title: Hip Fracture Outcomes During the COVID-19 Pandemic: Early Results from New York

text: OBJECTIVE: To evaluate inpatient outcomes among hip fracture patients treated during the COVID-19 pandemic in New York City. DESIGN: Multicenter retrospective cohort study SETTING:: One Level 1 Trauma Center and one orthopaedic specialty hospital in New York CityPatients/Participants: Fifty-nine consecutive patients (average age 85, range: 65 - 100 years) treated for a hip fracture (OTA/AO 31, 32.1) over a 5-week period, March 20, 2020 to April 24, 2020, during the height of the COVID-19 crisis. MAIN OUTCOME MEASUREMENTS: COVID-19 infection status was used to stratify patients. The primary outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, unexpected intubation, pneumonia, deep venous thrombosis, pulmonary embolus, myocardial infarction, cerebrovascular accident, urinary tract infection, and transfusion. Baseline demographics, comorbidities, treatment characteristics, and COVID-related symptomatology were also evaluated. RESULTS: Ten patients (15%) tested positive for COVID-19 (COVID+) (n=9; 7 preoperatively, 2 postoperatively) or were presumed positive (n=1), 40 (68%) patients tested negative, and 9 (15%) patients were not tested in the primary hospitalization. American Society of Anesthesiologists (ASA) scores were higher in the COVID+ group (d=-0.83; p=0.04); however, the Charlson Comorbidity Index was similar between the study groups (d=-0.17; p=0.63). Inpatient mortality was significantly increased in the COVID+ cohort (56% vs. 4%; OR 30.0, 95% CI 4.3-207; p=0.001). Including the one presumed positive case in the COVID+ cohort increased this difference (60% vs. 2%; OR 72.0, 95% CI 7.9-754; p<0.001). CONCLUSIONS: Hip fracture patients with concomitant COVID-19 infection had worse ASA scores but similar baseline comorbidities with significantly higher rates of inpatient mortality compared to those without concomitant COVID-19 infection. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.


title: Chest X-ray severity index as a predictor of in-hospital mortality in coronavirus disease 2019: A study of 302 patients from Italy

text: OBJECTIVES: This study aimed to assess the usefulness of a new chest X-ray scoring system - the Brixia score - to predict the risk of in-hospital mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: Between March 4, 2020 and March 24, 2020, all CXR reports including the Brixia score were retrieved. We enrolled only hospitalized Caucasian patients with COVID-19 for whom the final outcome was available. For each patient, age, sex, underlying comorbidities, immunosuppressive therapies, and the CXR report containing the highest score were considered for analysis. These independent variables were analyzed using a multivariable logistic regression model to extract the predictive factors for in-hospital mortality. RESULTS: 302 Caucasian patients who were hospitalized for COVID-19 were enrolled. In the multivariable logistic regression model, only Brixia score, patient age, and conditions that induced immunosuppression were the significant predictive factors for in-hospital mortality. According to receiver operating characteristic curve analyses, the optimal cutoff values for Brixia score and patient age were 8 points and 71 years, respectively. Three different models that included the Brixia score showed excellent predictive power. CONCLUSIONS: Patients with a high Brixia score and at least one other predictive factor had the highest risk of in-hospital death.


SARS-CoV-2: Naso-bronchial cytological correlations


title: Convalescent plasma, an apheresis research project targeting and motivating the fully recovered COVID 19 patients: A rousing message of clinical benefit to both donors and recipients alike

text: This concise manuscript aims to make suggestions for a small step forward in both preventative and therapeutic measures against the Coronavirus disease 2019 (COVID 19) pandemic. This targeted strategy consists of using fully recovered COVID 19 Heroes, that is, brave volunteers, as the source of antibodies in plasma collected by plasmapheresis or affinity column- derived antibodies, both are sterilised and pathogen inactivated for substitution therapy for use in those populations in need of antibody. This include for use in critically ill COVID 19 patients and as a preventative measure, in those at potential risk of infection as no vaccine is yet available. This would be a small step forward, while we are waiting to produce an effective, validated vaccine and witnessing increasing demands for testing and self-isolation which are the two most effective current strategies. In line with this concept, some methodological aspects of the use of the UVC sterilization of FFP/ cryoprecipitate-depleted FFP or immunoglobulins containing neutralizing antibodies for clinical use against COVID-19 are highlighted. The plasmapheresis procedure is, of course, particularly targeted to male donors, who consist of about 75 % of the COVID-19 population and who are able to undergo multiple double, or even triple plasmapheresis procedures. Moreover, as some of these donors have already been in an induced-hypercoagulable state and prone to thrombosis and DVT, this strategy will be partially aimed at improving their health with the use of citrate based anticoagulants and removal of high molecular weight viscous components which contribute to the untoward clinical effects of DVT. Repeated targeted plasmapheresis or plasma exchange of selected COVID-19 positive individuals would undoubtedly lower their state of hypercoagulability and normalize their hypercoagulability. The recipients of such a derived FFP-product would benefit from the two to 3 doses of viral inactivated antibodies, which could neutralize the viral antigens even at very low concentration if present in the early stage. So, this practice would be a double-edged sword with benefits for both donors and recipients.


Protect the vulnerable from extreme heat during the COVID-19 pandemic


COVID-19 Curbside Consults at www.CCJM.org


Resuming bowel cancer screening post-COVID-19


title: Methods for forecasting the effect of exogenous risk on stock markets

text: Markets are subjected to both endogenous and exogenous risks that have caused disruptions to financial and economic markets around the globe, leading eventually to fast stock market declines. In the past, markets have recovered after any economic disruption. On this basis, we focus on the outbreak of COVID-19 as a case study of an exogenous risk and analyze its impact on the Standard and Poor's 500 (S\&P500) index. We assumed that the S\&P500 index reaches a minimum before rising again in the not-too-distant future. Here we present two cases to forecast the S\&P500 index. The first case uses an estimation of expected deaths released on 02/04/2020 by the University of Washington. For the second case, it is assumed that the peak number of deaths will occur 2-months since the first confirmed case occurred in the USA. The decline and recovery in the index were estimated for the following three months after the initial point of the predicted trend. The forecast is a projection of a prediction with stochastic fluctuations described by $q$-gaussian diffusion process with three spatio-temporal regimes. Our forecast was made on the premise that any market response can be decomposed into an overall deterministic trend and a stochastic term. The prediction was based on the deterministic part and for this case study is approximated by the extrapolation of the S\&P500 data trend in the initial stages of the outbreak. The stochastic fluctuations have the same structure as the one derived from the past 24 years. A reasonable forecast was achieved with 85\% of accuracy.


title: Protocol for an Observational Study on the Effects of Social Distancing on Influenza-Like Illness and COVID-19

text: The novel coronavirus disease (COVID-19) is a highly contagious respiratory disease that was first detected in Wuhan, China in December 2019, and has since spread around the globe, claiming more than 69,000 lives by the time this protocol is written. It has been widely acknowledged that the most effective public policy to mitigate the pandemic is \emph{social and physical distancing}: keeping at least six feet away from people, working from home, closing non-essential businesses, etc. There have been a lot of anecdotal evidences suggesting that social distancing has a causal effect on disease mitigation; however, few studies have investigated the effect of social distancing on disease mitigation in a transparent and statistically-sound manner. We propose to perform an optimal non-bipartite matching to pair counties with similar observed covariates but vastly different average social distancing scores during the first week (March 16th through Match 22nd) of President's \emph{15 Days to Slow the Spread} campaign. We have produced a total of $302$ pairs of two U.S. counties with good covariate balance on a total of $16$ important variables. Our primary outcome will be the average observed illness collected by Kinsa Inc. two weeks after the intervention period. Although the observed illness does not directly measure COVID-19, it reflects a real-time aspect of the pandemic, and unlike confirmed cases, it is much less confounded by counties' testing capabilities. We also consider observed illness three weeks after the intervention period as a secondary outcome. We will test a proportional treatment effect using a randomization-based test with covariance adjustment and conduct a sensitivity analysis.


Characteristics of COVID-19 disease in multiple sclerosis patients


Pandemic research: UK must coordinate


Mask-wearing in pediatric age


Cardiopulmonary resuscitation in COVID-19 patients - To do or not to?


Hopelessness, helplessness and resilience: The importance of safeguarding our trainees' mental wellbeing during the COVID-19 pandemic


Editorial: Tele-ICU in the Age of COVID-19: Built for This Challenge


title: Virtual screening based on molecular docking of possible inhibitors of Covid-19 main protease

text: Coronavirus (COVID-19) is an enveloped RNA virus that is diversely found in humans and that has now been declared a global pandemic by the World Health Organization. Thus, there is an urgent need to develop effective therapies and vaccines against this disease. In this context, this study aimed to evaluate in silico the molecular interactions of drugs with therapeutic indications for treatment of COVID-19 (Azithromycin, Baricitinib and Hydroxychloroquine) and drugs with similar structures (Chloroquine, Quinacrine and Ruxolitinib) in docking models from the SARS-CoV-2 main protease (M-pro) protein. The results showed that all inhibitors bound to the same enzyme site, more specifically in domain III of the SARS-CoV-2 main protease. Therefore, this study allows proposing the use of baricitinib and quinacrine, in combination with azithromycin; however, these computer simulations are just an initial step for conceiving new projects for the development of antiviral molecules.


title: Novel therapeutic approaches for treatment of COVID-19

text: To date, there is no licensed treatment or approved vaccine to combat the coronavirus disease of 2019 (COVID-19), and the number of new cases and mortality multiplies every day. Therefore, it is essential to develop an effective treatment strategy to control the virus spread and prevent the disease. Here, we summarized the therapeutic approaches that are used to treat this infection. Although it seems that antiviral drugs are effective in improving clinical manifestation, there is no definite treatment protocol. Lymphocytopenia, excessive inflammation, and cytokine storm followed by acute respiratory distress syndrome are still unsolved issues causing the severity of this disease. Therefore, immune response modulation and inflammation management can be considered as an essential step. There is no doubt that more studies are required to clarify immunopathogenesis and immune response; however, new therapeutic approaches including mesenchymal stromal cell and immune cell therapy showed inspiring results.


Covid-19: Patients who are improving could have treatment withdrawn if others could benefit more


title: Spiritual care - 'A deeper immunity' - A response to Covid-19 pandemic

text: Coronavirus disease 2019 (COVID-19) has presented unprecedented health challenges across all strata in society throughout the world. The COVID experience has caused us to reflect on quality of life, health and well-being and, just as important, end of life. During this time, spiritual care forms a vital component of holistic health management, especially in terms of coping, coming to terms with illness, suffering and ultimately death. The relationship with the transcendent or sacred has a strong influence on a people's beliefs, attitudes, emotions and behaviour. Populations, communities, families and individuals have always found solace through their religious or philosophical beliefs during times of personal adversity and widespread anxiety or disaster. Although spiritual care has always been a part of the domain of religious beliefs, a more contemporary perspective is that spiritual care forms part of the human psyche and thus forms part of human care, health and well-being for families, patients and healthcare workers. Spiritual care deals with the provision of compassion and empathy during periods of heightened stress, distress and anxiety within care. This article provides insights into the necessity of providing spiritual care as a means of coping and well-being for families, patients and healthcare workers during the COVID-19 pandemic.


Supporting Clinicians During the COVID-19 Pandemic


COVID-19: Once upon a time in Portugal: A brief atlas of ongoing pandemic Portuguese research


Comment on "Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiotherapy During the COVID-19 Pandemic: An ASTRO-ESTRO Consensus Statement"


title: Expression and prognostic significance of pyruvate dehydrogenase kinase 1 in bladder urothelial carcinoma

text: Muscular infiltrating bladder urothelial carcinoma (MIBC) is a highly malignant disease with a poor prognosis. Radical cystectomy is the standard treatment. However, due to surgery and postoperative complications, the quality of life of patients is seriously affected. Therefore, it is increasingly important to find prognostic markers and new therapeutic targets for MIBC. Here, we investigated the expression of PDK1, a key regulator of glucose metabolism, in bladder urothelial carcinoma (BLCA) and its effect on prognosis. The expression pattern of PDK1 was examined by bioinformatics analysis and immunohistochemistry. A total of 101 cases of BLCA were selected for tissue microarrays (TMAs) that contained both tumour and paired normal tissues. We demonstrated that PDK1 expression was correlated with tumour grade and Ki67expression in our TMA cohort (all p values < 0.05). Kaplan-Meier survival analysis showed that patients with MIBC with high PDK1 expression had a worse prognosis than patients with low PDK1 expression (p = 0.016). Multifactor risk analysis showed that increased PDK1 expression was an independent prognostic factor affecting the overall survival of MIBC patients. GSEA showed that the mTOR pathway, HIF pathway, glycolysis, PI3K/AKT/mTOR signalling, etc. were differentially enriched in the PDK1 high expression phenotype. Hence, PDK1 may be a prognostic and therapeutic target for MIBC.


A framework for identifying regional outbreak and spread of COVID-19 from one-minute population-wide surveys


Evans syndrome in a patient with COVID-19


title: Safety and Efficacy of Anti-il6-receptor Tocilizumab Use in Severe and Critical Patients Affected by Coronavirus Disease 2019: a Comparative Analysis

text: BACKGROUND: As the novel SARS-CoV-2 pandemic occurred, no specific treatment was yet available. Inflammatory response secondary to viral infection might be the driver of severe diseases. We report the safety and efficacy (in terms of overall survival and hospital discharge) of the anti-IL6 tocilizumab (TCZ) in subjects with COVID-19. METHODS: This retrospective, single-center analysis included all the patients consecutively admitted to our Hospital with severe or critical COVID-19 who started TCZ treatment from March 13th to April 03rd, 2020. A 1:2 matching to patients not treated with TCZ was performed according to age, sex, severity of disease, P/F, Charlson Comorbidity Index and length of time between symptoms onset and hospital admittance. Descriptive statistics and non-parametric tests to compare the groups were applied. Kaplan Meier probability curves and Cox regression models for survival, hospital discharge and orotracheal intubation were used. RESULTS: Seventy-four patients treated with TCZ were matched with 148 matched controls. They were mainly males (81.5%), Caucasian (82.0%) and with a median age of 59 years. The majority (69.8%) showed critical stage COVID-19 disease. TCZ use was associated with a better overall survival (HR 0.499 [95% CI 0.262-0.952], p=0.035) compared to controls but with a longer hospital stay (HR 1.658 [95% CI 1.088-2.524], p=0.019) mainly due to biochemical, respiratory and infectious adverse events. DISCUSSION: TCZ use resulted potentially effective on COVID-19 in terms of overall survival. Caution is warranted given the potential occurrence of adverse events. FINANCIAL SUPPORT: Some of the tocilizumab doses used in the subjects included in this analysis were provided by the "Multicenter study on the efficacy and tolerability of tocilizumab in the treatment of patients with COVID-19 pneumonia" (EudraCT Number: 2020-001110-38) supported by the Italian National Agency for Drugs (AIFA). No specific funding support was planned for study design, data collection and analysis and manuscript writing of this paper.


Innovative liver research continues during the current pandemic


title: Banxia Xiexin Decoction () Treats Diabetic Gastroparesis through PLC-IP3-Ca2+/NO-cGMP-PKG Signal Pathway

text: OBJECTIVE: To test the effect of Banxia Xiexin Decoction (, BXD) on the contraction and relaxation of gastric smooth muscle (SM) in diabetic gastroparesis (DGP) model rats, and to explore the mechanism of BXD in the prevention and treatment of DGP through experiments of signal pathway both in vivo and in vitro. METHODS: Sixty Sprague-Dawley rats were divided into 6 groups according to a random number table: control group, model group, high-, medium- and low-dose BXD groups (9.2, 4.6 and 1.8 g/(kg·d), respectively), and domperidone group (10 mg/(kg·d)), 10 rats per group. DGP model was established initially by a single intraperitoneal injection of streptozotocin (STZ), and was confirmed by recording gastric emptying, intestinal transport velocity and gastric myoelectric activity of rats after 2 months. Each group was treated with a corresponding drug for 4 weeks. The mRNA and protein expressions of phospholipase C (PLC), inositol triphosphate (IP3), neuronal nitric oxide synthase (nNOS), and cyclic guanosine monophosphate (cGMP) dependent protein kinase G (PKG) were detected by reverse transcription-polymerase chain reaction and Western blot, respectively, while nitric oxide (NO) and cGMP expressions were detected by enzyme-linked immunosorbent assay. Gastric tissues were obtained from rats for primary cell culture preparation. Gastric SM cells were treated with 0.8 µmol/L of STZ or STZ plus 1,000, 500 and 200 µg/mL of BXD or STZ plus 2.5 µmol/mL of domperidone for 24, 48, 72 or 96 h, respectively. The length of gastric SM cells and intracellular Ca2+ concentration ([Ca2+]i) before and after BXD treatment was measured. RESULTS: Compared with the model group, high- and medium-dose BXD and domperidone significantly increased the expressions of PLC, IP3, NO, nNOS, cGMP and PKG in rat's gastric tissue (P<0.01). Gastric SM cells treated with BXD showed a time- and dose-dependent increase in cell viability (P<0.01). The treatment with high- and medium-dose BXD and domperidone inhibited the increase in gastric SM cells length and increased [Ca2+]i compared with the model cells (P<0.01). CONCLUSIONS: Treatment with high- and medium-dose BXD significantly attenuated STZ-induced experimental DGP in rats. The therapeutic effect of BXD on DGP rats might be associated with the PLC-IP3-Ca2+/NO-cGMP-PKG signal pathway.


title: [A Case of Gastric Schwannoma Diagnosed Preoperatively]

text: The patient was a 52-year-old woman, who was found to have an abnormality in the upper gastrointestinal(UGI)tract, via a contrast-imaging study; she had no symptoms.Computed tomography(CT)revealed a tumor, measuring approximately 100mm in diameter, in the antrum of the stomach.The tumor was diagnosed as gastric schwannoma using endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA).Preoperative CT revealed multiple lymph adenopathies around the antrum, which led to the suspicion of lymph node metastasis. The patient underwent a laparoscopic partial gastrectomy after the confirmation of the absence of lymph node metastasis by intraoperative rapid diagnosis.


The role of the environment and its pollution in the prevalence of COVID-19


title: Using Insights from Behavioral Economics to Mitigate the Spread of COVID-19

text: The outbreak of 2019 coronavirus disease (COVID-19) has become a public health emergency of international concern. The number of COVID-infected individuals and related deaths continues to rise rapidly. Encouraging people to adopt and sustain preventive behaviors is a central focus of public health policies that seek to mitigate the spread of COVID-19. Public health policy needs improved methods to encourage people to adhere to COVID-19-preventive behaviors. In this paper, we introduce a number of insights from behavioral economics that help explain why people may behave irrationally during the COVID-19 pandemic. In particular, present bias, status quo bias, framing effect, optimism bias, affect heuristic, and herding behavior are discussed. We hope this paper will shed light on how insights from behavioral economics can enrich public health policies and interventions in the fight against COVID-19.


Tocilizumab in COVID-19: Beware the risk of intestinal perforation


title: Basic Immunology may lead to translational therapeutic rationale:: SARS-CoV-2 and Rheumatic Diseases

text: COVID-19 pandemia is a major concern for patients and health care systems. The fear of infection by patients with concomitant rheumatic diseases (either adult or children) and connective tissue diseases is arising worldwide, because of their immunological background and immunological therapies. Analyzing the basic biology of single diseases, the data suggest that there is an "immunological umbrella" that seems to protect against the infection, through IFN type 1 and NK cell function. To date, reports from China, US and Europe, did not reveal an higher risk of infection, either for Rheumatoid Arthritis, Juvenile Idiopathic Arthritis nor for Lupus Erythematosus. Antimalarials, anti-IL6-Anti-IL6-receptor, anti-IL1, anti-GM-CSF-receptor , JAK1/2/3 inhibitors, are under investigation in COVID-dedicated clinical trials to control the inflammation raised by SARS-CoV-2 infection. Initial reports on the occurrence of autoimmune phenomena in the convalescence phase of SARS-CoV-2 infection, suggests that the immunological consequences of the infection need to be strictly understood.


title: The dynamics of entropy in the COVID-19 outbreaks

text: With the unfolding of the COVID-19 pandemic, mathematical modeling of epidemics has been perceived and used as a central element in understanding, predicting, and governing the pandemic event. However, soon it became clear that long term predictions were extremely challenging to address. Moreover, it is still unclear which metric shall be used for a global description of the evolution of the outbreaks. Yet a robust modeling of pandemic dynamics and a consistent choice of the transmission metric is crucial for an in-depth understanding of the macroscopic phenomenology and better-informed mitigation strategies. In this study, we propose a Markovian stochastic framework designed to describe the evolution of entropy during the COVID-19 pandemic and the instantaneous reproductive ratio. We then introduce and use entropy-based metrics of global transmission to measure the impact and temporal evolution of a pandemic event. In the formulation of the model, the temporal evolution of the outbreak is modeled by the master equation of a nonlinear Markov process for a statistically averaged individual, leading to a clear physical interpretation. We also provide a full Bayesian inversion scheme for calibration. The time evolution of the entropy rate, the absolute change in the system entropy, and the instantaneous reproductive ratio are natural and transparent outputs of this framework. The framework has the appealing property of being applicable to any compartmental epidemic model. As an illustration, we apply the proposed approach to a simple modification of the Susceptible-Exposed-Infected-Removed (SEIR) model. Applying the model to the Hubei region, South Korean, Italian, Spanish, German, and French COVID-19 data-sets, we discover a significant difference in the absolute change of entropy but highly regular trends for both the entropy evolution and the instantaneous reproductive ratio.


title: Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020 ;MMWR

text: Fourteen cases have been diagnosed in the United States, in addition to 39 cases among repatriated persons from high-risk settings, for a current total of 53 cases within the United States U S government agencies and public health partners are implementing aggressive measures to slow and try to contain transmission of COVID-19 in the United States


title: Update: Public Health Response to the Coronavirus Disease 2019 Outbreak - United States, February 24, 2020

text: An outbreak of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) began in Wuhan, Hubei Province, China in December 2019, and has spread throughout China and to 31 other countries and territories, including the United States (1). As of February 23, 2020, there were 76,936 reported cases in mainland China and 1,875 cases in locations outside mainland China (1). There have been 2,462 associated deaths worldwide; no deaths have been reported in the United States. Fourteen cases have been diagnosed in the United States, and an additional 39 cases have occurred among repatriated persons from high-risk settings, for a current total of 53 cases within the United States. This report summarizes the aggressive measures (2,3) that CDC, state and local health departments, multiple other federal agencies, and other partners are implementing to slow and try to contain transmission of COVID-19 in the United States. These measures require the identification of cases and contacts of persons with COVID-19 in the United States and the recommended assessment, monitoring, and care of travelers arriving from areas with substantial COVID-19 transmission. Although these measures might not prevent widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare state and local health departments, health care systems, businesses, educational organizations, and the general public in the event that widespread transmission occurs; and 3) better characterize COVID-19 to guide public health recommendations and the development and deployment of medical countermeasures, including diagnostics, therapeutics, and vaccines. U.S. public health authorities are monitoring the situation closely, and CDC is coordinating efforts with the World Health Organization (WHO) and other global partners. Interim guidance is available at https://www.cdc.gov/coronavirus/index.html. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC, state and local health departments, health care providers, and communities.


COVID-19 and Shock: A Cautionary Tale for Elderly Patients From a Pooled Analysis


title: Will the COVID-19 Pandemic Change National Security and Healthcare in the Spectrum of Cardiovascular Disease?

text: COVID-19 pandemic changed the current state of healthcare, especially in terms of reorganization of resources. Chief complaints of patients admitted to hospitals changed drastically in the proceeding months, which worsened the treatment of many acute and chronic conditions involving cardiovascular system pathologies and resources were moved in order to fight COVID-19. Moreover, the pandemic had long-term effects not only on healthcare but also national security on global scale. The COVID-19 drastically changed perception of global health and safety, trust in healthcare professionals as well as patients' willingness to seek medical help. The long-term effect of the epidemic, in terms of its impact cardiovascular disease progression and prognosis remain to be observed. The current paper discusses the impact of COVID-19 on healthcare and national security based on the currently available data.


title: The psychological status of people affected by the COVID-19 outbreak in China

text: OBJECTIVE: An outbreak of 2019 coronavirus disease (COVID-19) occurred in Wuhan (Hubei, China) in December, 2019. Facing this largescale infectious public health event, everyone is under great psychological pressure. The aim was to investigate the psychological status of people affected by the COVID-19 outbreak in China. METHODS: The online cross-sectional study involving 922 participants (656 medical staff and 266 general population) was conducted in China between February and March, 2020. The psychological status was evaluated using the Symptom Check List 90 Revised (SCL-90). Linear and logistic regression analysis were used to examine the effect in the study. RESULTS: Of the 922 participants, approximately 18.3% had psychological health problems. The score of the SCL-90 was significant higher in medical staff (mean = 1.49) than that in general population (mean = 1.36). In addition, the participants enrolled in March were less likely to have psychological health problems than in February (odds ratio = 0.42, 95% confidence interval [CI] = 0.30 to 0.59). Female had a 1.44-fold risk of psychological health problems than male (95% CI = 1.01 to 2.03). CONCLUSIONS: In the study, 18.3% had psychological health problems during the outbreak of COVID-19 epidemic. With the remission of the epidemic, the psychological health status of participants has been improved. Medical staff were likely to have higher SCL-90 scores than general population and female had more psychological problems than male. Our findings can be used to formulate psychological interventions for improving the mental health of vulnerable groups during the COVID-19 epidemic.


Commentary: Evolving understanding of coronavirus disease 2019: Molecular biology, immunology, and surgery


A case of cefditoren-induced acute generalized exanthematous pustulosis during COVID-19 pandemics. Severe cutaneous adverse reactions are an issue


title: Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription PCR (RT-PCR) method has limitations for clinical diagnosis and treatment. METHODS: A total of 323 samples from 76 COVID-19 confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based two target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and urine were collected. Clinical and imaging data were obtained for clinical staging. RESULTS: In 95 samples tested positive by both methods, the cycle threshold (Ct) of RT-PCR was highly correlated with the copy numbed of ddPCR (ORF1ab gene, R2 = 0.83; N gene, R2 = 0.87). 4 (4/161) negative and 41 (41/67) single-gene positive samples tested by RT-PCR were positive according to ddPCR with viral load ranging from 11.1 to 123.2 copies/test. Then the viral load of respiratory samples was compared and the average viral load in sputum (17429 ± 6920 copies/test) was found to be significantly higher than in throat swabs (2552 ± 1965 copies/test, p < 0.001) and nasal swabs (651 ± 501 copies/test, p < 0.001). Furthermore, the viral load in the early and progressive stages were significantly higher than that in the recovery stage (46800 ± 17272 vs 1252 ± 1027, p < 0.001) analyzed by sputum samples. CONCLUSIONS: Quantitative monitoring of viral load in lower respiratory tract samples helps to evaluate disease progression, especially in cases of low viral load.


COVID-19: the current situation in Afghanistan


title: Evaluation of ocular symptoms and tropism of SARS-CoV-2 in patients confirmed with COVID-19

text: PURPOSE: The SARS-CoV-2 RNA has been detected in tears and conjunctival samples from infected individuals. Conjunctivitis is also reported in a small number of cases. We evaluated ocular symptoms and ocular tropism of SARS-CoV-2 in a group of patients with COVID-19. METHOD: Fifty-six patients infected with SARS-CoV-2 were recruited as subjects. Relevant medical histories were obtained from the electronic medical record system. Ocular history and ocular symptoms data were obtained by communicating directly with the subjects. The Ocular Surface Disease Index (OSDI) and Salisbury Eye Evaluation Questionnaire (SEEQ) were used to assess the anterior ocular surface condition before and after the onset of disease. RESULTS: Patients classified as severe COVID-19 cases were more likely to have hypertension compared to mild cases (p = 0.035). Of the 56 subjects, thirteen patients (23%) were infected in Wuhan, 32 patients (57%) were community-infected, 10 patients (18%) were unknown origin, 1 (2%) was a physician likely infected by a confirmed patient. Three patients wore face mask with precaution when contacting the confirmed patients. Fifteen (27%) had aggravated ocular symptoms, of which 6 (11%) had prodromal ocular symptoms before disease onset. The differences in mean scores of OSDI questionnaire and SEEQ between before and after onset of COVID-19 were all significant (p < 0.05 for both). CONCLUSIONS: Ocular symptoms are relatively common in COVID-19 disease and may appear just before the onset of respiratory symptoms. Our data provided the anecdotal evidences of transmission of SARS-CoV-2 via ocular surface.


title: Prediction for the spread of COVID-19 in India and effectiveness of preventive measures

text: The spread of COVID-19 in the whole world has put the humanity at risk. The resources of some of the largest economies are stressed out due to the large infectivity and transmissibility of this disease. Due to the growing magnitude of number of cases and its subsequent stress on the administration and health professionals, some prediction methods would be required to predict the number of cases in future. In this paper, we have used data-driven estimation methods like long short-term memory (LSTM) and curve fitting for prediction of the number of COVID-19 cases in India 30 days ahead and effect of preventive measures like social isolation and lockdown on the spread of COVID-19. The prediction of various parameters (number of positive cases, number of recovered cases, etc.) obtained by the proposed method is accurate within a certain range and will be a beneficial tool for administrators and health officials.


title: Comparison of the Elecsys® Anti-SARS-CoV-2 immunoassay with the EDI™ enzyme linked immunosorbent assays for the detection of SARS-CoV-2 antibodies in human plasma

text: BACKGROUND: Here, we report on a head-to-head comparison of the fully-automated Elecsys® Anti-SARS-CoV-2 immunoassay with the EDITM enzyme linked immunosorbent assays (ELISA) for the detection of SARS-CoV-2 antibodies in human plasma. METHODS: SARS-CoV-2 antibodies were measured with the Elecsys® assay and the EDITM ELISAs (IgM and IgG) in 64 SARS-CoV-2 RT-PCR confirmed COVID-19 patients with serial blood samples (n = 104) collected at different time points from symptom onset. Blood samples from 200 healthy blood donors and 256 intensive care unit (ICU) patients collected before the COVID-19 outbreak were also used. RESULTS: In COVID-19 patients, the percentage of positive results rose with time from symptom onset, peaking to positivity rates after 15-22 days of 100% for the Elecsys® assay, of 94% for the EDITM IgM-ELISA and of 100% for the EDITM IgG ELISA. In the 104 blood samples, the agreement between positive/negative classifications of the Elecsys® assay and the EDITM ELISAs (IgM or IgG) was 90%. The false positivity rates in the healthy blood donors and the ICU patients were < 1% for the Elecsys® assay and < 3% for the EDITM ELISAs. CONCLUSIONS: Our results indicate a high sensitivity and specificity for the Elecsys® assay and an acceptable agreement with the EDITM ELISAs.


title: Stress detection using ECG and EMG signals: A comprehensive study

text: BACKGROUND AND OBJECTIVE: In recent years, stress and mental health have been considered as important worldwide concerns. Stress detection using physiological signals such as electrocardiogram (ECG), skin conductance (SC), electromyogram (EMG) and electroencephalogram (EEG) is a traditional approach. However, the effect of stress on the EMG signal of different muscles and the efficacy of combination of the EMG and other biological signals for stress detection have not been taken into account yet. This paper presents a comprehensive review of the EMG signal of the right and left trapezius and right and left erector spinae muscles for multi-level stress recognition. Also, the ECG signal was employed to evaluate the efficacy of EMG signals for stress detection. METHODS: Both EMG and ECG signals were acquired simultaneously from 34 healthy students (23 females and 11 males, aged 20-37 years). Mental arithmetic, Stroop color-word test, time pressure, and stressful environment were employed to induce stress in the laboratory. RESULTS: The accuracies of stress recognition in two, three and four levels were 100%, 97.6%, and 96.2%, respectively, obtained from the distinct combination of feature selection and machine learning algorithms. CONCLUSIONS: The comparison of stress detection accuracies resulted from EMG and ECG indicators demonstrated the strong ability and the effectiveness of EMG signal for multi-level stress detection.


Starting a biologic therapy in IBD patients amidst COVID-19: hold, careful monitoring or testing?


Human patient simulation: educational issues and practical implications in COVID-19 times


title: SARS-CoV-2: fear versus data

text: SARS-CoV-2, the novel coronavirus from China, is spreading around the world, causing a huge reaction despite its current low incidence outside China and the Far East. Four common coronaviruses are in current circulation and cause millions of cases worldwide. This article compares the incidence and mortality rates of these four common coronaviruses with those of SARS-CoV-2 in Organisation for Economic Co-operation and Development countries. It is concluded that the problem of SARS-CoV-2 is probably being overestimated, as 2.6 million people die of respiratory infections each year compared with less than 4000 deaths for SARS-CoV-2 at the time of writing.


title: Extra-respiratory manifestations of COVID-19

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health threat. Although most patients with COVID-19 manifest fever and respiratory tract symptoms, SARS-CoV-2 infection may also involve other organs/systems and present with extra-respiratory manifestations, including cardiac, gastrointestinal, hepatic, renal, neurological, olfactory, gustatory, ocular, cutaneous and haematological symptoms. Occasionally, these extra-respiratory symptoms/signs represent the initial presentation of SARS-CoV-2 infection, prior to fever or respiratory manifestations. Therefore, this comprehensive review of the extra-respiratory manifestations of COVID-19 is intended to help clinicians better understand the range of clinical presentations associated with SARS-CoV-2 infection, allowing the consideration of COVID-19 in differential diagnoses. A screening test for SARS-CoV-2 should be performed when patients have these extra-respiratory manifestations. In addition, clinicians should be alerted to the adverse effects of anti-SARS-CoV-2 agents that can mimic the extra-respiratory manifestations of COVID-19. Moreover, some extra-respiratory manifestations, such as ocular and gastrointestinal involvement, may be caused by direct invasion of SARS-CoV-2. Therefore, protective measures should be taken while managing the associated clinical specimens. Finally, several extra-respiratory manifestations, such as cardiac involvement, acute kidney injury, coagulation disorders and thrombotic complications, could be associated with a poor prognosis.


Psychological effects of COVID-19 on parenting and maternal-fetal mental health


Rising Concern on Damaged Testis of COVID-19 Patients


Leveraging IR's Adaptability During COVID-19: A Multicenter Single Urban Health System Experience


title: COVID-19 infection and recovery in various countries: Modeling the dynamics and evaluating the non-pharmaceutical mitigation scenarios

text: The coronavirus disease 2019 (COVID-19) pandemic radically impacts our lives, while the transmission/infection and recovery dynamics of COVID-19 remain obscure. A time-dependent Susceptible, Exposed, Infectious, and Recovered (SEIR) model was proposed and applied to fit and then predict the time series of COVID-19 evolution observed in the last three months (till 3/22/2020) in various provinces and metropolises in China. The model results revealed the space dependent transmission/infection rate and the significant spatiotemporal variation in the recovery rate, likely due to the continuous improvement of screening techniques and public hospital systems, as well as full city lockdowns in China. The validated SEIR model was then applied to predict COVID-19 evolution in United States, Italy, Japan, and South Korea which have responded differently to monitoring and mitigating COVID-19 so far, although these predictions contain high uncertainty due to the intrinsic change of the maximum infected population and the infection/recovery rates within the different countries. In addition, a stochastic model based on the random walk particle tracking scheme, analogous to a mixing-limited bimolecular reaction model, was developed to evaluate non-pharmaceutical strategies to mitigate COVID-19 spread. Preliminary tests using the stochastic model showed that self-quarantine may not be as efficient as strict social distancing in slowing COVID-19 spread, if not all of the infected people can be promptly diagnosed and quarantined.


Insight into the relationship between obesity-induced low-level chronic inflammation and COVID-19 infection


title: The Role of the Global Health Development/Eastern Mediterranean Public Health Network and the Eastern Mediterranean Field Epidemiology Training Programs in Preparedness for COVID-19

text: The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR's Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.


title: The COVID-19 Epidemic and the Prison System in Italy

text: The Italian Ministry of Justice and that of Health have established two strategies to limit the spread of COVID-19 in prisons: progressive isolation from the external world and adoption of practices to identify possible cases and to treat infected subjects. After the announcement of regulations revolts erupted in numerous Italian prisons. The motivations and effects of these strategy are discussed critically into the search for a balance between the right to health and other rights of prisoners in Italian prisons with the problem of an occupancy level of 121.75%.


Critical Concerns About 2019 Novel Coronavirus Infection in Pediatric Population


title: Personalized workflow to identify optimal T-cell epitopes for peptide-based vaccines against COVID-19

text: Traditional vaccines against viruses are designed to target their surface proteins, i.e., antigens, which can trigger the immune system to produce specific antibodies to capture and neutralize the viruses. However, viruses often evolve quickly, and their antigens are prone to mutations to avoid recognition by the antibodies (antigenic drift). This limitation of the antibody-mediated immunity could be addressed by the T-cell mediated immunity, which is able to recognize conserved viral HLA peptides presented on virus-infected cells. Thus, by targeting conserved regions on the genome of a virus, T-cell epitope-based vaccines are less subjected to mutations and may work effectively on different strains of the virus. Here we propose a personalized workflow to identify an optimal set of T-cell epitopes based on the HLA alleles and the immunopeptidome of an individual person. Specifically, our workflow trains a machine learning model on the immunopeptidome and then predicts HLA peptides from conserved regions of a virus that are most likely to trigger responses from the person T cells. We applied the workflow to identify T-cell epitopes for the SARS-COV-2 virus, which has caused the recent COVID-19 pandemic in more than 100 countries across the globe.


title: In silico ADMET and molecular docking study on searching potential inhibitors from limonoids and triterpenoids for COVID-19

text: The computational strategies like molecular docking, simulation, in silico ADMET and drug-likeness prediction were adopted to search potential compounds that can inhibit the effects of SARS-CoV-2. Considering the published literatures on medicinal importance, total 154 phytochemicals with analogous structure from limonoids and triterpenoids were selected to search potential inhibitors for the five protein targets of SARS-CoV-2, i.e., 3CLpro (main protease), PLpro (papain like protease), SGp-RBD (spike glycoprotein-receptor binding domain), RdRp (RNA dependent RNA polymerase, ACE2 (angiotensin converting enzyme 2). Analyses of the in silico computational results and reported medicinal uses, the phytochemicals such as 7-deacetyl-7-benzoylgedunin, epoxyazadiradione, limonin, maslinic acid, glycyrrhizic acid and ursolic acid were found to be effective against the target proteins of SARS-CoV-2. The protein-ligand interaction study revealed that these phytochemicals bind at the main active site of the target proteins. Therefore, the core structure of these potential hits can be used for further lead optimization to design drugs for SARS-CoV-2. Also, the plants extracts like neem, tulsi, citrus and olives containing these phytochemicals can be used to formulate suitable therapeutics approaches in traditional medicines.


Integrative considerations during the COVID-19 pandemic


title: Rapid Decline in Online Search Queries for Hip and Knee Arthroplasties Concurrent With the COVID-19 Pandemic

text: BACKGROUND: In response to the coronavirus disease 2019 (COVID-19) pandemic, US hospitals have canceled elective surgeries. This decline in total joint arthroplasty (TJA) revenue may place financial strain on hospitals. Our goal was to quantify the impact of COVID-19 on the public interest in elective TJA. METHODS: The Google Search Volume Index (GSVI) identified the terms "knee replacement," "hip replacement," and "orthopedic surgeon" as the most common to describe TJA. The term "elective surgery cancellation" was also analyzed. Weekly GSVI data were extracted between 04-01-2015 and 04-04-2020. Time series analysis was conducted and state GSVI values were compared with COVID-19 prevalence and unemployment claims. RESULTS: The relative public interest in elective TJA has sharply declined since the WHO declaration of COVID-19 as a global pandemic. Between 03-01-2020 and 03-29-2020, the popularity of searches for "knee replacement", "hip replacement," and "orthopedic surgeon" dropped by 62.1%, 52.1%, and 44.3%, respectively. A concurrent spike was observed for the term "elective surgery cancellation." California, New Hampshire, Maine, and Nevada showed a low relative rate for TJA searches, and the highest increase in unemployment claims. CONCLUSION: The onset of COVID-19 correlates with declining relative popularity of searches related to elective TJA. Higher volume of COVID-19 cases in certain states may correspond with lower relative search popularity, although this correlation remains unclear. These results portend the possibility of a decline in elective TJA case volume, further straining hospitals. Further research is required to inform stakeholders how best to proceed and determine any sustained effects from the current diminished relative interest in TJA. LEVEL OF EVIDENCE: Level III.


Mental health assessment of frontline COVID-19 dermatologists: A Pan-Indian multicentric cross-sectional study


Covid 19: Transcending social distance


Exploring the risk of severe COVID-19 infection in patients with hidradenitis suppurativa


title: Corrigendum: A Multicenter Phase II RCT to Compare the Effectiveness of EMDR Versus TAU in Patients With a First-Episode Psychosis and Psychological Trauma: A Protocol Design

text: [This corrects the article DOI: 10.3389/fpsyt.2019.01023.].


Effectiveness of a COVID-19 screening questionnaire for pregnant women at admission to an obstetric unit in Milan


title: Status of a real-life cohort of patients with moderate-to-severe plaque psoriasis treated with secukinumab and considerations on the use of biological agents in the Covid-19 era

text: INTRODUCTION: In light of the current Covid-19 pandemic and the ongoing, extensive debate about the use of biological agents in psoriatic patients, we felt compelled to relate our experience in the use of secukinumab in the same cohort before and during the lockdown in Italy. Areas covered: Secukinumab was not discontinued, and there were no cases of confirmed infection with SARS-CoV-2 in this cohort. Expert opinion: In our practice, there is no evidence favoring the discontinuation of secukinumab in these patients. We also present a brief commentary on the use of biological agents in patients with moderate-to-severe plaque psoriasis.


title: Comparison of diagnostic accuracies of rapid serological tests and ELISA to molecular diagnostics in patients with suspected coronavirus disease 2019 presenting to the hospital

text: OBJECTIVES: To assess the diagnostic performance of rapid lateral flow immunochromatographic assays (LFAs) compared with an ELISA and nucleic acid amplification tests (NATs) in individuals with suspected coronavirus disease 2019 (COVID-19). METHODS: Patients presenting to a Dutch teaching hospital were eligible between 17 March and 10 April 2020, when they had respiratory symptoms that were suspected for COVID-19. The performances of six different LFAs were evaluated in plasma samples obtained on corresponding respiratory sample dates of NATs testing. Subsequently, the best performing LFA was evaluated in 228 patients and in 50 sera of a historical patient control group. RESULTS: In the pilot analysis, sensitivity characteristics of LFA were heterogeneous, ranging from 2/20 (10%; 95% CI 0%-23%) to 11/20 (55%; 95% CI 33%-77%). In the total cohort, Orient Gene Biotech COVID-19 IgG/IgM Rapid Test LFA had a sensitivity of 43/99 (43%; 95% CI 34%-53%) and specificity of 126/129 (98%; 95% CI 95%-100%). Sensitivity increased to 31/52 (60%; 95% CI 46%-73%) in patients with at least 7 days of symptoms, and to 21/33 (64%; 95% CI 47%-80%) in patients with C-reactive protein (CRP) ≥100 mg/L. Sensitivity and specificity of Wantai SARS-CoV-2 Ab ELISA was 59/95 (62%; 95% CI 52%-72%) and 125/128 (98%; 95% CI 95%-100%) in all patients, respectively, but sensitivity increased to 38/48 (79%; 95% CI 68%-91%) in patients with at least 7 days of symptoms. CONCLUSIONS: There is large variability in diagnostic test performance between rapid LFAs, but overall limited sensitivity and high specificity in acutely admitted patients. Sensitivity improved in patients with longer existing symptoms or high CRP. LFAs should only be considered as additional triage tools when these may lead to the improvement of hospital logistics.


Summarizing societal guidelines regarding bronchoscopy during the COVID-19 pandemic


title: Containing 2019-nCoV (Wuhan) coronavirus

text: The novel coronavirus 2019-nCoV first appeared in December 2019 in Wuhan, China. While most of the initial cases were linked to the Huanan Seafood Wholesale Market, person-to-person transmission has been verified. Given that a vaccine cannot be developed and deployed for at least a year, preventing further transmission relies upon standard principles of containment, two of which are the isolation of known cases and the quarantine of persons believed at high risk of exposure. This note presents probability models for assessing the effectiveness of case isolation and quarantine within a community during the initial phase of an outbreak with illustrations based on early observations from Wuhan.


title: Epidemiology of bacteria and viruses in the respiratory tract of humans and domestic pigs

text: Bacteria and viruses were analysed in the upper respiratory tract of symptomatic pig farmers and their domestic pigs. Eighty six human nasal and 495 (50 pools) porcine snout swabs were collected in Schleswig-Holstein, Germany. Staphylococcus (S.) aureus (62.8%, 54/86), human rhino- and coronaviruses (HRV, 29.1%, 25/86; HCoV, 16.3%, 14/86) were frequently detected in humans, while Haemophilus parasuis (90.0%, 45/50), Mycoplasma hyorhinis (78.6%, 11/14), Enterovirus G (EV-G, 56.0%, 28/50) and S. aureus (36.0%, 18/50), respectively, were highly prevalent in pigs. The detection of S. aureus in human follow-up samples indicates a carrier status. The methicillin-resistant phenotype (MRSA) was identified in 33.3% (18/54) of nasal swabs and in one of 18 (5.6%) pooled snout swabs that were tested positive for S. aureus. Strains were indicative of the livestock-associated clonal complex CC398, with t011 being the most common staphylococcal protein A type. Enterobacterales and non-fermenters were frequently isolated from swabs. Their detection in follow-up samples suggests a carrier status. All were classified as being non-multiresistant. There was no example for cross-species transmission of viruses. In contrast, transmission of S. aureus through occupational contact to pigs seems possible. The study contributes to the 'One Health' approach.


[Prevention and control program on 2019 novel coronavirus infection in Children's digestive endoscopy center]


title: COVID-19: Special Precautions in Ophthalmic Practice and FAQs on Personal Protection and Mask Selection

text: The Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory coronavirus-2, was first reported in December 2019. The World Health Organization declared COVID-19 a pandemic on March 11, 2020 and as of April 17, 2020, 210 countries are affected with >2,000,000 infected and 140,000 deaths. The estimated case fatality rate is around 6.7%. We need to step up our infection control measures immediately or else it may be too late to contain or control the spread of COVID-19. In case of local outbreaks, the risk of infection to healthcare workers and patients is high. Ophthalmic practice carries some unique risks and therefore high vigilance and special precautions are needed. We share our protocols and experiences in the prevention of infection in the current COVID-19 outbreak and the previous severe acute respiratory syndrome epidemic in Hong Kong. We also endeavor to answer the key frequently asked questions in areas of the coronaviruses, COVID-19, disease transmission, personal protection, mask selection, and special measures in ophthalmic practices. COVID-19 is highly infectious and could be life-threatening. Using our protocol and measures, we have achieved zero infection in our ophthalmic practices in Hong Kong and China. Preventing spread of COVID-19 is possible and achievable.


Fear of disease progression and psychological stress in cancer patients under the outbreak of COVID-19


Five severe COVID-19 pneumonia patients treated with triple combination therapy with lopinavir/ritonavir, hydroxychloroquine, and interferon ß-1b


title: Contact tracing for COVID-19: An opportunity to reduce health disparities and End the HIV/AIDS Epidemic in the US

text: SARS-CoV2 testing and contact tracing have been proposed as critical components of a safe and effective COVID-19 public health strategy. We argue that COVID-19 contact tracing may provide a unique opportunity to also conduct widespread HIV testing, among other health promotion activities.


Epidemic psychiatry: The opportunities and challenges of COVID-19


Introducing the Zoom interview: tips for job hunting during the coronavirus pandemic


title: Four point-of-care lateral flow immunoassays for diagnosis of COVID-19 and for assessing dynamics of antibody responses to SARS-CoV-2

text: OBJECTIVES: We aimed to evaluate the role of rapid serological tests in the management of coronavirus disease 2019 (COVID-19) patients. METHODS: This retrospective study enrolled 16 real-time reverse transcription polymerase chain reaction-confirmed symptomatic patients with COVID-19 and 58 COVID-19 negative patients at a medical center in Taiwan over a 3-month period. Serial serum samples were collected and tested for antibody response using four point-of-care (POC) lateral flow immunoassays (LFIA) (ALLTEST 2019-nCoV IgG/IgM Rapid Test, Dynamiker 2019-nCoV IgG/IgM Rapid Test, ASK COVID-19 IgG/IgM Rapid Test, and Wondfo SARS-CoV-2 Antibody Test). Time-dependent detection sensitivity and timeliness of seroconversion were determined and compared between the four POC rapid tests. RESULTS: The overall sensitivity and specificity of the four tests for detecting anti-SARS-CoV-2 antibodies after 3 weeks of symptom onset were 100% and 100%, respectively. There was no significant difference between the rapid tests used for detection of IgM and IgG separately and those used for detection of combined total antibody (mainly IgM/IgG). There was no significant difference between the four POC rapid tests in terms of time required for determining seroconversion of COVID-19. Patients with COVID-19 with pneumonia demonstrated shorter seroconversion time than those without pneumonia. CONCLUSION: Though the POC antibody rapid tests based on LFIA showed reliable performance in the detection of SARS-CoV-2-specific antibodies, the results of these tests should be interpreted and applied appropriately in the context of antibody dynamic of COVID-19 infection. COVID-19 patients complicated with pneumonia exhibited earlier anti-SARS-CoV-2 antibody response than COVID-19 patients without pneumonia.


Pregnant women's knowledge and practice of preventive measures against COVID-19 in a low-resource African setting


title: The prevention and management of the coronavirus disease 2019 (COVID-19) outbreak in radiology departments in epidemic areas

text: This review based on the actual results of epidemic prevention management in radiology departments in epidemic areas, and using designated hospital management methods, to summarize the radiology protection system. With the cooperation of the whole hospital and radiology department, a number of effective evaluation methods have been carried out to ensure the optimization of clinical protection. These practical methods provide a basis for the further promotion of management strategies and reduction of nosocomial infection. To our knowledge, the establishment of standardized protection and clear process has opened up a new idea of epidemic prevention management, which can effectively provide timely, efficient, and accurate support for clinical research, and promote the transformation from clinical research type to scientific research management type.


title: Olfactory Detection Thresholds for Primary Aliphatic Alcohols in Mice

text: Probing the neural mechanisms that underlie each sensory system requires the presentation of perceptually appropriate stimulus concentrations. This is particularly relevant in the olfactory system as additional odorant receptors typically respond with increasing stimulus concentrations. Thus, perceptual measures of olfactory sensitivity provide an important guide for functional experiments. This study focuses on aliphatic alcohols because they are commonly used to survey neural activity in a variety of olfactory regions, probe the behavioral limits of odor discrimination and assess odor-structure activity relationships in mice. However, despite their frequent use, a systematic study of the relative sensitivity of these odorants in mice is not available. Thus, we assayed the ability of C57BL/6J mice to detect a homologous series of primary aliphatic alcohols (1-propanol to 1-heptanol) using a head-fixed Go / No-Go operant conditioning assay combined with highly reproducible stimulus delivery. To aid in the accessibility of our data, we report the animal's threshold to each odorant according to the 1) ideal gas condition, 2) non-ideal gas condition (factoring in the activity of the odorant in the solvent), and 3) the liquid dilution of the odorant in the olfactometer. Of the odorants tested, mice were most sensitive to 1-hexanol and least sensitive to 1-butanol. These updated measures of murine sensitivity will hopefully guide experimenters in choosing appropriate stimulus concentrations for experiments using these odorants.


title: Delayed diagnosis of paediatric appendicitis during the COVID-19 pandemic

text: AIM: To present seven paediatric patients with appendicitis, all with late diagnosis resulting from different aspects of the fear from the current global COVID-19 pandemic. METHODS: Cases were collected from three paediatric surgical wards. Comparison between complicated appendicitis rates in the COVID-19 era and similar period in previous year was performed. RESULTS: All seven children presented with complicated appendicitis. Main reasons for the delayed diagnosis during the COVID-19 era were parental concern, telemedicine use and insufficient evaluation. Higher complication rates were found during the COVID-19 era compared to similar period in previous year (22% vs 11%, P-value .06). CONCLUSION: The fear from COVID-19 pandemic may result in delayed diagnosis and higher complication rates in common paediatric medical conditions. We believe caregivers and healthcare providers should not withhold necessary medical care since delay in diagnosis and treatment in these routinely seen medical emergencies may become as big of a threat as COVID-19 itself.


Audio Interview: Finding Reliable Information about Covid-19


title: The experience on coronavirus disease 2019 and cancer from an oncology hub institution in Milan, Lombardy Region

text: The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (coronavirus disease 2019 [COVID-19]) has spread rapidly to a pandemic proportion, increasing the demands on health systems for the containment and management of COVID-19. Cancer has been reported as a major risk factor for adverse outcomes of and death from COVID-19. We extracted data from the World Health Organization's progress reports and from the Italian Council of Medicine. In addition, we retrieved clinical data on patients with cancer and with confirmed COVID-19 in our institution. As of 2nd April 2020, 110,574 COVID-19 cases and 13,157 deaths have been reported in Italy, representing a global share of 5.1% and 28.9% for incidence and mortality, respectively. In Italy, we report the analysis of the Italian Medical Council on 909 patients who died from COVID-19; of whom, 16.5% were patients with cancer. The population was enriched with subjects with multiple comorbid non-communicable diseases, with less than 1% of the population presenting no comorbid conditions. At the patient level, we identified nine patients referred to our department in the last two months who were receiving standard-of-care or experimental medications in the curative and palliative settings. The median age was 68 years (range = 42-79 years), and patients carried a median of one comorbid condition (0-2); two of nine patients presented with severe COVID-19 and were receiving inpatient care. None of the patients receiving immunotherapy experienced severe adverse outcomes, and four patients were discharged with complete reversal of the clinical syndrome and SARS-CoV-2 clearance. Learning from the experience of countries with a high burden, efforts must be made to assure the access of patients with cancer to treatments, prioritising the cancer health interventions based on their intrinsic value and limiting the exposure to an unacceptable risk of infection for both health providers and patients. Any significant work in the design and implementation of health system actions, including clinical care, must be framed as an initiative under the global response agenda and through a community approach, with the intention of pursuing common goals to tackle COVID-19 and cancer, as 'One Community' working for 'One Health's.


title: Modelling remote epidemic transmission in Western Australia and implications for pandemic response

text: We develop an agent-based model of disease transmission in remote communities in Western Australia. Despite extreme isolation, we show that the movement of people amongst a large number of small but isolated communities has the effect of causing transmission to spread quickly. Significant movement between remote communities, and regional and urban centres allows for infection to quickly spread to and then among these remote communities. Our conclusions are based on two characteristic features of remote communities in Western Australia: (1) high mobility of people amongst these communities, and (2) relatively high proportion of travellers from very small communities to major population centres. In models of infection initiated in the state capital, Perth, these remote communities are collectively and uniquely vulnerable. Our model and analysis does not account for possibly heightened impact due to preexisting conditions, such additional assumptions would only make the projections of this model more dire. We advocate stringent monitoring and control of movement to prevent significant impact on the indigenous population of Western Australia.


title: Asthma increases risk of severity of COVID-19

text: Current Centers for Disease Control and Prevention guidelines state that patients with moderate to severe asthma may be at greater risk for more severe disease if infected with SARS-CoV-2; however, no published data support this suggestion. During this pandemic, it is recommended that patients with asthma continue taking all controller inhalers and other asthma medication as prescribed to prevent exacerbations and limit outpatient clinic and emergency room exposure. Symptoms that may differentiate COVID-19 from asthma exacerbations caused by another trigger may include fever, fatigue, anorexia, or myalgias. Patients with suspected or confirmed COVID-19 should avoid nebulizer treatments due to the risk of aerosolization.


title: Cardiothoracic robotic assisted surgery in times of COVID-19

text: The coronavirus disease 2019 (COVID-19) pandemic poses an immense threat to healthcare systems worldwide. At a time when elective surgeries are being suspended and questions are being raised about how the remaining procedures on COVID-19 positive patients can be performed safely, it is important to consider the potential role of robotic assisted surgery within the current pandemic. Recently, several robotic assisted surgery societies have issued their recommendations. To date, however, no specific recommendations are available for cardiothoracic robotic assisted surgery in COVID-19 positive patients. Here, we discuss the potential risks, benefits, and preventive measures that need to be taken into account when considering robotic assisted surgery for cardiothoracic indications in patients with confirmed COVID-19. It is suggested that robotic assisted surgery might have various advantages such as early recovery after surgery, shorter hospital stay, and reduced loss of blood and fluids as well as smaller incisions. However, electrosurgical and ultrasonic devices, as well as CO2 insufflation should be managed with caution to prevent the risk of aerosolization of viral particles.


Retiform purpura as a dermatological sign of coronavirus disease 2019 (COVID-19) coagulopathy


title: [De-escalation urology measures. COVID-19 pandemia stepwise recommendations.]

text: El nuevo coronavirus tipo 2 (SARS-CoV-2)del sindrome respiratorio agudo grave y la enfermedadque produce, enfermedad por coronavirus2019 (COVID-19) fueron descritos por primera vezen la ciudad China de Wuhan en Diciembre de2019 (1) En Marzo de 2020, la dispersion mundialde este nuevo patogeno, condujo a la declaracionde pandemia por parte de la Organizacion Mundialde la Salud (OMS) (2)


title: De-escalation urology measures. COVID-19 pandemia stepwise recommendations./ La desescalada en urologia. Recomendaciones de actuacion en pandemia COVID-19

text: El nuevo coronavirus tipo 2 (SARS-CoV-2)del sindrome respiratorio agudo grave y la enfermedadque produce, enfermedad por coronavirus2019 (COVID-19) fueron descritos por primera vezen la ciudad China de Wuhan en Diciembre de2019 (1) En Marzo de 2020, la dispersion mundialde este nuevo patogeno, condujo a la declaracionde pandemia por parte de la Organizacion Mundialde la Salud (OMS) (2) El nuevo coronavirus tipo 2 (SARS-CoV-2) del sindrome respiratorio agudo grave y la enfermedadq ue produce, enfermedad por coronavirus 2019 (COVID-19) fueron descritos por primera vez en la ciudad China de Wuhan en Diciembre de 2019 (1) En Marzo de 2020, la dispersion mundial de este nuevo patogeno, condujo a la declaracion de pandemia por parte de la Organizacion Mundial de la Salud (OMS) (2)


title: The development and initial tests for the psychometric properties of the COVID-19 Phobia Scale (C19P-S)

text: Researchers predict that the negative effects of the 2019 novel coronavirus (COVID-19) pandemic will continue to increase. These negative effects are not solely limited to psycho-pathological problems. Serious physiological, social, and economical difficulties due to COVID-19 have already been observed in various nations. In this study, we suggest a new type of specific phobia, which may be categorized under DSM-V 300.29. The current study developed a self-report instrument whose items address the specific phobia diagnosis criteria of the DSM-V and tested its initial psychometric properties. Results show that the scale has initial evidence of construct, convergent, and discriminant validity, and internal consistency reliability. It should be further tested; however, the COVID-19 Phobia Scale (C19P-S) items provide support for assessing the levels of phobia reactions among a wide range of age groups.


title: Bayesian adjustment for preferential testing in estimating the COVID-19 infection fatality rate: Theory and methods

text: A key challenge in estimating the infection fatality rate (IFR) of COVID-19 is determining the total number of cases. The total number of cases is not known because not everyone is tested but also, more importantly, because tested individuals are not representative of the population at large. We refer to the phenomenon whereby infected individuals are more likely to be tested than non-infected individuals, as"preferential testing."An open question is whether or not it is possible to reliably estimate the IFR without any specific knowledge about the degree to which the data are biased by preferential testing. In this paper we take a partial identifiability approach, formulating clearly where deliberate prior assumptions can be made and presenting a Bayesian model, which pools information from different samples. Results suggest that when limited knowledge is available about the magnitude of preferential testing, reliable estimation of the IFR is still possible so long as there is sufficient"heterogeneity of bias"across samples.


title: Psychosocial impact of COVID-19

text: BACKGROUND: Along with its high infectivity and fatality rates, the 2019 Corona Virus Disease (COVID-19) has caused universal psychosocial impact by causing mass hysteria, economic burden and financial losses. Mass fear of COVID-19, termed as "coronaphobia", has generated a plethora of psychiatric manifestations across the different strata of the society. So, this review has been undertaken to define psychosocial impact of COVID-19. METHODS: Pubmed and GoogleScholar are searched with the following key terms- "COVID-19", "SARS-CoV2", "Pandemic", "Psychology", "Psychosocial", "Psychitry", "marginalized", "telemedicine", "mental health", "quarantine", "infodemic", "social media" and" "internet". Few news paper reports related to COVID-19 and psychosocial impacts have also been added as per context. RESULTS: Disease itself multiplied by forced quarantine to combat COVID-19 applied by nationwide lockdowns can produce acute panic, anxiety, obsessive behaviors, hoarding, paranoia, and depression, and post-traumatic stress disorder (PTSD) in the long run. These have been fueled by an "infodemic" spread via different platforms of social media. Outbursts of racism, stigmatization, and xenophobia against particular communities are also being widely reported. Nevertheless, frontline healthcare workers are at higher-risk of contracting the disease as well as experiencing adverse psychological outcomes in form of burnout, anxiety, fear of transmitting infection, feeling of incompatibility, depression, increased substance-dependence, and PTSD. Community-based mitigation programs to combat COVID-19 will disrupt children's usual lifestyle and may cause florid mental distress. The psychosocial aspects of older people, their caregivers, psychiatric patients and marginalized communities are affected by this pandemic in different ways and need special attention. CONCLUSION: For better dealing with these psychosocial issues of different strata of the society, psychosocial crisis prevention and intervention models should be urgently developed by the government, health care personnel and other stakeholders. Apt application of internet services, technology and social media to curb both pandemic and infodemic needs to be instigated. Psychosocial preparedness by setting up mental organizations specific for future pandemics is certainly necessary.


The Global Spine Community and COVID-19: Divided or United?


title: IgA-Ab response to spike glycoprotein of SARS-CoV-2 in patients with COVID-19: A longitudinal study

text: Validation studies of serological antibody tests must be properly designed for clinical, epidemiological and Public Health objectives such as confirmation of suspected COVID-19 cases, certification of seroconversion after infection, and epidemiological surveillance. We evaluated the kinetics of IgM, IgA and IgG SARS-CoV-2 antibodies in COVID-19 patients with confirmed (rRT-PCR) infection. We found that the IgA response appears and grows early, peaks at week 3, and it is stronger and more persistent than the IgM response. Further longitudinal investigations of virus-specific antibodies functions and of their protective efficacy over time are needed.


COVID 19 et cancer : quelles sont les conséquences de la réorganisation des soins oncologiques ?/ [COVID 19 and cancer: What are the consequences of the cancer care reorganization?]


title: Digital Herd Immunity and COVID-19

text: A population can be immune to epidemics even if not all of its individual members are immune to the disease, just as long as sufficiently many are immune - this is the traditional notion of herd immunity. In the smartphone era a population can be immune to epidemics even if not a single one of its members is immune to the disease - a notion we propose to call"digital herd immunity", which is similarly an emergent characteristic of the population. This immunity arises because contact-tracing protocols based on smartphone capabilities can lead to highly efficient quarantining of infected population members and thus the extinguishing of nascent epidemics. When the disease characteristics are favorable and smartphone usage is high enough, the population is in this immune phase. As usage decreases there is a novel"contact tracing"phase transition to an epidemic phase. We present and study a simple branching-process model for COVID-19 and show that digital immunity is possible regardless of the proportion of non-symptomatic transmission. We believe this is a promising strategy for dealing with COVID-19 in many countries such as India, whose challenges of scale motivated us to undertake this study.


title: ACE2 and TMPRSS2 variants and expression as candidates to sex and country differences in COVID-19 severity in Italy Orthopaedic Guidelines for the COVID-19 Post-Outbreak Period: Experience from Wuhan, People's Republic of China

text: As the outbreak of coronavirus disease 2019 (COVID-19) progresses, prognostic markers for early identification of high-risk individuals are an urgent medical need Italy has one of the highest numbers of SARS-CoV-2-related deaths and one of the highest mortality rates Worldwide, a more severe course of COVID-19 is associated with older age, comorbidities, and male sex Hence, we searched for possible genetic components of COVID-19 severity among Italians by looking at expression levels and variants in ACE2 and TMPRSS2 genes, crucial for viral infection Exome and SNP-array data from a large Italian cohort were used to compare the rare-variants burden and polymorphisms frequency with Europeans and East Asians Moreover, we looked into gene expression databases to check for sex-unbalanced expression While we found no significant evidence that ACE2 is associated with disease severity/sex bias, TMPRSS2 levels and genetic variants proved to be possible candidate disease modulators, prompting for rapid experimental validations on large patient cohorts Currently, the coronavirus disease 2019 (COVID-19) crisis has rapidly spread worldwide As the earliest outbreak area of the pandemic, Wuhan, People's Republic of China, is gradually recovering to its normal state under the effective control of government authorities Outpatient services in major hospitals are now being restored An accumulation of asymptomatic infections is a potential risk for medical personnel, especially when there is crowding in hospitals As the biggest center for orthopaedic patients in Wuhan, our orthopaedic outpatient department admits >300 patients per day Optimal guidelines on how to handle this huge number of patients during the post-outbreak stage of the COVID-19 pandemic, particularly with regard to potential asymptomatic infection, are urgently needed for orthopaedic surgeons We have developed and proposed applicable guidelines to fill this knowledge gap, including the necessary protective strategies for medical personnel in orthopaedic outpatient and inpatient wards as well as during surgery We also have provided mental health recommendations for health-care workers To the best of our knowledge, these guidelines are the first of their kind for orthopaedic surgeons who are slowly reestablishing medical activity following the pandemic


Rash maculopapuloso como manifestación inicial de infección por SARS-coronavirus-2./ Rash maculopapuloso como manifestación inicial de infección por SARS-coronavirus-2./ Maculopapular rash as initial manifestation of SRAS-coronavirus-2 infection


Responding to COVID-19: The experience from Italy and recommendations for management and prevention


A Need for Data-driven Public Health Responses to COVID-19


Candidate rheumatologic treatments for COVID-19. Response to: 'COVID-19 infection in a patient with FMF: does colchicine have a protective effect?' by Kobak


Covid-19: GPs have a fortnight to start organising weekly care home reviews, says NHS


Concerns in Redirecting Uro-oncologic Patients During COVID-19 Pandemic


title: Thromboprophylaxis in a patient with COVID-19 and severe hemophilia A on emicizumab prophylaxis

text: COVID-19 can be associated with coagulopathy (CAC, COVID-19-associated coagulopathy) with a high prothrombotic risk based on an intense inflammatory response to viral infection leading to immunothrombosis through different procoagulant pathways. Emerging evidence suggests that the use of heparin in these patients could be associated with lower mortality. Emicizumab is a bispecific humanized monoclonal antibody that bridges activated factor IX and factor X, thereby restoring the function of missing factor VIIIa in hemophilia A. The use of emicizumab has been associated with thrombotic events in patients who also received high cumulative amounts of activated prothrombin complex concentrates. Although this risk is extremely low, there is a lack of evidence on whether CAC increases the thrombotic risk in patients on emicizumab prophylaxis. We present the case of a patient with severe hemophilia A in prophylaxis treatment with emicizumab; due to the potential thrombotic risk we decided to administer low molecular weight heparin as prophylaxis treatment without any thrombotic or bleeding complications.


title: COVID 19-Depression and Neurosurgeons

text: OBJECTIVE: The goal of this survey was to determine factors associated with anxiety/depression among neurosurgeons during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: An online survey was performed of neurosurgeons worldwide, conducted over 3 weeks. Depression in neurosurgeons was assessed by Self-Reporting Questionnaire-20. RESULTS: A total of 375 responses were received from 52 countries. Among all neurosurgeons, 34% felt tense, 32.5% were unhappy, 25% experienced insomnia, almost 20% had headaches, and 5% had suicidal ideation during the pandemic. Of participants, 14% had a score on Self-Reporting Questionnaire-20 consistent with depression. The likelihood of depression was significantly higher among those who did not receive guidance about self-protection from their institutions (odds ratio [OR], 2.47), those who did not feel safe with provided personal protective equipments (OR, 3.13), and those whose families considered their workplace unsafe (OR, 2.29). Depression was less likely in neurosurgeons who had minor concerns, compared with those with significant health concerns for their families (OR, 0.36). In multivariate analysis after controlling for effects of other covariates, odds of depression were significantly higher among neurosurgeons who did not feel safe with the provided personal protective equipment (OR, 2.43) and who were exposed to a COVID-19-positive colleague (OR, 2.54). Participants who had moderate concerns for their families had lesser odds of anxiety/depression than did those with significant concerns (OR, 0.28). CONCLUSIONS: Based on the modifiable risk factors of depression in this study, it is recommended that the safety of neurosurgeons be ensured by providing appropriate safety measures for them to regain their confidence and hence reduce the incidence of depression.


Oral manifestations in coronavirus disease 2019 (COVID-19)


Correlation analysis of the severity and clinical prognosis of 32 cases of patients with COVID-19


Acute Myocardial Injury at Hospital Admission Is Associated With All-Cause Mortality in COVID-19


Acute Myocardial Injury at Hospital Admission is Associated with All-cause Mortality in COVID-19


title: Olfactory Dysfunction and Sinonasal Symptomatology in COVID-19: Prevalence, Severity, Timing, and Associated Characteristics

text: OBJECTIVE: Olfactory dysfunction (OD)-hyposmia or anosmia-is a symptom of coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We sought to better determine prevalence, severity, and timing of OD in COVID-19 relative to other sinonasal and pulmonary symptoms. STUDY DESIGN: Prospective, cross-sectional. SETTING: Regional/cantonal hospital. SUBJECTS: In total, 103 patients diagnosed with COVID-19 with reverse transcription polymerase chain reaction (RT-PCR)-based testing. METHODS: All patients testing positive for COVID-19 at Kantonsspital Aarau over a 6-week period were approached. Timing and severity (at its worst, on scale of 0 [none], 1 [mild], 2 [moderate], and 3 [severe]) of OD, loss of taste, nasal obstruction, rhinorrhea/mucus production, fever, cough and shortness of breath (SOB) were assessed for each patient. RESULTS: Prevalence of OD was 61.2%, and severity of OD was strongly correlated with severity of loss of taste experienced (ρ = 0.87, P < .001). OD was experienced on the first day of COVID-19 by 8.7% and overall occurred at median infection day 3 (mean, 3.4; range, 0-12). Most experiencing OD reported anosmia, and mean severity of all with OD was moderate to severe (mean [SD], 2.7 [0.6]). Nasal obstruction (49.5%) and rhinorrhea (35.0%) were frequently reported but not correlated with OD. SOB was more severe in patients with OD. OD was associated negatively with older age (OR, 0.96; 95% CI, 0.93-0.99; P = .007) and positively with female sex (OR, 2.46; 95% CI, 0.98-6.19; P = .056). CONCLUSIONS: OD is highly prevalent during COVID-19, occurring early and severely, often in conjunction with loss of taste. OD is associated negatively with older age and positively with female sex. Patients with OD may also experience more severe SOB.


title: COVID-19 and the cardiovascular system: A review of current data, summary of best practices, outline of controversies, and illustrative case reports

text: As the severe acute respiratory syndrome coronavirus 2 virus pandemic continues to grow globally, an association is apparent between patients with underlying cardiovascular disease comorbidities and the risk of developing severe COVID-19. Furthermore, there are potential cardiac manifestations of severe acute respiratory syndrome coronavirus 2 including myocyte injury, ventricular dysfunction, coagulopathy, and electrophysiologic abnormalities. Balancing management of the infection and treatment of underlying cardiovascular disease requires further study. Addressing the increasing reports of health care worker exposure and deaths remains paramount. This review summarizes the most contemporary literature on the relationship of the cardiovascular system and COVID-19 and society statements with relevance to protection of health care workers, and provides illustrative case reports in this context.


Lack of Efficacy of SGLT2-i in Severe Pneumonia Related to Novel Coronavirus (nCoV) Infection: No Little Help from Our Friends


title: TREC-COVID: Constructing a Pandemic Information Retrieval Test Collection

text: TREC-COVID is a community evaluation designed to build a test collection that captures the information needs of biomedical researchers using the scientific literature during a pandemic. One of the key characteristics of pandemic search is the accelerated rate of change: the topics of interest evolve as the pandemic progresses and the scientific literature in the area explodes. The COVID-19 pandemic provides an opportunity to capture this progression as it happens. TREC-COVID, in creating a test collection around COVID-19 literature, is building infrastructure to support new research and technologies in pandemic search.


title: Neurological manifestations of patients with COVID-19: potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), has caused a global pandemic in only 3 months. In addition to major respiratory distress, characteristic neurological manifestations are also described, indicating that SARS-CoV-2 may be an underestimated opportunistic pathogen of the brain. Based on previous studies of neuroinvasive human respiratory coronaviruses, it is proposed that after physical contact with the nasal mucosa, laryngopharynx, trachea, lower respiratory tract, alveoli epithelium, or gastrointestinal mucosa, SARS-CoV-2 can induce intrinsic and innate immune responses in the host involving increased cytokine release, tissue damage, and high neurosusceptibility to COVID-19, especially in the hypoxic conditions caused by lung injury. In some immune-compromised individuals, the virus may invade the brain through multiple routes, such as the vasculature and peripheral nerves. Therefore, in addition to drug treatments, such as pharmaceuticals and traditional Chinese medicine, non-pharmaceutical precautions, including facemasks and hand hygiene, are critically important.


title: COVID-19 trials in Italy: A call for simplicity, top standards and global pooling

text: The novel coronavirus disease, affecting ~9 million people in the past five months and causing >460,000 deaths worldwide, is completely new to mankind. More than 2,000 research projects registered at ClinTrials.gov are aiming at finding effective treatments for rapid transfer to clinical practice. Unfortunately, just few studies have a sufficiently valid design to provide reliable information for clinical practice.


Hookah smoking and COVID-19: call for action


title: [Diagnostic efficacy of three test kits for SARS-CoV-2 nucleic acid detection]

text: OBJECTIVE: To compare the diagnostic efficacy among three RT-PCR test kits for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid detection. METHODS: The throat swab samples from 40 hospitalized patients clinically diagnosed as coronavirus disease 2019 (COVID-19) and 16 hospitalized non-COVID-19 patients were recruited. The SARS-CoV-2 nucleic acid was detected in throat swab samples with RT-PCR test kits from Sansure Biotech ("Sansure" for short), Jiangsu Bioperfectus Technologies ("Bioperfectus" for short) and BGI Genomics ("BGI" for short). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Kappa value were analyzed. The viral nucleic acid was extracted from the throat swab samples by one-step cleavage and magnetic bead methods, and the efficacy of two extraction methods was also compared. The results of magnetic bead method for nucleic acid extraction by two different extractors (Sansure Natch CS S12C Fully Automated Nucleic Acid Extraction System vs. Tianlong NP968-C Nucleic Acid Extractor) were also compared. RESULTS: The sensitivity, specificity, PPV, NPV and kappa value were 95.00%, 87.50%, 95.00%, 87.50%and 0.825 for Sansure kit; 90.00%, 87.50%, 94.74%, 77.78%and 0.747 for the Bioperfectus kit, and 82.50%, 81.25%, 91.67%, 65.00%and 0.593 for the BGI kit, respectively. The positive, negative and total coincident rates and kappa value of viral nucleic acid detection results using the samples extracted by one-step cleavage and magnetic bead methods were 95.24%, 100.00%, 96.43%and 0.909, respectively, but the one-step cleavage method took only 25 min, while the magnetic bead method required 180 min. The positive, negative and total coincident rates and kappa value of viral nucleic acid detection results using the samples extracted by the two different nucleic acid extractors were 85.00%, 100.00%, 89.29% and 0.764, respectively. CONCLUSIONS: The detection efficacy for SARS-CoV-2 nucleic acid by the Sansure kit is relatively higher and the one-step cleavage method has advantages of convenient operation and less time consuming.


Letter to the Editor: The Use of Telemedicine by Neurosurgeons During the Covid Era: Preliminary Results of a Cross-Sectional Research


Considerations for Underrepresented in Medicine Dermatology Residency Applicants Amidst the COVID-19 Pandemic


Erythematous-oedematous type of chilblain-like lesions and COVID-19 : an Indian perspective


title: Clinical features of rheumatic patients infected with COVID-19 in Wuhan, China

text: OBJECTIVE: The clinical features of rheumatic patients with coronavirus disease 2019 (COVID-19) have not been reported. This study aimed to describe the clinical features of COVID-19 in rheumatic patients and provide information for handling this situation in clinical practice. METHODS: This is a retrospective case series study. Deidentified data, including gender, age, laboratory and radiological results, symptoms, signs, and medication history, were collected from 2326 patients diagnosed with COVID-19, including 21 cases in combination with rheumatic disease, in Tongji Hospital between 13 January and 15 March 2020. RESULTS: Length of hospital stay and mortality rate were similar between rheumatic and non-rheumatic groups, while the presence of respiratory failure was more common in rheumatic cases (38% vs 10%, p<0.001). Symptoms of fever, fatigue and diarrhoea were seen in 76%, 43% and 23% of patients, respectively. There were four rheumatic patients who experienced a flare of rheumatic disease during hospital stay, with symptoms of muscle aches, back pain, joint pain or rash. While lymphocytopaenia was seen in 57% of rheumatic patients, only one patient (5%) presented with leucopenia in rheumatic cases. Rheumatic patients presented with similar radiological features of ground-glass opacity and consolidation. Patients with pre-existing interstitial lung disease showed massive fibrous stripes and crazy-paving signs at an early stage. Five rheumatic cases used hydroxychloroquine before the diagnosis of COVID-19 and none progressed to critically ill stage. CONCLUSIONS: Respiratory failure was more common in rheumatic patients infected with COVID-19. Differential diagnosis between COVID-19 and a flare of rheumatic disease should be considered. TRIAL REGISTRATION NUMBER: ChiCTR2000030795.


European Association for the Study of Obesity Position Statement on the Global COVID-19 Pandemic


A Lesson from Temporary Closing of a Single University-affiliated Hospital owing to In-Hospital Transmission of Coronavirus Disease 2019


title: Qualitative Analysis of a Mathematical Model in the Time of COVID-19

text: In this article, a qualitative analysis of the mathematical model of novel corona virus named COVID-19 under nonsingular derivative of fractional order is considered. The concerned model is composed of two compartments, namely, healthy and infected. Under the new nonsingular derivative, we, first of all, establish some sufficient conditions for existence and uniqueness of solution to the model under consideration. Because of the dynamics of the phenomenon when described by a mathematical model, its existence must be guaranteed. Therefore, via using the classical fixed point theory, we establish the required results. Also, we present the results of stability of Ulam's type by using the tools of nonlinear analysis. For the semianalytical results, we extend the usual Laplace transform coupled with Adomian decomposition method to obtain the approximate solutions for the corresponding compartments of the considered model. Finally, in order to support our study, graphical interpretations are provided to illustrate the results by using some numerical values for the corresponding parameters of the model.


Pandemic: Psychiatric-Mental Health Nurses Providing Hope in the Midst of Chaos


title: Construction of confidence interval for a univariate stock price signal predicted through Long Short Term Memory Network

text: In this paper, we show an innovative way to construct bootstrap confidence interval of a signal estimated based on a univariate LSTM model. We take three different types of bootstrap methods for dependent set up. We prescribe some useful suggestions to select the optimal block length while performing the bootstrapping of the sample. We also propose a benchmark to compare the confidence interval measured through different bootstrap strategies. We illustrate the experimental results through some stock price data set.


Being African American and Rural: A Double Jeopardy From COVID-19