title: Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality

text: Since December 2019, a viral pneumonia, named coronavirus disease 2019 (COVID-19), from Wuhan, China, has swept the world. Although the case fatality rate is not high, the number of people infected is large and there is still a large number of patients dying. With the collation and publication of more and more clinical data, a large number of data suggest that there are mild or severe cytokine storms in severe patients, which is an important cause of death. Therefore, treatment of the cytokine storm has become an important part of rescuing severe COVID-19 patients. Interleukin-6 (IL-6) plays an important role in cytokine release syndrome. If it is possible to block the signal transduction pathway of IL-6, it is expected to become a new method for the treatment of severe COVID-19 patients. Tocilizumab is an IL-6 receptor (IL-6R) blocker that can effectively block the IL-6 signal transduction pathway and thus is likely to become an effective drug for patients with severe COVID-19.


Equity360: Gender, Race, and Ethnicity-COVID-19 and Preparing for the Next Pandemic


title: Research on the prevention and control of 2019 novel coronavirus pneumonia for Internet-based hospitals using UTAUT-DST model/ 中华医院管理杂志

text: Thanks to the transmission characteristics of 2019 novel coronavirus pneumonia, Internet-based hospitals can effectively cut off the transmission route via online consulting service. The hospital, leveraging the UTAUT model and DST theory, and advantages of Internet-based hospitals, is deploying step by step such four modules, as "pre-hospital screening", "patient acceptance", "auxiliary diagnosis and treatment", and "prevention and control linkage". These efforts ultimately contribute to an innovative prevention and control pattern against the novel coronary pneumonia for Internet-based hospitals and based on the UTAUT-DST model. This practice proves an initial success, and offers useful references for prevention and control of the NCP and development of other Internet-based hospitals.


SLE, hydroxychloroquine and no SLE patients with COVID-19: a comment


title: Factors Associated with Preventive Behaviours of COVID-19 among Hospital Staff in Iran in 2020: An Application of the Protection Motivation Theory

text: This study was conducted for predicting preventive behaviours of healthcare workers (HCW) towards Covid-19 based on the Protection Motivation Theory (PMT). This cross-sectional and analytical study was conducted on 761 HCW in Hamadan, Iran, using multi-stage random sampling. The preventive behaviours against COVID-19 among HCW were assessed at a relatively desirable level. Based on the PMT, threat and coping appraisal were predictors of protection motivation to conduct COVID-19 preventive behaviours (P<0.001). The intention was also predictive of COVID-19 preventive behaviours (P<0.001). Consideration of personnel's self-efficacy and their knowledge regarding the effectiveness of protective behaviours in designing staff training programs are recommended.


In reply to Simcock et al


title: The Prevention and Management of COVID-19: Seeking a Practical and Timely Solution

text: We read with interest several manuscripts recently published in the International Journal of Environmental Research and Public Health (IJERPH) on the ongoing coronavirus pandemic. While these articles provide a well-rounded overview on the risk and current status of this virus, we herein add some relevant information on its etiology, prevention and management, especially for resource-limited healthcare systems. The use of protective actions is both complex and expensive. Affordable options are essential to respond to this and future viral outbreaks.


title: COVID-19 pandemic and its impact on service provision: A cardiology prospect

text: Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the availability of cardiology services and management of cardiac conditions. Elective surgeries, outpatient appointments and cardiac imaging have been largely cancelled across the world due to the risk of infection transmission and the need for reallocation of resources to deal with the increasing number of COVID-19 patients. The impact on patients with cardiac co-morbidities during these times may be drastic. However, cardiologists and hospitals across the world have implemented measures to ensure on-going monitoring and care of patients remotely. In this review, we discuss the impact of COVID-19 on cardiac services including interventional cardiology services, cardiac imaging and outpatient appointments. In addition, implications for future research and clinical practice are also discussed.


The early effects of social distancing resultant from COVID-19 on admissions to a Level I trauma center


title: Innovative screening tests for COVID-19 in South Korea

text: Recently, the number of Corona Virus Disease 2019 (COVID-19) cases has increased remarkably in South Korea, so the triage clinics and emergency departments (ED) are expected to be overcrowded with patients with presumed infection. As of March 21st, there was a total of 8,799 confirmed cases of COVID-19 and 102 related deaths in South Korea that was one of the top countries with high incidence rates [1]. This sharp increase in infection is associated with 1) outbreaks in individual provinces, 2) deployment of rapid and aggressive screening tests, 3) dedicated healthcare staffs for virus screening tests, 4) quarantine inspection data transparency and accurate data reporting, and 5) public health lessons from previous Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) outbreaks. This commentary introduces innovative screening tests that are currently used in South Korea for COVID-19, e.g., Drive-Through and Walk-Through tests, and compare the advantages and disadvantages of both methods.


Des propositions pragmatiques pour le suivi respiratoire des patients après une infection à SARS-CoV-2 établies en un temps record à destination de tous les professionnels de santé./ [Pragmatic proposals of respiratory follow-up for patients with SARS-CoV-2 infection established in record time for all healthcare practioners]


Health status of patients with autoimmune liver disease during SARS-CoV-2 outbreak in northern Italy


title: Mesenchymal Stem Cell Therapy for COVID-19: Present or Future

text: "COVID-19" is the word that certainly isn't forgotten by everybody who lives in the first half of the twenty-first century. COVID-19, as a pandemic, has led many researchers from different biomedical fields to find solutions or treatments to manage the pandemic. However, no standard treatment for this disease has been discovered to date. Probably, preventing the severe acute respiratory infection form of COVID-19 as the most dangerous phase of this disease can be helpful for the treatment and reduction of the death rate. In this regard, mesenchymal stem cells (MSCs)-based immunomodulation treatment has been proposed as a suitable therapeutic approach and several clinical trials have begun. Recently, MSCs according to their immunomodulatory and regenerative properties attract attention in clinical trials. After the intravenous transplantation of MSCs, a significant population of cells accumulates in the lung, which they alongside immunomodulatory effect could protect alveolar epithelial cells, reclaim the pulmonary microenvironment, prevent pulmonary fibrosis, and cure lung dysfunction. Given the uncertainties in this area, we reviewed reported clinical trials and hypotheses to provide useful information to researchers and those interested in stem cell therapy. In this study, we considered this new approach to improve patient's immunological responses to COVID-19 using MSCs and discussed the aspects of this proposed treatment. However, currently, there are no approved MSC-based approaches for the prevention and/or treatment of COVID-19 patients but clinical trials ongoing.


title: Barriers to Hospital Electronic Public Health Reporting and Implications for the COVID-19 Pandemic

text: We sought to identify barriers to hospital reporting of electronic surveillance data to local, state, and federal public health agencies and the impact on areas projected to be overwhelmed by the COVID-19 pandemic. Using 2018 American Hospital Association data, we identified barriers to surveillance data reporting, and combined this with data on the projected impact of the COVID-19 pandemic on hospital capacity at the hospital referral region (HRR) level. Our results find the most common barrier was public health agencies lacked the capacity to electronically receive data, with 41.2% of all hospitals reporting it. We also identified 31 HRRs in the top quartile of projected bed capacity needed for COVID-19 patients in which over half of hospitals in the area reported that the relevant public health agency was unable to receive electronic data. Public health agencies' inability to receive electronic data is the most prominent hospital-reported barrier to effective syndromic surveillance. This reflects the policy commitment of investing in information technology for hospitals without a concomitant investment in IT infrastructure for state and local public health agencies.


title: Impact of national lockdown on COVID-19 deaths in select European countries and the US using a Changes-in-Changes model

text: In this paper, we estimate the impact of national lockdown on COVID-19 related total and daily deaths, per million people, in select European countries. In particular, we compare countries that imposed a nationwide lockdown (Treatment group); Belgium, Denmark, France, Germany, Italy, Norway, Spain, United Kingdom (UK), and the US, to Sweden (Control group) that did not impose national lockdown using a changes-in-changes (CIC) estimation model. The key advantage of the CIC model as compared to the standard difference-in-difference model is that CIC allows for mean and variance of the outcomes to change over time in the absence of any policy intervention, and CIC accounts for endogeneity in the choice of policy intervention. Our results indicate that in contrast to Sweden, which did not impose a national lockdown, Germany, and to some extent, the US were the two countries where nationwide lockdown had a significant impact on the reduction in COVID-19 related total and daily deaths per million people. In Norway and Denmark, there was no significant impact on total and daily deaths per million people relative to Sweden. Whereas in other countries; Belgium, France, Italy, Spain, and the UK, the effect of the lockdown was in the opposite direction, that is, they experienced significantly higher COVID-19 related total and daily deaths per million people, post the lockdown as compared to Sweden. Our results suggest that the impact of nationwide lockdown on COVID-19 related total and daily deaths per million people varied from one country to another.


Rapid ramp-up of powered air-purifying respirator (PAPR) training for infection prevention and control during the COVID-19 pandemic


Derivation and validation of a scoring system to assess pre-test probability of being COVID-19 positive


[Analysis of low positive rate of nucleic acid detection method used for diagnosis of novel coronavirus pneumonia]


title: Robust Screening of COVID-19 from Chest X-ray via Discriminative Cost-Sensitive Learning

text: This paper addresses the new problem of automated screening of coronavirus disease 2019 (COVID-19) based on chest X-rays, which is urgently demanded toward fast stopping the pandemic. However, robust and accurate screening of COVID-19 from chest X-rays is still a globally recognized challenge because of two bottlenecks: 1) imaging features of COVID-19 share some similarities with other pneumonia on chest X-rays, and 2) the misdiagnosis rate of COVID-19 is very high, and the misdiagnosis cost is expensive. While a few pioneering works have made much progress, they underestimate both crucial bottlenecks. In this paper, we report our solution, discriminative cost-sensitive learning (DCSL), which should be the choice if the clinical needs the assisted screening of COVID-19 from chest X-rays. DCSL combines both advantages from fine-grained classification and cost-sensitive learning. Firstly, DCSL develops a conditional center loss that learns deep discriminative representation. Secondly, DCSL establishes score-level cost-sensitive learning that can adaptively enlarge the cost of misclassifying COVID-19 examples into other classes. DCSL is so flexible that it can apply in any deep neural network. We collected a large-scale multi-class dataset comprised of 2,239 chest X-ray examples: 239 examples from confirmed COVID-19 cases, 1,000 examples with confirmed bacterial or viral pneumonia cases, and 1,000 examples of healthy people. Extensive experiments on the three-class classification show that our algorithm remarkably outperforms state-of-the-art algorithms. It achieves an accuracy of 97.01%, a precision of 97%, a sensitivity of 97.09%, and an F1-score of 96.98%. These results endow our algorithm as an efficient tool for the fast large-scale screening of COVID-19.


The impact of COVID-19


title: Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'

text: On the 21st of February 2020 a resident of the municipality of Vo', a small town near Padua, died of pneumonia due to SARS-CoV-2 infection1. This was the first COVID-19 death detected in Italy since the emergence of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province2. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days3. We collected information on the demography, clinical presentation, hospitalization, contact network and presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo' at two consecutive time points. On the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI) 2.1-3.3%). On the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% Confidence Interval (CI) 0.8-1.8%). Notably, 42.5% (95% CI 31.5-54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (i.e. did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI 5.9-9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (p-values 0.62 and 0.74 for E and RdRp genes, respectively, Exact Wilcoxon-Mann-Whitney test). This study sheds new light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides new insights into its transmission dynamics and the efficacy of the implemented control measures.


title: SNMMI COVID-19 Resource Center

text: SNMMI COVID-19 Resource Center On March 27, SNMMI President Vasken Dilsizian, MD, announced the launch of the society’s online COVID-19 Resource Center in response to the global pandemic He noted a confluence of factors that were changing the nature of day-to-day nuclear medicine practice across the country Among these were: • Nuclear medicine physicians and technologists were being called on to step outside their areas of practice to help with issues related to COVID-19, sometimes with inadequate protection • Nuclear medicine researchers were facing mandatory closure of labs and discontinuation or delay of important research studies • Nuclear medicine pharmacists were challenged to ensure the availability of all needed clinical drugs, with growing concern about isotope supply pipelines • Educators were transitioning rapidly to virtual learning, with little preparation and limited resources • Residents and other trainees were confronting questions about ways to continue their educational paths in uncertain times • In some cases, nuclear medicine professionals were facing furloughs or layoffs as a result of decreases in or elimination of elective, outpatient, and other procedures As of this writing, these challenges not only persist but have been magnified by the impact of the virus spread The SNMMI COVID-19 Resource Center continues to consolidate information and resources to address these issues Special features include: • Information specific to nuclear medicine, including advice on ventilation/perfusion studies and updates on radioisotope supply, as well as useful articles from The Journal of Nuclear Medicine;• Government agency resources on COVID-19;• Other resources, such as American Medical Association and COVID-19 data websites;• Training and certification resources, with advice from nuclear medicine–related boards and associations;and • Current status of SNMMI activities, including the SNMMI Annual Meeting in June Information on the center is frequently updated and expanded with new resources Individuals with special concerns and questions are urged to send these to covidhelp@snmmi org The SNMMI COVID-19 Resource Center is available at http://www snmmi org/COVID-19 SNMMI


Emergence of a Novel Coronavirus Disease (COVID-19) and the Importance of Diagnostic Testing: Why Partnership between Clinical Laboratories, Public Health Agencies, and Industry Is Essential to Control the Outbreak


title: Iterated $S^3$ Sasaki Joins and Bott Orbifolds

text: We present a categorical relationship between iterated $S^3$ Sasaki-joins and Bott orbifolds. Then we show how to construct smooth Sasaki-Einstein (SE) structures on the iterated joins. These become increasingly complicated as dimension grows. We give an explicit construction of (infinitely many) smooth SE structures up through dimension eleven, and conjecture the existence of smooth SE structures in all odd dimensions.


title: Biventricular thrombi associated with myocardial infarction in a patient with COVID-19: a case report

text: A wide spectrum of cardiovascular manifestations has been documented in patients suffering from coronavirus disease (COVID-19). Usually associated with a poor prognosis, these manifestations include thrombo-embolic events, acute coronary syndrome, heart failure and cardiogenic shock. We describe a COVID-19 patient who presented with subacute myocardial infarction, biventricular thrombi and bilateral pulmonary emboli. Biventricular thrombi are rare, and their presence raises concern for an underlying prothrombotic condition.


Willingness to vaccinate against COVID-19 in Australia


title: COVID-19: An otolaryngological perspective

text: Otolaryngologists around the world are amongst the front-line fighters against the pandemic coronavirus disease (COVID-19). As knowledge about the disease epidemiology and clinical profile is rapidly evolving, we are still not sure about many different aspects of the disease transmission and presentation. Otolaryngologists regularly deal with the upper aerodigestive tract, which is the portal of transmission and site of multiplication of the virus. There is a substantial risk of getting infected and transmitting the disease further. We discuss the various recommendations pertaining to the emergency and elective procedures in otolaryngology, and head and neck surgeries in these difficult times, so as to sensitise the clinicians while dealing with such cases, till the pandemic is under control and things get back to normal.


Emergency ambulance services for heart attack and stroke during UK's COVID-19 lockdown


COVID-19 Diagnostic Imaging: Caution Need Before the End of the Game


title: Therapeutic opportunities to manage COVID-19/SARS-CoV-2 infection: Present and future

text: A severe form of respiratory disease - COVID-19, caused by SARS-CoV-2 infection, has evolved into a pandemic resulting in significant morbidity and mortality. The unabated spread of the disease is due to lack of vaccine and effective therapeutic agents against this novel virus. Hence, the situation demands an immediate need to explore all the plausible therapeutic and prophylactic strategies that can be made available to stem the spread of the disease. Towards this effort, the current review outlines the key aspects of the pathobiology associated with the morbidity and mortality in COVID-19 patients, which includes a viral response phase and an exaggerated host response phase. The review also summarizes therapeutic agents that are currently being explored along with those with potential for consideration. The broad groups of therapeutic agents discussed include those that: (i) block viral entry to host cells, (ii) block viral replication and survival in host cells, and (iii) dampen exaggerated host immune response. The various kinds of pharmaceutical prophylactic options that may be followed to prevent COVID-19 have also been discussed.


title: Managing psychological distress in children and adolescents following the COVID-19 epidemic: A cooperative approach

text: Children and adolescents are susceptible to the 2019 novel coronavirus (COVID-19) epidemic and tend to show posttraumatic distress. Immediately after an epidemic, governments and social organizations often provide psychological services for children and adolescents to relieve their distress. However, many adolescents report distress even long after a traumatic event because of the unaddressed traumatic atmosphere in schools or families. To advance this issue, this article proposes a cooperative model of psychological services provision for children and adolescents in response to the COVID-19 epidemic. This model suggests that psychological services should simultaneously include social, school, and family systems, which interact and have a synergistic effect. The social system provides direct services not only for children and adolescents but also for their school and family systems; school and family systems cooperate to support adolescents. Psychological work also needs to emphasize the key elements of school and family systems. Attention should be given to teachers' distress, teacher-student relationships, and peer relationships in the school system, as well as to parents' distress, parent-child relationships, and the marital relationship in the family system. In these ways, adolescents can achieve an efficient and sustainable recovery following a disaster. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Can North Korea Cope With the Coronavirus? Kim Jong Un Faces His Greatest Test Yet


Serious adverse drug reactions with hydroxychloroquine: a pharmacovigilance study in Vigibase®


Covid-19 in dementia: an insidious pandemic


An academic allergy unit during COVID-19 pandemic in Italy


Increased flare of acne caused by long-time mask wearing during COVID-19 pandemic among general population


Increased Flare of Acne Caused by Long-Time Mask Wearing During COVID-19 Pandemic among General Population


Age but not sex may explain the negative effect of arterial hypertension and diabetes on COVID-19 prognosis


title: Awake laparotomy: is locoregional anesthesia a functional option for major abdominal surgeries in the COVID-19 era?

text: OBJECTIVE: Over the ongoing pandemic of coronavirus disease 2019 (COVID-19), the demand for critical care beds among medical services has rapidly exceeded its supply. Elective surgery has comprehensively been drastically limited and allocating intensive care beds to emergency cases or to high risk scheduled elective cases has become an even more difficult task. Here we present our experience which could help to handle undelayable surgical procedures during this emergency. PATIENTS AND METHODS: In 2019, eight patients (4 men, 4 women) with a mean age of 88 years, needing emergency abdominal surgery underwent awake open surgery at our Department of Surgery. All of them were identified as fragile patients at preoperative evaluation by the anesthesiologist. In all cases, locoregional anesthesia (spinal, epidural or combined spinal-epidural anesthesia) was performed. Intraoperative and postoperative pain has been monitored and regularly assessed. RESULTS: None of the patients was intubated. Mean operative time was 80 minutes (minimum 30 minutes, maximum 130 minutes). Intraoperative and postoperative pain were both well controlled. None of them required postoperative intensive care support. No perioperative complications were observed. CONCLUSIONS: Based on our preliminary case series, awake open surgery has resulted feasible and safe. This approach has allowed to perform undelayable major abdominal surgeries on fragile patients when intensive care beds were not available. Surely, it represents a helpful alternative in the COVID-19 era. A streamlining of workflows would fast-track both fragile patients management, as well as healthcare workers' tasks and activity.


An educational case series of electrocardiographs during the COVID-19 pandemic and their implications on therapy


title: Declines in Hospitalizations for Acute Cardiovascular Conditions During the COVID-19 Pandemic: A Multicenter Tertiary Care Experience

text: BACKGROUND: While patients with cardiovascular disease face excess risks of severe illness with coronavirus disease-2019 (COVID-19), there may be indirect consequences of the pandemic on this high-risk patient segment. OBJECTIVES: To examine longitudinal trends in hospitalizations for acute cardiovascular conditions across a tertiary care healthcare system. METHODS: We tracked acute cardiovascular hospitalizations between January 1st, 2019 and March 31st, 2020. We estimated daily hospitalization rates using negative binomial models. Temporal trends in hospitalization rates were compared across the first 3 months of 2020, with the first 3 months of 2019 as a reference. RESULTS: From January 1, 2019 to March 31, 2020, 6,083 patients experienced 7,187 hospitalizations for primary acute cardiovascular reasons. There was 43.4% (27.4% to 56.0%) fewer estimated daily hospitalizations in March 2020 as compared with March 2019 (P<0.001). The daily rate of hospitalizations did not change throughout 2019 (-0.01% per day [-0.04% to +0.02%], P=0.50), January 2020 (-0.5% per day [-1.6% to +0.5%], P=0.31), or February 2020 (+0.7% per day [-0.6% to +2.0%], P=0.27). There was significant daily decline in hospitalizations in March 2020 (-5.9% per day [-7.6% to -4.3%], P<0.001). Length of stay was shorter (4.8 [2.4,8.3] days vs. 6.0 [3.1,9.6] days; P=0.003) and in-hospital mortality was not significantly different (6.2% vs. 4.4%; P=0.30) in March 2020 compared with March 2019. CONCLUSIONS: During the first phase of the COVID-19 pandemic, there was a marked decline in acute cardiovascular hospitalizations and patients who were admitted had shorter lengths of stay. These data substantiate concerns that acute care of cardiovascular conditions may be delayed, deferred, or abbreviated during the COVID-19 pandemic.


title: Who's afraid of Ebola? Epidemic fires and locative fears in the Information Age

text: Epidemics have traditionally been viewed as the widespread occurrence of infectious disease within a community, or a sudden increase above what is typical. But modern epidemics are both more and less than the diffusion of viral entities. We argue that epidemics are 'fire objects', using a term coined by Law and Singleton: They generate locative fears through encounters that focus attention on entities that are unknown or imprecisely known, transforming spaces and humans into indeterminate dangers, alternating appearance and absence. The Ebola epidemic of 2014 had more complex impacts than the number of infections would suggest. We employ multi-sited qualitative interviews to argue that locative fear is the essence of modern global epidemics. In the discussion we contrast Ebola with both the Zika epidemic that followed and the ongoing coronavirus (COVID-19) pandemic.


Prophylactic anticoagulant therapy for reducing the risk of stroke and other thrombotic events in COVID-19 patients


title: SARS-CoV-2: The Path of Prevention and Control

text: The 2019 coronavirus pandemic (COVID-19) continues to expand worldwide. Although the number of cases and the death rate among children and adolescents are reported to be low compared to adults, limited data have been reported. We urgently need to find treatment and vaccine to stop the epidemic. Vaccine development is in progress, but any approved and effective vaccine for COVID-19 is at least 12 to 18 months. The World Health Organization (WHO), the Center for Disease Control and Prevention (CDC), and the Food and Agriculture Organization (FAO) have issued instructions and strategies for containing COVID-19 outbreak to the general public, physicians, travelers and injured patients to follow so that the transmission to a healthy population can be prevented. In this review, we summarize demographic data, clinical characteristics, complications and outcomes and finally prevention and control of this serious pandemic.


Chilblain-like lesions on feet and hands during the COVID-19 Pandemic


Mapping the Changes on Incidence, Case Fatality Rates and Recovery Proportion of COVID-19 in Afghanistan Using Geographical Information Systems


title: COVID-19 Has Clarified 2 Foundational Policy Questions in Dentistry

text: Before the COVID-19 pandemic, health policy debates about the importance of oral health and dental care were intensifying around the world. These debates were invariably complex and muddled by political, professional, and commercial interests. Although, in broad terms, 2 foundational questions have tended to undergird debates on how dental care should be addressed in health policy. These are: who should receive the support of governments, and what constitutes essential or medically necessary dental care? In our view, the COVID-19 pandemic has provided a stark social and policy context that has radically clarified both questions. Knowledge Transfer Statement: This commentary can be used by governments, regulators, professional groups, and other stakeholders in their considerations of what constitutes essential or medically necessary dental care and how to best allocate dental care resources.


title: Faecal calprotectin and gut microbiota do not predict enteropathy in very preterm infants

text: AIM: Very preterm birth is associated to a high risk of enteropathies. Diagnosis is challenging, especially in mild forms, leading to unnecessary periods of cessation of enteral feeding. This study aimed at establishing a prognosis score of enteropathy combining clinical parameters and faecal calprotectin concentration. METHODS: This prospective multicentric study included preterm neonates born at a gestational age of 33 weeks or less. Stools were collected weekly until hospital discharge, and daily in case of digestive events for calprotectin measurement (ELISA and immunochromatography) and microbiota analyses (16S rRNA gene sequencing). RESULTS: Among the 121 neonates included, 21 experienced at least one episode of enteropathy, mainly mild forms. By ELISA testing, median faecal calprotectin was 88 (8-798) µg/g faeces. No statistically significant association was found between the outset of enteropathy and maternal and neonatal characteristics, and calprotectin levels. The agreement between ELISA and immunochromatography assay was moderate (intra-class correlation coefficient 0.58, 95%CI [0.47-0.66]). Comparison of species diversity and relative bacterial abundance profiles between infants with or without enteropathy revealed no specific alterations associated with enteropathy. CONCLUSION: The study failed to propose a prognostic score of enteropathy, probably due the large inter- and intra-individual variability of faecal calprotectin in very preterm neonates.


title: Adapting palliative radiation therapy for bone metastases during the Covid-19 pandemic: GEMO position paper

text: The current health crisis caused by COVID-19 is a challenge for oncology treatment, especially when it comes to radiotherapy. Cancer patients are already known to be very fragile and COVID-19 brings about the risk of severe respiratory complications. In order to treat patients safely while protecting medical teams, the entire health care system must optimize the way it approaches prevention and treatment at a time when social distancing is key to stemming this pandemic. All indications and treatment modalities must be re-discussed. This is particularly the case for radiotherapy of bone metastases for which it is possible to reduce the number of sessions, the frequency of transport and the complexity of treatments. These changes will have to be discussed according to the organization of each radiotherapy department and the health situation, while medical teams must remain vigilant about the risks of complications of bone metastases, particularly spinal metastases. In this short piece, the members of the GEMO (the European Study Group of Bone Metastases) offer a number of recommendations to achieve the above objectives, both in general and in relation to five of the most common situations on radiation therapy for bone metastases.


title: Surveillance and Monitoring of Hepatocellular Carcinoma During the COVID-19 Pandemic

text: The Coronavirus disease 2019 (COVID-19) pandemic is expected to have a long-lasting impact on the approach to care for patients at risk for and with hepatocellular carcinoma (HCC) due to the risks from potential exposure and resource reallocation. The goal of this document is to provide recommendations on HCC surveillance and monitoring, including strategies to limit unnecessary exposure while continuing to provide high-quality care for patients. Publications and guidelines pertaining to the management of HCC during COVID-19 were reviewed for recommendations related to surveillance and monitoring practices, and any available guidance was referenced to support the authors' recommendations when applicable. Existing HCC risk stratification models should be utilized to prioritize imaging resources to those patients at highest risk of incident HCC and recurrence following therapy though surveillance can likely continue as before in settings where COVID-19 prevalence is low and adequate protections are in place. Waitlisted patients who will benefit from urgent LT should be prioritized for surveillance whereas it would be reasonable to extend surveillance interval by a short period in HCC patients with lower risk tumor features and those more than 2 years since their last treatment. For patients eligible for systemic therapy, the treatment regimen should be dictated by the risk of COVID-19 associated with route of administration, monitoring and treatment of adverse events, within the context of relative treatment efficacy.


title: The Novel Coronavirus - A Snapshot of Current Knowledge

text: Another animal to human transmission of a coronavirus occurred in December 2019 on a live animal market in the Chinese city of Wuhan causing an epidemic in China, reaching now different continents. This minireview summarizes the research literature on the virological, clinical and epidemiological aspects of this epidemic published until end of February 2020.


COVID-19 in a melanoma patient under treatment with checkpoint inhibition


title: Meta-analysis of chest CT features of patients with COVID-19 pneumonia

text: The objective of this paper is to perform a meta-analysis regarding the chest computed tomography (CT) manifestations of coronavirus disease-2019 (COVID-19) pneumonia patients. PubMed, Embase, and Cochrane Library databases were searched from 1 December 2019 to 1 May 2020 using the keywords of "COVID-19 virus," "the 2019 novel coronavirus," "novel coronavirus," and "COVID-19." Studies that evaluated the CT manifestations of common and severe COVID-19 pneumonia were included. Among the 9736 searched results, 15 articles describing 1453 common patients and 697 severe patients met the inclusion criteria. Based on the CT images, the common patients were less frequent to exhibit consolidation (odds ratio [OR] = 0.31), pleural effusion (OR = 0.19), lymphadenopathy (OR = 0.17), crazy-paving pattern (OR = 0.22), interlobular septal thickening (OR = 0.27), reticulation (OR = 0.20), traction bronchiectasis (OR = 0.40) with over two lobes involved (OR = 0.07) and central distribution (OR = 0.18) while more frequent to bear unilateral pneumonia (OR = 4.65) involving one lobe (OR = 13.84) or two lobes (OR = 6.95) when compared with severe patients. Other CT features including ground-glass opacities (P = .404), air bronchogram (P = .070), nodule (P = .093), bronchial wall thickening (P = .15), subpleural band (P = .983), vascular enlargement (P = .207), and peripheral distribution (P = .668) did not have a significant association with the severity of the disease. No publication bias among the selected studies was suggested (Harbord's tests, P > .05 for all.) We obtained reliable estimates of the chest CT manifestations of COVID-19 pneumonia patients, which might provide an important clue for the diagnosis and classification of COVID-19 pneumonia.


Distributive justice during the coronavirus disease 2019 pandemic in Australia


title: Isolation of infectious SARS-CoV-2 from urine of a COVID-19 patient

text: SARS-CoV-2 caused a major outbreak of severe pneumonia (COVID-19) in humans. Viral RNA was detected in multiple organs in COVID-19 patients. However, infectious SARS-CoV-2 was only isolated from respiratory specimens. Here, infectious SARS-CoV-2 was successfully isolated from urine of a COVID-19 patient. The virus isolated could infect new susceptible cells and was recognized by its' own patient sera. Appropriate precautions should be taken to avoid transmission from urine.


title: Clinical Characteristics of COVID-19 Infection in Newborns and Pediatrics: A Systematic Review

text: Introduction: World Health Organization has declared COVID-19 a pandemic and a global health emergency Thus, it is necessary to clearly characterize clinical manifestations and management of COVID-19 infection in children to provide accurate information for healthcare workers Accordingly, the present study was designed to review articles published on clinical manifestations and characteristics of children and infants with COVID-19 Methods: In this systematic review, medical databases including Cochrane Library, Web of Science, Embase, Scopus, SID, Medline, WHO and LitCovid were searched using English and Persian keywords including COVID-19, Pediatrics, Newborn, Coronavirus 2019, 2019-nCoV, SARS-CoV-2 Finally, data of 14 related articles were included in the study Results: A total of 2228 children, newborns and infants were studied Clinical manifestation in children may be mild (72%), moderate (22%) or severe (6%), and the most common symptoms include dry cough (91%) and fever (96%) According to the included articles, two children had died, one of which was a 14-year-old boy and his exposure history and underlying disease were unclear, and the other was a male newborn with gestational age of 35 weeks and 5 days, birth weight of 2200, Apgar score of 8, 8 (1 min and 5 min) and his first symptom was increased heart rate No differences were found between male and female children regarding infection with COVID-19 Conclusion: Most pediatrics were infected with COVID-19 due to family cluster or history of close contact Infected children have relatively milder clinical symptoms compared to infected adults We should pay special attention to early diagnosis and early treatment in children infected with COVID-19


COVID-19 and biologics for psoriasis: A high-epidemic area experience-Bergamo, Lombardy, Italy


Covid-19: 146 researchers raise concerns over chloroquine study that halted WHO trial


Locating and repurposing anesthetic machines as intensive care unit ventilators during the COVID-19 pandemic


Covid-19: Adapting the geriatric organisations to respond to the pandemic


title: Talk to Patients About: Why Will It Take So Long for a COVID-19 Vaccine?

text: Of all the solutions to the COVID-19 pandemic, a vaccine is the most attractive With just one shot, people could transform the disease from a global disruptor to an easily manageable public health problem But vaccines can't be whipped up overnight


Equality or utility? Ethics and law of rationing ventilators


title: Thrombus in Transit and Impending Pulmonary Embolism Detected on POCUS in a Patient with COVID-19 Pneumonia

text: Coronavirus disease 2019 (COVID-19) is a pandemic that started in China in December 2019 and carries a high risk of morbidity and mortality To-date (4-22-2020) it affected over 2 6 million people and resulted in nearly 200,000 death worldwide mainly due to severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) Among the major underlying pathophysiologic mechanisms in COVID 19 is hypercoagulability, leading to increased risk for deep vein thrombosis and pulmonary embolism that contribute to increased morbidity and mortality In this report, we present the case of a 55-year-old man who presented with COVID-19 pneumonia, and was found to have a thrombus in transit by routine point of care ultrasound (POCUS) While computer tomography (CT) angiography is the test of choice, the utilization of point of care ultrasound (POCUS) has gained traction as an adjunctive means of surveillance for the development of VTE in patients with COVID-19 In this report, we discuss the clinical utility of POCUS in diagnosing thrombus in transit in COVID 19 populations


title: Analysis and Prediction of COVID-19 Pandemic in Pakistan using Time-dependent SIR Model

text: The current outbreak is known as Coronavirus Disease or COVID-19 caused by the virus SAR-COV-2 which continues to wreak havoc across the globe. The World Health Organization (WHO) has declared the outbreak a Public Health Emergency of International Concern. In Pakistan, the spread of the virus is on the rise with the number of infected people and causalities rapidly increasing. In the absence of proper vaccination and treatment, to reduce the number of infections and casualties, the only option so far is to educate people regarding preventive measures and to enforce countrywide lock-down. Any strategy about the preventive measures needs to be based upon detailed analysis of the COVID-19 outbreak and accurate scientific predictions. In this paper, we conduct mathematical and numerical analysis to come up with reliable and accurate predictions of the outbreak in Pakistan. The time-dependent Susceptible-Infected-Recovered (SIR) model is used to fit the data and provide future predictions. The turning point of the peak of the pandemic is defined as the day when the transmission rate becomes less than the recovering rate. We have predicted that the outbreak will reach its maximum peak occurring from late May to 9 June with unrecovered number of Infectives in the range 20000-47000 and the cumulative number of infected cases in the range of 57500-153100. The number of Infectives will remain at the lower end in the lock-down scenario but can rapidly double or triple if the spread of the epidemic is not curtailed and localized. The uncertainty on single day projection in our analysis after April 15 is found to be within 5\%.


The UK hibernated pandemic influenza research portfolio: triggered for COVID-19


Home Hospice Services during COVID-19: Ensuring Comfort in Unsettling Times in Singapore


title: Provision of Pediatric Immunization Services During the COVID-19 Pandemic: an Assessment of Capacity Among Pediatric Immunization Providers Participating in the Vaccines for Children Program - United States, May 2020

text: Recent reports suggest that routine childhood immunization coverage might have decreased during the coronavirus disease 2019 (COVID-19) pandemic (1,2). To assess the capacity of pediatric health care practices to provide immunization services to children during the pandemic, a survey of practices participating in the Vaccines for Children (VFC) program was conducted during May 12-20, 2020. Data were weighted to account for the sampling design; thus, all percentages reported are weighted. Among 1,933 responding practices, 1,727 (89.8%) were currently open; 1,397 (81.1%) of these reported offering immunization services to all of their patients. When asked whether the practice would likely be able to accommodate new patients to assist with provision of immunization services through August, 1,135 (59.1%) respondents answered affirmatively. These results suggest that health care providers appear to have the capacity to deliver routinely recommended childhood vaccines, allowing children to catch up on vaccines that might have been delayed as a result of COVID-19-related effects on the provision of or demand for routine well child care. Health care providers and immunization programs should educate parents on the need to return for well-child and immunization visits or refer patients to other practices, if they are unable to provide services (3).


title: The future of business education: A commentary in the shadow of the Covid-19 pandemic

text: The Covid-19 pandemic has disrupted business schools worldwide mainly through the shift to emergency remote teaching. I provide a rudimentary framework to understand this transformation through recognizing the changes in the university, the business world and the student. This disruption is going to lead to a decade-long technology-led remaking of business education. Finally, I share a triphasic model that maps the evolution of online learning in business schools.


title: Importation of SARS-CoV-2 infection leads to major COVID-19 epidemic in Taiwan

text: OBJECTIVE: COVID-19 has recently become a pandemic affecting many countries worldwide. This study aims to evaluate the current status of COVID-19 in Taiwan and analyze the source of infection. METHODS: National data regarding SARS-CoV-2 infection were obtained from Taiwan. CDC at the end of April 2020. These data were subjected to analysis of the current status and correlation between indigenous and imported COVID-19 cases. A phylogenetic tree was created to analyze the phylogeny of Taiwanese SARS-CoV-2 isolates. RESULTS: The first case of SARS-CoV-2 infection in Taiwan was detected on January 21, 2020. Epidemiological data indicate that by April 30, there were a total of 429 COVID-19 confirmed cases with the death rate of 1.3%. Most cases were identified as imported (79.9%; 343/429), with the majority originating from the United States of America (22.1%) and the United Kingdom (17.6%). Results from phylogenetic tree analyses indicate that the Taiwanese SARS-CoV-2 isolates were clustered with the SARS-CoV-2 isolates from other countries (bootstrap value 98%) and sub-clustered with bat SARS-like coronaviruses (bootstrap value 99%). CONCLUSION: This study suggests that the importation of SARS-CoV-2 infection was the primary risk-factor resulting in the COVID-19 epidemic in Taiwan.


title: Initial Stroke Thrombectomy Experience in New York City during the COVID-19 Pandemic

text: New York City has become the global epicenter of the coronavirus 2019 (COVID-19) pandemic. Despite a massive shift in health care resources, cerebrovascular disease continues to be a substantial burden. We review the first 10 patients undergoing thrombectomy following a series of governmental and institutional policy changes diverting resources to the care of critically ill patients with COVID-19. Ten patients with emergent large-vessel occlusion underwent thrombectomy between March 23 and April 1, 2020. Five patients tested positive for the COVID-19 virus. Successful reperfusion was achieved in 9 of 10 patients, at a median time of 37 minutes from vascular access. The postprocedural NIHSS score improved by an average of 7.7 points. Of the 5 patients positive for COVID-19, none have experienced a critical respiratory illness. We report the early incidence of COVID-19 positivity in patients with emergent large-vessel occlusion and demonstrate that thrombectomy continues to be an efficacious option, as well as safe for health care providers.


COVID-19 outbreak: Challenges for Addiction services in India


title: Analysis of Spatial Spread Relationships of Coronavirus (COVID-19) Pandemic in the World using Self Organizing Maps

text: We describe in this paper an analysis of the spatial evolution of coronavirus pandemic around the world by using a particular type of unsupervised neural network, which is called self-organizing maps. Based on the clustering abilities of self-organizing maps we are able to spatially group together countries that are similar according to their coronavirus cases, in this way being able to analyze which countries are behaving similarly and thus can benefit by using similar strategies in dealing with the spread of the virus. Publicly available datasets of coronavirus cases around the globe from the last months have been used in the analysis. Interesting conclusions have been obtained, that could be helpful in deciding the best strategies in dealing with this virus. Most of the previous papers dealing with data of the Coronavirus have viewed the problem on temporal aspect, which is also important, but this is mainly concerned with the forecast of the numeric information. However, we believe that the spatial aspect is also important, so in this view the main contribution of this paper is the use of unsupervised self-organizing maps for grouping together similar countries in their fight against the Coronavirus pandemic, and thus proposing that strategies for similar countries could be established accordingly.


title: Porcine Deltacoronavirus nsp5 Cleaves DCP1A to Decrease Its Antiviral Ability

text: Porcine deltacoronavirus (PDCoV) is an emerging swine enteropathogenic coronavirus. The nonstructural protein nsp5, also called 3C-like protease, is responsible for processing viral polyprotein precursors in coronavirus (CoV) replication. Previous studies have shown that PDCoV nsp5 cleaves the NF-κB essential modulator and the signal transducer and activator of transcription 2 to disrupt interferon (IFN) production and signaling, respectively. Whether PDCoV nsp5 also cleaves IFN-stimulated genes (ISGs), IFN-induced antiviral effector molecules, remains unclear. In this study, we screened 14 classical ISGs and found that PDCoV nsp5 cleaved the porcine mRNA-decapping enzyme 1a (pDCP1A) through its protease activity. Similar cleavage of endogenous pDCP1A was also observed in PDCoV-infected cells. PDCoV nsp5 cleaved pDCP1A at glutamine 343 (Q343) and the cleaved pDCP1A fragments, pDCP1A1-343 and pDCP1A344-580, could not inhibit PDCoV infection. Mutant pDCP1A-Q343A, which resists nsp5-mediated cleavage, exhibited a stronger ability to inhibit PDCoV infection compared with wild-type pDCP1A. Interestingly, the Q343 cleavage site is highly conserved in DCP1A homologs from other mammalian species. Further analyses demonstrated that nsp5 encoded by seven tested CoVs that can infect human or pig also cleaved pDCP1A and human DCP1A, suggesting that DCP1A maybe the common target for cleavage by nsp5 of mammalian CoVs.IMPORTANCE IFN-stimulated gene (ISG) induction through interferon (IFN) signaling is important to create an antiviral state and usually directly inhibits virus infection. The present study first demonstrated that PDCoV nsp5 can cleave mRNA-decapping enzyme 1a (DCP1A) to attenuate its antiviral activity. Furthermore, cleaving DCP1A is a common characteristic of nsp5 proteins from different coronaviruses (CoVs), which represents a common immune evasion mechanism of CoVs. Previous evidence showed that CoV nsp5 cleaves the NF-κB essential modulator and signal transducer and activator of transcription 2. Taken together, CoV nsp5 is a potent IFN antagonist because it can simultaneously target different aspects of the host IFN system, including IFN production and signaling and effector molecules.


COVID-19 and digital epidemiology


Surge capacity and updated admission criteria: response of the NHS-commissioned national respiratory extracorporeal membrane oxygenation network to the COVID-19 pandemic


title: Self-assessment of the Thai Department of Disease Control's communication for international response to COVID-19 in the early phase

text: OBJECTIVES: This study aimed to assess the Thailand Department of Disease Control's (DDC) early responses to COVID-19 in respect to communication with the international community and to identify the manner of Thailand's response during public health emergencies. METHODS: Documents and international response communication from 4-31 January 2020 were reviewed and dates of responses were collected for descriptive analysis. A questionnaire was submitted to the DDC officers responsible for international coordination. A meeting to identify responses was held to evaluate the self-assessed capacities of the Department's international communication. RESULTS: Thailand began the COVID-19 screening protocol on 3 January 2020. International correspondence subsequently occurred continually either through the ASEAN or International Health Regulations (IHR) mechanisms. The total score of communication for international response was 88.9%. For IHR reporting duties, the median duration to respond was 2.49hours. Official news was sent within a mean of 9.18hours and the English daily situation reports were always uploaded onto the official website within 24hours. CONCLUSIONS: This study provided a benchmark for international coordination and communication capacities and also identified areas for improvement during public health emergencies, such as the need to identify English-speaking spokespeople to communicate at an international level.


Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies


title: Chilblain-like lesions during COVID-19 pandemic: a serological study on a case series

text: The outbreak of chilblain-like lesions (CLL) coincidentally to the COVID-19 pandemic is a topic of great concern. SARS-CoV-2 has been hypothesized as the etiologic agent of CLL, on the basis of the temporal correlation between the "burst" of skin manifestations and the viral pandemic. However, the relationship between CLL and COVID-19 remains unclear, since authors failed to confirm the SARS-CoV-2 infection in these patients using a real-time reverse transcription polymerase chain reaction (rt-PCR) test from nasopharyngeal swabs, which seldom resulted positive. Indeed, the most recent articles on the prevalence of the SARS-CoV-2 infection in CLL reported a positive swab test in only about a fifth of these patients.


Parenting in a time of COVID-19


Detection of Hemosiderin-Laden Macrophages in Bronchoalveolar Lavage Fluid of COVID-19 Patients: Is Perls Stain a Potential Indicator of Oxidative Alveolar Damage?


title: Phase 2 study of NAB-paclitaxel in SensiTivE and refractory relapsed small cell lung cancer (SCLC) (NABSTER TRIAL)

text: BACKGROUND: Despite sensitivity to first-line chemotherapy, most small-cell lung cancer (SCLC) patients relapse. In this setting, topotecan demonstrated modest activity with significant toxicity. Paclitaxel was also active. This study was designed to evaluate activity and safety of nab-paclitaxel in relapsed SCLC. METHODS: In this multicentre prospective Phase 2 trial, patients with refractory or sensitive SCLC progressed to first-line platinum-based chemotherapy received nab-paclitaxel 100 mg/smq on days 1, 8, 15 every 4 weeks up to six cycles, progressive disease or intolerable toxicity. Primary endpoint was investigator-assessed objective tumour response. Secondary endpoints were toxicity, progression-free survival (PFS) and overall survival (OS). RESULTS: Of the 68 patients treated, partial response was 8% in the refractory cohort and 14% in the sensitive cohort. Most common toxicities of any grade were fatigue (54%), anaemia (38%), neutropenia (29%), leukopenia (26%) and diarrhoea (21%). Median PFS was similar in both refractory (1.8 months) and sensitive cohorts (1.9 months), while median OS was longer in sensitive one (6.6 versus 3.6 months). CONCLUSIONS: Although nab-paclitaxel has shown some modest anti-tumour activity in relapsed SCLC, associated with a favourable toxicity profile, the primary end-point of the study was not met. CLINICAL TRIAL REGISTRATION: Clinical Trial registration number is ClinicalTrials.gov Identifier: NCT03219762.


Understanding heterogeneity to inform the public health response to COVID-19 in Canada


title: Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS-COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

text: BACKGROUND: The worldwide spread of a novel coronavirus disease (COVID-19) has led to a near total stop of non-urgent, elective surgeries across all specialties in most affected countries. In the field of aesthetic surgery, the self-imposed moratorium for all aesthetic surgery procedures recommended by most international scientific societies has been adopted by many surgeons worldwide and resulted in a huge socioeconomic impact for most private practices and clinics. An important question still unanswered in most countries is when and how should elective/aesthetic procedures be scheduled again and what kind of organizational changes are necessary to protect patients and healthcare workers when clinics and practices reopen. Defining manageable, evidence-based protocols for testing, surgical/procedural risk mitigation and clinical flow management/contamination management will be paramount for the safety of non-urgent surgical procedures. METHODS: We conducted a MEDLINE/PubMed research for all available publications on COVID-19 and surgery and COVID-19 and anesthesia. Articles and referenced literature describing possible procedural impact factors leading to exacerbation of the clinical evolution of COVID-19-positive patients were identified to perform risk stratification for elective surgery. Based on these impact factors, considerations for patient selection, choice of procedural complexity, duration of procedure, type of anesthesia, etc., are discussed in this article and translated into algorithms for surgical/anesthesia risk management and clinical management. Current recommendations and published protocols on contamination control, avoidance of cross-contamination and procedural patient flow are reviewed. A COVID-19 testing guideline protocol for patients planning to undergo elective aesthetic surgery is presented and recommendations are made regarding adaptation of current patient information/informed consent forms and patient health questionnaires. CONCLUSION: The COVID-19 crisis has led to unprecedented challenges in the acute management of the crisis, and the wave only recently seems to flatten out in some countries. The adaptation of surgical and procedural steps for a risk-minimizing management of potential COVID-19-positive patients seeking to undergo elective aesthetic procedures in the wake of that wave will present the next big challenge for the aesthetic surgery community. We propose a clinical algorithm to enhance patient safety in elective surgery in the context of COVID-19 and to minimize cross-contamination between healthcare workers and patients. New evidence-based guidelines regarding surgical risk stratification, testing, and clinical flow management/contamination management are proposed. We believe that only the continuous development and broad implementation of guidelines like the ones proposed in this paper will allow an early reintegration of all aesthetic procedures into the scope of surgical care currently performed and to prepare the elective surgical specialties better for a possible second wave of the pandemic. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.


Asthma and COVID-19: Is asthma a risk factor for severe outcomes?


Liberté, égalité, fraternité à l'épreuve du COVID-19./ [Freedom, equality, fraternity facing the COVID-19]


Intrapartum care of women with COVID-19: A practical approach


Gastrointestinal symptoms as the first, atypical indication of severe acute respiratory syndrome coronavirus 2 infection


title: Management of patients with liver derangement during the COVID-19 pandemic: an Asia-Pacific position statement

text: The COVID-19 pandemic has spread rapidly worldwide. It is common to encounter patients with COVID-19 with abnormal liver function, either in the form of hepatitis, cholestasis, or both. The clinical implications of liver derangement might be variable in different clinical scenarios. With growing evidence of its clinical significance, it would be clinically helpful to provide practice recommendations for various common clinical scenarios of liver derangement during the COVID-19 pandemic. The Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic was formed to systematically review the literature with special focus on the clinical management of patients who have been or who are at risk of developing liver derangement during this pandemic. Clinical scenarios covering the use of pharmacological treatment for COVID-19 in the case of liver derangement, and assessment and management of patients with chronic hepatitis B or hepatitis C, non-alcoholic fatty liver disease, liver cirrhosis, and liver transplantation during the pandemic are discussed.


title: Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient - Solano County, California, February 2020

text: On February 26, 2020, the first U.S. case of community-acquired coronavirus disease 2019 (COVID-19) was confirmed in a patient hospitalized in Solano County, California (1). The patient was initially evaluated at hospital A on February 15; at that time, COVID-19 was not suspected, as the patient denied travel or contact with symptomatic persons. During a 4-day hospitalization, the patient was managed with standard precautions and underwent multiple aerosol-generating procedures (AGPs), including nebulizer treatments, bilevel positive airway pressure (BiPAP) ventilation, endotracheal intubation, and bronchoscopy. Several days after the patient's transfer to hospital B, a real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test for SARS-CoV-2 returned positive. Among 121 hospital A health care personnel (HCP) who were exposed to the patient, 43 (35.5%) developed symptoms during the 14 days after exposure and were tested for SARS-CoV-2; three had positive test results and were among the first known cases of probable occupational transmission of SARS-CoV-2 to HCP in the United States. Little is known about specific risk factors for SARS-CoV-2 transmission in health care settings. To better characterize and compare exposures among HCP who did and did not develop COVID-19, standardized interviews were conducted with 37 hospital A HCP who were tested for SARS-CoV-2, including the three who had positive test results. Performing physical examinations and exposure to the patient during nebulizer treatments were more common among HCP with laboratory-confirmed COVID-19 than among those without COVID-19; HCP with COVID-19 also had exposures of longer duration to the patient. Because transmission-based precautions were not in use, no HCP wore personal protective equipment (PPE) recommended for COVID-19 patient care during contact with the index patient. Health care facilities should emphasize early recognition and isolation of patients with possible COVID-19 and use of recommended PPE to minimize unprotected, high-risk HCP exposures and protect the health care workforce.


title: Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey

text: China has been severely affected by Coronavirus Disease 2019(COVID-19) since December, 2019. We aimed to assess the mental health burden of Chinese public during the outbreak, and to explore the potential influence factors. Using a web-based cross-sectional survey, we collected data from 7,236 self-selected volunteers assessed with demographic information, COVID-19 related knowledge, generalized anxiety disorder (GAD), depressive symptoms, and sleep quality. The overall prevalence of GAD, depressive symptoms, and sleep quality of the public were 35.1%, 20.1%, and 18.2%, respectively. Younger people reported a significantly higher prevalence of GAD and depressive symptoms than older people. Compared with other occupational group, healthcare workers were more likely to have poor sleep quality. Multivariate logistic regression showed that age (< 35 years) and time spent focusing on the COVID-19 (≥ 3 hours per day) were associated with GAD, and healthcare workers were at high risk for poor sleep quality. Our study identified a major mental health burden of the public during the COVID-19 outbreak. Younger people, people spending too much time thinking about the outbreak, and healthcare workers were at high risk of mental illness. Continuous surveillance of the psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide.


Every cloud: how the COVID-19 pandemic may benefit child health


title: Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations

text: Tracheal intubation in coronavirus disease 2019 (COVID-19) patients creates a risk to physiologically compromised patients and to attending healthcare providers. Clinical information on airway management and expert recommendations in these patients are urgently needed. By analysing a two-centre retrospective observational case series from Wuhan, China, a panel of international airway management experts discussed the results and formulated consensus recommendations for the management of tracheal intubation in COVID-19 patients. Of 202 COVID-19 patients undergoing emergency tracheal intubation, most were males (n=136; 67.3%) and aged 65 yr or more (n=128; 63.4%). Most patients (n=152; 75.2%) were hypoxaemic (Sao2 <90%) before intubation. Personal protective equipment was worn by all intubating healthcare workers. Rapid sequence induction (RSI) or modified RSI was used with an intubation success rate of 89.1% on the first attempt and 100% overall. Hypoxaemia (Sao2 <90%) was common during intubation (n=148; 73.3%). Hypotension (arterial pressure <90/60 mm Hg) occurred in 36 (17.8%) patients during and 45 (22.3%) after intubation with cardiac arrest in four (2.0%). Pneumothorax occurred in 12 (5.9%) patients and death within 24 h in 21 (10.4%). Up to 14 days post-procedure, there was no evidence of cross infection in the anaesthesiologists who intubated the COVID-19 patients. Based on clinical information and expert recommendation, we propose detailed planning, strategy, and methods for tracheal intubation in COVID-19 patients.


title: Medications in COVID-19 patients: summarizing the current literature from an orthopaedic perspective

text: PURPOSE: The review aims to provide a summary of the current literature regarding common medications prescribed in orthopaedic surgery and their potential implications in COVID-19 patients. METHODS: A systematic review was performed using the PRISMA guidelines. All clinical studies, reviews, consensus and guidelines related to the above medications and COVID-19 were included. RESULTS: A total of 18 articles were included. The use of analgesia, anti-inflammatories, steroids, anticoagulants, antibiotics, vitamin B, vitamin C and vitamin D and their potential impact on COVID-19 patients were reported. CONCLUSION: Eight main recommendations were derived from the review. Firstly, paracetamol remains the first line of analgesia and antipyretic. Secondly, there is no need to avoid NSAIDs for COVID-19 patients. Thirdly, opioids have the potential for immunosuppression in addition to respiratory depression and, therefore, should be prescribed with care in COVID-19 patients. Fourthly, patients with conditions where steroids are proven to be efficacious can continue to receive their steroids; otherwise, systemic steroids are not recommended for COVID-19 patients. Fifthly, orthopaedic surgeons following up on COVID-19 patients who are using steroids should continue to follow them up for possible avascular necrosis. Sixthly, whenever possible, oral anticoagulation should be converted to parental heparin. Seventhly, common orthopaedic antibiotics including penicillin and clindamycin are safe to continue for COVID-19 patients. However, for COVID-19 patients, the antibiotics can potentially be switched to macrolides and tetracyclines if the organisms are sensitive. Lastly, prescription for vitamins B, C and D should continue as per usual clinical practice.


Urticarial eruption in coronavirus disease 2019 infection: a case report in Tangerang, Indonesia


Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence?


title: Novel therapeutic targets for SARS-CoV-2-induced acute lung injury: Targeting a potential IL-1ß/neutrophil extracellular traps feedback loop

text: Most COVID-19 infected individuals present with mild flu-like symptoms; however, 5-10% of cases suffer from life-threatening pneumonia and respiratory failure. The pathogenesis of SARS-CoV-2 and its pathology of associated acute lung injury (ALI), acute respiratory distress syndrome (ARDS), sepsis, coagulopathy and multiorgan failure is not known. SARS-CoV-2 is an envelope virus with S (spike), M (membrane), N (nucleocapsid) and E (envelop) proteins. In a closely related coronavirus (SARS-CoV), the transmembrane E protein exerts an important role in membrane-ionic transport through viroporins, deletion of which reduced levels of IL-1ß and a remarkably reduced lung edema compared to wild type. IL-1ß is generated by macrophages upon activation of intracellular NLRP3 (NOD-like, leucine rich repeat domains, and pyrin domain-containing protein 3), part of the functional NLRP3 inflammasome complex that detects pathogenic microorganisms and stressors, while neutrophils are enhanced by increasing levels of IL-1ß. Expiring neutrophils undergo "NETosis", producing thread-like extracellular structures termed neutrophil extracellular traps (NETs), which protect against mild infections and microbes. However, uncontrolled NET production can cause acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), coagulopathy, multiple organ failure, and autoimmune disease. Herein, we present arguments underlying our hypothesis that IL-1ß and NETs, mediated via NLRP3 inflammasomes, form a feed-forward loop leading to the excessive alveolar and endothelial damage observed in severe cases of COVID-19. Considering such assertions, we propose potential drug candidates that could be used to alleviate such pathologies. Considering that recent efforts to ascertain effective treatments of COVID-19 in severe patients has been less than successful, investigating novel avenues of treating this virus are essential.


title: Participant and Caregiver Perspectives on Clinical Research During Covid-19 Pandemic

text: BACKGROUND/OBJECTIVES: The COVID-19 pandemic has massively disrupted essential clinical research. Many regulatory organizations have rightfully advocated to temporarily halt enrollment and curtail all face-to-face interactions. Views and opinions of patients and their caregivers are seldom considered while making such decisions. The objective was to study older participants' and their caregivers' perspectives to participate in ongoing clinical research during the COVID-19 pandemic. DESIGN: Cross-sectional. SETTING: VISN-16/Geriatric Research, Education and Clinical Center (GRECC), Department of Veterans Affairs. PARTICIPANTS: Older participants and their caregivers (N = 51) enrolled in ongoing clinical research studies. MEASUREMENTS: Questions about perceptions of safety to attend research visit, the level of panic among the general public, and medical center's preparedness in handling the pandemic. Other questions identified the source of pandemic information and the preference of a phone or in-person visit. RESULTS: Mean age was 69.3 (±9.4) years, 53% were male, 39% were caregivers, and 65% were Caucasian. Majority (78%) of the participants felt safe/very safe attending the scheduled research appointment; 63% felt that the extra screening made them feel safe/very safe; 82% felt that the medical center was prepared/very prepared for the pandemic. Participants split evenly on their preference for phone versus in-person visits. Family members and television news media were the commonly used sources of pandemic information irrespective of their education. Perceptions were influenced by gender and source of information, not by age or education. Females perceived higher level of panic compared to males (P = .02). Those relying on news media felt safer compared to those that relied on family members (P = .008). CONCLUSION: Even though informants felt that the medical center was prepared to handle the pandemic, only half the participants preferred the in-person visit. Pandemic information was obtained from family members or the television news media. Knowing patients' perspectives may help researchers be better prepared for future pandemics. J Am Geriatr Soc 68:E14-E18, 2020.


title: The COVID-19 pandemic and health inequalities

text: This essay examines the implications of the COVID-19 pandemic for health inequalities. It outlines historical and contemporary evidence of inequalities in pandemics-drawing on international research into the Spanish influenza pandemic of 1918, the H1N1 outbreak of 2009 and the emerging international estimates of socio-economic, ethnic and geographical inequalities in COVID-19 infection and mortality rates. It then examines how these inequalities in COVID-19 are related to existing inequalities in chronic diseases and the social determinants of health, arguing that we are experiencing a syndemic pandemic It then explores the potential consequences for health inequalities of the lockdown measures implemented internationally as a response to the COVID-19 pandemic, focusing on the likely unequal impacts of the economic crisis. The essay concludes by reflecting on the longer-term public health policy responses needed to ensure that the COVID-19 pandemic does not increase health inequalities for future generations.


The battle against COVID-19: mortality in Italy


title: A serological assay to detect SARS-CoV-2 seroconversion in humans

text: Here, we describe a serological enzyme-linked immunosorbent assay for the screening and identification of human SARS-CoV-2 seroconverters. This assay does not require the handling of infectious virus, can be adjusted to detect different antibody types in serum and plasma and is amenable to scaling. Serological assays are of critical importance to help define previous exposure to SARS-CoV-2 in populations, identify highly reactive human donors for convalescent plasma therapy and investigate correlates of protection.


title: Optimal Control Concerns Regarding the COVID-19 (SARS-CoV-2) Pandemic in Bahia and Santa Catarina, Brazil

text: The COVID-19 pandemic is the profoundest health crisis of the 21rst century. The SARS-CoV-2 virus arrived in Brazil around March, 2020 and its social and economical backlashes are catastrophic. In this paper, it is investigated how Model Predictive Control (MPC) could be used to plan appropriate social distancing policies to mitigate the pandemic effects in Bahia and Santa Catarina, two states of different regions, culture, and population demography in Brazil. In addition, the parameters of Susceptible-Infected-Recovered-Deceased (SIRD) models for these two states are identified using an optimization procedure. The control input to the process is a social isolation guideline passed to the population. Two MPC strategies are designed: a) a centralized MPC, which coordinates a single control policy for both states; and b) a decentralized strategy, for which one optimization is solved for each state. Simulation results are shown to illustrate and compare both control strategies. The framework serves as guidelines to deals with such pandemic phenomena.


title: Relationship between clinical types and radiological subgroups defined by latent class analysis in 2019 novel coronavirus pneumonia caused by SARS-CoV-2

text: OBJECTIVES: To investigate whether meaningful subgroups sharing the CT features of patients with COVID-19 pneumonia could be identified using latent class analysis (LCA) and explore the relationship between the LCA-derived subgroups and clinical types. METHODS: This retrospective review included 499 patients with confirmed COVID-19 pneumonia between February 11 and March 8, 2020. Subgroups sharing the CT features were identified using LCA. Univariate and multivariate logistic regression models were utilized to analyze the association between clinical types and the LCA-derived subgroups. RESULTS: Two radiological subgroups were identified using LCA. There were 228 subjects (45.69%) in class 1 and 271 subjects (54.31%) in class 2. The CT findings of class 1 were smaller pulmonary infection volume, more peripheral distribution, more GGO, more maximum lesion range ≤ 5 cm, a smaller number of lesions, less involvement of lobes, less air bronchogram, less dilatation of vessels, less hilar and mediastinal lymph node enlargement, and less pleural effusion than the CT findings of class 2. Univariate analysis demonstrated that older age, therapy, presence of fever, presence of hypertension, decreased lymphocyte count, and increased CRP levels were significant parameters associated with an increased risk for class 2. Multivariate analyses revealed that the patients with clinically severe type disease had a 1.97-fold risk of class 2 than the patients with clinically moderate-type disease. CONCLUSIONS: The demographic and clinical differences between the two radiological subgroups based on the LCA were significantly different. Two radiological subgroups were significantly associated with clinical moderate and severe types. KEY POINTS: â¢ Two radiological subgroups were identified using LCA. â¢ Older age, therapy, presence of fever, presence of hypertension, decreased lymphocyte count, and increased CRP levels were significant parameters with an increased risk for class 2 defined by LCA. â¢ Patients with clinically severe type had a 1.97-fold higher risk of class 2 defined by LCA in comparison with patients showing clinically moderate-type disease.


title: An Optimal Predictive Control Strategy for COVID-19 (SARS-CoV-2) Social Distancing Policies in Brazil

text: The global COVID-19 pandemic (SARS-CoV-2 virus) is the defining health crisis of our century. Due to the absence of vaccines and drugs that can help to fight it, the world solution to control the spread has been to consider public social distance measures that avoids the saturation of the health system. In this context, we investigate a Model Predictive Control (MPC) framework to determine the time and duration of social distancing policies. We use Brazilian data in the period from March to May of 2020. The available data regarding the number of infected individuals and deaths suffers from sub-notification due to the absence of mass tests and the relevant presence of the asymptomatic individuals. We estimate variations of the SIR model using an uncertainty-weighted Least-Squares criterion that considers both nominal and inconsistent-data conditions. Moreover, we add to our versions of the SIR model an additional dynamic state variable to mimic the response of the population to the social distancing policies determined by the government that affects the speed of COVID-19 transmission. Our control framework is within a mixed-logical formalism, since the decision variable is forcefully binary (the existence or the absence of social distance policy). A dwell-time constraint is included to avoid harsh shifting between these two states. Finally, we present simulation results to illustrate how such optimal control policy would operate. These results point out that no social distancing should be relaxed before mid August 2020. If relaxations are necessary, they should not be performed before the beginning this date and should be in small periods, no longer than 25 days. This paradigm would proceed roughly until January/2021. The second peak of infections, which has a forecast to the beginning of October, can be reduced if the periods of no-isolation days are shortened.


title: Enjeux de l'utilisation des psychotropes dans le cadre de la pandémie au SARS-Cov-2./ [Challenges for psychotropics in the context of the SARS-Cov-2 pandemic]

text: French recommendations have been proposed for psychotropics use and possible adaptations during the SARS-CoV-2 epidemic. Between uncertainties linked to the lack of data and speculations about possible benefits of psychotropics against the coronavirus, we propose here elements allowing to base the pharmacotherapeutic decisions potentially useful in Covid+ patients with psychiatric disorders.


title: Working Hard or Hardly Working? Regulatory Bottlenecks in Developing a COVID-19 Vaccine

text: Vaccine solutions rarely reach the public until after an outbreak abates; an Ebola vaccine was approved 5 years after peak outbreak and SARS, MERS, and Zika vaccines are still in clinical development. Despite massive leaps forward in rapid science, other regulatory bottlenecks are hamstringing the global effort for pandemic vaccines.


title: Morphology and numerical characteristics of epidemic curves for SARS-Cov-II using Moyal distribution

text: In this paper, it is shown that the Moyal distribution is an excelent tool to study the SARS-Cov-II (Covid-19) epidemiological associated curves and its propagation. The Moyal parameters give all the information to describe the form and the impact of the illness outbreak in the different affected countries and its global impact. We checked that the Moyal distribution can accurately fit the daily report of {\it{new confirmed cases of infected people}} (NCC) per country, in that places where the contagion is reaching their final phase, describing the beginning, the most intense phase and the descend of the contagion, simultaneously . In order to achieve the purpose of this work, it is important to work with a complete and well compilated set of the data to be used to fit the curves. Data from European countries like France, Spain, Italy Belgium, Sweden, United Kingdom, Denmark and others like USA and China, have been used. Also, the correlation between the parameters of the Moyal distribution fitting and the general public health measures imposed in each country, have been discussed. A relation between those policies and the features of the Moyal distribution, in terms of their parameters and critical points, is shown; from that, it can be seen that the knowledge of the time evolution of the epidemiological curve, their critical points, superposition properties and rates of the rising and the ending, could help to find a way to estimate the efficiency of social distancing measures, imposed in each country, and anticipate the different phases of the pandemic.


COVID-19: Importance of the Awareness of the Clinical Syndrome by Urologists


title: Needles in the 'Sheet'stack: Augmented Analytics to get Insights from Spreadsheets

text: Business intelligence (BI) tools for database analytics have come a long way and nowadays also provide ready insights or visual query explorations, e.g. QuickInsights by Microsoft Power BI, SpotIQ by ThoughtSpot, Zenvisage, etc. In this demo, we focus on providing insights by examining periodic spreadsheets of different reports (aka views), without prior knowledge of the schema of the database or reports, or data information. Such a solution is targeted at users without the familiarity with the database schema or resources to conduct analytics in the contemporary way.


England and Wales see 20â000 excess deaths in care homes


Offline: After COVID-19-is an "alternate society" possible?


Covid-19: Over 300 Italian doctors and scientists call for more testing


'We need to be alert': Scientists fear second coronavirus wave as China's lockdowns ease


Suggesting Ritonavir against COVID-19/SARS-CoV-2


title: Neutrophil-to-Lymphocyte Ratio and Outcomes in Louisiana Covid-19 Patients

text: BACKGROUND: Due to the rapidly escalating number of cases and the low baseline of overall health in Louisiana, we sought to determine the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in hospitalized COVID patients in 2 major metropolitan areas with the highest prevalence of cases and exceedingly high rates of obesity and other comorbid conditions. We hypothesized that elevated NLR would be a prognostic indicator of mortality. METHODS: This was a review of a prospective registry of adult (18+ years) hospitalized SARS-CoV-2 patients from to two large urban safety net hospitals in Louisiana. Blood cell counts at days 2 and 5 were used to obtain NLR. Receiver operating characteristic (ROC) curve analysis assessed predictive capacity of NLR on mortality. Kaplan-Meier (KM) survival analysis and Cox regression models examined the effect of NLR on survival. RESULTS: The study population of 125 patients was majority African American (88.6%) and female (54.8%) with a mean age and BMI of 58.7 years and 34.2. Most (96.0%) had comorbidities of which hypertension (72.0%), obesity (66.7%), and diabetes (40.0%) were the most common. Mortality was 18.4%. NLRâ>â4.94 on day 1 predicted intubation (Pâ=â0.02). NLR above established cutoff values on hospital days 2 and 5 each significantly predicted mortality (Pâ<â0.001 and Pâ=â0.002, respectively). CONCLUSIONS: NLR is a prognostic factor for endotracheal intubation upon hospital admission and independent predictor for risk of mortality in SARS-CoV-2 patients on subsequent hospital days. Clinical research efforts should examine effects of strategies such as arginase inhibition alone and/or inhaled nitric oxide to ameliorate the effects of elevated NLR.


Basing Respiratory Management of COVID-19 on Physiological Principles


Smell and taste dysfunction in patients with COVID-19


title: Comparing COVID-19 and the 1918-19 influenza pandemics in United Kingdom

text: We compare the COVID-19 pandemic and 1918-19 influenza pandemic in United Kingdom. We found that the on-going COVID-19 wave of infection matched the major wave of the 1918-19 influenza pandemic surprisingly well, both reached similar magnitude (in term of estimated weekly new infections) and spent the same duration above 5 cases per 1000 inhabitants, for the past two months. We discussed the similar characteristics between these two pandemics.


Pitfalls of possible reporting of same patients with COVID-19 in dermatology journals


Chirurgische Aspekte zur Tracheostomie bei COVID-19-positiven Patienten - Stellungnahme im Auftrag der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie (DGHNO-KHC) und der AG Laryngologie & Trachealerkrankungen


title: Antibodies to SARS-CoV-2 and their potential for therapeutic passive immunization

text: We review aspects of the antibody response to SARS-CoV-2, the causative agent of the COVID-19 pandemic. The topics we cover are relevant to immunotherapy with plasma from recovered patients, monoclonal antibodies against the viral S-protein, and soluble forms of the receptor for the virus, angiotensin converting enzyme 2. The development of vaccines against SARS-CoV-2, an essential public health tool, will also be informed by an understanding of the antibody response in infected patients. Although virus-neutralizing antibodies are likely to protect, antibodies could potentially trigger immunopathogenic events in SARS-CoV-2-infected patients or enhance infection. An awareness of these possibilities may benefit clinicians and the developers of antibody-based therapies and vaccines.


COVID-19: a public health approach to manage domestic violence is needed


title: Novel Immunoglobulin Domain Proteins Provide Insights into Evolution and Pathogenesis of SARS-CoV-2-Related Viruses

text: A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was recently identified as the causative agent for the coronavirus disease 2019 (COVID-19) outbreak that has generated a global health crisis. We use a combination of genomic analysis and sensitive profile-based sequence and structure analysis to understand the potential pathogenesis determinants of this virus. As a result, we identify several fast-evolving genomic regions that might be at the interface of virus-host interactions, corresponding to the receptor binding domain of the Spike protein, the three tandem Macro fold domains in ORF1a, and the uncharacterized protein ORF8. Further, we show that ORF8 and several other proteins from alpha- and beta-CoVs belong to novel families of immunoglobulin (Ig) proteins. Among them, ORF8 is distinguished by being rapidly evolving, possessing a unique insert, and having a hypervariable position among SARS-CoV-2 genomes in its predicted ligand-binding groove. We also uncover numerous Ig domain proteins from several unrelated metazoan viruses, which are distinct in sequence and structure but share comparable architectures to those of the CoV Ig domain proteins. Hence, we propose that SARS-CoV-2 ORF8 and other previously unidentified CoV Ig domain proteins fall under the umbrella of a widespread strategy of deployment of Ig domain proteins in animal viruses as pathogenicity factors that modulate host immunity. The rapid evolution of the ORF8 Ig domain proteins points to a potential evolutionary arms race between viruses and hosts, likely arising from immune pressure, and suggests a role in transmission between distinct host species.IMPORTANCE The ongoing COVID-19 pandemic strongly emphasizes the need for a more complete understanding of the biology and pathogenesis of its causative agent SARS-CoV-2. Despite intense scrutiny, several proteins encoded by the genomes of SARS-CoV-2 and other SARS-like coronaviruses remain enigmatic. Moreover, the high infectivity and severity of SARS-CoV-2 in certain individuals make wet-lab studies currently challenging. In this study, we used a series of computational strategies to identify several fast-evolving regions of SARS-CoV-2 proteins which are potentially under host immune pressure. Most notably, the hitherto-uncharacterized protein encoded by ORF8 is one of them. Using sensitive sequence and structural analysis methods, we show that ORF8 and several other proteins from alpha- and beta-coronavirus comprise novel families of immunoglobulin domain proteins, which might function as potential immune modulators to delay or attenuate the host immune response against the viruses.


Unconditional Care in Academic Emergency Departments


Focal Cerebral Arteriopathy in a COVID-19 Pediatric Patient


Using socioeconomics to counter health disparities arising from the covid-19 pandemic


Persistence of viral RNA in stool samples from patients recovering from covid-19


title: Influencia de la infección SARS-CoV-2 sobre enfermedades neurodegenerativas y neuropsiquiátricas: ¿una pandemia demorada?/ Influencia de la infección SARS-CoV-2 sobre enfermedades neurodegenerativas y neuropsiquiátricas: ¿una pandemia demorada?/ Impact of SARS-CoV-2 infection on neurodegenerative and neuropsychiatric diseases: a delayed pandemic?

text: INTRODUCTION: SARS-CoV-2 was first detected in December 2019 in the Chinese city of Wuhan and has since spread across the world. At present, the virus has infected over 1.7 million people and caused over 100 000 deaths worldwide. Research is currently focused on understanding the acute infection and developing effective treatment strategies. In view of the magnitude of the epidemic, we conducted a speculative review of possible medium- and long-term neurological consequences of SARS-CoV-2 infection, with particular emphasis on neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin, based on the available evidence on neurological symptoms of acute SARS-CoV-2 infection. DEVELOPMENT: We systematically reviewed the available evidence about the pathogenic mechanisms of SARS-CoV-2 infection, the immediate and lasting effects of the cytokine storm on the central nervous system, and the consequences of neuroinflammation for the central nervous system. CONCLUSIONS: SARS-CoV-2 is a neuroinvasive virus capable of triggering a cytokine storm, with persistent effects in specific populations. Although our hypothesis is highly speculative, the impact of SARS-CoV-2 infection on the onset and progression of neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin should be regarded as the potential cause of a delayed pandemic that may have a major public health impact in the medium to long term. Cognitive and neuropsychological function should be closely monitored in COVID-19 survivors.


An Atypical Presentation of Novel Coronavirus Disease 2019 (COVID-19)


title: Optimal quarantine strategies for COVID-19 control models

text: Optimal control problems reflecting the finding of effective quarantine strategies are considered for two control SEIR~type models describing the spread of the COVID-19 virus in the human population. The properties of the corresponding optimal controls are established analytically by applying the Pontryagin maximum principle. The optimal solutions are obtained numerically using BOCOP 2.0.5 software. The behavior of the appropriate optimal solutions and their dependence on the basic reproductive ratio and length of quarantine are discussed in detail. Necessary conclusions are made.


title: Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands

text: A potential link between mortality, D-dimer values and a prothrombotic syndrome has been reported in patients with COVID-19 infection. The National Institute for Public Health of the Netherlands asked a group of Radiology and Vascular Medicine experts to provide guidance for the imaging workup and treatment of these important complications. This report summarizes evidence for thromboembolic disease, potential diagnostic and preventive actions as well as recommendations for patients with COVID-19 infection.


The neuroinvasive potential of severe acute respiratory syndrome coronavirus 2


title: How to reduce the likelihood of coronavirus-19 (CoV-19 or SARS-CoV-2) infection and lung inflammation mediated by IL-1

text: SARS-CoV-2, also referred to as CoV-19, is an RNA virus which can cause severe acute respiratory diseases (COVID-19), with serious infection of the lower respiratory tract followed by bronchitis, pneumonia and fibrosis. The severity of the disease depends on the efficiency of the immune system which, if it is weak, cannot stem the infection and its symptoms. The new CoV-19 spreads in the population at a rate of 0.8-3% more than normal flu and mostly affects men, since immune genes are more expressed on the X chromosome. If CoV-19 would spread with a higher incidence rate (over 10%), and affect the people who live in closed communities such as islands, it would cause many more deaths. Moreover, people from the poorest classes are most at risk because of lack of health care and should be given more assistance by the competent authorities. To avoid the aggravation of CoV-19 infection, and the collapse of the health system, individuals should remain at home in quarantine for a period of approximately one month in order to limit viral transmission. In the case of a pandemic, the severe shortage of respirators and protective clothing, due to the enormous demand and insufficient production, could lead the CoV-19 to kill a large number of individuals. At present, there is no drug capable of treating CoV-19 flu, the only therapeutic remedies are those aimed at the side effects caused by the virus, such as inflammation and pulmonary fibrosis, recognized as the first causes of death. One of the COVID-19 treatments involves inhaling a mixture of gaseous hydrogen and oxygen, obtaining better results than with oxygen alone. It was also noted that individuals vaccinated for viral and/or bacterial infectious diseases were less likely to become infected. In addition, germicidal UV radiation "breaks down" the oxygen O2 which then aggregate into O3 (ozone) molecules creating the ozone layer, capable of inhibiting viral replication and improving lung respiration. All these precautions should be taken into consideration to lower the risk of infection by CoV-19. New anti-viral therapies with new drugs should also be taken into consideration. For example, microbes are known to bind TLR, inducing IL-1, a pleiotropic cytokine, highly inflammatory, mediator of fever and fibrosis. Therefore, drugs that suppress IL-1 or IL-1R, also used for the treatment of rheumatoid arthritis are to be taken into consideration to treat COVID-19. We strongly believe that all these devices described above can lead to greater survival and. therefore, reduction in mortality in patients infected with CoV-19.


title: Comments on Wu et al: Possible special needs for mental online support in female and male health care workers during the COVID-19

text: In their article Wu and colleagues, similarly to other authors, present the effects of stress on medical staff during the COVID-19 pandemic as an unprecedented challenge for all communities. Their observation is within current literature trends, which identify 7 population subgroups affected by the psychosocial consequences of the COVID-19: general population affected by restrictive measures, people subjected to quarantine, positive for the virus (isolated/hospitalized), health care personnel, relatives of persons who died, and mentally ill patients. This article is protected by copyright. All rights reserved.


Comments on the publication by Yerramilli et al titled "Palliative Radiotherapy for Oncologic emergencies in the setting of COVID-19: Approaches to Balancing Risks and Benefits."