologic (n = 763; 58.3%), with antiparasitic medications being the most common subcategory. Although over half of the trials were already recruiting, we identified published peer-reviewed results for only 8 of those trials. CONCLUSION: There is a relatively large number of registered trials but with very few results published so far. Although our findings suggest an appropriate initial response by the research community, the real challenge will be to get these trials completed, published, and translated into practice and policy.


title: Medical Student Mobilization During A Crisis: Lessons From A COVID-19 Medical Student Response Team

text: PROBLEM: On March 17, 2020, the Association of American Medical Colleges recommended the suspension of all direct patient contact responsibilities for medical students because of the COVID-19 pandemic. Given this change, medical students nationwide had to grapple with how and where they could fill the evolving needs of their schools' affiliated clinical sites, physicians, and patients and the community. APPROACH: At Harvard Medical School (HMS), student leaders created a COVID-19 Medical Student Response Team to: (1) develop a student-led organizational structure that would optimize students' ability to efficiently mobilize interested peers in the COVID-19 response, both clinically and in the community, in a strategic, safe, smart, and resource-conscious way; and (2) serve as a liaison with the administration and hospital leaders to identify evolving needs and rapidly engage students in those efforts. OUTCOMES: Within a week of its inception, the COVID-19 Medical Student Response Team had more than 500 medical student volunteers from HMS and had shared the organizational framework of the response team with multiple medical schools across the country. The HMS student volunteers joined any of the 4 virtual committees to complete this work: Education for the Medical Community, Education for the Broader Community, Activism for Clinical Support, and Community Activism. NEXT STEPS: The COVID-19 Medical Student Response Team helped to quickly mobilize hundreds of students and has been integrated into HMS's daily workflow. It may serve as a useful model for other schools and hospitals seeking medical student assistance during the COVID-19 pandemic. Next steps include expanding the initiative further, working with the leaders of response teams at other medical schools to coordinate efforts, and identifying new areas of need at local hospitals and within nearby communities that might benefit from medical student involvement as the pandemic evolves.


title: COVID-19 pandemic control: balancing detection policy and lockdown intervention under ICU sustainability

text: We consider here an extended SIR model, including several features of the recent COVID-19 outbreak: in particular the infected and recovered individuals can either be detected (+) or undetected (-) and we also integrate an intensive care unit (ICU) capacity. Our model enables a tractable quantitative analysis of the optimal policy for the control of the epidemic dynamics using both lockdown and detection intervention levers. With parametric specification based on literature on COVID-19, we investigate the sensitivities of various quantities on the optimal strategies, taking into account the subtle trade-off between the sanitary and the socio-economic cost of the pandemic, together with the limited capacity level of ICU. We identify the optimal lockdown policy as an intervention structured in 4 successive phases: First a quick and strong lockdown intervention to stop the exponential growth of the contagion; second a short transition phase to reduce the prevalence of the virus; third a long period with full ICU capacity and stable virus prevalence; finally a return to normal social interactions with disappearance of the virus. The optimal scenario hereby avoids the second wave of infection, provided the lockdown is released sufficiently slowly. We also provide optimal intervention measures with increasing ICU capacity, as well as optimization over the effort on detection of infectious and immune individuals. Whenever massive resources are introduced to detect infected individuals, the pressure on social distancing can be released, whereas the impact of detection of immune individuals reveals to be more moderate.


title: Correlations of Online Search Engine Trends With Coronavirus Disease (COVID-19) Incidence: Infodemiology Study

text: BACKGROUND: The coronavirus disease (COVID-19) is the latest pandemic of the digital age. With the internet harvesting large amounts of data from the general population in real time, public databases such as Google Trends (GT) and the Baidu Index (BI) can be an expedient tool to assist public health efforts. OBJECTIVE: The aim of this study is to apply digital epidemiology to the current COVID-19 pandemic to determine the utility of providing adjunctive epidemiologic information on outbreaks of this disease and evaluate this methodology in the case of future pandemics. METHODS: An epidemiologic time series analysis of online search trends relating to the COVID-19 pandemic was performed from January 9, 2020, to April 6, 2020. BI was used to obtain online search data for China, while GT was used for worldwide data, the countries of Italy and Spain, and the US states of New York and Washington. These data were compared to real-world confirmed cases and deaths of COVID-19. Chronologic patterns were assessed in relation to disease patterns, significant events, and media reports. RESULTS: Worldwide search terms for shortness of breath, anosmia, dysgeusia and ageusia, headache, chest pain, and sneezing had strong correlations (r>0.60, P<.001) to both new daily confirmed cases and deaths from COVID-19. GT COVID-19 (search term) and GT coronavirus (virus) searches predated real-world confirmed cases by 12 days (r=0.85, SD 0.10 and r=0.76, SD 0.09, respectively, P<.001). Searches for symptoms of diarrhea, fever, shortness of breath, cough, nasal obstruction, and rhinorrhea all had a negative lag greater than 1 week compared to new daily cases, while searches for anosmia and dysgeusia peaked worldwide and in China with positive lags of 5 days and 6 weeks, respectively, corresponding with widespread media coverage of these symptoms in COVID-19. CONCLUSIONS: This study demonstrates the utility of digital epidemiology in providing helpful surveillance data of disease outbreaks like COVID-19. Although certain online search trends for this disease were influenced by media coverage, many search terms reflected clinical manifestations of the disease and showed strong correlations with real-world cases and deaths.


COVID-19 Pandemic and Nationwide Lockdown - Implications of the Double Trouble on Radiotherapy Practice in India


title: Clinical characteristics of a case series of children with coronavirus disease 2019

text: We reported the clinical characteristics of a case series of 10 patients with coronavirus disease 2019 (COVID-19) aged from 1 year to 18 years. Seven patients had contact with confirmed COVID-19 family members before onset. Fever (4 [40.0%]) and cough (3 [30.0%]) were the most common symptoms. No patient showed leucopenia and lymphopenia on admission. Pneumonia was observed in chest CT images in 5 (50.0%) patients. Five (50.0%) patients received antiviral treatment. No patient had severe complications or developed a severe illness in our study. Our study indicated that COVID-19 children present less severe symptoms and have better outcomes.


title: Stability of SARS-CoV-2 and other coronaviruses in the environment and on common touch surfaces and the influence of climatic conditions: a review

text: Although the unprecedented efforts the world has been taking to control the spread of the human coronavirus disease (COVID-19) and its causative etiology [Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2)], the number of confirmed cases has been increasing drastically. Therefore, there is an urgent need for devising more efficient preventive measures, to limit the spread of the infection until an effective treatment or vaccine is available. The preventive measures depend mainly on the understanding of the transmission routes of this virus, its environmental stability, and its persistence on common touch surfaces. Due to the very limited knowledge about SARS-CoV-2, we can speculate its stability in the light of previous studies conducted on other human and animal coronaviruses. In this review, we present the available data on the stability of coronaviruses (CoVs), including SARS-CoV-2, from previous reports to help understand its environmental survival. According to available data, possible airborne transmission of SARS-CoV-2 has been suggested. SARS-CoV-2 and other human and animal CoVs have remarkably short persistence on copper, latex, and surfaces with low porosity as compared to other surfaces like stainless steel, plastics, glass, and highly porous fabrics. It has also been reported that SARS-CoV-2 is associated with diarrhea and that it is shed in the feces of COVID-19 patients. Some CoVs show persistence in human excrement, sewage, and waters for a few days. These findings suggest a possible risk of fecal-oral, foodborne, and waterborne transmission of SARS-CoV-2 in developing countries that often use sewage-polluted waters in irrigation and have poor water treatment systems. CoVs survive longer in the environment at lower temperatures and lower relative humidity. It has been suggested that large numbers of COVID-19 cases are associated with cold and dry climates in temperate regions of the world and that seasonality of the virus spread is suspected.


title: COVID-19 in lung transplant recipients: A case series from Milan, Italy

text: Limited data are currently available regarding the course of COVID-19 in lung and solid organ transplant recipients. We hereby present four cases of SARS-CoV-2 pneumonia in lung transplant recipients from our center, set in Milan, Italy. We reduced immunosuppressive regimen in all these patients, typically holding the antiproliferative agent and augmenting steroids; everybody received hydroxychloroquine, initial empiric antibiotic treatment with piperacillin/tazobactam, and high-dose low molecular weight heparin. Clinical course seemed favorable in three of our patients, but one of them deteriorated after 10 days of hospitalization, probably due to an acute form of graft dysfunction triggered both by COVID-19 and a nosocomial bacterial infection, and eventually died. Although short-term prognosis could be considered benign in the majority of our patients, we should carefully monitor these individuals in order to detect early sign of clinical deterioration and graft dysfunction in the next few months.


title: Cardiac Surgery During the Coronavirus Disease 2019 Pandemic: Perioperative Considerations and Triage Recommendations

text: The coronavirus disease 2019 pandemic, caused by severe acute respiratory syndrome coronavirus-2, represents the third human affliction attributed to the highly pathogenic coronavirus in the current century. Because of its highly contagious nature and unprecedented global spread, its aggressive clinical presentation, and the lack of effective treatment, severe acute respiratory syndrome coronavirus-2 infection is causing the loss of thousands of lives and imparting unparalleled strain on healthcare systems around the world. In the current report, we discuss perioperative considerations for patients undergoing cardiac surgery and provide clinicians with recommendations to effectively triage and plan these procedures during the coronavirus disease 2019 outbreak. This will help reduce the risk of exposure to patients and healthcare workers and allocate resources appropriately to those in greatest need. We include an algorithm for preoperative testing for coronavirus disease 2019, personal protective equipment recommendations, and a classification system to categorize and prioritize common cardiac surgery procedures.


title: A New Susceptible-Infectious (SI) Model With Endemic Equilibrium

text: The focus of this article is on the dynamics of a new susceptible-infected model which consists of a susceptible group ($S$) and two different infectious groups ($I_1$ and $I_2$). Once infected, an individual becomes a member of one of these infectious groups which have different clinical forms of infection. In addition, during the progress of the illness, an infected individual in group $I_1$ may pass to the infectious group $I_2$ which has a higher mortality rate. In this study, positiveness of the solutions for the model is proved. Stability analysis of species extinction, $I_1$-free equilibrium and endemic equilibrium as well as disease-free equilibrium is studied. Relation between the basic reproduction number of the disease and the basic reproduction number of each infectious stage is examined. The model is investigated under a specific condition and its exact solution is obtained.


title: How to conduct clinical research on anesthesiology during epidemic of the novel coronavirus pneumonia: recommendations from the epidemiological perspective/ 中华麻醉学杂志

text: During the outbreak and epidemic of novel coronavirus pneumonia, anesthesiologists are not only the high-risk group of secondary infection, but also undertake tasks to initiate clinical research so that the regular pattern of disease could be summarized, which will product clinical evidences for clinical decision-making and optimization of anesthesia therapy as soon as possible. The clinical research evidences of anaesthesia are of great importance for improving the prevention and control strategy of infectious diseases and implementing relevant measures effectively. The recommendations from the epidemiological perspective are provided on how to conduct clinical research on anesthesiology during epidemic of the novel coronavirus pneumonia in the present paper: (1) The case report and case series research should be initiated promptly once the infectious cases treated in anesthesia department are diagnosed; (2) To focus on need of evidence of decision-making of diagnosis and treatment, to summarize general rules timely and to promote the rapidly production of evidence; (3) To establish a special cohort of novel coronavirus pneumonia so that more prognosis studies could be carried out; (4) To explore the risk factors which result in hospital infection among medical staffs so that hospital infection could be controlled. The purpose of this study is to provide clinicians with methodological suggestions on how to carry out high-quality clinical research in the epidemic period of infectious diseases, and to close the gap between clinical and public health.


Serological tests for COVID-19 antibodies: Limitations must be recognized


title: Daily emotional well-being during the COVID-19 pandemic

text: The COVID-19 outbreak has become one of the largest public health crises of our time. Governments have responded by implementing self-isolation and physical distancing measures that have profoundly impacted daily life throughout the world. In this study, we aimed to investigate how people experience the activities, interactions, and settings of their lives during the pandemic. The sample (N = 604) was assessed in Ireland on the 25 March 2020, following the closure of schools and non-essential businesses. We examined within-person variance in emotional well-being and how people spend their time. We found that while most time was spent in the home (74%), time spent outdoors (8%) was associated with markedly raised positive affect and reduced negative emotions. Exercising, going for walks, gardening, pursuing hobbies, and taking care of children were the activities associated with the greatest affective benefits. Home-schooling children and obtaining information about COVID-19 were ranked lowest of all activities in terms of emotional experience. These findings highlight activities that may play a protective role in relation to well-being during the pandemic, the importance of setting limits for exposure to COVID-19-related media coverage, and the need for greater educational supports to facilitate home-schooling during this challenging period.


Recommendations of the ecocardiography and cardiac images committeefor the protection of patients and health personnel during the covid-19 pandemic


title: COVID-19 Pandemic: Consensus guidelines for preferred practices in an aesthetic clinic

text: Strict infection control measures in response to the current COVID-19 pandemic are expected to remain for an extended period. In aesthetic clinics, most procedures are provided on one to one basis by the physician or therapist. In such a scenario, guidelines detailing the infection control measures for aesthetic clinics are of particular importance. An online meeting of an international group of experts in the field of aesthetic medicine, with experience in administration of an aesthetic clinic, was convened. The meeting aimed to provide a set of consensus guidelines to protect clinic staff and patients from SARS-CoV-2 infection. Consensus guidelines for "preferred practices" were provided for scheduling of patients, patient evaluation and triaging, and for safety precautions about the different procedures. Procedures were categorized into low-risk, moderate risk, and high-risk based on the likelihood of transmission of SARS-CoV-2 virus from the patient to the treating physician or therapist. While not intended to be complete or exhaustive, these guidelines provide sound infection control measures for aesthetic practices. Since guidelines regarding safety measures and use of PPEs may vary from country to country, the local guidelines should also be followed to prevent COVID-19 infection in aesthetic clinics.


Coronavirus Disease 2019: The Role of the Fibrinolytic System from Transmission to Organ Injury and Sequelae


Association between regional selenium status and reported outcome of COVID-19 cases in China


title: Potent binding of 2019 novel coronavirus spike protein by a SARS coronavirus-specific human monoclonal antibody

text: The newly identified 2019 novel coronavirus (2019-nCoV) has caused more than 11,900 laboratory-confirmed human infections, including 259 deaths, posing a serious threat to human health. Currently, however, there is no specific antiviral treatment or vaccine. Considering the relatively high identity of receptor-binding domain (RBD) in 2019-nCoV and SARS-CoV, it is urgent to assess the cross-reactivity of anti-SARS CoV antibodies with 2019-nCoV spike protein, which could have important implications for rapid development of vaccines and therapeutic antibodies against 2019-nCoV. Here, we report for the first time that a SARS-CoV-specific human monoclonal antibody, CR3022, could bind potently with 2019-nCoV RBD (KD of 6.3 nM). The epitope of CR3022 does not overlap with the ACE2 binding site within 2019-nCoV RBD. These results suggest that CR3022 may have the potential to be developed as candidate therapeutics, alone or in combination with other neutralizing antibodies, for the prevention and treatment of 2019-nCoV infections. Interestingly, some of the most potent SARS-CoV-specific neutralizing antibodies (e.g. m396, CR3014) that target the ACE2 binding site of SARS-CoV failed to bind 2019-nCoV spike protein, implying that the difference in the RBD of SARS-CoV and 2019-nCoV has a critical impact for the cross-reactivity of neutralizing antibodies, and that it is still necessary to develop novel monoclonal antibodies that could bind specifically to 2019-nCoV RBD.


Will COVID-19 generate global preparedness?


¿Está España preparada para apoyo psicológico durante la crisis COVID-19?/ [Is Spain prepared to provide psychological support during the COVI-19 crisis?]


title: Binding affinities of 438 HLA proteins to complete proteomes of seven pandemic viruses and distributions of strongest and weakest HLA peptide binders in populations worldwide

text: We report detailed peptide-binding affinities between 438 HLA Class I and Class II proteins and complete proteomes of seven pandemic human viruses, including coronaviruses, influenza viruses and HIV-1. We contrast these affinities with HLA allele frequencies across hundreds of human populations worldwide. Statistical modelling shows that peptide-binding affinities classified into four distinct categories depend on the HLA locus but that the type of virus is only a weak predictor, except in the case of HIV-1. Among the strong HLA binders (IC50 ≤ 50), we uncovered 16 alleles (the top ones being A*02:02, B*15:03 and DRB1*01:02) binding more than 1% of peptides derived from all viruses, 9 (top ones including HLA-A*68:01, B*15:25, C*03:02 and DRB1*07:01) binding all viruses except HIV-1, and 15 (top ones A*02:01 and C*14:02) only binding coronaviruses. The frequencies of strongest and weakest HLA peptide binders differ significantly among populations from different geographic regions. In particular, Indigenous peoples of America show both higher frequencies of strongest and lower frequencies of weakest HLA binders. As many HLA proteins are found to be strong binders of peptides derived from distinct viral families, and are hence promiscuous (or generalist), we discuss this result in relation to possible signatures of natural selection on HLA promiscuous alleles due to past pathogenic infections. Our findings are highly relevant for both evolutionary genetics and the development of vaccine therapies. However they should not lead to forget that individual resistance and vulnerability to diseases go beyond the sole HLA allelic affinity and depend on multiple, complex and often unknown biological, environmental and other variables.


title: Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of COVID-19 Pandemic

text: BACKGROUND: A novel viral strain known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a worldwide pandemic known as coronavirus 2019 (COVID-19). Early reports from China have highlighted the risks associated with performing endoscopic endonasal skull base surgery in patients with SARS-CoV-2. We present a rare complication of nasoseptal flap (NSF) necrosis associated with COVID-19, further emphasizing the challenges of performing these procedures in this era. CASE DESCRIPTION: A 78-year-old man underwent an extended endoscopic endonasal transplanum resection of a pituitary macroadenoma for decompression of the optic chiasm. The resulting skull base defect was repaired using a pedicled NSF. The patient developed meningitis and cerebrospinal fluid (CSF) leak on postoperative day 13, requiring revision repair of the defect. Twelve days later, he developed persistent fever and rhinorrhea. The patient was reexplored endoscopically, and the NSF was noted to be necrotic and devitalized with evident CSF leakage. At that time, the patient tested positive for SARS-CoV-2. Postoperatively, he developed acute respiratory distress syndrome complicated by hypoxic respiratory failure and death. CONCLUSIONS: To our knowledge, this is the first reported case of NSF necrosis in a patient with COVID-19. We postulate that the thrombotic complications of COVID-19 may have contributed to vascular pedicle thrombosis and NSF necrosis. Although the pathophysiology of SARS-CoV-2 and its effect on the nasal tissues is still being elucidated, this case highlights some challenges of performing endoscopic skull base surgery in the era of COVID-19.


title: Social media as a recruitment platform for a nationwide online survey of COVID-19 knowledge, beliefs, and practices in the United States: methodology and feasibility analysis

text: BACKGROUND: The COVID-19 pandemic has evolved into one of the most impactful health crises in modern history, compelling researchers to explore innovative ways to efficiently collect public health data in a timely manner. Social media platforms have been explored as a research recruitment tool in other settings; however, their feasibility for collecting representative survey data during infectious disease epidemics remain unexplored. OBJECTIVES: This study has two aims 1) describe the methodology used to recruit a nationwide sample of adults residing in the United States (U.S.) to participate in a survey on COVID-19 knowledge, beliefs, and practices, and 2) outline the preliminary findings related to recruitment, challenges using social media as a recruitment platform, and strategies used to address these challenges. METHODS: An original web-based survey informed by evidence from past literature and validated scales was developed. A Facebook advertisement campaign was used to disseminate the link to an online Qualtrics survey between March 20-30, 2020. Two supplementary male-only and racial minority- targeted advertisements were created on the sixth and tenth day of recruitment, respectively, to address issues of disproportionate female- and White-oriented gender- and ethnic-skewing observed in the advertisement's reach and response trends. RESULTS: In total, 6602 participant responses were recorded with representation from all U.S. 50 states, the District of Columbia, and Puerto Rico. The advertisements cumulatively reached 236,017 individuals and resulted in 9609 clicks (4.07% reach). Total cost of the advertisement was $906, resulting in costs of $0.09 per click and $0.18 per full response (completed surveys). Implementation of the male-only advertisement improved the cumulative percentage of male respondents from approximately 20 to 40%. CONCLUSIONS: The social media advertisement campaign was an effective and efficient strategy to collect large scale, nationwide data on COVID-19 within a short time period. Although the proportion of men who completed the survey was lower than those who didn't, interventions to increase male responses and enhance representativeness were successful. These findings can inform future research on the use of social media recruitment for the rapid collection of survey data related to rapidly evolving health crises, such as COVID-19.


Palliative Care Pandemic Support for Long-Term Care


title: An overview of mobile applications (apps) to support the coronavirus disease 2019 response in India

text: Background & objectives: The potential benefits of mobile health (mHealth) initiatives to manage the coronavirus disease 2019 (COVID-19) pandemic have been explored. The Government of India, State governments, and healthcare organizations have developed various mobile apps for the containment of COVID-19. This study was aimed to systematically review COVID-19 related mobile apps and highlight gaps to inform the development of future mHealth initiatives. Methods: Google Play and the Apple app stores were searched using the terms 'COVID-19', 'coronavirus', 'pandemic', and 'epidemic' in the first week of April 2020. A list of COVID-19-specific functions was compiled based on the review of the selected apps, the literature on epidemic surveillance, and national and international media reports. The World Health Organization guideline on Digital Health Interventions was used to classify the app functions under the categories of the general public, health workers, health system managers, and data services. Results: The search yielded 346 potential COVID-19 apps, of which 50 met the inclusion criteria. Dissemination of untargeted COVID-19-related information on preventative strategies and monitoring the movements of quarantined individuals was the function of 27 (54%) and 19 (32%) apps, respectively. Eight (16%) apps had a contact tracing and hotspot identification function. Interpretation & conclusions: Our study highlights the current emphasis on the development of self-testing, quarantine monitoring, and contact tracing apps. India's response to COVID-19 can be strengthened by developing comprehensive mHealth solutions for frontline healthcare workers, rapid response teams and public health authorities. Among this unprecedented global health emergency, the Governments must ensure the necessary but least intrusive measures for disease surveillance.


title: An overview of mobile applications (apps) to support the coronavirus disease-2019 response in India

text: Background & objectives: The potential benefits of mobile health (mHealth) initiatives to manage the coronavirus disease-2019 (COVID-19) pandemic have been explored. The Government of India, State governments, and healthcare organizations have developed various mobile apps for the containment of COVID-19. This study was aimed to systematically review COVID-19 related mobile apps and highlight gaps to inform the development of future mHealth initiatives. Methods: Google Play and the Apple app stores were searched using the terms 'COVID-19', 'coronavirus', 'pandemic', and 'epidemic' in the first week of April 2020. A list of COVID-19-specific functions was compiled based on the review of the selected apps, the literature on epidemic surveillance, and national and international media reports. The World Health Organization guideline on Digital Health Interventions was used to classify the app functions under the categories of the general public, health workers, health system managers, and data services. Results: The search yielded 346 potential COVID-19 apps, of which 50 met the inclusion criteria. Dissemination of untargeted COVID-19-related information on preventative strategies and monitoring the movements of quarantined individuals was the function of 27 (54%) and 19 (32%) apps, respectively. Eight (16%) apps had a contact tracing and hotspot identification function. Interpretation & conclusions: Our study highlights the current emphasis on the development of self-testing, quarantine monitoring, and contact tracing apps. India's response to COVID-19 can be strengthened by developing comprehensive mHealth solutions for frontline healthcare workers, rapid response teams and public health authorities. Among this unprecedented global health emergency, the Governments must ensure the necessary but least intrusive measures for disease surveillance.


Resilience or resistance: A personal response to COVID-19


Median-joining network analysis of SARS-CoV-2 genomes is neither phylogenetic nor evolutionary


Balancing infection control and frailty prevention during and after the COVID-19 pandemic: Introduction of the NCGG Home Exercise Program for Older People 2020


First reorganization in Europe of a regional cardiac surgery system to deal with the coronavirus-2019 pandemic


Smokers are actually at a higher risk of dying from covid-19


SARS-CoV-2 infection control measures for the anesthesiology department: experience from the Sichuan Provincial People's Hospital, China


Unusual presentation of acute coronary syndrome in a patient with SARS-CoV-2 infection


Defining protective epitopes for COVID-19 vaccination models


Successful treatment of patients severely ill with COVID-19


title: Advantages of Using Lotteries to Select Participants for High-Demand Covid-19 Treatment Trials

text: As hospitals have experienced a surge of Covid-19 patients, investigators of Covid-19 treatment trials face a difficult problem: when an institution has more eligible and interested patients than trial slots, who should be enrolled? Defining a clear strategy for selecting participants for "high-demand" Covid-19 treatment trials is important to avoid ad hoc and potentially biased decision-making by local investigators, which could inadvertently compromise a trial's social value, participants' interests, or fairness. In this article, we propose a set of ethical criteria for evaluating participant-selection strategies for such trials. We argue that the pandemic context-in particular, great urgency to develop safe and effective treatments, uncertainty surrounding Covid-19, and strain on the health care system that limits the time and effort available for trial enrollment-favors participant-selection strategies that optimize the ease of enrollment and, ideally, social value. A lottery and, where possible, a weighted lottery have important advantages in these respects.


Responding to the COVID-19 Pandemic: The Need for a Structurally Competent Health Care System


title: [Healthcare, European Stability Mechanism and public funding following the Covid-19 pandemic]

text: The aim of this editorial is to illustrate the new public funding framework of the Italian National Health System following the Covid-19 pandemic. The document reviews the measures put in place by the Italian Government and European Institutions such as the European Commission (EC), the European Central Bank (ECB) and the European Stability Mechanism (ESM) to deal with this health crisis and subsequent severe economic recession, with particular reference to sources and uses of resources. The use of new budgetary financial spaces in deficit entails greater attention to the assessment of interventions and makes it necessary to keep expenditure under strict control. At the same time, the remodeling of expenditure within its aggregates, public investment in innovation, and the removal of administrative obstacles can strengthen the capacity of the healthcare system to meet the extraordinary needs deriving from the spread of Covid-19 and its resilience to future health shocks.


COVID-19: the need for continuous medical education and training


title: [Clinical observation of 6 severe COVID-19 patients treated with plasma exchange or tocilizumab]

text: OBJECTIVE: To observe the clinical effect of plasma exchange and tocilizumab in treatment of patients with severe coronavirus disease 2019 (COVID-19). METHODS: Six patients with severe COVID-19 admitted in First Affiliated Hospital of Bengbu Medical College from January 25 to February 25, 2020. Three patients were treated with plasma exchange and three patients were treated with tocilizumab. The effect on excessive inflammatory reaction of plasma exchange and tocilizumab was observed. RESULTS: The C-reactive protein (CRP) and IL-6 levels were significantly decreased and the lymphocyte and prothrombin time were improved in 3 patients after treatment with plasma exchange; while inflammation level was not significantly decreased, and lymphocyte and prothrombin time did not improve in 3 patients treated with tocilizumab. CONCLUSIONS: For severe COVID-19 patients with strong inflammatory reaction, plasma exchange may be preferred.


When weighing universal precautions, filtration efficiency is not universal


Interferon beta-1a for COVID-19: critical importance of the administration route


title: Updated Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States

text: We updated estimates of adults at risk for coronavirus disease complications on the basis of data for China by using recent US hospitalization data. This update to our previous publication substitutes obesity for cancer as an underlying condition and increases adults reporting any of the conditions from 45.4% to 56.0%.


title: Novel Coronavirus disease 2019 (COVID-19): new challenges and new responsibilities in developing countries

text: Novel coronavirus disease 2019 (COVID-19) is caused by the SARS-CoV-2 virus, which belongs to the genus Coronaviridae with its high mutation rate. From the current perspective, we discuss the current status of COVID-19, new challenges, and potential interventions to control the pandemic in developing counties such as Pakistan.


Reflections and recommendations on the COVID-19 pandemic: Should hormone therapy be discontinued?


[Interpretation of pathological changes for "Guidelines for the Diagnosis and Treatment of COVID-19 by the National Health Commission (Trial Version 7) "]


title: Are black and Hispanic persons disproportionately affected by COVID-19 because of higher obesity rates?

text: BACKGROUND: On March 13, 2020, the World Health Organization declared COVID-19 a pandemic. Shortly after that, it was reported that mortality rates in New York City (NYC), the epicenter of the pandemic in the United States, were found to be significantly higher in black and Hispanic populations. OBJECTIVES: The aim of this article is to evaluate the mortality rates in NYC among the different ethnic groups and the different boroughs as they relate to the obesity rates to see whether this issue merits further evaluation. SETTING: NYC. METHODS: COVID-19 data were obtained from the official New York authorities in relation to total number of cases in the different boroughs of NYC. Age-adjusted COVID-19-related mortality rates of the different ethnic groups were also obtained. These data were cross-compared with historic community health data on obesity rates previously published and also obesity rates among the different ethnic groups in NYC. RESULTS: The 2 NYC boroughs that have the highest mortality rates are the Bronx (6%) and Brooklyn (5.4%). Both the Bronx and Brooklyn were also found to have the highest obesity rates at 32% and 27%, respectively. The 2 ethnic groups with the highest obesity rates (Hispanic and black) were also found to have the highest age-adjusted mortality rates per 100,000 compared with the other ethnic groups (22.8% and 19.8%, respectively). CONCLUSIONS: The Hispanic and black populations in NYC seem to be disproportionately affected by the COVID-19 pandemic because of the higher incidence of mortality rates. Obesity may have played a role in the high incidence of mortality in those ethnic groups.


title: Evolution of olfactory disorders in COVID-19 patients

text: OBJECTIVES: A high frequency and a strong association of olfactory/gustatory impairment with COVID-19 were reported. Its spontaneous evolution remains unknown. The aim of this study was to investigate the spontaneous evolution of olfactory disorders in COVID-19 patients. STUDY DESIGN: Cross-sectional study METHODS: A total of 229 patients with laboratory-confirmed COVID-19 from March 1 through 31, 2020 in our institution were included. Among them, 140 patients (mean age, 38.5 years, 89 women) reported sudden olfactory/gustatory disorders during COVID-19. All patients were interviewed by phone based on a questionnaire with 16 questions at time of survey. The primary end point was olfactory recovery rate at time of survey. RESULTS: The frequency of patients with olfactory disorders was higher before March 20, 2020 than since (70.3% vs 53.9%, respectively) (p=0.016). At time of survey (26 days of the mean time from anosmia onset), 95.71% reported to start an olfactory recovery. The mean time from olfactory loss onset to recovery onset was 11.6 days. Recovery started between the 4th and the 15th day after olfactory loss onset in 78.4% of patients. Complete olfactory recovery happened for 51.43% of patients. There was a significant relationship between the complete olfactory recovery and a short time from olfactory loss onset to recovery onset (p=0.0004), absence of nasal obstruction (p=0.023), and absence of sore/dry/tingling feeling in the nose (p=0.007) in COVID-19 patients. CONCLUSION: Knowledge of spontaneous evolution of olfactory disorders allows reassuring patients and planning therapeutic strategies for persistent olfactory dysfunction after having definitely recovered from COVID-19.


Alarm at the Gate-Health and Social Inequalities are Comorbid Conditions of HIV and COVID-19


title: Correlation between Heart fatty acid binding protein and severe COVID-19: A case-control study

text: BACKGROUND: Heart-fatty acid binding protein (HFABP) has been recognized as a highly heart-specific marker. However, it is currently unknown that its HFABP is also closely related to the severity of COVID-19. METHODS: We retrospectively screened 46 patients who met our inclusion criteria within 4 weeks. They were tested for HFABP after the diagnosis of COVID-19, and monitored for HFABP during their hospital stay. We tracked the patients during their hospital stay to determine if they had severe COVID-19 or mild-to-severe transition features. We calculated the chi-square test values found for HFABP to predict the correlation between HFABP levels and the severity of the COVID-19. RESULTS: Of these 46 cases, 16 cases with confirmed COVID-19 were tested for HFABP> 7 ng / mL upon admission; among them, 14 cases were diagnosed with severe COVID-19 within the hospitalization. The Odds ratio of the measured HFABP elevation was 6.81(95% confidence interval [CI] 5.23-8.40), and 3 patients with severe COVID-19 progressed in 5 patients with mild HFABP> 7 ng/mL. CONCLUSION: These data indicate that the elevation of HFABP is closely related to the severity of COVID-19 in the patients, and the elevated HFABP may cause rapid development of patients with mild COVID-19 into severe COVID-19. But serum HFABP negative maybe make patients with mild COVID-19 safer, the current data show no effect on the all-cause mortality. TRIAL REGISTRATION: Our study has been registered with the Chinese Clinical Trial Registry, the registration number: ChiCTR2000029829.


title: Implementation of HIV care in Western Kenya during corona virus disease 2019 response

text: : To ensure the continuity of high-quality HIV care in Kisumu County, Kenya during the corona virus disease 2019 pandemic, the Ministry of Health implemented a strategy to promote physical distancing and corona virus disease 2019 case detection. A total of 23â262 (84.2%) of the 27â641 patients eligible for early refill received an extra 3-month supply of antiretrovirals. Across 60 Ministry of Health clinics, average attendance decreased from 1298 to 640 patients per day postintervention, representing a 50.7% reduction.


COVID-19 mortality and ICU admission: the Italian experience


China coronavirus: Six questions scientists are asking


title: Protection by Exclusion: Another Missed Opportunity to Include Pregnant Women in Research During the Coronavirus Disease 2019 (COVID-19) Pandemic

text: Coronavirus disease 2019 (COVID-19) is a novel infectious disease that started in Wuhan, China, and has rapidly spread all across the world. With limited ability to contain the virus and relatively high transmissibility and case fatality rates, governmental institutions and pharmaceutical companies are racing to find therapeutics and vaccines that target this novel coronavirus. However, once again, pregnant and breastfeeding women are excluded from participating in clinical trials during this pandemic. This "protection by exclusion" of pregnant women from drug development and clinical therapeutic trials, even during epidemics and pandemics, is not unprecedented. Moreover, it is both misguided and not justifiable and may have excluded them from potentially beneficial interventions. This is another missed opportunity to obtain pregnancy-specific safety and efficacy data, because therapeutics developed for men and nonpregnant women may not be generalizable to pregnant women. Therefore, we recommend and urge the scientific community and professional societies that, without clear justification for exclusion, pregnant women should be given the opportunity to be included in clinical trials for COVID-19 based on the concepts of justice, equity, autonomy, and informed consent.


title: COVID-19 and newborn health: systematic review

text: Objective To describe perinatal and neonatal outcomes in newborns exposed to SARS-CoV-2 Methods A systematic review was conducted by searching PubMed Central, LILACS, and Google Scholar using the keywords 'covid 'AND 'newborn'OR 'child'OR 'infant,'on 18 March 2020, and again on 17 April 2020 One researcher conducted the search and extracted data on demographics, maternal outcomes, diagnostic tests, imaging, and neonatal outcomes Results Of 256 publications identified, 20 met inclusion criteria and comprised neonatal outcome data for 222 newborns whose mothers were suspected or confirmed to be SARS-CoV-2 positive perinatally (17 studies) or of newborns referred to hospital with infection/pneumonia (3 studies) Most (12 studies) were case-series reports;all were from China, except three (Australia, Iran, and Spain) Of the 222 newborns, 13 were reported as positive for SARS-CoV-2;most of the studies reported no or mild symptoms and no adverse perinatal outcomes Two papers among those from newborns who tested positive reported moderate or severe clinical characteristics Five studies using data on umbilical cord blood, placenta, and/or amniotic fluid reported no positive results Nine studies reported radiographic imaging, including 5 with images of pneumonia, increased lung marking, thickened texture, or high-density nodular shadow Minor, non-specific changes in biochemical variables were reported Studies that tested breast milk reported negative SARS-CoV-2 results Conclusions Given the paucity of studies at this time, vertical transmission cannot be confirmed or denied Current literature does not support abstaining from breastfeeding nor separating mothers and newborns Further evidence and data collection networks, particularly in the Americas, are needed for establishing definitive guidelines and recommendations (AU) Objetivo Describir los resultados perinatales y neonatales de los recién nacidos expuestos al SARS-CoV-2 Métodos Se realizó una revisión sistemática con búsqueda bibliográfica en PubMed Central, LILACS, y Google Scholar usando las palabras clave 'covid'Y 'newborn'O 'child'O 'infant', el 18 de marzo de 2020, y de nuevo el 17 de abril de 2020 Un investigador llevó a cabo la búsqueda y extrajo datos sobre demografía, resultados maternos, pruebas de diagnóstico, imágenes y resultados neonatales Resultados De las 256 publicaciones identificadas, 20 cumplieron los criterios de inclusión y comprendían datos de resultados neonatales de 222 recién nacidos cuyas madres eran casos sospechosos o positivos confirmados de SARS-CoV-2 en el período perinatal (17 estudios) o bien recién nacidos internados en el hospital con infección/neumonía (3 estudios) La mayoría (12 estudios) eran informes de series de casos;todos procedían de China, excepto tres (de Australia, España e Irán) De los 222 recién nacidos, 13 tenían resultados positivos para SARS-CoV-2;en la mayoría de los estudios se informó que los recién nacidos eran asintomáticos o tenían síntomas leves y que no se habían producido resultados perinatales adversos Entre los estudios con recién nacidos positivos, en dos se informaron características clínicas moderadas o graves En cinco estudios se analizó la sangre del cordón umbilical, la placenta o el líquido amniótico y no se informaron resultados positivos En nueve estudios se reportaron imágenes radiográficas, entre ellos cinco con imágenes de neumonía, aumento de la trama pulmonar, textura engrosada u opacidades nodulares de alta densidad Se informaron alteraciones menores e inespecíficas de los parámetros bioquímicos En los estudios en que se analizó la leche materna se informaron resultados negativos para el SARS-CoV-2 (AU) Objetivo Descrever os resultados perinatais e neonatais dos recém-nascidos expostos à SARS-CoV-2 Métodos Uma revisão sistemática com pesquisa bibliográfica em PubMed Central, LILACS e Google Scholar foi realizada utilizando as palavras-chave 'covid'E ('newborn'OU 'child'OU 'infant') em 18 de março de 2020, e novamente em 17 de abril de 2020 por um pesquisador Foram analisados dados sobre demografia, resultados maternos, testes de diagnóstico, técnicas de imagem e resultados neonatais Resultados Das 256 publicações identificadas, 20 preenchiam os critérios de inclusão e incluíam dados de resultados neonatais de 222 recém-nascidos cujas mães eram suspeitas ou positivas para a SARSCoV-2 no período perinatal (17 estudos) ou recém-nascidos internados no hospital com infecção/pneumonia (3 estudos) A maioria (12 estudos) eram relatos de séries de casos;todos, exceto três (Austrália, Irão e Espanha), eram provenientes da China Dos 222 recém-nascidos, 13 eram positivos para SARS-CoV-2;a maioria dos estudos relatou que os recém-nascidos eram assintomáticos ou tinham sintomas leves e que não foram observados resultados perinatais adversos Entre os estudos com recém-nascidos positivos, dois descreviam características clínicas moderadas ou graves O sangue do cordão umbilical, a placenta ou o líquido amniótico foram analisados em cinco estudos, não tendo sido relatados resultados positivos Imagens radiográficas foram descritas em nove estudos, incluindo cinco com imagens de pneumonia, aumento da trama pulmonar, espessamento da textura ou opacidades nodulares de alta densidade Foram relatadas alterações menores e não específicas dos parâmetros bioquímicos Estudos que analisaram leite materno mostraram resultados negativos para SARS-CoV-2 Conclusões Dada a escassez de estudos, neste momento a transmissão vertical não pode ser confirmada ou excluída A literatura atual não apoia a abstenção da amamentação ou a separação dos recém-nascidos das suas mães São necessárias mais provas e mais dados, especialmente na Região das Américas, para estabelecer orientações e recomendações definitivas (AU)


title: Management of Outpatient Warfarin Therapy amid COVID-19 Pandemic: A Practical Guide

text: Many healthcare resources have been and continue to be allocated to the management of patients with COVID-19. Therefore, the ongoing care of patients receiving oral anticoagulation with warfarin is likely to be compromised amid this unprecedented crisis. This article discusses a stepwise algorithm for the management of outpatient warfarin therapy. Alternative management strategies are presented and discussed, including alternative pharmacological therapy options and self-monitoring. Our algorithm aims to help clinicians safely optimize the treatment of patients requiring anticoagulation therapy in the context of the global response to the current pandemic.


COVID-19 Is Disproportionately High in African Americans. This Will Come as No Surprise


title: Need for Speed: From Human SARS-CoV-2 Samples to Protective and Efficacious Antibodies in Weeks

text: The emergence of SARS-CoV-2 has driven a global research effort to identify medical countermeasures at an unprecedented pace. In this issue of Cell, Cao et al. identify thousands of SARS-CoV-2 neutralizing antibodies from convalescent donors. The authors improve our understanding of immunity against the coronavirus spike glycoprotein and detail novel pathways to rapidly identify and characterize protective monoclonal antibodies.


Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic


Nursing homes or besieged castles: COVID-19 in northern Italy


title: Appréhender le COVID-19 au fil de l'eau en tant que psychiatre d'enfant et d'adolescent./ [Appreciating COVID-19 as a child and adolescent psychiatrist on the move]

text: COVID-19 is a multi-organ disease due to an infection with the SARS-CoV2 virus. It has become a pandemic in early 2020. The disease appears less devastating in children and adolescents. However, stress, quarantine and eventually mourning have major impacts on development. It is difficult to describe what this pandemic implies for a child psychiatrist, other than by giving a first-hand account. I propose to go through the main ethical questions that have arisen; to describe how my hospital team has reorganized itself to meet the new demands and questions, in particular by opening a unit dedicated to people with autism and challenging behaviors affected by COVID-19; and to address, in a context of national discussion, how the discipline has sought to understand the conditions of a certain well-being during quarantine. Finally, I will try to conclude with more speculative reflections on re-opening.


title: How good is good enough for COVID19 apps? The influence of benefits, accuracy, and privacy on willingness to adopt

text: A growing number of contact tracing apps are being developed to complement manual contact tracing. A key question is whether users will be willing to adopt these contact tracing apps. In this work, we survey over 4,500 Americans to evaluate (1) the effect of both accuracy and privacy concerns on reported willingness to install COVID19 contact tracing apps and (2) how different groups of users weight accuracy vs. privacy. Drawing on our findings from these first two research questions, we (3) quantitatively model how the amount of public health benefit (reduction in infection rate), amount of individual benefit (true-positive detection of exposures to COVID), and degree of privacy risk in a hypothetical contact tracing app may influence American's willingness to install. Our work takes a descriptive ethics approach toward offering implications for the development of policy and app designs related to COVID19.


Oral and nasal decontamination for COVID-19 patients: more harm than good?


title: Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak

text: BACKGROUNDS: An ongoing outbreak of a novel coronavirus (2019-nCoV) pneumonia hit a major city in China, Wuhan, December 2019 and subsequently reached other provinces/regions of China and other countries. We present estimates of the basic reproduction number, R0, of 2019-nCoV in the early phase of the outbreak. METHODS: Accounting for the impact of the variations in disease reporting rate, we modelled the epidemic curve of 2019-nCoV cases time series, in mainland China from January 10 to January 24, 2020, through the exponential growth. With the estimated intrinsic growth rate (Î³), we estimated R0 by using the serial intervals (SI) of two other well-known coronavirus diseases, MERS and SARS, as approximations for the true unknown SI. FINDINGS: The early outbreak data largely follows the exponential growth. We estimated that the mean R0 ranges from 2.24 (95%CI: 1.96-2.55) to 3.58 (95%CI: 2.89-4.39) associated with 8-fold to 2-fold increase in the reporting rate. We demonstrated that changes in reporting rate substantially affect estimates of R0. CONCLUSION: The mean estimate of R0 for the 2019-nCoV ranges from 2.24 to 3.58, and is significantly larger than 1. Our findings indicate the potential of 2019-nCoV to cause outbreaks.


title: How Has COVID-19 Affected Our Orthopedic Implant Industry Partners? Implications for the Surgeon-Industry Relationship in 2020 and Beyond

text: BACKGROUND: The COVID-19 pandemic has had far-reaching societal and financial consequences. The purpose of this study was to evaluate how COVID-19 has affected AAHKS industry partners and the surgeon-industry relationship, emphasizing education, resource allocation, and strategic direction for the second half of 2020. METHODS: AAHKS industry partners were contacted to participate in a blinded survey and optional interview with the AAHKS Industry Relations Committee. Based on the results, a group of AAHKS member surgeons with disparate practice types were asked to postulate on how the COVID-19 pandemic has and will affect their practice and relationship with Industry. RESULTS: AAHKS industry partner responses indicated decreased resource allocation for regional, "other national," and AAHKS annual meetings (67%, 55%, and 30%, respectively). Web-based educational content was expected to increase in 2020 and will likely remain a point of emphasis in 2021 (100% and 70% of responders). For Q3/Q4 2020, a significant emphasis was placed on site of service/outpatient TJA and COVID-19-related safety measures (70% and 90% of responders), as well as increased availability of instrumentation and implants (40% and 60%, respectively). CONCLUSION: The COVID-19 pandemic has altered the orthopedic landscape for the foreseeable future. Survey responses by AAHKS industry partners demonstrate a continued commitment to surgeon education with an increasing shift to a web-based platform. Increased resource allocation for outpatient TJA and COVID-19-related safety measures were significant. Articulating optimal mechanisms to aid industry in supporting surgeons with different practice models to meet demand during the second half of fiscal year 2020 will be critical.