title: Insight into COVID-2019 for pediatricians

text: Since December 2019, patients with unexplained pneumonia have been found in Wuhan City, Hubei Province, China. The pathogen in these cases is a new type of coronavirus. The World Health Organization confirmed this diagnosis and named the pathogen SARSCoV-2. The disease caused by SARSCoV-2 is called Corona Virus Disease (COVID-2019). The virus is highly infectious and pathogenic, causing human-to-human transmission. At present, SARSCoV-2 is still rampant in the world. Zhengzhou City in Henan Province serves as an example, 102 people have been confirmed to be infected with SARSCoV-2 (at 24:00 on February 5th, 2020), including three children, the youngest is 4 years old. From the perspective of clinical pediatricians as the first line fighting the epidemic, this paper will discuss the clinical characteristics, prevention and control measures, outcomes, diagnosis, and treatment of pediatric cases.


title: The Potential for Remotely Mentored Patient-Performed Home Self-Monitoring for New Onset Alveolar-Interstitial Lung Disease

text: Purpose: Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is an acute respiratory illness. Although most infected persons are asymptomatic or have only mild symptoms, some patients progress to devastating disease; such progression is difficult to predict or identify in a timely manner. COVID-19 patients who do not require hospitalization can self-isolate at home. Calls from one disease epicenter identify the need for homebased isolation with telemedicine surveillance to monitor for impending deterioration. Methodology: Although the dominant approach for these asymptomatic/paucisymptomatic patients is to monitor oxygen saturation, we suggest additionally considering the potential merits and utility of home-based imaging. Chest computed tomography is clearly impractical, but ultrasound has shown comparable sensitivity for lung involvement, with major advantages of short and simple procedures, low cost, and excellent repeatability. Thoracic ultrasound may thus allow remotely identifying the development of pneumonitis at an early stage of illness and potentially averting the risk of insidious deterioration to severe pneumonia and critical illness while in home isolation. Conclusions: Lung sonography can be easily performed by motivated nonmedical caregivers when directed and supervised in real time by experts. Remote mentors could thus efficiently monitor, counsel, and triage multiple home-based patients from their "control center." Authors believe that this approach deserves further attention and study to reduce delays and failures in timely hospitalization of home-isolated patients.


title: Assessing the anxiety level of Iranian general population during COVID-19 outbreak

text: This study is aimed to assess the anxiety level of Iranian general population during COVID-19 outbreak. The online questionnaire surveyed 10,754 individuals from the general population of 31 provinces of Iran who completed the questionnaire on social networks from March 1 to March 9, 2020. The inferential statistics suggests that the level of anxiety was higher among women (95 % CI [0.1, 81.36], pâ¯<â¯0.001), people who more followed corona-related news (pâ¯<â¯0.001) and the age group of 21-40 years (pâ¯<â¯0.001). Ultimately, the level of anxiety was significantly higher among people who had at least one family member, relative, or friend who contracted COVID-19 disease (95 % CI [1.2, 35.03], pâ¯<â¯0.001). The health care system should adopt a package of psychosocial interventions to reduce the anxiety of high risk groups.


SARS-CoV-2 RNA Detection in Gastrointestinal Sample Displays Poor Performance


Endoscopy during the COVID-19 pandemic: simple construction of a single-use, disposable face shield using inexpensive and readily available materials


title: SARS, MERS and SARS-CoV-2 (COVID-19) treatment: a patent review

text: INTRODUCTION: Coronavirus has been responsible for several virus outbreaks since 2003, caused by SARS-CoV-1, MERS-CoV, and currently SARS-CoV-2 (COVID-19), the causative agent of coronavirus disease in 2019. COVID-19 has become a global public health emergency because of its high virulence and mortality capacity. This patent review aims to provide an overview of the patents that present possible treatments for SARS-CoV-1, SARS-CoV-2 and MERS-CoV. AREAS COVERED: To treat SARS, MERS and SARS-CoV-2, researchers have filed patents for a number of therapeutic agents. Most of the treatments found were protease inhibitors aimed at proteases such as PLpro, 3 CLpro, RNA helicase, and Spike protein, or used monoclonal antibodies and interferons. In addition, the use of Chinese folk medicine and its multitude of medicinal plants with strong antiviral properties was reinforced. Thus, these therapies used in previous epidemics can serve as an aid in the new pandemic by SARS-CoV-2 and be a starting point for new treatments. EXPERT OPINION: The various antiviral alternatives presented in this review offer therapeutic options to fight coronavirus infections. If shown to be effective, these drugs may be extremely important in the current pandemic.


title: Two cases of coronavirus 2019-related cardiomyopathy in pregnancy

text: At our institution, 2 of the initial 7 pregnant patients with confirmed coronavirus disease 2019 severe infection (28.6%; 95% CI, 8.2%-64.1%) developed cardiac dysfunction with moderately reduced left ventricular ejection fractions of 40%-45% and hypokinesis. Viral myocarditis and cardiomyopathy have also been reported in nonpregnant coronavirus disease 2019 patients. A case series of nonpregnant patients with coronavirus disease 2019 found that 33% of those in intensive care developed cardiomyopathy. More data are needed to ascertain the incidence of cardiomyopathy from coronavirus disease 2019 in pregnancy, in all pregnant women with coronavirus disease 2019, and those with severe disease (eg, pneumonia). We suggest an echocardiogram in pregnant women with coronavirus disease 2019 pneumonia, in particular those necessitating oxygen, or those who are critically ill, and we recommend the use of handheld, point-of-care devices where possible to minimize contamination of staff and traditional large echocardiogram machines.


Puzzle of highly pathogenic human coronaviruses (2019-nCoV)


Mexican Human Leukocyte Antigen Alleles Might Predict Clinical Outcome in Sars-cov-2 Infected Patients


Telehealth Policies Impacting Federally Qualified Health Centers in Face of COVID-19


title: Health plan responses to covid-19

text: The health insurance industry is responding to COVID-19 by paying for testing and treatment, and working with providers to assure that coverage for proper care is available Many people are losing employment and potentially health insurance coverage, shifting the responsibility for payment among private sector and government payers The unbudgeted costs of COVID-19 care will be substantial At the same time, providers are postponing routine care and treatments that are not time-sensitive, reducing or deferring similarly substantial sums The balance of payments is uncertain, though likely to favor health plans in the short run


title: Positive Correlation Between General Public Knowledge and Attitudes Regarding COVID-19 Outbreak 1 Month After First Cases Reported in Indonesia

text: The increasing number cases of coronavirus disease (COVID-19) infections in the general population in Indonesia raises questions concerning the public's knowledge and attitudes regarding this pandemic. To determine the correlation between the general public's knowledge and attitudes regarding the COVID-19 outbreak 1 month after the first cases were reported in Indonesia. This cross-sectional study was conducted between early March and the end of April 2020 in the general population of Indonesia, beginning with the North Sumatra region, where the spread of COVID-19 in Indonesia began. Questionnaires were randomly distributed online in the red zone in Indonesia. Data were collected by collecting people's responses to the questionnaire, which were distributed via WhatsApp (WA) application and were competed independently by the participants. A descriptive analysis was conducted to describe the demographic characteristics, knowledge, and attitudes of the general population. A total of 201 people had good knowledge (98%) and a positive attitude (96%) regarding the COVID-19 pandemic. The respondents had a negative attitude in relation to two aspects of the COVID-19 outbreak: having to always maintain a distance of 1.5 m when in crowds, and not being able to regularly exercise or eat nutritious food (78.6% and 79.1%, respectively). Most people in Indonesia have good knowledge and a positive attitude regarding the COVID-19 pandemic. However, negative attitudes were still found in this study, and as a result, transmission prevention measures cannot reach their maximum effectiveness by simply publicizing the increase in day-to-day cases to the general public.


Optical theranostics and treatment dosimetry for COVID-19 lung complications: towards increasing the survival rate of vulnerable populations


Policy Solutions for Reversing the Color-blind Public Health Response to COVID-19 in the US


title: Telemedicine in Orthopaedic Surgery: Challenges and Opportunities

text: Improvements in technology and a push toward value-based health care have poised the telemedicine industry for growth; however, despite the benefits of virtual care, widespread implementation had not occurred until the coronavirus 2019 (COVID-19) pandemic. Powerful barriers have hindered the widespread adoption of telemedicine, including lack of awareness, implementation costs, inefficiencies introduced, difficulty performing physical examinations, overall lack of perceived benefit of virtual care, negative financial implications, concern for medicolegal liability, and regulatory restrictions. Some of these challenges have been addressed with temporary state and federal mandates in response to the COVID-19 pandemic; however, continued investment in systems and technology as well as refinement of regulations around telemedicine are needed to sustain widespread adoption by patients and providers.


New clinical needs and strategies for care in children with neurodisability during COVID-19


Ensuring care for clozapine-treated schizophrenia patients during the COVID-19 pandemic


title: Against the odds: unlikely COVID-19 recovery

text: BACKGROUND: We present a 67-year-old male, with palliative hypopharyngeal squamous cell carcinoma, who contracted COVID-19 infection while in hospital. Cancer diagnosis, among other clinical features, increases the risk of poor outcome of COVID-19 infection. A recently validated risk calculator (COVID-GRAM) can help to guide prognosis. EVENTS: COVID-19 infection caused significant clinical deterioration in this patient. A Treatment Escalation Plan of ward-based care was put in place and the palliative care team involved. The goal of care was comfort. RESULTS: The patient improved clinically and retested negative for COVID-19. He was discharged to a nursing home for ongoing supportive care of his malignancy. DISCUSSION: The validated COVID-GRAM calculator predicted a greater than 99% risk that this patient would require intensive therapy unit admission or die. This patient overcame significant physiological challenges to survive COVID-19, highlighting the challenges of prognostication and suggesting that palliation of COVID-19 is not detrimental to survival.


COVID-19: science must not be the boy who cried wolf


title: COVID-19 outbreak in Iraqi Kurdistan: The first report characterizing epidemiological, clinical, laboratory, and radiological findings of the disease

text: INTRODUCTION: On March 11, 2020, the novel coronavirus was declared a global pandemic. The disease was named COVID-19 standing for coronavirus disease 2019. The objectives were to determine the epidemiological, clinical, laboratory, and radiological characteristics of COVID-19 patients. METHODS: In this prospective descriptive study, 15 confirmed hospitalized cases of COVID-19 between 18th March and April 7, 2020 were followed-up till discharge. RESULTS: There were 15 reported patients infected by 3 imported index cases from Europe. The mean age of the patients was 28.06 (SD: 16.42 years). The patients' age stratification was as follows: 0-5 (2, 13.3%); 6-18 (2, 13.3); 19-50 (10, 66.7%), and 51-64 years (1, 6.7%). The patients were male (9, 60.0%) and female (6, 40.0%). Most of the patients had mild disease severity (13, 86.7%), followed by mild-moderate (1, 6.7%) and moderate-severe (1, 6.7%). The study revealed that 6 patients were asymptomatic, and 9 patients were symptomatic. The most common symptoms were: fever (n = 8; 53.3%), cough (n = 7; 46.7%), shortness of breath (n = 3; 20.0%), fatigue (n = 3; 20.0%), and taste and smell disorders (n = 4; 26.7%). All patients were recovered and discharged over a median of 8 between 8 and 21 days. The mean and Std. deviation values of the hematological were: WBC: 6.57 (1.86); neutrophil count: 3.75 (1.26); lymphocyte count: 1.87 (0.41); Hb: 13.89 (1.26); platelet count: 207.67 (52.21). CONCLUSION: All COVID-19 cases were linked to foreign visits with few local transmissions to close contacts without community transmission. The majority of cases were mild illnesses with full recovery.


title: Detectable SARS-CoV-2 viral RNA in feces of three children during recovery period of COVID-19 pneumonia

text: Coronavirus Disease 2019 (COVID-19) is a newly emerging infectious disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After its first occurrence in Wuhan of China from December 2019, COVID-19 rapidly spread around the world. According to the World Health Organization statement on 13 March 2020, there had been over 132 500 confirmed cases globally. Nevertheless, the case reports of children are rare, which results in the lack of evidence for preventing and controlling of children's infection. Here, we report three cases of SARS-CoV-2 infected children diagnosed from 3 February to 17 February 2020 in Tianjin, China. All of these three cases experienced mild illness and recovered soon after the treatment, with the nucleic acid of throat swab turning negative within 14, 11, and 7 days after diagnosis, respectively. However, after been discharged, all three cases were tested SARS-CoV-2 positive in the stool samples within 10 days, in spite of their remained negative nucleic acid in throat swab specimens. Therefore, it is necessary to be aware of the possibility of fecal-oral transmission of SARS-CoV-2 infection, especially for children cases.


title: A computational insight of the improved nicotine binding with ACE2-SARS-CoV-2 complex with its clinical impact

text: Smokers being witnessed with the mild adverse clinical symptoms of SARS-CoV-2, the in-silico study is intended to explore the effect of nicotine binding to the soluble angiotensin converting enzyme II (ACE2) receptor with or without SARS-CoV-2 binding. Nicotine established a stable interaction with the conserved amino acid residues: Asp382, Gly405, His378 and Tyr385 through His401 of the soluble ACE2 that seals its interaction with the INS1. Also, nicotine binding has significantly reduced the affinity score of ACE2 with INS1 to -12.6 kcal/mol (versus -15.7 kcal/mol without nicotine) and the interface area to 1933.6 square Angstrom (versus 2057.3 square Angstrom without nicotine). Nicotine exhibited a higher binding affinity score with ACE2-SARS-CoV-2 complex with -6.33 kcal/mol (Vs -5.24 kcal/mol without SARS-CoV-2) and a lowered inhibitory contant value of 22.95 micromolar (Vs 151.69 micromolar without SARS-CoV). Eventhough ACE2 is not a potential receptor for nicotine binding in the healthy people, in COVID19 patients, it may exhibit better binding affinity with the ACE2 receptor. In overall, nicotines strong preference for ACE2-SARS-CoV-2 complex might drastically reduce the SARS-CoV-2 virulence by intervening the ACE2 conserved residues interaction with the spike (S1) protein of SARS-CoV-2.


Clinician Education and Adoption of Preventive Measures for COVID-19: A Survey of a Convenience Sample of General Practitioners in Lombardy, Italy


title: The Impact of Sociocultural Influences on the COVID-19 Measures-Reflections From Singapore

text: The coronavirus disease 2019 (COVID-19) pandemic presents unique challenges to Asian countries like Singapore with a predominantly Confucian culture. Palliative care providers play an important role in supporting their patients and family members in these difficult times.


COVID-19: Emerging compassion, courage and resilience in the face of misinformation and adversity


COVID-19 and student nurses: A view from England


title: Attitudes of Anesthesiology Specialists and Residents toward Patients Infected with the Novel Coronavirus (COVID-19): A National Survey Study

text: Background: The novel coronavirus (COVID-19) emerged in Wuhan, China, in December 2019. This study aims to evaluate the knowledge of anesthesiology specialists and residents in Turkey about COVID-19 and their attitudes toward the strategies and application methods to be used for a suspected/confirmed COVID-19 case that needs to be operated on or followed up in an intensive care unit, as well as to raise awareness about this issue. Methods: This descriptive study comprised anesthesiology specialists and residents working in various health institutions in Turkey. The data used in this study were obtained online between March 13, 2020 and March 25, 2020 through the website SurveyMonkey (SurveyMonkey, San Mateo, CA) by using a survey form. We contacted members of the Turkish Anaesthesiology and Reanimation Society through the social media platforms Twitter, LinkedIn, and WhatsApp, as well as through their e-mail addresses and invited them to participate in the study. Those who agreed to participate responded to the aforementioned survey. We used SPSS 22.0 (IBM, Armonk, NY) to analyze the survey data statistically. Results: A total of 346 anesthesiology specialists and residents participated in the study. Although the majority of the participants exhibited the correct attitudes toward airway management, research assistants with little professional experience were observed to be undecided or had the tendency to make incorrect decisions. Conclusions: The COVID-19 pandemic is spreading rapidly worldwide. The incidence of COVID-19 cases is increasing daily, and this disease can cause patient death. Anesthesiology specialists and residents who perform emergency operations on these patients in settings other than intensive care units should follow simple and easy-to-understand algorithms to ensure safety. The provision of theoretical and practical training to healthcare providers before they meet patients will help ensure patient-healthcare provider safety and prevent panic, which can cause distress among healthcare providers.


title: Picking low hanging fruit - A scoping review of work environment related interventions in the home care sector

text: Home care for elderly people is an important part of the social welfare system. The sector employs many people, especially women, and work environment issues are common. This review explores the scientific literature on organizational interventions that target the home care work environment. Altogether, 16 studies of varying quality met the inclusion criteria. The interventions identified involved organizational change, education and training, digitalization and scheduling. Many interventions were concerned with changing specific behaviors or with introducing new technology rather than tackling complex issues such as sick leave, stress or gender inequality. Employee participation increased the likelihood of success.


title: The cost of Bitcoin mining has never really increased

text: The Bitcoin network is burning a large amount of energy for mining. In this paper we estimate the lower bound for the global energy cost for a period of ten years from 2010, taking into account changing oil costs, improvements in hashing technologies and hashing activity. Despite a ten-billion-fold increase in hashing activity and a ten-million-fold increase in total energy consumption, we find the cost relative to the volume of transactions has not increased nor decreased since 2010. This is consistent with the perspective that, in order to keep a the Blockchain system secure from double spending attacks, the proof or work must cost a sizable fraction of the value that can be transferred through the network. We estimate that in the Bitcoin network this fraction is of the order of 1%.


title: The comparison of trends in Spain and the Nederland: a Dynamical compartment model of the transmission of Coronavirus

text: The recent spreading of coronavirus made many countries impose restrictions in order to control its dangerous effect on the citizens. We developed a theoretical dynamical model based on compartmental SIR system with additional adjustment taken from Flow network and Markov chain frameworks to illustrate developments and trends based on publicly available data. Based on this Model, code in R was written and fed by stamped publicly available data from authorized governmental websites in Spain and in the Nederlands, to compare trends. Our results show that the 'peak' of infection is already behind us in both countries, but also demonstrate that there is a danger of rebound of a spread. It is obvious that measures imposed are giving the results, but we should be precarious of near future practices and developments since the majority of population will still be without immunity.


title: Directiva sanitaria para garantizar la salud de las gestantes y la continuidad de la atención en planificación familiar ante la infección por COVID-19/ Health directive to guarantee the health of pregnant women and the continuity of care in family planning for COVID-19 infection

text: El documento contiene las disposiciones para realizar las actividades de atención de la salud materna relacionadas con las prestaciones que contribuyan a la prevención, reducción y manejo de los casos de gestantes y puérperas sospechosas o infectadas por el COVID-19, y para mantener la continuidad de la provisión de métodos anticonceptivos a la población que lo requiera.


Endothelial cell dysfunction: a major player in SARS-CoV-2 infection (COVID-19)?


title: Ultrastructural Evidence for Direct Renal Infection with SARS-CoV-2

text: BACKGROUND: A significant fraction of patients with coronavirus disease 2019 (COVID-19) display abnormalities in renal function. Retrospective studies of patients hospitalized with COVID-19 in Wuhan, China, report an incidence of 3%-7% progressing to ARF, a marker of poor prognosis. The cause of the renal failure in COVID-19 is unknown, but one hypothesized mechanism is direct renal infection by the causative virus, SARS-CoV-2. METHODS: We performed an autopsy on a single patient who died of COVID-19 after open repair of an aortic dissection, complicated by hypoxic respiratory failure and oliguric renal failure. We used light and electron microscopy to examine renal tissue for evidence of SARS-CoV-2 within renal cells. RESULTS: Light microscopy of proximal tubules showed geographic isometric vacuolization, corresponding to a focus of tubules with abundant intracellular viral arrays. Individual viruses averaged 76 µm in diameter and had an envelope studded with crown-like, electron-dense spikes. Vacuoles contained double-membrane vesicles suggestive of partially assembled virus. CONCLUSIONS: The presence of viral particles in the renal tubular epithelium that were morphologically identical to SARS-CoV-2, and with viral arrays and other features of virus assembly, provide evidence of a productive direct infection of the kidney by SARS-CoV-2. This finding offers confirmatory evidence that direct renal infection occurs in the setting of AKI in COVID-19. However, the frequency and clinical significance of direct infection in COVID-19 is unclear. Tubular isometric vacuolization observed with light microscopy, which correlates with double-membrane vesicles containing vacuoles observed with electronic microscopy, may be a useful histologic marker for active SARS-CoV-2 infection in kidney biopsy or autopsy specimens.


Effects of COVID 19 pandemic in daily life


Pooled Prevalence of Diarrhea Among COVID-19 Patients


title: Day Level Forecasting for Coronavirus Disease (COVID-19) Spread: Analysis, Modeling and Recommendations

text: In mid of March 2020, Coronaviruses such as COVID-19 is declared as an international epidemic. More than 125000 confirmed cases and 4,607 death cases have been recorded around more than 118 countries. Unfortunately, a coronavirus vaccine is expected to take at least 18 months if it works at all. Moreover, COVID -19 epidemics can mutate into a more aggressive form. Day level information about the COVID -19 spread is crucial to measure the behavior of this new virus globally. Therefore, this study presents a comparison of day level forecasting models on COVID-19 affected cases using time series models and mathematical formulation. The forecasting models and data strongly suggest that the number of coronavirus cases grows exponentially in countries that do not mandate quarantines, restrictions on travel and public gatherings, and closing of schools, universities, and workplaces (Social Distancing).


CT, [18F]FDG-PET/CT and clinical findings before and during early Covid-19 onset in a patient affected by vascular tumour


title: Global Reach of an Online COVID-19 Course in Multiple Languages on OpenWHO in the First Quarter of 2020: Analysis of Platform Use Data

text: BACKGROUND: At the onset of the coronavirus outbreak, the World Health Organization's (WHO) Health Emergencies Learning and Capacity Development Unit, together with the WHO's health technical lead on coronaviruses, developed a massive open online course within 3 weeks as part of the global response to the emergency. The introductory coronavirus disease (COVID19) course was launched on January 26, 2020, on the health emergencies learning platform OpenWHO.org. OBJECTIVE: The aim of this paper is to investigate the geographic reach of different language courses accessed by a worldwide audience seeking information on COVID-19. Users' professional identities and backgrounds were explored to inform course owners on the use case. The course was developed and delivered via the open-access learning platform OpenWHO.org. The self-paced resources are available in a total of 13 languages and were produced between January 26 and March 25, 2020. METHODS: Data were collected from the online courses' statistical data and metrics reporting system on the OpenWHO platform. User patterns and locations were analyzed based on Google Analytics and the platform's own statistics capabilities, and data sets were overlaid. This analysis was conducted based on user location, with the data disaggregated according to the six WHO regions, the top 10 countries, and the proportion of use for each language version. Data included affiliation, gender, age, and other parameters for 32.43% (52,214/161,007) of the users who indicated their background. RESULTS: As of March 25, 2020, the introductory COVID-19 course totaled 232,890 enrollments across all languages. The Spanish language course was comprised of more than half (n=118,754, 50.99%) of all course enrollments, and the English language course was comprised of 38.21% (n=88,988) of enrollments. The WHO's Region of the Americas accounted for most of the course enrollments, with more than 72.47% (138,503/191,130) enrollment across all languages. Other regions were more evenly distributed with less than 10% enrollment for each. A total of 32.43% (52,214/161,007) of users specified a professional affiliation by choosing from the 12 most common backgrounds in the OpenWHO user profiles. Before the COVID-19 pandemic, users were spread over the 11 distinct affiliations, with a small fraction of users identifying themselves as "Other." With the COVID-19 introductory course, the largest number of users selected "Other" (16,527/52,214, 31.65%), suggesting a large number of users who were not health professionals or academics. The top 10 countries with the most users across all languages were Argentina, Chile, Colombia, Ecuador, India, Mexico, Peru, Spain, the United Kingdom, and the United States. CONCLUSIONS: The online course has addressed a worldwide learning need by providing WHO's technical guidance packaged in simple formats for access and use. The learning material development was expedited to meet the onset of the epidemic. Initial data suggest that the various language versions of the course, in particular Spanish, have reached new user groups, fulfilling the platform's aim of providing learning everywhere to anyone that is interested. User surveys will be carried out to measure the real impact.


title: Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection

text: In this retrospective study, chest CTs of 121 symptomatic patients infected with coronavirus disease-19 (COVID-19) from four centers in China from January 18, 2020 to February 2, 2020 were reviewed for common CT findings in relationship to the time between symptom onset and the initial CT scan (i.e. early, 0-2 days (36 patients), intermediate 3-5 days (33 patients), late 6-12 days (25 patients)). The hallmarks of COVID-19 infection on imaging were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Notably, 20/36 (56%) of early patients had a normal CT. With a longer time after the onset of symptoms, CT findings were more frequent, including consolidation, bilateral and peripheral disease, greater total lung involvement, linear opacities, "crazy-paving" pattern and the "reverse halo" sign. Bilateral lung involvement was observed in 10/36 early patients (28%), 25/33 intermediate patients (76%), and 22/25 late patients (88%).


Detect to protect: pneumoperitoneum gas samples for SARS-CoV-2 and biohazard testing


The COVID-19 response must be disability inclusive


title: Review: Graphene-based biosensor for Viral Detection

text: Viral infections are among the main reasons for serious pandemics and contagious infections; hence, they cause thousands of fatalities and economic losses annually. In the case of COVID-19, world economies have shut down for months, and physical distancing along with drastic changes in the social behavior of many humans has generated many issues for all countries. Thus, a rapid, low-cost, and sensitive viral detection method is critical to upgrade the living standards of humans while exploiting biomedicine, environmental science, bioresearch, and biosecurity. The emergence of various carbon-based nanomaterials such as carbon nanotubes, graphene, and carbon nanoparticles provided a great possibility for researchers to develop a new and wide variety of biosensors. In particular, graphene has become a promising tool for biosensor fabrication owing to its many interesting properties, such as its exceptional conductivity, ultrahigh electron mobility, and excellent thermal conductivity. This paper provides an overall perspective of graphene-based biosensors and a critical review of the recent advances in graphene-based biosensors that are used to detect different types of viruses, such as Ebola, Zika, and influenza.


The role of CT in case ascertainment and management of COVID-19 pneumonia in the UK: insights from high-incidence regions


title: Home testing for COVID-19: lessons from direct to consumer genetics

text: On March 11th, 2020, COVID-19 was declared a worldwide pandemic. Publicly available testing has lagged, and tech entrepreneurs have quickly volunteered to fill this gap. Over the last two decades, genetic testing ordered outside of a clinic and without the involvement of a physician has been a way for the average individual to get genetic testing. In this commentary, we discuss the lessons learned from this parallel case from genetics and suggest regulatory caution in establishing direct-to-consumer COVID testing.


title: A Measurement of Transportation Ban inside Wuhan on the COVID-19 Epidemic by Vehicle Detection in Remote Sensing Imagery

text: Wuhan, the biggest city in China's central region with a population of more than 11 million, was shut down to control the COVID-19 epidemic on 23 January, 2020. Even though many researches have studied the travel restriction between cities and provinces, few studies focus on the transportation control inside the city, which may be due to the lack of the measurement of the transportation ban. Therefore, we evaluate the implementation of transportation ban policy inside the city by extracting motor vehicles on the road from two high-resolution remote sensing image sets before and after Wuhan lockdown. In order to detect vehicles from the remote sensing image datasets with the resolution of 0.8m accurately, we proposed a novel method combining anomaly detection, region grow and deep learning. The vehicle numbers in Wuhan dropped with a percentage of at least 63.31% caused by COVID-19. Considering fewer interferences, the dropping percentages of ring road and high-level road should be more representative with the value of 84.81% and 80.22%. The districts located in city center were more intensively affected by the transportation ban. Since the public transportations have been shut down, the significant reduction of motor vehicles indicates that the lockdown policy in Wuhan show effectiveness in controlling human transmission inside the city.


Brazil undermines parks by relocating staff


title: Correction to: COVID-19 and heme oxygenase: novel insight into the disease and potential therapies

text: In the original publication, one of the last paragraphs should have read as follows.


Clinical Performance of the Roche SARS-CoV-2 Serologic Assay


Health Professions' Educators (HPEs) and their learners have to adapt their educational provision to rapidly changing and uncertain circumstances linked to the COVID-19 pandemic. This paper reports on an AMEE-hosted webinar: Adapting to the impact of COVID-19: Sharing stories, sharing practice. Attended by over 500 colleagues from five continents, this webinar focused on the impact of the virus across the continuum of education and training. Short formal presentations on teaching and learning, assessment, selection and postgraduate training generated wide-ranging questions via the Chatbox. A thematic analysis of the Chatbox thread indicated the most pressing concerns and challenges educators were experiencing in having to adapt programmes and learning across the continuum of medical education and training. The main areas of concern were: campus-based teaching and learning; clinical teaching; selection and assessment, and educator needs. While there is clearly no one simple solution to the unprecedented issues medical education and training face currently, there were two over-arching messages. First, this is a time for colleagues across the globe to help and support each other. Second, many local responses and innovations could have the potential to change the shape of medical education and training in the future.


title: Glycyrrhizin: An alternative drug for the treatment of COVID-19 infection and the associated respiratory syndrome?

text: Safe and efficient drugs to combat the current COVID-19 pandemic are urgently needed. In this context, we have analyzed the anti-coronavirus potential of the natural product glycyrrhizic acid (GLR), a drug used to treat liver diseases (including viral hepatitis) and specific cutaneous inflammation (such as atopic dermatitis) in some countries. The properties of GLR and its primary active metabolite glycyrrhetinic acid are presented and discussed. GLR has shown activities against different viruses, including SARS-associated Human and animal coronaviruses. GLR is a non-hemolytic saponin and a potent immuno-active anti-inflammatory agent which displays both cytoplasmic and membrane effects. At the membrane level, GLR induces cholesterol-dependent disorganization of lipid rafts which are important for the entry of coronavirus into cells. At the intracellular and circulating levels, GLR can trap the high mobility group box 1 protein and thus blocks the alarmin functions of HMGB1. We used molecular docking to characterize further and discuss both the cholesterol- and HMG box-binding functions of GLR. The membrane and cytoplasmic effects of GLR, coupled with its long-established medical use as a relatively safe drug, make GLR a good candidate to be tested against the SARS-CoV-2 coronavirus, alone and in combination with other drugs. The rational supporting combinations with (hydroxy)chloroquine and tenofovir (two drugs active against SARS-CoV-2) is also discussed. Based on this analysis, we conclude that GLR should be further considered and rapidly evaluated for the treatment of patients with COVID-19.


Schrödinger's Resident: Redeployment in the Age of COVID-19


Covid-19 - The Law and Limits of Quarantine


title: Implementation science in times of Covid-19

text: The emergence of SARS-CoV-2/Covid-19 affects all of us and is associated with rapid and massive changes in healthcare and societies. As a response, a range of interventions for patients and populations have been implemented in health and preventive settings, or need to be implemented in the short and long term. Implementation science offers a multidisciplinary perspective and systematic approach for the design, evaluation and analysis of programmes and policies to enhance implementation. The emergence of Covid-19 provides an urgent need to develop new perspectives and approaches in implementation science, such as the addition of innovative and rigorous approaches to the collection, use and analysis of 'real-world' data. Above all, we hope that implementation scientists will focus on what they can contribute to manage Covid-19 and its consequences for people, healthcare and society.


COVID-19 and drug-induced liver injury: a problem of plenty or a petty point?


Morphological changes in a case of SARS-CoV-2 infection


title: Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers

text: BACKGROUND AND AIMS: COVID-19 is already a pandemic. Emerging data suggest an increased association and a heightened mortality in patients of COVID-19 with comorbidities. We aimed to evaluate the outcome in hypertensive patients with COVID-19 and its relation to the use of renin-angiotensin system blockers (RASB). METHODS: We have systematically searched the medical database up to March 27, 2020 and retrieved all the published articles in English language related to our topic using MeSH key words. RESULTS: From the pooled data of all ten available Chinese studies (n = 2209) that have reported the characteristics of comorbidities in patients with COVID-19, hypertension was present in nearly 21%, followed by diabetes in nearly 11%, and established cardiovascular disease (CVD) in approximately 7% of patients. Although the emerging data hints to an increase in mortality in COVID-19 patients with known hypertension, diabetes and CVD, it should be noted that it was not adjusted for multiple confounding factors. Harm or benefit in COVID-19 patients receiving RASB has not been typically assessed in these studies yet, although mechanistically and plausibly both, benefit and harm is possible with these agents, given that COVID-19 expresses to tissues through the receptor of angiotensin converting enzyme-2. CONCLUSION: Special attention is definitely required in patients with COVID-19 with associated comorbidities including hypertension, diabetes and established CVD. Although the role of RASB has a mechanistic equipoise, patients with COVID-19 should not stop these drugs at this point of time, as recommended by various world organizations and without the advice of health care provider.


title: Sub-continental Atmosphere and Inherent Immune System may have Impact on Novel Corona Virus' 2019 (nCovid-19) Prevalence in South East Asia

text: Pandemic enveloped RNA Novel Corona Virus' 2019 (SARS-CoV-2) appears as a beating reed which induce overwhelming outbreak all over the world since November 2019 to till date. Inherent Immunity developed by traditional food habit, exposure to various antigens and vitamin D induced sunlight exposure. Meteorological parameters are the important factors which influencing the severe acute respiratory syndrome (SARS) like infectious disease. Aim of this review to enhance our knowledge and explore the association among build up immunity, weather parameters and Corona virus disease (COVID-19) death. In this review we emphasize role of meteorological factor included degree of sun exposure and effect of temperature on enveloped lipid bi-layer structure of Novel corona virus. These meteorological factors and inherent immunity may have impact on SARS-CoV-2 incidence among South East Asian including Bangladeshi. In summary, this study suggests that temperature-humidity variation, inherent immunity and lower life expectancy of South East Asia may be important.


Post-pandemic economic overhaul will take more than tweaks


title: The Expression and Polymorphism of Entry Machinery for COVID-19 in Human: Juxtaposing Population Groups, Gender, and Different Tissues

text: (1) Background: Combating viral disease outbreaks has doubtlessly been one of the major public health challenges for the 21st century. (2) Methods: The host entry machinery required for COVID-19 (SARS-CoV-2) infection was examined for the gene expression profiles and polymorphism. (3) Results: Lung, kidney, small intestine, and salivary glands were among the tissues which expressed the entry machinery coding genes Ace2, Tmprss2, CtsB, and CtsL. The genes had no significant expression changes between males and females. The four human population groups of Europeans, Africans, Asians, and Americans had specific and also a common pool of rare variants for the X-linked locus of ACE2 receptor. Several specific and common ACE2 variants including S19P, I21T/V, E23K, A25T, K26R, T27A, E35D/K, E37K, Y50F, N51D/S, M62V, N64K, K68E, F72V, E75G, M82I, T92I, Q102P, G220S, H239Q, G326E, E329G, G352V, D355N, H378R, Q388L, P389H, E467K, H505R, R514G/*, and Y515C were of the utmost importance to the viral entry and infection. The variants of S19P, I21T, K26R, T27A, E37K, N51D, N64K, K68E, F72V, M82I, G326E, H378R, Q388L, and P389H also had significant differences in frequencies among the population groups. Most interestingly, the analyses revealed that more than half of the variants can exist in males, i.e., as hemizygous. (4) Conclusions: The rare variants of human ACE2 seem to be one of the determinant factors associated with fitness in the battle against SARS viruses. The hemizygous viral-entry booster variants of ACE2 describe the higher SARS-CoV-2 mortality rate in males. This is also supported by the lack of gender bias for the gene expression profiles of entry machinery. A personalized medicine strategy is conceived for isolating high-risk individuals in epidemic circumstances.


Can the enteric nervous system be an alternative entrance door in SARS-CoV2 neuroinvasion?


title: La obesidad como factor de riesgo en personas con COVID-19: posibles mecanismos e implicaciones./ [Obesity as a risk factor in COVID-19: Possible mechanisms and implications]

text: Recent reports suggest that obesity is a risk factor for more severe coronavirus disease. This article summarizes the available scientific evidence on the role of obesity in COVID-19. We focus on implications for younger patients and the proposed biological mechanisms that could explain both the higher risk observed and the possible higher contagiousness of people with obesity. We consider implications of the pandemic for people with obesity in relation to: difficulties in managing hospitalized patients, implications of confinement for the control and treatment of obesity, and the stigma people with obesity suffer, that could increase should the relationship between obesity and COVID-19 be confirmed. Understanding the role of obesity in COVID-19 should be a public health priority, given the high prevalence of this condition in our country.


Comment on: Coronavirus 2019 in Geriatrics and Long-Term Care: The ABCDs of COVID-19


[Explanation of expert recommendations on medical nutrition for patients with novel coronavirus pneumonia]


COVID-19 and Nasal Cytobrush Cytology


title: The 3 B's of cancer care amid the COVID-19 pandemic crisis: "Be safe, be smart, be kind"-A multidisciplinary approach increasing the use of radiation and embracing telemedicine for head and neck cancer

text: Because of the national emergency triggered by the coronavirus disease 2019 (COVID-19) pandemic, government-mandated public health directives have drastically changed not only social norms but also the practice of oncologic medicine. Timely head and neck cancer (HNC) treatment must be prioritized, even during emergencies. Because severe acute respiratory syndrome coronavirus 2 predominantly resides in the sinonasal/oral/oropharyngeal tracts, nonessential mucosal procedures are restricted, and HNCs are being triaged toward nonsurgical treatments when cures are comparable. Consequently, radiation utilization will likely increase during this pandemic. Even in radiation oncology, standard in-person and endoscopic evaluations are being restrained to limit exposure risks and preserve personal protective equipment for other frontline workers. The authors have implemented telemedicine and multidisciplinary conferences to continue to offer standard-of-care HNC treatments during this uniquely challenging time. Because of the lack of feasibility data on telemedicine for HNC, they report their early experience at a high-volume cancer center at the domestic epicenter of the COVID-19 crisis.


Paternal Behaviors in the Era of COVID-19


Skin signs resembling vascular acrosyndromes during the COVID-19 outbreak in Italy


Interventions for Financial Toxicity: More Crucial Than Ever in the Time of COVID-19


COVID-19 vaccination clinical trials should consider multiple doses of BCG


Bacillus Calmette Guérin (BCG) vaccination use in the fight against COVID-19 - what's old is new again?


Covid-19 - The Search for Effective Therapy


Acute myocardial injury, MINOCA, or myocarditis? Improving characterization of coronavirus-associated myocardial involvement


title: What country, university or research institute, performed the best on COVID-19? Bibliometric analysis of scientific literature

text: In this article, we conduct data mining to discover the countries, universities and companies, produced or collaborated the most research on Covid-19 since the pandemic started. We present some interesting findings, but despite analysing all available records on COVID-19 from the Web of Science Core Collection, we failed to reach any significant conclusions on how the world responded to the COVID-19 pandemic. Therefore, we increased our analysis to include all available data records on pandemics and epidemics from 1900 to 2020. We discover some interesting results on countries, universities and companies, that produced collaborated most the most in research on pandemic and epidemics. Then we compared the results with the analysing on COVID-19 data records. This has created some interesting findings that are explained and graphically visualised in the article.


title: A super-spreader of COVID-19 in Ningbo city in China

text: An outbreak of Coronavirus Disease 2019 (COVID-19) has spread rapidly. It is imperative to control the epidemic by understanding the epidemiological feature, preventative quarantine, and effective hygiene measures. In the present study, we report a case of super-spreader who transmitted the disease to over twenty-eight persons in Ningbo, Zhejiang. Identifying and isolated super-spreaders, understanding the reasons behind the efficient transmission ability are important for the control and management of the ongoing COVID-19 pandemic.


Learning at home during COVID-19: A multi-institutional virtual learning collaboration


Letter: COVID-19 Infection Affects Surgical Outcome of Chronic Subdural Hematoma


The Right Time for Steroids in Covid-19


Laryngectomy Care in the COVID-19 Era


15-day mortality and associated risk factors for hospitalized patients with COVID-19 in Wuhan, China: an ambispective observational cohort study


China Coronavirus Outbreak: All the Latest Updates


Modification of non-invasive ventilation for the advanced amyotrophic lateral sclerosis patient during the COVID-19 pandemic - do it now


title: Genetic evolution analysis of 2019 novel coronavirus and coronavirus from other species

text: The Corona Virus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a Public Health Emergency of International Concern. However, so far, there are still controversies about the source of the virus and its intermediate host. Here, we found the novel coronavirus was closely related to coronaviruses derived from five wild animals, including Paguma larvata, Paradoxurus hermaphroditus, Civet, Aselliscus stoliczkanus and Rhinolophus sinicus, and was in the same branch of the phylogenetic tree. However, genome and ORF1a homology show that the virus is not the same coronavirus as the coronavirus derived from these five animals, whereas the virus has the highest homology with Bat coronavirus isolate RaTG13.


A glimpse into the origins of genetic diversity in SARS-CoV-2


title: Phylogenetic relationships of Chanidae (Teleostei: Gonorynchiformes) as impacted by Dastilbe moraesi, from the Sanfranciscana basin, Early Cretaceous of Brazil

text: Fossil gonorynchiform fishes range from the Lower Cretaceous to the early Miocene, and are represented by a few dozen living species. The order is currently divided into two major clades: Gonorynchoidei, which includes the families Gonorynchidae and Kneriidae, and Chanoidei, encompassing a single family, Chanidae, with a single recent species, the Indo-Pacific Chanos chanos, and several fossil taxa. Chanidae includes some poorly known taxa, such as Dastilbe moraesi, described from the Aptian (Lower Cretaceous) of the Areado Formation, Sanfranciscana basin, Brazil. This species is currently considered to be a junior synonym of the type species of its genus, Dastilbe crandalli, from Santana Formation, Aptian, northeastern Brazil. The analysis of abundant D. moraesi specimens revealed several new morphological features, many of which had previously been misinterpreted. Dastilbe moraesi was incorporated into a gonorynchiform character matrix as revised and modified for the Chanidae. We obtained a single most parsimonious tree in which D. moraesi is distinct and phylogenetically apart from D. crandalli. According our analysis, D. moraesi forms a sister pair with Chanos, a clade which is closely related to Tharrhias, all composing the tribe Chanini.(AU)


La médecine interne dans la pandémie à SARS-CoV-2


title: A Novel Scoring System for Prediction of Disease Severity in COVID-19

text: Background: A novel enveloped RNA beta coronavirus, Corona Virus Disease 2019 (COVID-19) caused severe and even fetal pneumonia in China and other countries from December 2019. Early detection of severe patients with COVID-19 is of great significance to shorten the disease course and reduce mortality. Methods: We assembled a retrospective cohort of 80 patients (including 56 mild and 24 severe) with COVID-19 infection treated at Beijing You'an Hospital. We used univariable and multivariable logistic regression analyses to select the risk factors of severe and even fetal pneumonia and build scoring system for prediction, which was validated later on in a group of 22 COVID-19 patients. Results: Age, white blood cell count, neutrophil, glomerular filtration rate, and myoglobin were selected by multivariate analysis as candidates of scoring system for prediction of disease severity in COVID-19. The scoring system was applied to calculate the predictive value and found that the percentage of ICU admission (20%, 6/30) and ventilation (16.7%, 5/30) in patients with high risk was much higher than those (2%, 1/50; 2%, 1/50) in patients with low risk (p = 0.009; p = 0.026). The AUC of scoring system was 0.906, sensitivity of prediction is 70.8%, and the specificity is 89.3%. According to scoring system, the probability of patients in high risk group developing severe disease was 20.24 times than that in low risk group. Conclusions: The possibility of severity in COVID-19 infection predicted by scoring system could help patients to receiving different therapy strategies at a very early stage. Topic: COVID-19, severe and fetal pneumonia, logistic regression, scoring system, prediction.


COVID-19 in People With Diabetes: Urgently Needed Lessons From Early Reports


title: A Hospital Partnership with a Nursing Home Experiencing a COVID-19 Outbreak: Description of a Multiphase Emergency Response in Toronto, Canada

text: Nursing homes have become "ground zero" for the coronavirus disease 2019 (COVID-19) epidemic in North America, with homes experiencing widespread outbreaks, resulting in severe morbidity and mortality among their residents. This article describes a 371-bed acute-care hospital's emergency response to a 126-bed nursing home experiencing a COVID-19 outbreak in Toronto, Canada. Like other healthcare system responses to COVID-19 outbreaks in nursing homes, this hospital-nursing home partnership can be characterized in several phases: (1) engagement, relationship, and trust building; (2) environmental scan, team building, and immediate response; (3) early-phase response; and (4) stabilization and transition period. J Am Geriatr Soc 68:1376-1381, 2020.


title: Novel Coronavirus 2019 (2019-nCoV) Infection: Part II - Respiratory Support in the Pediatric Intensive Care Unit in Resource-limited Settings

text: The 2019-novel coronavirus predominantly affects the respiratory system with manifestations ranging from upper respiratory symptoms to full blown acute respiratory distress syndrome (ARDS). It is important to recognize the risk factors, categorize severity and provide early treatment. Use of high flow devices and non-invasive ventilation has been discouraged due to high chances of aerosol generation. Early intubation and mechanical ventilation areessential to prevent complications and worsening, especially in resource-limited settings with very few centers having expertise to manage critical cases. Hydrophobic viral filter in the ventilator circuit minimizes chances of transmission of virus. Strategies to manage ARDS in COVID-19 include low tidal volume ventilation with liberal sedation-analgesia. At the same time, prevention of transmission of the virus to healthcare workers is extremely important in the intensive care setting dealing with severe cases and requiring procedures generating aerosol. We, herein, provide guidance on non-invasive respiratory support, intubation and management of ARDS in a child with COVID-19.


title: Progress of COVID-19 Epidemic in Pakistan

text: The outbreak of corona virus initiated as pneumonia of unknown cause in December 2019 in Wuhan, China, which has been now spreading rapidly out of Wuhan to other countries. On January 30, 2020, the World Health Organization (WHO) declared coronavirus outbreak as the sixth public health emergency of international concern (PHEIC), and on March 11, 2020, the WHO announced coronavirus as pandemic. Coronavirus is thought to be increasing in Pakistan. The first case of coronavirus was reported from Karachi on February 26, 2020, with estimated populace of Pakistan as 204.65 million. Successively, the virus spreads into various regions nationwide and has currently become an epidemic. The WHO has warned Pakistan that the country could encounter great challenge against the outbreak of coronavirus in the coming days. This short communication is conducted to shed light on the epidemic of coronavirus in the country. It would aid in emphasizing the up-to-date situation in a nutshell and the measures taken by the health sector of Pakistan to abate the risk of communication.


Dynamic Trainee Support for Residents Involved in COVID-19 Treatment and Response


The role of percutaneous interventions in the management of lung cancer patients during the Covid-19 pandemic


The Topic of COVID-19-Related Liver Injury Needs More Rigorous Research


title: Ethical triage during the COVID-19 pandemic: a toolkit for neurosurgical resource allocation

text: BACKGROUND: The COVID-19 pandemic confronts healthcare workers, including neurosurgeons, with difficult choices regarding which patients to treat. METHODS: In order to assist ethical triage, this article gives an overview of the main considerations and ethical principles relevant when allocating resources in times of scarcity. RESULTS: We discuss a framework employing four principles: prioritizing the worst off, maximizing benefits, treating patients equally, and promoting instrumental value. We furthermore discuss the role of age and comorbidity in triage and highlight some principles that may seem intuitive but should not form a basis for triage. CONCLUSIONS: This overview is presented on behalf of the European Association of Neurosurgical Societies and can be used as a toolkit for neurosurgeons faced with ethical dilemmas when triaging patients in times of scarcity.


title: In the search of potential epitopes for Wuhan seafood market pneumonia virus using high order nullomers

text: Alarms periodically emerge for viral pneumonia infections due to coronavirus. In all cases, these are zoonoses passing the barrier between species and infect humans. The legitimate concern of the international community is due to the fact that the new identified coronavirus, named SARS-CoV-2 (previously called 2019-nCoV), has a quite high mortality rate, around 2%, and a strong ability to spread, with an estimated reproduction number higher than 2. Even though all countries are doing their utmost to stop the pandemic, the only reliable solution to tackle the infection is the rapid development of a vaccine. For this purpose, the means of bioinformatics, applied in the context of reverse-vaccinology paradigm, can be of fundamental help to select the most promising peptides able to trigger an effective immune response. In this short report, using the concept of nullomer and introducing a distance from human self, we provide a list of peptides that could deserve experimental investigation in the view of a potential vaccine for SARS-CoV-2.


What to do next to control the 2019-nCoV epidemic?


title: Living with a disability during the pandemic. "Instant paper from the field" on rehabilitation answers to the COVID-19 emergency

text: COVID-19 pandemic is creating collateral damage to persons with disabling conditions of different aetiology. The restrictions imposed to contain the spread of infection is limiting the access to many health services, including rehabilitation. It is expected that such situation will lead to long lasting negative consequences for persons with disability, increasing functional limitations in chronic conditions and hindering the recovery after acute events. The aim of this paper is to explore the impact on people with disability, reporting the contents of the sixth Italian Society of Physical and Rehabilitation Medicine (SIMFER) webinar on the COVID-19 impact on rehabilitation ("Covinars"). Seven representatives of Associations of persons affected by different disabling conditions described the difficulties they are facing during the pandemic, the initiatives undertaken to support their members and their future perspectives and expectations. The users' inputs will be helpful in planning the future phases of the emergency and improve preparedness for other emergencies.


title: Encephalomyelitis associated with Covid-19 infection: case report

text: We describe a COVID-19 patient who presented with persistent headache and anosmia that was related to viral encephalomyelitis with acute lesions on MRI in both the brain and upper cervical cord.


title: Construction of Integrated Emergency Management Model for Novel Coronavirus Pneumonia Epidemic Prevention and Control in Hospital Pharmacy Department/ 中国药房

text: OBJECTIVE： To provide reference for improving emergency capacity of the hospital pharmacy department in response to the novel coronavirus pneumonia （COVID-19） epidemic. METHODS ：According to the related regulations and requirements of Law of the People ’s Republic of China on the Prevention and Control of Infectious Diseases ，combined with the situation of COVID- 19 epidemic prevention and control ，and management experience of relevant hospitals ，on the basis of in-depth analysis of drug supply and quality assurance ，drug dispensing management ，provision of clinical pharmaceutical services and other related material support of hospital pharmacy department，integrated emergency management model was constructed for COVID- 19 epidemic prevention and control ，and the precautions and response measures of each link were sorted out. RESULTS ：Integruted emergency management mode for COVID-19 epidemic prevention and control in hospital pharmacy department included but was not limited to human resource management，drug and disinfection products supply management （mainly including key treatment drugs and disinfection product list formulation，control，inventory increase ，etc.）；drug dispensing management （mainly including prescription ，pharmacy window ， planning quantitative reserve ， drug return ， etc.）；clinical pharmaceutical care management （mainly including providing pharmaceutical information support ，online pharmaceutical service ，monitoring drug safety ，etc.）；personnel protection and disinfection （mainly including personnel protection ，environment and window ，equipment and container ，paper prescription disinfection，etc.）；special management of donated drugs ；prevention and control knowledge training ；pharmaceutical education and scientific research management ，etc. CONCLUSIONS ：The integrated emergency management model for epidemic prevention and control is helpful for hospital pharmacy to manage public health emergencies. During the outbreak of COVID- 19，hospital pharmacy department should start integrated emergency management mode for epidemic prevention and control ，strengthen the risk control of each link ，and play a good role in the key functional departments in the special period.


COVID-19: Never Seen Anything Like This Ever!


title: Perceptions of the adult US population regarding the novel coronavirus outbreak

text: The Coronavirus Disease 2019 (COVID-19) outbreak is spreading globally. Although COVID-19 has now been declared a pandemic and risk for infection in the United States (US) is currently high, at the time of survey administration the risk of infection in the US was low. It is important to understand the public perception of risk and trust in sources of information to better inform public health messaging. In this study, we surveyed the adult US population to understand their risk perceptions about the COVID-19 outbreak. We used an online platform to survey 718 adults in the US in early February 2020 using a questionnaire that we developed. Our sample was fairly similar to the general adult US population in terms of age, gender, race, ethnicity and education. We found that 69% of the respondents wanted the scientific/public health leadership (either the CDC Director or NIH Director) to lead the US response to COVID-19 outbreak as compared to 14% who wanted the political leadership (either the president or Congress) to lead the response. Risk perception was low (median score of 5 out of 10) with the respondents trusting health professionals and health officials for information on COVID-19. The majority of respondents were in favor of strict infection prevention policies to control the outbreak. Given our results, the public health/scientific leadership should be at the forefront of the COVID-19 response to promote trust.


Response to Carletti et al, "About the origin of the first two SARS-CoV-2 infections in Italy: Inference not supported by appropriate sequence analysis"


Covid-19: GPs can't get results of tests carried out at drive-through centres


title: Use of the informational spectrum methodology for rapid biological analysis of the novel coronavirus 2019-nCoV: prediction of potential receptor, natural reservoir, tropism and therapeutic/vaccine target

text: A novel coronavirus recently identified in Wuhan, China (2019-nCoV) has expanded the number of highly pathogenic coronaviruses affecting humans. The 2019-nCoV represents a potential epidemic or pandemic threat, which requires a quick response for preparedness against this infection. The present report uses the informational spectrum methodology to identify the possible origin and natural host of the new virus, as well as putative therapeutic and vaccine targets. The performed in silico analysis indicates that the newly emerging 2019-nCoV is closely related to severe acute respiratory syndrome (SARS)-CoV and, to a lesser degree, Middle East respiratory syndrome (MERS)-CoV. Moreover, the well-known SARS-CoV receptor (ACE2) might be a putative receptor for the novel virus as well. Additional results indicated that civets and poultry are potential candidates for the natural reservoir of the 2019-nCoV, and that domain 288-330 of S1 protein from the 2019-nCoV represents promising therapeutic and/or vaccine target.


Thanks to all medical workers fighting against COVID-19


COVID-19 testing delays and pathology services in the UK


title: [Effect of heat inactivation of blood samples on the efficacy of three detection methods of SARS-CoV-2 antibodies]

text: OBJECTIVE: To evaluate the effects of heat inactivation of blood samples at 56â for 30 min on the results of SARS-CoV-2 antibody detection using different methods. METHODS: This retrospective study was conducted in 11 patients with established diagnosis of COVID-19 and 10 patients with diseases other than COVID- 19 in our hospital. We collected samples of serum, plasma and whole blood from each patient between February, 12 and 18, 2020, and with a double- blind design, the samples were examined for SARS-CoV-2 antibodies before and after heat inactivation at 56 â for 30 min. In all the samples, the total SARS-CoV-2 antibodies were detected using immunochromatography, and the IgM antibodies were detected using fluorescence immunochromatography; the IgM and IgG antibodies in the serum and plasma samples detected with chemiluminescence immunoassay. We compared the detection results and analyzed the correlation of semi-quantitative detection results of IgM and IgG antibodies before and after heat inactivation of the samples. RESULTS: With immuno-chromatography, the coincidence rate of the total SARS-CoV-2 antibody detection before and after heat inactivation of the serum and plasma samples was 90.0% in COVID-19 cases and 100.0% in the negative cases, resulting in a total coincidence rate 95.2%; for the whole blood samples, the total coincidence rates of the total SARS-CoV-2 antibodies were 100.0%. For detection of IgM antibodies in the serum, plasma and whole blood samples using fluorescence immunochromatography, the coincidence rates in SARS-CoV-2-positive and negative cases and the total coincidence rate before and after inactivation were 100.0%, 0 and 47.6%, respectively. For detection of serum IgM and IgG antibodies and plasma IgG antibodies with chemiluminescence immunoassay, the coincidence rates in SARS-CoV-2-positive and negative cases and the total coincidence rate before and after inactivation were all 100.0%, and the total coincidence rate of plasma IgM antibodies was 95.2%. Pearson correlation analysis of the semi-quantitative results of IgM and IgG detection in the serum and plasma samples showed a correlation coefficient of 0.9999 (95%CI: 0.9998-1.000, P < 0.001) between the results before and after sample inactivation. CONCLUSIONS: Heat inactivation of blood samples at 56 â for 30 min does not obviously affect the results of immunochromatography and chemiluminescent immunoassay for detection of SARS-COV-2 antibodies but can reduce the risk of infection for the operators. Heat-inactivated samples can not be used in fluorescence immunochromatography for SARS-CoV-2 antibody detection.


title: Analytical sensitivity and efficiency comparisons of SARS-CoV-2 RT-qPCR primer-probe sets

text: The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription-PCR (RT-qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer-probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT-qPCR analytical efficiency and sensitivity, we show that all primer-probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer-probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes.


Lichenoid eruptions with interface dermatitis and necrotic subepidermal blister associated with COVID-19


title: Information Seeking Responses to News of Local COVID-19 Cases: Evidence from Internet Search Data

text: The novel coronavirus (COVID-19) outbreak is a global pandemic with community circulation in many countries, including the U.S. where every state is reporting confirmed cases. The course of this pandemic will be largely shaped by how governments enact timely policies, disseminate the information, and most importantly, how the public reacts to them. Here, we examine informationseeking responses to the first COVID-19 case public announcement in a state. By using an eventstudy framework, we show that such news increases collective attention to the crisis right away, but the elevated level of attention is short-lived, even though the initial announcements were followed by increasingly strong measures. We find that people respond to the first report of COVID-19 in their state by immediately seeking information about COVID-19, as measured by searches for coronavirus, coronavirus symptoms and hand sanitizer. On the other hand, searches for information regarding community level policies (e.g., quarantine, school closures, testing), or personal health strategies (e.g., masks, grocery delivery, over-the-counter medications) do not appear to be immediately triggered by first reports. These results are encouraging given our study period is relatively early in the epidemic and more elaborate policy responses were not yet part of the public discourse. Further analysis will track evolving patterns of responses to subsequent flows of public information.


[Hematologic Malignancies/Pediatric Malignancies Update on Novel Treatment Strategies in Multiple Myeloma]


title: Ageing and COVID-19: What is the Role for Elderly People?

text: Italy is one of the oldest countries in Europe and in the world and now it is also one of the first countries that are fighting against COVID-19. In our country, the increasing life expectancy (80.5 for males and 84.9 for females, with a total life expectancy of 82.9) has led to very positive consequences for health and the well-being of elderly people: a very high number of older adults lives and acts independently in their daily life, even if they have one or more than one chronic disease. In the time of COVID-19's outbreak in Italy, the focus of the media was on elderly people for two main reasons. First, many older people demonstrated a very high civic sense and they were helping society to fight against the pandemic. Second, also in Italy, like in China, the older adults are at higher risk in being infected with COVID-19 and if they get ill, they have a higher risk of death. The balance previously achieved between age-related disorders and a good quality of life and good health is now under high pressure. It is very important to protect elderly people from infection, but also it is important to respect them and to support them in this complex situation. There is a great risk of "ageism". In agreement with Lloyd-Sherlock and colleagues (2020), in this editorial we propose some hints of analysis, starting from the ongoing experience in Italy.


title: The post-lockdown period should be used to acquire effective therapies for future resurgence in SARS-Cov-2 infections

text: COVID-19 will be with us through the remainder of 2020 and almost certainly beyond New Zealand needs a viable strategy to protect its populace until a vaccine is developed and in wide use Until that time, it makes sense to protect the population by putting in place treatments that will be safe and effective, such as the use of convalescent sera and the use of direct-acting anti-virals These treatments should be sourced externally or made locally, but steps in this direction must now begin as the lockdown ends New Zealand has the scientists, the facilities and the will to make this happen, but the support of the government and the population will be needed if this plan is to succeed


Impact of COVID-19 pandemic on SLE: beyond the risk of infection


Leveraging Africa's preparedness towards the next phase of the COVID-19 pandemic


title: CT features of novel coronavirus pneumonia (COVID-19) in children

text: A serious epidemic of COVID-19 broke out in Wuhan, Hubei Province, China, and spread to other Chinese cities and several countries now. As the majority of patients infected with COVID-19 had chest CT abnormality, chest CT has become an important tool for early diagnosis of COVID-19 and monitoring disease progression. There is growing evidence that children are also susceptible to COVID-19 and have atypical presentations compared with adults. This review is mainly about the differences in clinical symptom spectrum, diagnosis of COVID-19, and CT imaging findings between adults and children, while highlighting the value of radiology in prevention and control of COVID-19 in pediatric patients. KEY POINTS: â¢ Compared with adults, pediatric patients with COVID-19 have the characteristics of lower incidence, slighter clinical symptoms, shorter course of disease, and fewer severe cases. â¢ The chest CT characteristics of COVID-19 in pediatric patients were atypical, with more localized GGO extent, lower GGO attenuation, and relatively rare interlobular septal thickening. â¢ Chest CT should be used with more caution in pediatric patients with COVID-19 to protect this vulnerable population from risking radiation.


title: Dynamics of Interacting Hotspots - II

text: In the absence of any proper clinical solution, human civilization is only left with sophisticated intervention measures to contain the spread of COVID-19. However, the existing models to estimate the intervention does not take into account the realistic connectivity of the epicentres of the pandemic. We generalise our earlier model of interacting hotspots to test various possibilities of intervention in a model state consisting of multiple epicentres. We also analyse situations when the hotspots are spatially correlated and the interaction is limited to population exchanges with the nearest neighbours. We show that the heterogeneity in the infection propagation is solely dependent on the protocol of the containment and its strength. We explore many such situations and discuss possibilities.


title: Novel Coronavirus-Induced Right Ventricular Failure and Point of Care Echocardiography: A Case Report

text: Various cardiovascular complications have been reported in patients with coronavirus disease 2019. Common complications include acute myocardial injury, myocarditis, arrhythmia, pericarditis, heart failure, and shock. We present a case of cor pulmonale diagnosed with serial point of care ultrasound. Given the current shortage of personal protective equipment (PPE) and high infectivity of this virus, we acknowledge the utility of this tool in obtaining important clinical information while minimizing exposure and PPE consumption.


Cone-beam CT for Diagnosis of Avulsion Injuries of the Hand and Wrist


title: Countering hate on social media: Large scale classification of hate and counter speech

text: Hateful rhetoric is plaguing online discourse, fostering extreme societal movements and possibly giving rise to real-world violence. A potential solution to this growing global problem is citizen-generated counter speech where citizens actively engage in hate-filled conversations to attempt to restore civil non-polarized discourse. However, its actual effectiveness in curbing the spread of hatred is unknown and hard to quantify. One major obstacle to researching this question is a lack of large labeled data sets for training automated classifiers to identify counter speech. Here we made use of a unique situation in Germany where self-labeling groups engaged in organized online hate and counter speech. We used an ensemble learning algorithm which pairs a variety of paragraph embeddings with regularized logistic regression functions to classify both hate and counter speech in a corpus of millions of relevant tweets from these two groups. Our pipeline achieved macro F1 scores on out of sample balanced test sets ranging from 0.76 to 0.97---accuracy in line and even exceeding the state of the art. On thousands of tweets, we used crowdsourcing to verify that the judgments made by the classifier are in close alignment with human judgment. We then used the classifier to discover hate and counter speech in more than 135,000 fully-resolved Twitter conversations occurring from 2013 to 2018 and study their frequency and interaction. Altogether, our results highlight the potential of automated methods to evaluate the impact of coordinated counter speech in stabilizing conversations on social media.


title: Multicentre comparison of quantitative PCR-based assays to detect SARS-CoV-2, Germany, March 2020

text: Containment strategies and clinical management of coronavirus disease (COVID-19) patients during the current pandemic depend on reliable diagnostic PCR assays for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we compare 11 different RT-PCR test systems used in seven diagnostic laboratories in Germany in March 2020. While most assays performed well, we identified detection problems in a commonly used assay that may have resulted in false-negative test results during the first weeks of the pandemic.


Poor clinical outcomes for patients with cancer during the COVID-19 pandemic


title: Artificial intelligence to codify lung CT in Covid-19 patients

text: The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already assumed pandemic proportions, affecting over 100 countries in few weeks. A global response is needed to prepare health systems worldwide. Covid-19 can be diagnosed both on chest X-ray and on computed tomography (CT). Asymptomatic patients may also have lung lesions on imaging. CT investigation in patients with suspicion Covid-19 pneumonia involves the use of the high-resolution technique (HRCT). Artificial intelligence (AI) software has been employed to facilitate CT diagnosis. AI software must be useful categorizing the disease into different severities, integrating the structured report, prepared according to subjective considerations, with quantitative, objective assessments of the extent of the lesions. In this communication, we present an example of a good tool for the radiologist (Thoracic VCAR software, GE Healthcare, Italy) in Covid-19 diagnosis (Pan et al. in Radiology, 2020. https://doi.org/10.1148/radiol.2020200370). Thoracic VCAR offers quantitative measurements of the lung involvement. Thoracic VCAR can generate a clear, fast and concise report that communicates vital medical information to referring physicians. In the post-processing phase, software, thanks to the help of a colorimetric map, recognizes the ground glass and differentiates it from consolidation and quantifies them as a percentage with respect to the healthy parenchyma. AI software therefore allows to accurately calculate the volume of each of these areas. Therefore, keeping in mind that CT has high diagnostic sensitivity in identifying lesions, but not specific for Covid-19 and similar to other infectious viral diseases, it is mandatory to have an AI software that expresses objective evaluations of the percentage of ventilated lung parenchyma compared to the affected one.


title: COVID-19 and medical emergencies in the dental practice

text: As the government's coronavirus (COVID-19) lockdown starts to be eased and the NHS starts entering phase two of its response to the COVID-19 pandemic, dental practices are expecting a sharp increase in the need for dental treatment. Dental care professionals will have legitimate concerns regarding the risk of transmission of COVID-19, particularly if required to respond to a medical emergency, such as a cardiac arrest. This article provides an overview on being prepared for, and responding to, such an emergency, with particular reference to recently published Resuscitation Council (UK) guidance. A suggested aide-memoire for managing a COVID-19 resuscitation situation is also included, which the authors hope will help dental practices to devise guidelines to meet their local needs, as well as promoting the team response to such a difficult and challenging event.


title: STEMI during the COVID-19 Pandemic - An Evaluation of Incidence

text: The COVID-19 pandemic has dramatically changed the practice medicine on a global scale during the year 2020. With fewer patients presenting to hospitals with the diagnosis of STEMI, healthcare workers are wondering what is causing this decline. This piece presents data from two medical centers and addresses several possible causes to explain this phenomenon. It was found that there was a statistically significant decrease from January to March 2020 in number of presenting STEMI diagnoses.


title: Establishment of an experimental model of small intestinal ischemia and reperfusion injuries in New Zealand rabbits/ Estabelecimento de modelo experimental de indução da lesão de isquemia e reperfusão de intestino delgado em coelhos Nova Zelândia

text: The present study aimed to establish a methodology capable to cause intestinal ischemia and reperfusion injuries, to perform clamping of the jejunal segment of the extramural peri-intestinal marginal artery branch. For this, 37, 10-week-old male New Zealand breed rabbits were used. One rabbit was used to establish the anatomic references for the procedure and was not part of the six experimental groups; the rest were allocated into six experimental groups: Sham group, negative control, subjected only to midline celiotomy; group I1H undergoing vascular occlusion for an hour; group I2H submitted to vascular occlusion for two hours; group I1H/R2H undergoing vascular occlusion for one hour followed by two hours of reperfusion; group I2H/R1H undergoing vascular occlusion for two hours, followed by reperfusion for one hour, and group I2H/R5H undergoing vascular occlusion for two hours followed by reperfusion for five hours. The rabbits were evaluated for the macroscopic aspects (color and peristalsis) of the jejunal segment, as well as the histological aspect, checking for presence or absence of mucosal destruction, edema, hemorrhaging, lymphatic vessel dilatation, and the presence of polymorphonuclear cells. It was observed that the macroscopic and histopathological lesions accentuated in larger employed ischemia and reperfusion times. Rabbits subjected to ischemia for two hours followed by reperfusion for five hours (I2H/R5H) made up the experimental group which was easily reproducible and showed moderate intestinal injury, different from the other groups.(AU)


title: Otolaryngology in the Time of Corona: Assessing Operative Impact and Risk During the COVID-19 Crisis

text: OBJECTIVE: Limited research exists on the coronavirus disease 2019 (COVID-19) pandemic pertaining to otolaryngology-head and neck surgery (OHNS). The present study seeks to understand the response of OHNS workflows in the context of policy changes and to contribute to developing preparatory guidelines for perioperative management in OHNS. STUDY DESIGN: Retrospective cohort study. SETTING: Pediatric and general adult academic medical centers and a Comprehensive Cancer Center (CCC). SUBJECTS AND METHODS: OHNS cases from March 18 to April 8, 2020-the 3 weeks immediately following the Ohio state-mandated suspension of all elective surgery on March 18, 2020-were compared with a 2019 control data set. RESULTS: During this time, OHNS at the general adult and pediatric medical centers and CCC experienced 87.8%, 77.1%, and 32% decreases in surgical procedures as compared with 2019, respectively. Aerosol-generating procedures accounted for 86.8% of general adult cases, 92.4% of pediatric cases, and 62.0% of CCC cases. Preoperative COVID-19 testing occurred in 7.1% of general adult, 9% of pediatric, and 6.9% of CCC cases. The majority of procedures were tiers 3a and 3b per the Centers for Medicare & Medicaid Services. Aerosol-protective personal protective equipment (PPE) was worn in 28.6% of general adult, 90% of pediatric, and 15.5% of CCC cases. CONCLUSION: For OHNS, the majority of essential surgical cases remained high-risk aerosol-generating procedures. Preoperative COVID-19 testing and intraoperative PPE usage were initially inconsistent; systemwide guidelines were developed rapidly but lagged behind recommendations of the OHNS department and its academy. OHNS best practice standards are needed for preoperative COVID-19 status screening and PPE usage as we begin national reopening.


Racial disparities in COVID-19 deaths reveal harsh truths about structural inequality in America


title: Pangolins Harbor SARS-CoV-2-Related Coronaviruses

text: The pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has posed a severe threat to global public health. Yet, the origin of SARS-CoV-2 remains mysterious. Several recent studies (e.g., Lam et al.,Xiao et al.) identified SARS-CoV-2-related viruses in pangolins, providing novel insights into the evolution and diversity of SARS-CoV-2-related viruses.


title: Mapping of Health Literacy and Social Panic Via Web Search Data During the COVID-19 Public Health Emergency: Infodemiological Study

text: BACKGROUND: Coronavirus disease (COVID-19) is a type of pneumonia caused by a novel coronavirus that was discovered in 2019. As of May 6, 2020, 84,407 cases and 4643 deaths have been confirmed in China. The Chinese population has expressed great concern since the COVID-19 outbreak. Meanwhile, an average of 1 billion people per day are using the Baidu search engine to find COVID-19-related health information. OBJECTIVE: The aim of this paper is to analyze web search data volumes related to COVID-19 in China. METHODS: We conducted an infodemiological study to analyze web search data volumes related to COVID-19. Using Baidu Index data, we assessed the search frequencies of specific search terms in Baidu to describe the impact of COVID-19 on public health, psychology, behaviors, lifestyles, and social policies (from February 11, 2020, to March 17, 2020). RESULTS: The search frequency related to COVID-19 has increased significantly since February 11th. Our heat maps demonstrate that citizens in Wuhan, Hubei Province, express more concern about COVID-19 than citizens from other cities since the outbreak first occurred in Wuhan. Wuhan citizens frequently searched for content related to "medical help," "protective materials," and "pandemic progress." Web searches for "return to work" and "go back to school" have increased eight-fold compared to the previous month. Searches for content related to "closed community and remote office" have continued to rise, and searches for "remote office demand" have risen by 663% from the previous quarter. Employees who have returned to work have mainly engaged in the following web searches: "return to work and prevention measures," "return to work guarantee policy," and "time to return to work." Provinces with large, educated populations (eg, Henan, Hebei, and Shandong) have been focusing on "online education" whereas medium-sized cities have been paying more attention to "online medical care." CONCLUSIONS: Our findings suggest that web search data may reflect changes in health literacy, social panic, and prevention and control policies in response to COVID-19.


title: The Decreasing Incidence of Acute Appendicitis During COVID-19: A Retrospective Multi-centre Study

text: BACKGROUND: As the novel coronavirus disease 19 (COVID-19) spreads, a decrease in the number of patients with acute appendicitis (AA) has been noted in our institutions. The aim of this study was to compare the incidence and severity of AA before and during the COVID-19 pandemic. METHODS: A retrospective cohort analysis was performed between December 2019 and April 2020 in the four high-volume centres that provide health care to the municipality of Jerusalem, Israel. Two groups were created. Group A consisted of patients who presented in the 7 weeks prior to COVID-19 first being diagnosed, whilst those in the 7 weeks after were allocated to Group B. A comparison was performed between the clinicopathological features of the patients in each group as was the changing incidence of AA. RESULTS: A total of 378 patients were identified, 237 in Group A and 141 in Group B (62.7% vs. 37.3%). Following the onset of COVID-19, the weekly incidence of AA decreased by 40.7% (p = 0.02). There was no significant difference between the groups in terms of the length of preoperative symptoms or surgery, need for postoperative peritoneal drainage or the distribution of complicated versus uncomplicated appendicitis. CONCLUSIONS: The significant decrease in the number of patients admitted with AA during the onset of COVID-19 possibly represents successful resolution of mild appendicitis treated symptomatically by patients at home. Further research is needed to corroborate this assumption and identify those patients who may benefit from this treatment pathway.


title: COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease

text: As of 22 February 2020, more than 77662 cases of confirmed COVID-19 have been documented globally with over 2360 deaths. Common presentations of confirmed cases include fever, fatigue, dry cough, upper airway congestion, sputum production, shortness of breath, myalgia/arthralgia with lymphopenia, prolonged prothrombin time, elevated C-reactive protein, and elevated lactate dehydrogenase. The reported severe/critical case ratio is approximately 7-10% and median time to intensive care admission is 9.5-10.5 days with mortality of around 1-2% varied geographically. Similar to outbreaks of other newly identified virus, there is no proven regimen from conventional medicine and most reports managed the patients with lopinavir/ritonavir, ribavirin, beta-interferon, glucocorticoid and supportive treatment with remdesivir undergoing clinical trial. In China, Chinese medicine is proposed as a treatment option by national and provincial guidelines with substantial utilization. We reviewed the latest national and provincial clinical guidelines, retrospective cohort studies, and case series regarding the treatment of COVID-19 by add-on Chinese medicine. We have also reviewed the clinical evidence generated from SARS and H1N1 management with hypothesized mechanisms and latest in silico findings to identify candidate Chinese medicines for the consideration of possible trials and management. Given the paucity of strongly evidence-based regimens, the available data suggest that Chinese medicine could be considered as an adjunctive therapeutic option in the management of COVID-19.


Communication with Patients and Families Regarding Health Care-Associated Exposure to Coronavirus 2019: A Checklist to Facilitate Disclosure


title: Using mobility data in the design of optimal lockdown strategies for the COVID-19 pandemic in England

text: A mathematical model for the COVID-19 pandemic spread in England is presented. The model integrates age-structured Susceptible-Exposed-Infected-Removed dynamics with real mobile phone data accounting for the population mobility. The dynamical model adjustment is performed via Approximate Bayesian Computation. Optimal lockdown and exit strategies are determined based on nonlinear model predictive control, constrained to public-health and socio-economic factors. Through an extensive computational validation of the methodology, it is shown that it is possible to compute robust exit strategies with realistic reduced mobility values to inform public policy making.


title: A 56-year-old man with RT-PCR negative nasopharyngeal swabs with Coronavirus Disease 2019 (COVID-19) Pneumonia

text: INTRODUCTION: Diagnostic procedure in Coronavirus Disease 2019 (COVID-19) is based mainly on performing real-time-reverse transcription-polymerase chain-reaction (RT-PCR), which has been accepted as the gold standard method. In some cases, such as mutations of the SARS-CoV-2 genome, variable viral load kinetics or laboratory errors, it can be false-negative. CASE REPORT: The case is presented of a 56-year-old man with respiratory tract symptoms, with twice negative results of real-time-reverse transcription-polymerase chain-reaction of nasopharyngeal swabs and positive chest computed tomography, with typical findings for COVID-19 pneumonia. CONCLUSIONS: Patients with negative RT-PCR results, but with positive computed tomography findings characteristic for COVID-19, should be treated as well as those infected.


A brave new world: the new normal for general practice after the COVID-19 pandemic


title: Coronavirus disease 2019 (COVID-19) pandemic: Review of guidelines for resuming non-urgent imaging and procedures in radiology during Phase II

text: Since the spread of the coronavirus disease 2019 (COVID-19) was designated as a pandemic by the World Health Organization, health care systems have been forced to adapt rapidly to defer less urgent care during the crisis. The United States (U.S.) has adopted a four-phase approach to decreasing and then resuming non-essential work. Through strong restrictive measures, Phase I slowed the spread of disease, allowing states to safely diagnose, isolate, and treat patients with COVID-19. In support of social distancing measures, non-urgent studies were postponed, and this created a backlog. Now, as states transition to Phase II, restrictions on non-essential activities will ease, and radiology departments must re-establish care while continuing to mitigate the risk of COVID-19 transmission all while accommodating this backlog. In this article, we propose a roadmap that incorporates the current practice guidelines and subject matter consensus statements for the phased reopening of non-urgent and elective radiology services. This roadmap will focus on operationalizing these recommendations for patient care and workforce management. Tiered systems are proposed for the prioritization of elective procedures, with physician-to-physician communication encouraged. Infection control methods, provision of personal protective equipment (PPE), and physical distancing measures are highlighted. Finally, changes in hours of operation, hiring strategies, and remote reading services are discussed for their potential to ease the transition to normal operations.


title: Innovative countermeasures can maintain cancer care continuity during the coronavirus disease-2019 pandemic in Korea

text: BACKGROUND: Even though Korea was known to have the highest number of coronavirus disease-2019 (COVID-19) infection in the early phase of the pandemic, Korea was able to successfully flatten the curve in a short period of time without extreme measures. We compared the status of cancer management before and after COVID-19 and analysed how cancer care continuity was maintained in Korea. PATIENTS AND METHODS: We investigated the medical records on the number of cancer diagnosis, cancer surgery, radiation therapy and scheduled chemotherapy conducted in Korea University Anam Hospital from January 1 to April 30, 2019 and from the same period in 2020. We also collected the data of metastatic cancer patients who were hospitalised due to respiratory disease. RESULTS: Of all diagnoses, 1694 cancer diagnoses were made in the study period of 2019, and 1445 diagnoses in 2020 (decreased by 14.7%); the cancer surgery performed 830 and 800 cases; the set-up for radiation therapy decreased from 185 to 140 cases; the number of systemic chemotherapies for metastatic cancer patients treated in department of medical oncology increased from 2555 to 2878 cases. Among hospitalised patients, emergency centre visit, intensive care unit admission, discharge after recovery and death reveal no drastic changes. CONCLUSIONS: Routine cancer care for patients with metastatic cancer has been maintained without significant difference before and after the COVID-19 pandemic. The Korean government's innovative countermeasures in the early phase of outbreak made it possible for cancer care practitioners to provide cancer patients with regular care under the standard infection control protocol.