title: Symptom Course in COVID-19 Outpatients

text: Objective: To describe the symptom course in outpatients with coronavirus disease 2019 (COVID-19). Design: Retrospective chart review of standardized symptom checklist for patients followed at home by telephone calls during their acute COVID-19 illness. Compile results by day of illness into a single heatmap representation of symptoms. Setting: COVID-19 Virtual Outpatient Management Clinic (VOMC) in Atlanta, Georgia; a practice that follows patients with mild COVID-19 at home. Participants: 272 patients with confirmed COVID-19 by nasopharyngeal PCR, who presented to the VOMC within 10 days of symptom onset and within 5 days of screening PCR test. Main outcome measure: Each symptom is recorded as yes/no for each patient on each day. The total number of yes replies is divided by the total number of patients in VOMC to generate a result for each cell in the heatmap. Patients admitted to the hospital are censored from the denominator. Results: The mean duration of follow-up was 20.2 days. The most commonly reported symptoms in the course of illness were cough (83%), headache (73%) loss of smell or taste (71%), sinus congestion (71%), and body ache (67%). Symptoms remained common at 3 weeks, including cough (41%), shortness of breath on exertion (24%), loss of smell or taste (23%), sinus congestion (23%), and headache (20%). Conclusions: Symptoms of acute COVID-19 frequently last longer than the minimum duration of isolation and patients and healthcare providers should be aware that symptom resolution may be gradual.


title: Text Mining Approach to Analyze Coronavirus Impact: Mexico City as Case of Study

text: The epidemiological outbreak of a novel coronavirus (2019-nCoV or Covid-19) in China, and its rapid spread, gave rise to the first pandemic in the digital age. Derived from this fact that has surprised humanity, many countries started with different strategies in order to stop the infection. In this context, one of the greatest challenges for the scientific community is monitoring (real time) the global population to get immediate feedback of what is happening with the people during this public health contingency. An alternative interesting and affordable for the materialization of the aforementioned are the social networks. In a social network, the persons can act as sensors/information not only of personal data but also data derived from their behavior. This paper aims to analyze the publications of people in Mexico using a Text Mining approach. Specifically, Mexico City is presented as a case study to help understand the impact on society of the spread of Covid-19.


title: Announcement Information Provided by United States’ Public Libraries during the 2020 COVID-19 Pandemic

text: This study synthesizes timely information about the COVID-19 virus and examines how public libraries have responded to the pandemic in real-time through their online announcements to the public. A content analysis of library announcements relating to the COVID-19 pandemic posted during the period of March 14–April 12, 2020, was performed. Over 90 percent of libraries announced a closure due to the pandemic and 98 percent libraries indicated programs were suspended. Over half of libraries posted about COVID-19 and general hygiene practices. Many announcements changed in terms of content from March 14 to April 12, demonstrating the rapidly evolving nature of the pandemic. This study suggests that libraries can and do play an important role in providing reliable information about pandemics like COVID-19 for patrons.


title: Consideration of traditional Chinese medicine in treatment of highly pathogenic human coronaviruses SARS-CoV-2 and SARS-CoV/ 中医药治疗人类高致病性冠状病毒SARS-CoV-2与SARS-CoV感染肺炎的思考

text: Recently, the coronavirus disease 2019 (COVID-19) has broken out in China, similar with the sever acute respiratory syndrome (SARS) outbroke in 2003, this pestilence has wide epidemic, strong infectivity and high pathogenicity, which led a great impact on the production, life and people's health in China, and brought huge losses to the economy as well. These two kinds of pestilence were caused by human highly pathogenic coronavirus SARS-CoV-2 and SARS-CoV, respectively. Traditional Chinese medicine, as a unique medical way from China, plays an indelible role in ensuring people’s health. By comparing the epidemiology, clinical manifestations, therapeutic principles and methods of traditional Chinese medicine, this paper puts forward the similarities and differences of traditional Chinese medicine in the prevention, treatment and recovery periods in COVID-19 and SARS, and gives corresponding suggestions.


title: Structure of the ForT/PRPP complex uncovers the mechanism of C-C bond formation in C-nucleotide antibiotic biosynthesis

text: C-C bond formation is at the heart of anabolism and organic chemistry, but relatively few enzymatic strategies for catalyzing this reaction are known. The enzyme ForT catalyzes C-C bond formation between 5’-phosphoribosyl-1’-pyrophosphate (PRPP) and 4-amino-1H-pyrazole-3,5-dicarboxylate to make a key intermediate in the biosynthesis of the C-nucleotide formycin A 5’-phosphate; we now report the 2.5 Å resolution structure of the ForT/PRPP complex and thus locate the active site. Site-directed mutagenesis has identified those residues critical for PRPP recognition and catalysis. Structural conservation with GHMP kinases suggests that stabilization of the negatively charged pyrophosphate leaving group is crucial for catalysis in ForT. A mechanism for this new class of C-C bond forming enzymes is proposed. Entry for the Table of Contents A new class of enzymes catalyse C-C bond formation by irreversible CO2 and pyrophosphate production.


title: Identification of SARS-CoV-2 in wastewater in Japan by multiple molecular assays-implication for wastewater-based epidemiology (WBE)

text: Presence of SARS-coronavirus-2 (SARS-CoV-2) in wastewater sample has been documented in several countries. Wastewater-based epidemiology (WBE) is potentially effective for early warning of COVID-19 outbreak. The purpose of this study was to verify the detection limit of WBE for COVID-19. In total, 27 influent wastewater samples were collected from four wastewater treatment plants in Ishikawa and Toyama prefectures in Japan. During the study period, numbers of the confirmed COVID-19 cases in these prefectures increased from almost 0 to around 20 per 100,000 peoples. SARS-CoV-2 RNA in the samples were identified by several PCR-based assays. Among the 27 samples, 7 were positive for SARS-CoV-2 by at least one out of the three quantitative RT-PCR assays. These samples were also positive by RT-nested PCR assays. The detection frequency became higher when the number of total confirmed SARS-CoV-2 cases in 100,000 peoples became above 10 in each prefecture. However, SARS-CoV-2 could also be detected with a low frequency when the number was below 1.0. Considering that the number of the confirmed cases does not necessarily reflect the actual prevalence of the infection at the time point, data on the relationship between the number of infection cases and concentration in wastewater needs to be accumulated further.


Post-It Pearl: Prevent Your Phone from Spreading COVID-19


Saudi Anesthesia Society and COVID-19 outbreak


title: In silico Study of Pharmacological Treatments against SARS-CoV2 Main Protease

text: The COVID-19 caused by a new type of coronavirus has emerged from China and led to thousands of death globally Despite the efforts engaged in studying this newly emerged virus and searching for its treatment, the understanding of the COVID-19 drug and target protein interactions still represent a key challenge Several molecules have demonstrated In-Vitro activity against the SARS-CoV-2 virus and/or potential clinical benefit in observational and non-randomized studies Randomized clinical trials of an appropriate size are currently ongoing to establish the efficacy of these therapeutic proposals Herein, concerning these diverse guidelines and therapeutic suggestions of different approaches to the treatment, this research aims to provide a molecular analysis of the interaction between the principal molecules cited in bibliography and the active protease site of the virus


title: Kidney function on admission predicts in-hospital mortality in COVID-19

text: Background Recent data have reinforced the concept of a reciprocal relationship between COVID-19 and kidney function. However, most studies have focused on the effect of COVID-19 on kidney function, whereas data regarding kidney function on the COVID-19 prognosis is scarce. Therefore, in this study, we aimed to investigate the association between eGFR on admission and the mortality rate of COVID-19. Methods We recruited 336 adult consecutive patients (male 57.1%, mean age 55.0 {+/-}15.9) that were hospitalized with the diagnosis of COVID-19 in the tertiary care university hospital. Data were collected from the electronic health records of the hospital. On admission, eGFR was calculated using the CKD-EPI formula. Acute kidney injury was defined according to the KDIGO criteria. Binary logistic regression and Cox regression analyses were used to assess the relationship between eGFR on admission and in-hospital mortality of COVID-19. Results Baseline eGFR was under 60 mL/min/1.73m2 in 61 patients (18.2%). Acute kidney injury occurred in 29.1% of the patients. In-hospital mortality was calculated as 12.8%. Age-adjusted and multivariate logistic regression analysis (p:0.005, odds ratio:0.974, CI:0.956-0.992) showed that baseline eGFR was independently associated with mortality. Additionally, age-adjusted Cox regression analysis revealed a higher mortality rate in patients with an eGFR under 60 mL/min/1.73m2. Conclusions On admission eGFR seems to be a prognostic marker for mortality in patients with COVID-19; We recommend to determine eGFR in all patients on admission and use it as an additional tool for risk stratification. Close follow-up should be warranted in patients with reduced eGFR.


title: Novel Coronavirus Disease 2019 and Subarachnoid Hemorrhage: A Case Report

text: The novel coronavirus disease 2019 (COVID-19) has had a profound impact on healthcare systems around the world. The emergency department (ED) in particular has become the frontline for the identification and care of these patients. While its effects on respiratory symptoms are well recognized, neurologic manifestations have been rarer. We report the case of a patient who presented in cardiac arrest with the return of spontaneous circulation (ROSC). The patient was found to have subarachnoid hemorrhage and later tested positive for COVID-19.


title: Estimated surge in hospitalization and intensive care due to the novel coronavirus pandemic in the Greater Toronto Area, Canada: a mathematical modeling study with application at two local area hospitals

text: Background: A hospital-level pandemic response involves anticipating local surge in healthcare needs. Methods: We developed a mechanistic transmission model to simulate a range of scenarios of COVID-19 spread in the Greater Toronto Area. We estimated healthcare needs against 2019 daily admissions using healthcare administrative data, and applied outputs to hospital-specific data on catchment, capacity, and baseline non-COVID admissions to estimate potential surge by day 90 at two hospitals (St. Michaels Hospital [SMH] and St. Josephs Health Centre [SJHC]). We examined fast/large, default, and slow/small epidemics, wherein the default scenario (R0 2.4) resembled the early trajectory in the GTA. Results: Without further interventions, even a slow/small epidemic exceeded the citys daily ICU capacity for patients without COVID-19. In a pessimistic default scenario, for SMH and SJHC to remain below their non-ICU bed capacity, they would need to reduce non-COVID inpatient care by 70% and 58% respectively. SMH would need to create 86 new ICU beds, while SJHC would need to reduce its ICU beds for non-COVID care by 72%. Uncertainty in local epidemiological features was more influential than uncertainty in clinical severity. If physical distancing reduces contacts by 20%, maximizing the diagnostic capacity or syndromic diagnoses at the community-level could avoid a surge at each hospital. Interpretation: As distribution of the citys surge varies across hospitals over time, efforts are needed to plan and redistribute ICU care to where demand is expected. Hospital-level surge is based on community-level transmission, with community-level strategies key to mitigating each hospitals surge. Keywords: COVID-19, pandemic preparedness, mathematical model, transmission model


title: Capacities and predicted demands of Brazil's health system in view of the novel coronavirus disease outbreak

text: The aim of this work is to estimate capacities of Brazil's health system and their demand as a result of predicted incoming severe cases of the novel coronavirus disease (COVID-19) outbreak. Three incrementing levels of hospital equipment usage are considered: (1) in terms of available intensive care unit (ICU) beds; (2) available ICU beds and existing surgery operating rooms; and (3) available ICU beds and existing surgery operating rooms and respirators located in other hospital areas. The average available (adult) ICU beds in a hospital has been computed deducting from the number of existing beds the equivalent number of beds that has been demanded during 2019 on a monthly average. Based on a reference mean duration of hospitalization for the disease, it is computed the daily admission capacity of infected patients per state and of the entire country health system for each of the three referred levels of hospital equipment usage. Furthermore, an exponential regression model is fitted using the daily available data for the number of patients who have been documented as infected in Brazil. It can then be predicted the three dates at which the health system might begin to demonstrate stress for the maximum demand of the three incrementing groups of hospital equipments. The necessary public data are analyzed by means of the Python programming language and are made available on the internet by the Department of Health Informatics of Brazil (DATASUS - Departamento de Informatica do Sistema Unico de Saude) and the Brazilian Institute of Geography and Statistics (IBGE - Instituto Brasileiro de Geografia e Estatistica).


title: Multidrug treatment with nelfinavir and cepharanthine against COVID-19

text: Antiviral treatments targeting the emerging coronavirus disease 2019 (COVID-19) are urgently required. We screened a panel of already-approved drugs in a cell culture model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and identified two new antiviral agents: the HIV protease inhibitor Nelfinavir and the anti-inflammatory drug Cepharanthine. In silico modeling shows Nelfinavir binds the SARS-CoV-2 main protease consistent with its inhibition of viral replication, whilst Cepharanthine inhibits viral attachment and entry into cells. Consistent with their different modes of action, in vitro assays highlight a synergistic effect of this combined treatment to limit SARS-CoV-2 proliferation. Mathematical modeling in vitro antiviral activity coupled with the known pharmacokinetics for these drugs predicts that Nelfinavir will facilitate viral clearance. Combining Nelfinavir/Cepharanthine enhanced their predicted efficacy to control viral proliferation, to ameliorate both the progression of disease and risk of transmission. In summary, this study identifies a new multidrug combination treatment for COVID-19.


title: Genome-wide association and HLA region fine-mapping studies identify susceptibility loci for multiple common infections

text: We performed 23 genome-wide association studies for common infections, including chickenpox, shingles, cold sores, mononucleosis, mumps, hepatitis B, plantar warts, positive tuberculosis test results, strep throat, scarlet fever, pneumonia, bacterial meningitis, yeast infections, urinary tract infections, tonsillectomy, childhood ear infections, myringotomy, measles, hepatitis A, rheumatic fever, common colds, rubella and chronic sinus infection, in more than 200,000 individuals of European ancestry. For the first time, genome-wide significant associations (P < 5 × 10−8) were identified for many common infections. The associations were mapped to genes with key roles in acquired and innate immunity (HLA, IFNA21, FUT2, ST3GAL4, ABO, IFNL4, LCE3E, DSG1, LTBR, MTMR3, TNFRSF13B, TNFSF13B, NFKB1, CD40) and in regulation of embryonic developmental process (TBX1, FGF, FOXA1 and FOXN1). Several missense mutations were also identified (in LCE5A, DSG1, FUT2, TBX1, CDHR3, PLG, TNFRSF13B, FOXA1, SH2B3, ST5 and FOXN1). Missense mutations in FUT2 and TBX1 were implicated in multiple infections. We applied fine-mapping analysis to dissect associations in the human leukocyte antigen region, which suggested important roles of specific amino acid polymorphisms in the antigen-binding clefts. Our findings provide an important step toward dissecting the host genetic architecture of response to common infections.


title: Nowcasting the COVID-19 Pandemic in Bavaria

text: To assess the current dynamic of an epidemic it is central to collect information on the daily number of newly diseased cases. This is especially important in real-time surveillance, when one aims at evaluating the effects of interventions on disease spread. Reporting delays between disease onset and case reporting hamper our ability to understand the dynamic of an epidemic when looking at the number of daily reported cases only. Nowcasting can be used to adjust daily case counts for occurred-but-not-yet-reported events. Here, we present a novel application of nowcasting to data on the current COVID-19 pandemic in Bavaria. It is based on a hierarchical Bayesian model that considers changes in the reporting delay distribution associated with the week and weekday of reporting and assumes a smooth epidemic curve. Furthermore, we present a way to estimate the time-dependent case reproduction number R(t) based on predictions of the nowcast. We provide methodological details of the developed approach, illustrate results based on data of the current epidemic, discuss limitations and alternative estimation strategies, and provide code for reproduction or adaption of the nowcasting to data from different regions. Results of the nowcasting approach are reported to the Bavarian health authority and published on a webpage on a daily basis.


title: Inhibition of Anti-viral Stress Granule Formation by infectious bronchitis virus endoribonuclease nsp15 Ensures Efficient Virus Replication

text: Cytoplasmic stress granules (SGs) are generally triggered by stress-induced translation arrest for storing mRNAs. Recently, it has been shown that SGs exert anti-viral functions due to their involvement in protein synthesis shut off and recruitment of innate immune signaling intermediates. The largest RNA virus, coronavirus, mutates frequently and circulates among animals, imposing great threat to public safety and animal health; however, the significance of SGs in coronavirus infections is largely unknown. Infectious bronchitis virus (IBV) is the first identified coronavirus in 1930s and has been prevalent in poultry farm for many years. In this study, we provide evidence that IBV overcomes the host antiviral response by inhibiting SGs formation via the virus-encoded endoribonuclease nsp15. By immunofluorescence analysis, we observed that IBV infection not only did not trigger SGs formation in approximately 80% of the infected cells, but also impaired the formation of SGs triggered by heat shock, sodium arsenite, or NaCl stimuli. We show that the intrinsic endoribonuclease activity of nsp15 is responsible for the inhibition of SGs formation. In fact, nsp15-defective recombinant IBV (rIBV-nsp15-H238A) greatly induced the formation of SGs, along with accumulation of dsRNA and activation of PKR, whereas wild type IBV failed to do so. Consequently, infection with rIBV-nsp15-H238A triggered transcription of IFN-β which in turn greatly affected recombinant virus replication. Further analysis showed that SGs function as antiviral hub, as demonstrated by the attenuated IRF3-IFN response and increased production of IBV in SG-defective cells. Additional evidence includes the aggregation of PRRs and signaling intermediates to the IBV-induced SGs. Collectively, our data demonstrate that the endoribonuclease nsp15 of IBV suppresses the formation of antiviral hub SGs by regulating the accumulation of viral dsRNA and by antagonizing the activation of PKR, eventually ensuring productive virus replication. We speculate that coronaviruses employ similar mechanisms to antagonize the host anti-viral SGs formation for efficient virus replication, as the endoribonuclease function of nsp15 is conserved in all coronaviruses. Author summary It has been reported that stress granules (SGs) are part of the host cell antiviral response. Not surprisingly, viruses in turn produce an array of antagonists to counteract such host response. Here, we show that IBV inhibits the formation of SGs through its endoribonuclease nsp15, by reducing the accumulation of viral dsRNA, evading the activation of PKR, and by subsequently inhibiting eIF2α phosphorylation and SGs formation. Nsp15 also inhibits SG formation independent of the eIF2α pathway, probably by targeting host mRNA. Depletion of SG scaffold proteins decreases IRF3-IFN response and increases the production of IBV. All coronaviruses encode a conserved endoribonuclease nsp15, and it will be important to determine whether also other (non-avian) coronaviruses limit the formation of anti-viral SGs in a similar manner.


Sharing Our Experience of Operating an Endoscopy Unit in the Midst of a COVID-19 Outbreak


title: A profiling analysis on the receptor ACE2 expression reveals the potential risk of different type of cancers vulnerable to SARS-CoV-2 infection

text: Background: The new coronavirus pneumonia (NCP) is now causing a severe public health emergency The novel coronavirus 2019 (2019-nCoV) infected individuals by binding human angiotensin converting enzyme II (ACE2) receptor ACE2 is widely expressed in multiple organs including respiratory, cardiovascular, digestive and urinary systems in healthy individuals These tissues with high expression level of ACE2 seemed to be more vulnerable to SARS-CoV-2 infection Recently, it has been reported that patients with tumors were likely to be more susceptible to SARS-CoV-2 infection and indicated poor prognosis Methods: The tissue atlas database and the blood atlas were used to analyze the distribution of ACE2 in human tissues or organs of cancers and normal samples Starbase dataset was applied to predict the prognosis of cancers according to expression level of ACE2 Results: In this study, we demonstrated a landscape profiling analysis on expression level of ACE2 in pan-cancers and showed the risky of different type of cancers to SARS-CoV-2 according to the expression level of ACE2 In addition, we found that ACE2 was both differential expression and related to the prognosis only in liver hepatocellular carcinoma (LIHC) Relative high expression of ACE2 indicated a favorable prognosis in LIHC, but they might be more susceptible to SARS-CoV-2 Conclusions: We indeed emphasized that LIHC patients with high expression level of ACE2 should be more cautious of the virus infection Our study might provide a potential clue for preventing infection of SARS-CoV-2 in cancers


title: Coronavirus Disease 2019 (COVID-19) From the Point of View of Neurologists: Observation of Neurological Findings and Symptoms During the Combat Against a Pandemic.

text: Some respiratory viruses have long been known to cause neurological involvement. A novel coronavirus, leading to severe acute respiratory syndrome, also called coronavirus disease 19 (COVID-19), seems to be a new member of neuroinvasive viruses. While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) keeps on spreading around the world rapidly, reports about the neurological manifestations associated with SARS-CoV-2, increases day by day. It is reported that a variety of symptoms and syndromes such as headache, dizziness, confusion, ataxia, epilepsy, ischemic stroke, neuropathic pain and myopathy are common especially in more severe COVID-19 patients. It is also suggested that the development of neurological complications is strongly associated with a poor outcome. On the other hand, hyposmia can be the unique symptom in COVID-19 carriers and this can serve as a marker for identifying the otherwise asymptomatically infected patients. It is thought that SARS-CoV-2 may cause neurological symptoms through direct or indirect mechanisms. Nevertheless, neuroinvasion capability of SARS-CoV2 is confirmed by the presence of the virus, in the cerebrospinal fluid of a COVID-19 patient with encephalitis, and this is proven by gene sequencing. In conclusion, during the COVID-19 pandemic, it is crucial to be aware of the possible neurological complications of the disease. Therefore, in this review, we aimed to report neurological manifestations associated with SARS-CoV-2 and possible underlying pathophysiological mechanisms. Due to the high homology of SARS-CoV-2 with other human coronaviruses such as SARS-CoV or Middle East Respiratory Syndrome (MERS)-CoV, reviewing the neurological involvement also associated with these coronaviruses will provide an idea about the long-term complications of COVID-19.


title: The role of institutional trust in preventive and treatment-seeking behaviors during the 2019 novel coronavirus (2019-nCoV) outbreak among residents in Hubei, China

text: Background Since December 2019, pneumonia associated with the 2019 novel coronavirus (2019-nCoV) has emerged in Wuhan, China. The exponential increase of the confirmed number of cases of 2019n-CoV is of great concern to the global community. The fears and panic among residents in the epicenters have prompted diverse responses, which are understudied. During such a crisis, community trust and support for the government and health authorities are important to contain the outbreak. We aimed to investigate the influence of institutional trust on public responses to the 2019-nCoV outbreak. Methods An anonymous Internet-based, cross-sectional survey was administered on January 29, 2020. The study population comprised all residents currently residing or working in the province of Hubei, where Wuhan is the capital city. The level of trust in information provision and preventive instructions, individual preventive behaviors and treatment-seeking behaviors were queried. Findings The majority of the participants expressed a great extent of trust in the information and preventive instructions provided by the central government than by the local government. A high uptake of 2019-nCoV preventive measures was found, particularly among people who had been placed under quarantine. Being under quarantine (adjusted odds ratio [OR] = 2.35, 95% confidence interval [CI] 1.80 to 3.08) and having a high institutional trust score (OR = 2.23, 95% CI 1.96 to 2.53) were both strong and significant determinants of higher preventive behavior scores. The majority of study participants (85.7%, n = 3,640) reported that they would seek hospital treatment if they suspected themselves to have been infected with 2019 n-CoV. Few of the participants from Wuhan (16.6%, n = 475) and those participants who were under quarantine (13.8%, n = 550) expressed an unwillingness to seek hospital treatment. Similarly, being under quarantine (OR = 2.36, 95% CI 1.80 to 3.09) and having a high institutional trust score (OR = 2.20, 95% CI 1.96 to 2.49) were two strong significant determinants of hospital treatment-seeking. Interpretation The results of this study suggest that institutional trust is an important factor influencing adequate preventive behavior and seeking formal medical care during an outbreak. In view of the 2019-nCoV being highly pathogenic and extremely contagious, our findings also underscore the importance of public health intervention to reach individuals with poor adherence to preventive measures and who are reluctant to seek treatment at formal health services. Funding National Key R&D Program of China, Ningbo Health Branding Subject Fund, Sanming Project of Medicine in Shenzhen, K.C. Wong Magna Fund in Ningbo University, National Natural Science Foundation of China, Fundamental Research Funds for the Central Universities, China Postdoctoral Science Foundation, and Natural Science Basic Research Program of Shanxi Province. Keywords: 2019-nCoV; institutional trust; preventive behaviors


title: The Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR) and routine hematological parameters of COVID-19 Patient : A perspective of the Indian scenario from a frontline pilot study of 32 COVID-19 cases in a Tertiary Care Institute of North India

text: Introduction The coronavirus disease 2019(COVID-19) is caused by the virus SARS-CoV-2 and is declared as a global pandemic by the World Health Organization (WHO). Various hematological parameters alteration has been documented in the Chinese literature in SARS-Cov-2 infection. However, there is a need for research to evaluate the pattern of the hematological parameters of COVID-19 patients in the Indian population. Aims & Objectives: The objective of the study is to see the Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), and other hematological parameters alteration of COVID-19 patients along with their clinical course in the Indian scenario. Methods: A single-center prospective study of 32 patients with laboratory-confirmed COVID-19 admitted to Super Speciality Pediatric Hospital & Post Graduate Teaching Institute NOIDA, from March to April, were enrolled for the study. The demographic data, the clinical status of the patients during admission and follow up, baseline, and follow up hematological findings were recorded. Statistical analysis of the data was carried out, and relevant findings were presented. Results: Demographic characterization shows a mean age of 37.7 years, male (41.9%), female (58.1%)with the majority of patients are mildly symptomatic to asymptomatic(93%). The CBC values and NLR, PLR at baseline between the male and the female patients, are not showing any statistically significant difference as the 95% C.I. A statistically significant increment in the lab parameters is observed in follow-up visits. Conclusion: The majority of the patients are younger and have mild clinical presentation with female predominance. Pediatric cases have mild symptomology. Baseline CBC findings show mild neutrophilia, lymphopenia, eosinopenia, and normal to mild thrombocytopenia. An increase in CBC parameters, NLR was noted in follow up cases. Anemia was not noted in baseline CBC and in the follow-up group. A onetime PLR is not indicative of disease progression. Key words: Corona virus,COVID-19,CBC,NLR,PLR


title: COVID-19 and maternal mental health: Are we getting the balance right?

text: This paper presents a rapid evidence review into the clinical and psychological impacts of COVID-19 on perinatal women and their infants. Literature search revealed that there is very little formal evidence on the impact of COVID-19 on pregnant, labouring and postnatal women or their babies. The clinical evidence to date suggests that pregnant and childbearing women, and their babies are not at increased risk of either getting infected, or of having severe symptoms or consequences than the population as a whole. There is no evidence on the short- and longer-term psychological impacts of restrictive practices or social and personal constraints for childbearing women during COVID-19 in particular, or infection pandemics in general. The potential for adverse mental health consequences of the pandemic should be recognised as a critical public health concern, together with appropriate care and support to prevent and ameliorate any negative impacts.


title: How to better communicate exponential growth of infectious diseases

text: Sustained non-pharmaceutical interventions (NPIs) can contain the spread of infectious disease when vaccines or treatments are not available. The benefit of such behavioural adaptations can be modelled as the deceleration of the exponential growth of cases. Humans underestimate exponential growth, as has been documented in biological, environmental and financial contexts. Hence, they might also underestimate the benefit of reducing the exponential growth rate. Different ways of communicating the same scenario, i.e. frames, have been found to have a large impact on people's evaluations and choices in the contexts of social behaviour, risk taking and health care. Here we show that framing matters for people's assessment of the benefits of measures to mitigate the spread of infectious disease. In two commonly used frames, most subjects in our experiment drastically underestimate the number of cases mitigation measures avoid. Framing growth in terms of doubling times, rather than growth rates, improves understanding. In a non-standard framing, which focuses on time gained rather than cases avoided, the median subject assesses the benefit of mitigation measures correctly. These findings suggest changes that public health authorities can adopt to communicate the exponential spread of infectious disease more effectively. Beyond public health, the findings have applications to, for example, the regulation of the sale of financial products, retirement savings, education and the public understanding of exponential processes in the environment.


title: Structural basis of SARS-CoV-2 spike protein induced by ACE2

text: Motivation The recent emergence of the novel SARS-coronavirus 2 (SARS-CoV-2) and its international spread pose a global health emergency. The viral spike (S) glycoprotein binds the receptor (angiotensin-converting enzyme 2) ACE2 and promotes SARS-CoV-2 entry into host cells. The trimeric S protein binds the receptor using the distal receptor-binding domain (RBD) causing conformational changes in S protein that allow priming by host cell proteases. Unravelling the dynamic structural features used by SARS-CoV-2 for entry might provide insights into viral transmission and reveal novel therapeutic targets. Using structures determined by X-ray crystallography and cryo-EM, we performed structural analysis and atomic comparisons of the different conformational states adopted by the SARS-CoV-2-RBD. Results Here, we determined the key structural components induced by the receptor and characterized their intramolecular interactions. We show that κ-helix (also known as polyproline II) is a predominant structure in the binding interface and in facilitating the conversion to the active form of the S protein. We demonstrate a series of conversions between switch-like κ-helix and β-strand, and conformational variations in a set of short α-helices which affect the proximal hinge region. This conformational changes lead to an alternating pattern in conserved disulfide bond configurations positioned at the hinge, indicating a possible disulfide exchange, an important allosteric switch implicated in viral entry of various viruses, including HIV and murine coronavirus. The structural information presented herein enables us to inspect and understand the important dynamic features of SARS-CoV-2-RBD and propose a novel potential therapeutic strategy to block viral entry. Overall, this study provides guidance for the design and optimization of structure-based intervention strategies that target SARS-CoV-2.


title: CORONAVIRUS IN PREGNANCY AND DELIVERY: RAPID REVIEW AND EXPERT CONSENSUS

text: BACKGROUND Person to person spread of COIVD-19 in the UK has now been confirmed. There are limited case series reporting the impact on women affected by coronaviruses (CoV) during pregnancy. In women affected by SARS and MERS, the case fatality rate appeared higher in women affected in pregnancy compared with non-pregnant women. We conducted a rapid, review to guide management of women affected by COVID -19 during pregnancy and developed interim practice guidance with the RCOG and RCPCH to inform maternity and neonatal service planning METHODS Searches were conducted in PubMed and MedRxiv to identify primary case reports, case series, observational studies or randomised-controlled trial describing women affected by coronavirus in pregnancy and on neonates. Data was extracted from relevant papers and the review was drafted with representatives of the RCPCH and RCOG who also provided expert consensus on areas where data were lacking RESULTS From 9964 results on PubMed and 600 on MedRxiv, 18 relevant studies (case reports and case series) were identified. There was inconsistent reporting of maternal, perinatal and neonatal outcomes across case reports and series concerning COVID-19, SARS, MERS and other coronaviruses. From reports of 19 women to date affected by COVID-19 in pregnancy, delivering 20 babies, 3 (16%) were asymptomatic, 1 (5%) was admitted to ICU and no maternal deaths have been reported. Deliveries were 17 by caesarean section, 2 by vaginal delivery, 8 (42%) delivered pre-term. There was one neonatal death, in 15 babies who were tested there was no evidence of vertical transmission. CONCLUSIONS Morbidity and mortality from COVID-19 appears less marked than for SARS and MERS, acknowledging the limited number of cases reported to date. Pre-term delivery affected 42% of women hospitalised with COVID-19, which may put considerable pressure on neonatal services if the UK reasonable worse-case scenario of 80% of the population affected is realised. There has been no evidence of vertical transmission to date. The RCOG and RCPCH have provided interim guidance to help maternity and neonatal services plan their response to COVID-19.


title: Solubility-Weighted Index: fast and accurate prediction of protein solubility

text: Motivation Recombinant protein production is a widely used technique in the biotechnology and biomedical industries, yet only a quarter of target proteins are soluble and can therefore be purified. Results We have discovered that global structural flexibility, which can be modeled by normalised B-factors, accurately predicts the solubility of 12,216 recombinant proteins expressed in Escherichia coli. We have optimised B-factors, and derived a new set of values for solubility scoring that further improves prediction accuracy. We call this new predictor the ‘Solubility-Weighted Index’ (SWI). Importantly, SWI outperforms many existing protein solubility prediction tools. Furthermore, we have developed ‘SoDoPE’ (Soluble Domain for Protein Expression), a web interface that allows users to choose a protein region of interest for predicting and maximising both protein expression and solubility. Availability The SoDoPE web server and source code are freely available at https://tisigner.com/sodope and https://github.com/Gardner-BinfLab/TISIGNER-ReactJS, respectively. The code and data for reproducing our analysis can be found at https://github.com/Gardner-BinfLab/SoDoPE_paper2020.


title: SARS-CoV-2 RNA concentrations in primary municipal sewage sludge as a leading indicator of COVID-19 outbreak dynamics

text: We report a time course of SARS-CoV-2 RNA concentrations in primary sewage sludge during the Spring COVID-19 outbreak in a northeastern U.S. metropolitan area. SARS-CoV-2 RNA was detected in all environmental samples and, when adjusted for the time lag, the virus RNA concentrations were highly correlated with the COVID-19 epidemiological curve (R2=0.99) and local hospital admissions (R2=0.99). SARS-CoV-2 RNA concentrations were a seven-day leading indicator ahead of compiled COVID-19 testing data and led local hospital admissions data by three days. Decisions to implement or relax public health measures and restrictions require timely information on outbreak dynamics in a community.


title: What Donald Trump’s response to COVID-19 teaches us: It’s time for our romance with leaders to end

text: This article challenges our collective focus on individual leaders such as Donald Trump especially during times of crisis such as the COVID-19 pandemic. It argues that such attention distracts us from larger systemic dynamics which are contributing to the severity of the pandemic in the US as well as obfuscating the influence of unelected parties whose interests are served by Trump’s actions. In light of these observations, rather than continuing to feed our romance with leaders, leadership scholars are encouraged to (1) expand their inquiries to interrogate the structural and societal forces which contribute to a situation’s outcomes and keep individuals in place as leaders and (2) pay greater attention to the irrational, primal dimensions at play in the relationship between leaders and those they lead.


Dogs catch coronavirus, suspicious images and an autopsy challenge


title: Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic disease-modifying anti-rheumatic drugs

text: OBJECTIVES: To investigate the incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases receiving targeted biologic and synthetic disease modifying anti-rheumatic drugs (tDMARDs) and to explore the possible effect of these treatments in the clinical expression of COVID-19. METHODS: A cross-sectional study comprising of a telephone survey and electronic health records review was performed including all adult and paediatric patients with rheumatic diseases treated with tDMARDs in a large rheumatology tertiary centre in Barcelona, Spain. Demographics, disease activity, COVID-19 related symptoms and contact history data were obtained from the start of the 2020 pandemic. Cumulative incidence of confirmed cases (SARS-CoV-2 positive PCR test) was compared to the population estimates for the same city districts from a governmental COVID-19 health database. Suspected cases were defined following WHO criteria and compared to those without compatible symptoms. RESULTS: 959 patients with rheumatic diseases treated with tDMARDs were included. We identified 11 confirmed SARS-CoV-2 positive cases in the adult cohort and no confirmed positive cases in the paediatric cohort. All patients had a successful recovery and only one patient required admission in the intensive care unit. When using the same classification criteria (only COVID-19 positive cases with pneumonia), COVID-19 incidence rates of the rheumatic patient cohort were very similar to that of the general population [(0.48% (95% CI 0.09 to 8.65%)] and [0.58% (95% CI 5.62 to 5.99%)], respectively. We found significant differences in tDMARDs proportions between the suspected and non-suspected cases (p=0.002). CONCLUSION: Adult and paediatric patients with rheumatic diseases on tDMARDs do not seem to present a higher risk of COVID-19 or a more severe disease outcome when compared to general population. Our exploratory analysis suggests that the proportion of COVID-19 suspected cases differs between tDMARDs.


title: Predictive Analysis for COVID-19 Spread in India by Adaptive Compartmental Model

text: The role of mathematical modelling in predicting spread of an epidemic is of vital importance. The purpose of present study is to develop and apply a computational tool for predicting evolution of different epidemiological variables for COVID-19 in India. We propose a dynamic SIRD (Susceptible-Infected-Recovered-Dead) and SEIRD (Susceptible-Exposed-Infected-Recovered-Dead) model for this purpose. In the dynamic model, time dependent infection rate is assumed for estimating evolution of different variables of the model. Parameter estimation of the model is the first step of the analysis which is performed by least square optimization of priori data. In the second step of the analysis, simulation is carried out by using evaluated parameters for prediction of the outbreak. The computational model has been validated against real data for COVID-19 outbreak in Italy. Time to reach peak, peak infected cases and total reported cases were compared with actual data and found to be in very good agreement. Next the model is applied for the case of India and various Indian states to predict different epidemiological parameters. Priori data was taken from the beginning of nation-wide lockdown on 24 March to 6 July. It was found that peak of the outbreak may reach in the month of August-September with maximum 4-5 lakhs active cases at peak. Total number of reported cases all over India would be in between three to five millions. State wise, Maharashtra, Tamilnadu and Delhi would be worst affected.


title: Global Spread of SARS-CoV-2 Subtype with Spike Protein Mutation D614G is Shaped by Human Genomic Variations that Regulate Expression of TMPRSS2 and MX1 Genes

text: COVID-19 pandemic is a major human tragedy. Worldwide, SARS-CoV-2 has already infected over 3 million and has killed about 230,000 people. SARS-CoV-2 originated in China and, within three months, has evolved to an additional 10 subtypes. One particular subtype with a non-silent (Aspartate to Glycine) mutation at 614th position of the Spike protein (D614G) rapidly outcompeted other pre-existing subtypes, including the ancestral. We assessed that D614G mutation generates an additional serine protease (Elastase) cleavage site near the S1-S2 junction of the Spike protein. We also identified that a single nucleotide deletion (delC) at a known variant site (rs35074065) in a cis-eQTL of TMPRSS2, is extremely rare in East Asians but is common in Europeans and North Americans. The delC allele facilitates entry of the 614G subtype into host cells, thus accelerating the spread of 614G subtype in Europe and North America where the delC allele is common. The delC allele at the cis-eQTL locus rs35074065 of TMPRSS2 leads to overexpression of both TMPRSS2 and a nearby gene MX1. The cis-eQTL site, rs35074065 overlaps with a transcription factor binding site of an activator (IRF1) and a repressor (IRF2). IRF1 activator can bind to variant delC allele, but IRF2 repressor fails to bind. Thus, in an individual carrying the delC allele, there is only activation, but no repression. On viral entry, IRF1 mediated upregulation of MX1 leads to neutrophil infiltration and processing of 614G mutated Spike protein by neutrophil Elastase. The simultaneous processing of 614G spike protein by TMPRSS2 and Elastase serine proteases facilitates the entry of the 614G subtype into host cells. Thus, SARS-CoV-2, particularly the 614G subtype, has spread more easily and with higher frequency to Europe and North America where the delC allele regulating expression of TMPRSS2 and MX1 host proteins is common, but not to East Asia where this allele is rare.


title: Mortality of the COVID-19 outbreak in Sweden in relation to previous severe disease outbreaks

text: Influenza viruses have caused disease outbreaks in human societies for a long time. Influenza often has rapid onset and relatively short duration, both in the individual and in the population. The case fatality rate varies for different strains of the virus, as do the effects on total mortality. Outbreaks related to coronavirus infections have recently become a global concern but much less is known about the dynamics of these outbreaks and their effects on mortality. In this work, disease outbreaks in Sweden, in the time period of 1860-2020, are characterized and compared to the currently ongoing COVID-19 outbreak. The focus is on outbreaks with a sharp increase in all-cause mortality. Outbreak onset is defined as the time point when deaths counts starts to increase consistently for a period of 10 days. The duration of the outbreak is defined as the time period in which mortality rates are elevated. Excess mortality is estimated by standard methods. In total there were 15 outbreaks detected in the time period, the first 14 were likely caused by influenza virus infections, the last by SARS-CoV-2. The mortality dynamics of the SARS-CoV-2 outbreak is shown to be similar to outbreaks due to influenza virus, and in terms of the number of excess deaths, might become the worst outbreak since the 'Spanish flu' of 1918-1919.


title: Analysis of prevention and control strategy of covid-19 epidemic in china based on the concept of "one health": An opinion paper

text: Background: In December 2019, new coronavirus pneumonia (COVID - 19) was found in Wuhan, China. The current epidemic is spreading in China and even the world. The virus has the characteristics of strong infectivity, long incubation period, mainly spread by droplets, close contact. So far there is no specific drug treatment. There are nearly 100,000 confirmed cases worldwide. Methods: In the current severe situation of the epidemic, this paper uses the methods of literature, investigation and logical and so on. Results: According to the special environment of China, the concept of One Health is proposed for prevention and control. Under the leadership of the government, multiple functional departments and disciplines cooperate to exchange information, forming a working mechanism of efficient coordination, seamless connection, a combination of prevention and control, and coordination among the masses. Conclusion: The government should set up a department of "One Health" to promote the coordination and cooperation between multiple departments and disciplines. It is suggested: 1. Strengthening infectious disease medical personnel training and public health research; 2. To intervene in the psychological crisis of different groups;3. Provide security and logistic support for medical staff; 4. Guarantee the reserve of protective and medical materials;5. Vigilance and prevention and control of the "weak period" of the epidemic; 6. International opinion dominates.


title: Propagation analysis and prediction of the COVID-19

text: Based on the official data modeling, this paper studies the transmission process of the Corona Virus Disease 2019 (COVID-19). The error between the model and the official data curve is within 3%. At the same time, it realized forward prediction and backward inference of the epidemic situation, and the relevant analysis help relevant countries to make decisions.


title: The mental health impact of COVID-19 and pandemic related stressors among adults in the UK

text: Background: The coronavirus pandemic has resulted in a wide range of social and economic changes that could, in turn, have affected the mental health of the UK adult population. Previous research has not been able to measure the broad range of potential stressors, nor examine whether recent changes in those stressors have positively or negatively impacted on common mental disorders. Furthermore, it is unclear whether the stressful impact of the lockdown on mental health has accumulated over time or whether people have adapted to the new conditions of lockdown. This study examines whether there was an increase in the prevalence and incidence of Common Mental Disorders (CMD) in the UK adult population during the first few months of lockdown related to the coronavirus pandemic and whether changes in CMD were associated with an increase in stressors related to lockdown and the pandemic. Methods: Longitudinal data from the UK Household Longitudinal Study (wave 9: 2017-2019 and waves 1 and 2 of the Coronavirus survey in April and May 2020 respectively), a representative sample of UK population, were analysed. Common mental disorders (CMD) were measured using the GHQ-12 (cut off >2) at all waves. The difference in the GHQ-12 (using Likert scores) between waves measured changes in psychological well-being. The incidence of CMD and changes in psychological well-being were analysed in relation to pandemic specific stressors and changes in economic, financial, household and psychosocial stressors. Findings: Around 30% of UKHLS adults without CMD in 2017/9 had a CMD in April 2020. However from April to May 2020, the incidence reduced considerably to below 13%. Much of the increase in incident CMD between April and May was associated with an increase in feelings of loneliness, but some of this increase was also associated with increasing domestic work demands (arising out of childcare and home-schooling), working from home, and the receipt of care from outside the home. The reduction in the incidence of many of these stressors in May (compared to April) coincided with a reduction in the incidence of CMD in May. Conclusion: The pandemic and resultant lockdown were associated with an increase in the incidence of CMD in the UK adult population initially in April 2020. These changes were associated with increases in feelings of loneliness and stressors related to work and domestic life and receipt of care. There was some evidence of adaptation to many of these stressors over the lockdown period by May 2020. However, if levels of unemployment and redundancy increase in the near future, the implications for the mental health of the population need careful thought and monitoring.


title: The prevention of nosocomial SARS-CoV2 transmission in endoscopy: a systematic review of recommendations within gastroenterology to identify best practice.

text: Endoscopy generates aerosol droplets and fomites, thereby increasing the risk of SARS-CoV2 transmission to healthcare workers and uninfected patients within endoscopy departments. Despite the sharp rise in the incidence of COVID-19, authoritative recommendations to limit the spread of SARS-CoV2 within gastrointestinal endoscopy units are lacking. Therefore, with the primary aim of identifying best practice and scrutinizing its supporting evidence, we conducted a systematic review of literature for articles published between 1 January 2002 and 15 March 2020 in five databases relating to both the current SARS-CoV2 and the previous SARS-CoV outbreaks. Official websites for gastroenterology and endoscopy societies in the 15 most affected countries were also searched. Unfortunately, a paucity of high quality data and heterogeneity of recommendations between countries was observed. Interestingly, not all countries advocated the postponement of non-urgent or elective procedures. Recommendations for patient screening and personal protective equipment were commonly featured in all recommendations but specifics varied. Only 32% (9/28) of all gastroenterology and endoscopy societies issued guidance on endoscopy in the COVID-19 pandemic. In conclusion, stronger evidence to inform current practice and robust guidelines are urgently needed to prevent the transmission of SARS-CoV2 in gastrointestinal endoscopy departments worldwide.


title: Pooled RNA sample reverse transcriptase real time PCR assay for SARS CoV-2 infection: a reliable, faster and economical method.

text: Background: Corona virus disease 2019 (COVID-19) which initially started as a cluster of pneumonia cases in the Wuhan city of China has now become a full blown pandemic. Timely diagnosis of COVID-19 is the key in containing the pandemic and breaking the chain of In low and middle income countries availability of testing kits has become the major bottle neck in testing. Novel methods like pooling of samples are the need of the hour. Method: Extracted RNA samples were randomly placed in pools of 8 on a 96 well plate. Both individual RNA (ID) and pooled RNA RT-qPCR for the screening E gene were done in the same plate and the positivity for the E gene was seen. Results: The present study demonstrated that pool testing with 8 RNA samples can easily detect even up to a single positive sample with Ct value as high as 38. The present study also showed that the results of pool testing is not affected by number of positive samples in a pool. Conclusion: Pooling of 8 RNA samples can reduce the time and expense by one eighth, and can help expand diagnostic capabilities, especially during constrained supply of reagents and PCR kits for the diagnosis of SARS-CoV-2 infection.


title: Manufacturing and Society – A Freshman Introduction to Engineering Course with Manufacturing and Social Science Partnership

text: Abstract The curriculum and pedagogy of a freshman introduction to engineering course on manufacturing and society are presented. This course is designed to use the quadcopter drone as an example to teach knowledge in manufacturing processes and systems, illustrate potential impacts of manufacturing to society, and stimulate learning in innovation, teamwork, and communication in a real-world engineering environment. It is also designed to teach students how to best communicate their findings and conclusions. This course is built on two team-based projects. Students practiced and timed the assembly of a state-of-the-art drone, the DJI Spark, and created a mid-term project presentation and report of their plan to setup an assembly plant in Michigan for this drone. Students learned the assembly line design, cycle time balancing, time study, automation, robotics, ergonomics, process capability index, and plant layout. The final project is the design and manufacture of an attachment to a hobby drone, DJI F330, for a mission that will benefit society. Students learned the social-aspects of manufacturing, computer-aided design, additive manufacturing, fabrication skills, and manufacturing processes. Each team identified a societal need, designed an attachment to the DJI F330 drone, reviewed the design with experienced engineers, manufactured components, assembled the attachment, and evaluated them in drone test flights. This course was implemented in close collaboration with a local community college to share the lecture and lab materials as well as pedagogy in manufacturing to benefit the same cohort of high school graduates. This approach of integrated social science, manufacturing, and technical communication to teach manufacturing using drones and connect manufacturing and society were demonstrated to be effective for an introductory freshman engineering course. Freshman engineering students often experience tremendous changes and pressure in their first semester. The lecture, lab, and discussion session for communication were adjusted to help students’ transition in their first semester engineering study.


title: Clinical performance of SARS-CoV-2 IgG antibody tests and potential protective immunity

text: As the current SARS-CoV-2 pandemic continues, serological assays are urgently needed for rapid diagnosis, contact tracing and for epidemiological studies. So far, there is little data on how commercially available tests perform with real patient samples and if detected IgG antibodies provide protective immunity. Focusing on IgG antibodies, we demonstrate the performance of two ELISA assays (Euroimmun SARS-CoV-2 IgG & Vircell COVID-19 ELISA IgG) in comparison to one lateral flow assay ((LFA) FaStep COVID-19 IgG/IgM Rapid Test Device) and two in-house developed assays (immunofluorescence assay (IFA) and plaque reduction neutralization test (PRNT)). We tested follow up serum/plasma samples of individuals PCR-diagnosed with COVID-19. Most of the SARS-CoV-2 samples were from individuals with moderate to severe clinical course, who required an in-patient hospital stay. For all examined assays, the sensitivity ranged from 58.8 to 76.5% for the early phase of infection (days 5-9) and from 93.8 to 100% for the later period (days 10-18) after PCR-diagnosed with COVID-19. With exception of one sample, all positive tested samples in the analysed cohort, using the commercially available assays examined (including the in-house developed IFA), demonstrated neutralizing (protective) properties in the PRNT, indicating a potential protective immunity to SARS-CoV-2. Regarding specificity, there was evidence that samples of endemic coronavirus (HCoV-OC43, HCoV-229E) and Epstein Barr virus (EBV) infected individuals cross-reacted in the ELISA assays and IFA, in one case generating a false positive result (may giving a false sense of security). This need to be further investigated.


title: Dengue and Zika virus infection are impaired by small molecule ER proteostasis regulator 147 in an ATF6-independent manner

text: Flaviviruses, including Dengue and Zika, are widespread human pathogens, however, no broadly active therapeutics exist to fight infection. Here, we establish the recently discovered pharmacologic modulator of ER proteostasis 147 as an effective host-centered antiviral strategy. Compound 147 reduces infection by attenuating viral replication without causing toxicity in host cells. 147 is a preferential activator of the ATF6 pathway of the unfolded protein response, which requires targeting of cysteine residues primarily on protein disulfide isomerases (PDIs). We find that the antiviral activity of 147 is independent of ATF6 induction but does require modification of reactive thiols on protein targets. Targeting PDIs using RNAi and other PDI small molecule inhibitors was unable to recapitulate the antiviral effects, suggesting additional identified protein targets of 147 may mediate the activity. Importantly, 147 can impair infection of multiple strains of Dengue and Zika virus, indicating that it is suitable as a broad-spectrum antiviral agent.


title: Antimalarial drugs put to the test for COVID-19

text: Over 200,000 people worldwide could receive the old antimalarial drugs chloroquine and hydroxychloroquine across more than 130 clinical trials designed to treat or prevent COVID-19, according to the US clinical trials database A small study in March suggested that hydroxychloroquine plus the antibiotic azithromycin helped people with COVID-19 recover faster President Donald J Trump touted hydroxychloroquine’s potential in the following weeks, spurring huge demand for the drug While some doctors prescribed it without proof, others scrambled to construct clinical studies to assess the drug’s efficacy The earliest results are discouraging A team of investigators in Brazil gave chloroquine to 81 hospitalized patients;32% of those who received high doses died, compared with 15% who received the low dose (medRxiv 2020, DOI: 10 1101/2020 04 07 20056424) Separately, data analyzed from 368 people with COVID-19 at hospitals run by the US Veterans Health Administration revealed that 28% who received hydroxychloroquine and 22% who got that View: PDF ;Full Text HTML


title: Examining the protection efficacy of face shields against cough aerosol droplets using water sensitive papers

text: Simple plastic face shields have many advantages compared to regular medical masks. They are easily cleaned for reuse and comfortable to wear. In light of the spreading COVID-19 pandemic, the potential of face shields as a substitution for medical masks, as a recommendation to the general population, was tested. Testing the efficacy of the protective equipment utilized a cough simulator that was carefully tuned to replicate human cough in terms of droplet size distribution and outlet velocity. The tested protective equipment was worn on a manikin head simulating human breathing. An Aerodynamic Particle Sizer (APS) was used to analyze the concentration and size distribution of small particles that reach the manikin head respiration pathways. Additionally, Water sensitive papers were taped over and under the tested protective equipment, and were subsequently photographed and analyzed. For droplets larger than 3m by diameter, the efficiency of shields to block cough droplets was found to be comparable to that of regular medical masks, with enhanced protection on face parts the mask does not cover. Additionally, for finer particles, of the order 0.3 to few microns, a shield was found to perform even better, blocking about 10 times more fine particles than the medical mask. This implies that for the general population that is not intendedly exposed to confirmed infected individuals, recommending the use of face shields as an alternative to medical masks should be considered.


title: Comparison of SARS-CoV-2 serological tests with different antigen targets

text: Background These last months, dozens of SARS-CoV-2 serological tests have become available with varying performances. A major effort was completed to compare 17 serological tests. Methods In a preliminary phase, we compared 17 IgG, IgM, IgA and pan Ig serological tests including ELISA, LFA, CLIA and ECLIA on a panel of 182 sera, comprising 113 sera from hospitalized patients with a positive RT-PCR, and 69 sampled before 1st November 2019, expected to give a positive and negative results, respectively. In a second phase, the five best performing and most available tests were further evaluated on a total of 582 sera (178 and 404 expected positive and negative, respectively), allowing the assessment of 20 possible cross-reactions with other virus. Results In the preliminary phase, among eight IgG/pan-Ig ELISA or CLIA/ECLIA tests, four had a sensitivity and specificity above 90% and 98% respectively, and on six IgM/IgA tests, only one was acceptable. Only one LFA test on three showed good performances for both IgG and IgM. For all the tests IgM and IgG aroused concomitantly. In the second phase, no tests showed particular cross-reaction. We observed an important heterogeneity in the development of the antibody response, and that anti-nucleocapside (anti-N) antibodies appeared earlier than the anti-spike (anti-S) proteins. Conclusions The identified SARS-CoV-2 serology tests may be used for the diagnostic of CoviD-19 for negative RT-PCR patients presenting severe to mild suggestive symptoms or particular clinical presentation. Detection of both anti-N and anti-S could be complementary to increase the sensitivity of the analysis.


title: Alternative Qualitative Fit Testing Method for N95 Equivalent Respirators in the Setting of Resource Scarcity at the George Washington University

text: The 2019 Novel Coronavirus (COVID-19) has caused an acute shortage of personal protective equipment (PPE) globally as well as shortage in the ability to test PPE such as respirator fit testing. This limits not only the ability to fit PPE to medical practitioners, but also the ability to rapidly prototype and produce alternative sources of PPE as it is difficult to validate fit. At the George Washington University, we evaluated an easily sourced method of qualitative fit testing using a nebulizer or atomizer and a sodium saccharin solution in water. If aerosolized saccharin entered candidate masks due to poor fit or inadequate filtration, then a sweet taste was detected in the mouth of the user. This method was tested against previously fit tested Milwaukee N95 and 3D Printed Reusable N95 Respirator as a positive control. A Chinese sourced KN95, cotton cloth material, and surgical mask were tested as other masks of interest. Sensitivity testing was done with no mask prior to fit test. A sweet taste was detected for both the surgical mask and cotton cloth, demonstrating a lack of seal. However, there was no sweet taste detected for the Milwaukee N95, 3D Printed Reusable N95 Respirator, or Chinese KN95. These results demonstrate this could be a valuable methodology for rapid prototyping, evaluation, and validation of fit in a non-clinical environment for use in creation of PPE. This method should be not be used without confirmation in a formal qualitative or quantitative fit test but can be used to preserve those resources until developers are confident that potential new N95 comparable respirators will pass. We strongly suggest validation of masks and respirators with Occupational Safety and Health Administration (OSHA) approved fit testing prior to use in a clinical environment.


title: Quantifying Costs of Urbanisation: Wetland Loss and Impacts in a Rapidly Developing Global City

text: As cities grow, natural ecosystems decline through conversion to urban environments. Cities are often viewed as biodiversity wastelands, but they can be hotspots of global biodiversity. Urban biodiversity emphasises two fundamentals. First, people living in cities enjoy wildlife and second, there is virtually no planning for species that co-inhabit our cities. If urban biodiversity was a significant part of planning, then we would be far better at integrating green infrastructure into expanding urban environments. Wetlands are among the most important and productive ecosystems in the world. They are the main suppliers of fresh water for human use and provide habitat to critical fauna and flora. In urban areas they are a vital link to nature and social cohesion. Currently, there is an absence of wetland inventory quantifying loss and changes overtime. Hence the broad impacts of urbanisation on wetland loss are difficult to assess. We explored wetland loss and created a wetland inventory for Western Sydney, Australia, one of the world’s fastest growing urban regions. We used satellite imagery to determine wetland number and type, and calculated changes in wetland surface area from 2010-2017. Broad changes to land use were also quantified. We developed species distribution models of a common urban wetland turtle (Chelodina longicollis) that people interact with regularly or have as pets. Chelodina longicollis utilises both aquatic and terrestrial environments, and we determined if changes in distribution were associated with changes in the wetland inventory and urbanisation. Most local government areas (LGA) experienced a decrease in wetland surface area from 2010-2017, ranging from -1% (Cumberland) to -21% (Blacktown). Majority of LGAs experienced a decrease in wetland density, with wetland densities declining by 25% (Blacktown). All LGAs experienced an increase in urban land use, ranging from 3-12%, which was associated with high rates of wetland loss. Changes in turtle distribution over the decade reflects a southern distribution shift away from where wetland losses were concentrated. We estimated that ∼40,000 individual turtles were displaced or killed due to wetland loss and urbanisation. Urbanisation was the leading cause of wetland loss and degradation in Western Sydney between 2010 and 2017. Wetlands provide critical green infrastructure and significant green space for social cohesion in urban areas. Integration of current wetlands, or the creation of functional wetlands, is key for sustainable development of urban landscapes. Urban wetlands (natural and constructed) may provide “biodiversity arks” for endangered species and facilitate community led conservation programs.


title: Who is at the highest risk from COVID-19 in India? Analysis of health, healthcare access, and socioeconomic indicators at the district level

text: Despite measures such as travel restrictions and lockdowns, the novel coronavirus (SARS-COV-2) is projected to spread across India. Considering that a vaccine for COVID-19 is expected to take at least a year to become widely available, it is important to identify populations with the highest risk from COVID-19 and take measures to prevent incident cases and build healthcare infrastructure at the local level. We used data from two large nationally representative household surveys, administrative sources, and published studies to estimate the risk of COVID-19 at the district level in India. We employed principal component analysis to create a composite index of the health risk of COVID-19 from demographic and comorbidity indicators such at the proportion of elderly population and rates of diabetes, hypertension, and respiratory illnesses. We created another principal component index of the socioeconomic and healthcare access risk from COVID-19, based on the standard of living, proportion of socioeconomically disadvantaged groups, and per capita access to public healthcare in each district. We found that districts in northern, southern and western Indian states such as Punjab, Tamil Nadu, Kerala, and Maharashtra were at the highest health risk from COVID-19. Many of these districts have already been designated as COVID-19 hotspots by the Indian government because of emergent outbreaks. Districts in eastern and central states such as Uttar Pradesh, Bihar, and Madhya Pradesh have higher socioeconomic and healthcare access risk as compared with other areas.


title: COVID19-Global: A shiny application to perform a global comparative data visualization for the SARS-CoV-2 epidemic

text: Data visualization is an essential tool for exploring and communicating findings in medical research, especially in epidemiological surveillance. The COVID19-Global online web application systematically produces daily updated data visualization and analysis of the SARS-CoV-2 epidemic on a global scale. It collects automatically daily data on COVID-19 diagnosed cases and mortality worldwide from January 1st, 2020 onwards. We have implemented comparative data visualization between countries for the most common indicators in epidemiological surveillance to follow an epidemic: attack rate, population fatality rate, case fatality rate, and basic reproduction number. The application may help for a better understanding of the SARS-CoV-2 epidemic worldwide.


title: Battling the COVID-19 Pandemic: Is Bangladesh Prepared?

text: Following detection of the first few COVID-19 cases in early March, Bangladesh has stepped up its efforts to strengthen capacity of the healthcare system to avert a crisis in the event of a surge in the number of cases. This paper sheds light on the preparedness of the healthcare system by examining the spatial distribution of isolation beds across districts and divisions, forecasting the number of ICU units that may be required in the short term and analyzing the availability of frontline healthcare workers to combat the pandemic. As of April 18, COVID-19 cases have been found in 53 of the 64 districts in Bangladesh with Dhaka District being the epicenter. Seventy-five percent of the cases have been identified in 5 neighboring districts, namely, Dhaka, Narayanganj, Gazipur, Narsingdi and Kishoreganj, which appear to form a spatial cluster. However, if one takes into account the population at risk, the prevalence appears to be highest in Narayanganj, followed by Dhaka, Gazipur, Narsingdi and Munshiganj. These regions may therefore be flagged as the COVID-19 hotspots in Bangladesh. Among the eight divisions, prevalence is highest in Dhaka Division followed by Mymensingh and Barishal. The number of cases per million exceeds the number of available isolation beds per million in the major hotspots indicating that there is a risk of the healthcare system becoming overwhelmed should the number of cases rise. This is especially true for Dhaka Division, where the ratio of COVID-19 patients to doctors appears to be alarmingly high. Mymensingh Division also has a disproportionately small number of doctors relative to the number of COVID-19 patients. Using second order polynomial regression, the analysis predicts that even if all ICU beds are allocated to COVID-19 patients, Bangladesh may run out of ICU beds soon after May 4, 2020. We conclude that in spite of a significant increase in hospital capacity during 2005-15 and a 57% rise in the number of doctors during the same period, the healthcare system in Bangladesh and Dhaka Division in particular, may not be fully prepared to handle the COVID-19 crisis. Thus, further steps need to be taken to flatten the curve and improve healthcare capacity.


Building trust during COVID 19: Value-driven and ethical priority-setting


title: The Relationship between the Global Burden of Influenza from 2017-2019 and COVID-19

text: Background SARS-CoV-2 and Influenza are lipid-enveloped viruses with differential morbidity and mortality but shared modes of transmission. We assessed whether historical patterns of regional influenza burden are reflected in the observed heterogeneity in COVID-19 cases across and within regions of the world. Methods Weekly surveillance data reported in FluNet from January 2017-December 2019 for influenza and World Health Organization for COVID-19 (to May 31, 2020) across the seven World Bank regions were used to assess the total and annual number of influenza and COVID-19 cases per country, within and across all regions, to generate comparative descending ranks from highest to lowest burden of disease. Results Across and within regions, rankings of influenza and COVID-19 were relatively consistent. Europe and Central Asia and North America ranked first and second for COVID-19 and second and first for influenza, respectively. East Asia and the Pacific traditionally ranked higher for influenza but to date, has been less affected by COVID-19. Between regions, Sub-Saharan Africa ranked amongst the least affected by both influenza and COVID-19. Conclusion Consistency in distribution of the burden of COVID-19 and influenza suggest shared individual, structural, and environmental determinants of transmission. Regions with discrepancies between influenza and COVID-19 burden may provide further insight into the potential impact of non-pharmacologic interventions and intersections with environmental conditions. Ultimately, forecasting trends and informing interventions for novel respiratory pathogens like COVID-19 should leverage patterns in the relative burden of past respiratory pathogens and the relative impact of non-pharmacologic intervention strategies as prior information.


title: COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. An N=18147 web-based survey.

text: Background The psychological impact of the COronaVIrus Disease 2019 (COVID-19) outbreak and lockdown measures on the Italian population are unknown. The current study assesses rates of mental health outcomes in the Italian general population three to four weeks into lockdown measures and explores the impact of COVID-19 related potential risk factors. Methods A web-based survey spread throughout the internet between March 27th and April 6th 2020. 18147 individuals completed the questionnaire, 79.6% women. Selected outcomes were post-traumatic stress symptoms (PTSS), depression, anxiety, insomnia, perceived stress and adjustment disorder symptoms (ADS). Seemingly unrelated logistic regression analysis was performed to identify COVID-19 related risk factors. Results Respondents endorsing PTSS, depression, anxiety, insomnia, high perceived stress and adjustment disorder were 6604 (37%), 3084 (17.3%), 3700 (20.8%), 1301 (7.3%), 3895 (21.8%) and 4092 (22.9%), respectively. Being woman and younger age were associated with all of the selected outcomes. Quarantine was associated with PTSS, anxiety and ADS. Any recent COVID-related stressful life event was associated with all the selected outcomes. Discontinued working activity due to the COVID-19 was associated with all the selected outcomes, except for ADS; working more than usual was associated with PTSS, Perceived stress and ADS. Having a loved one deceased by COVID-19 was associated with PTSS, depression, perceived stress and insomnia. Conclusion We found high rates of negative mental health outcomes in the Italian general population three weeks into the COVID-19 lockdown measures and different COVID-19 related risk factors. These findings warrant further monitoring on the Italian population s mental health.


title: SIR-PID: A Proportional-Integral-Derivative Controller for COVID-19 Outbreak Containment

text: Ongoing social restrictions, as distancing and lockdown, adopted by many countries for contrasting the COVID-19 epidemic spread, try to find a trade-off between induced economic crisis, healthcare system collapse and costs in terms of human lives. Applying and removing restrictions on a system with uncontrollable inertia, as represented by an epidemic outbreak, may create critical instabilities, overshoots and strong oscillations of infected people around the desirable set-point, defined as the maximum number of hospitalizations acceptable by a given healthcare system. A good understanding of the system reaction to a change of the input control variable can be reasonably achieved using a proportional-integral-derivative controller, widely used in technological applications. In this paper we make use of this basic control theory for understanding the reaction of COVID-19 propagation to social restrictions and for exploiting a very known technology to reduce the epidemic damages through the correct tuning of the containment policy.


title: Effect of tocilizumab in hospitalized patients with severe pneumonia COVID-19: a cohort study

text: Background. Tocilizumab, a drug targeting interleukin-6 administrated in the right timeframe may be beneficial in coronavirus-disease-2019 (COVID-19). We aimed to assess its benefit, drawing from observations in compassionately treated patients. Methods: In a retrospective case-control study, treatment effect (tocilizumab 400mg, single-dose) was assessed using three statistical methods: propensity-score matching, Cox multivariable survival and inverse probability score weighting (IPSW) analyses. Were included all patients hospitalized with COVID-19, who presented severity criteria with SpO2<96% despite O2-support >6L/min for more than 6 hours. Were excluded patients in critical care medicine department and those under invasive mechanical ventilation. Primary outcome was a composite of mortality and ventilation, with a maximum follow-up of 28 days. Results: 246 patients were included (106 treated by tocilizumab). They were 67.6 +/-15.3 years-old, with 95 (38.5%) women. Delay between first symptoms and inclusion was 8.4 +/-4.5 days. Overall, 105 (42.7%) patients presented the primary outcome, with 71 (28.9%) deaths during the 28-days follow-up. Propensity-score-matched 84 pairs of comparable patients. In the matched cohort (n=168), tocilizumab was associated with fewer primary outcomes (hazard ratio (HR)=0.49 (95% confidence interval (95CI)=0.3-0.81), p-value=0.005). These results were similar in the overall cohort (n=246), with Cox multivariable analysis yielding a protective association between tocilizumab and primary outcome (adjusted HR=0.26 (95CI=0.135-0.51, p=0.0001), confirmed by IPSW analysis (p<0.0001). Analyses on mortality with 28-days follow-up yielded similar results. Conclusion: In this retrospective study, tocilizumab single-dose was associated with improved survival without mechanical ventilation in patients with severe COVID-19.


title: The characteristics and death risk factors of 132 COVID-19 pneumonia patients with comorbidities: a retrospective single center analysis in Wuhan, China

text: Background: The new coronavirus pneumonia (COVID-19) has evolved into a global pandemic disease, and the epidemiological characteristics of the disease have been reported in detail. However, many patients with new coronary pneumonia have comorbidities, and there are few researches reported in this special population. Methods: a retrospective analysis was performed on 132 consecutive COVID-19 patients with comorbidities from January 19, 2020 to March 7, 2020 in Hubei NO.3 People Hospital. Patients were divided into mild group and critical group and were followed up to the clinical endpoint. The observation biomarkers include the clinical feature, blood routine, blood biochemistry, inflammation biomarkers, and coagulation function. Univariate and multivariate logistic regression was used to analyze the risk factors associated with death. Results: 132 patients were enrolled in this study and divided into the mild group (n=109, 82.6%) and critical group (n=23, 17.4%), of whom 119 were discharged and 13 were died in hospital. The all-cause mortality rate was 9.8%, of which 7 patients died of respiratory failure, 5 patients died of heart failure, and 1 patient died of chronic renal failure. There was significant statistical difference of mortality rates between the mild group (5.5%) and the critical group (30.4%).The average time of hospitalization was 16.9 (9, 22) days. Hypertension was the most common comorbidity (n=90, 68.2%), followed by diabetes (n=45, 34.1%), coronary heart disease (31, 23.5%). Compared with the mild group, the patients were older in critical group (P <0.05), and neutrophils, neutrophil ratio, neutrophil-lymphocyte ratio (NLR), serum urea nitrogen (BUN), procalcitonin (PCT), C-reactive protein CRP), serum amyloid protein (SSA), N-terminal brain natriuretic peptide precursor (NT-pro BNP) were significantly increased (P <0.05). However, lymphocytes lymphocyte ratio, albumin were lower than those in the critical group (P <0.05). The patients were further divided into the survivor group (n=119, 90.2%) and the non-survivor group (n=13, 9.8%). Compared with the survivor group, the death rate of patients with coronary heart disease was significantly increased (53.8% vs 20.2%), and The neutrophil ratio, aspartate aminotransferase (AST), BUN, PCT, CRP, SAA, interleukin-6(IL-6) and D-dimer were significantly increased (P <0.05), while the lymphocytes and NLR reduced (P <0.05). Multivariate logistic stepwise regression analysis showed that the past medical history of coronary heart disease[OR:2.806 95%CI:0.971~16.795], decreased lymphocytes[OR:0.040, 95%CI:0.001~2.306], increased AST[OR:1.026, 95%CI:1.000~1.052], increased SSA[OR:1.021, 95%CI:1.001~1.025], and increased D-dimer[OR:1.231, 95%CI:1.042~1.456] are risk factors associated with death in COVID-19 patients pneumonia with comorbidities. Conclusion: The mortality rate of COVID-19 patients with coronary heart disease is relatively high. In all patients, the lower lymphocytes, and higher NLR, BUN, PCT, CRP, SSA, D-dimer are significant characteristics. The past medical history of coronary heart disease, decreased lymphocytes, increased AST, SSA and D-dimer are risk factors associated with death in COVID-19 pneumonia patients with comorbidities


title: A multisystem approach by bed-side ultrasound in patients with COVID-19 infection: a case series

text: Recent epidemiological reports on Chinese population affected by novel coronavirus showed a wide spread of clinical and biochemical alterations, suggesting a relationship between progression of lung damage to acute respiratory distress syndrome and the systemic inflammatory response, triggering an irreversible multiple organ damage and disseminated intravascular coagulation Bedside ultrasound assessment provides integrated information, describing a multisystemic and dynamic clinical scenario for every patient Furthermore, this approach allows to concentrate multiple information in the hands of a single operator, also limiting the risk of exposure to infection for healthcare professionals As per our experience, herewith reported, we described the characteristics of 10 patients with SARS-CoV-2 infection Ultrasound findings were related to clinical information, blood test analysis, and results of instrumental tests, such as chest X-ray and chest computed tomography According to our ultrasound data, COVID-19 appears to be a systemic pathology even in those cases of mild to moderate disease By this multisystem ultrasound approach, we could immediately recognize patients with a diffuse organ involvement and a more severe clinical pattern;moreover, we can protect healthcare workers and limit infection within health facilities


title: A Saudi G6PD Deficient Girl Died with Pediatric Multisystem Inflammatory Syndrome-COVID-19

text: Reports on pediatric multisystem inflammatory syndrome (PMIS) temporally related to coronavirus disease 2019 (COVID-19) are increasing. African and Afro-Caribbean children constituted about 47% of the cases in these reports. Despite the fact that glucose-6-phosphatase dehydrogenase (G6PD) deficiency is common among this population, the G6PD status of these cases has not been reported in these reports. We reported the first case of PMIS related to COVID-19 from Saudi Arabia. This case was a Saudi G6PD deficient girl who died with PMIS related to COVID-19. G6PD deficiency induces redox imbalance and exaggerates the inflammatory response; thus, it might contribute to the development or the grave outcome of our case. We urgently need to assess the association between G6PD deficiency and COVID-19 in a large study as the G6PD deficiency may be a useful predictor for the progression of the COVID-19.


title: A novel in-cell ELISA assay allows rapid and automated quantification of SARS-CoV-2 to analyse neutralizing antibodies and antiviral compounds

text: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently the most pressing medical and socioeconomic challenge. Constituting important correlates of protection, determination of virus-neutralizing antibodies (NAbs) is indispensable for convalescent plasma selection, vaccine candidate evaluation, and immunity certificates. In contrast to standard serology ELISAs, plaque reduction neutralization tests (PRNTs) are laborious, time-consuming, expensive, and restricted to specialized laboratories. To replace microscopic counting-based SARS-CoV-2 PRNTs by a novel assay exempt from genetically modified viruses, which are inapplicable in most diagnostics departments, we established a simple, rapid, and automated SARS-CoV-2 neutralization assay employing an in-cell ELISA (icELISA) approach. After optimization of various parameters such as virus-specific antibodies, cell lines, virus doses, and duration of infection, SARS-CoV-2-infected cells became amenable as direct antigen source for quantitative icELISA. Using commercially available nucleocapsid protein-specific antibodies, viral infection could easily be quantified in human and highly permissive Vero E6 cells by icELISA. Antiviral agents such as human sera containing NAbs or antiviral interferons dose-dependently reduced the SARS-CoV-2-specific signal. Applying increased infectious doses, the icNT was superior to PRNT in discriminating convalescent sera with high from those with intermediate neutralizing capacities. The SARS-CoV-2 icELISA test allows rapid (<48h in total, read-out in seconds) and automated quantification of virus infection in cell culture to evaluate the efficacy of NAbs as well as antiviral drugs, using reagents and equipment present in most routine diagnostics departments. We propose the icELISA and the icNT for COVID-19 research and diagnostics.


title: Population mobility reductions during COVID-19 epidemic in France under lockdown

text: On March 17, 2020, French authorities implemented a nationwide lockdown to respond to COVID-19 epidemic emergency and curb the surge of patients requiring critical care, similarly to other countries. Evaluating the impact of lockdown on population mobility is important to help characterize the changes in social dynamics that affected viral diffusion. Using travel flows reconstructed from mobile phone trajectories, we measured how lockdown altered mobility patterns at both local and country scales. Lockdown caused a 65% reduction in countrywide number of displacements, and was particularly effective in reducing work-related short-range mobility, especially during rush hours, and recreational long-range trips. Anomalous increases in long-range movements, localized in both time and space, emerged even before lockdown announcement. Mobility drops were unevenly distributed across regions. They were strongly associated with active population, workers employed in sectors highly impacted by lockdown, and number of hospitalizations per region, and moderately associated with socio-economic level of the region. Major cities largely shrank their pattern of connectivity, reducing it mainly to short-range commuting, despite the persistence of some long-range trips. Our findings indicate that lockdown was very effective in reducing population mobility across scales. Caution should be taken in the timing of policy announcements and implementation. Individual response to policy announcements may generate unexpected anomalous behaviors increasing the risk of geographical diffusion. On the other hand, risk awareness may be beneficial in further decreasing mobility in largely affected regions. Our findings help predicting how and where restrictions will be the most effective in reducing the mobility and mixing of the population, thus aiding tuning recommendations in the upcoming weeks, when phasing out lockdown.


title: Distinguishing COVID-19 from influenza pneumonia in the early stage through CT imaging and clinical features

text: Purpose: To identify differences in CT imaging and clinical features between COVID-19 and influenza pneumonia in the early stage, and to identify the most valuable features in the differential diagnosis. Materials and Method: A consecutive cohort of 73 COVID-19 and 48 influenza pneumonia patients were retrospectively recruited from five independent institutions. The courses of both diseases were confirmed to be in the early stages (mean 2.66 (SD 2.62) days for COVID-19 and mean 2.19 (SD 2.10) days for influenza pneumonia after onset). The chi-square test, student`s t-test, and Kruskal-Wallis H-test were performed to compare CT imaging and clinical features between the two groups. Spearman or Kendall correlation tests between feature metrics and diagnosis outcomes were also assessed. The diagnostic performance of each feature in differentiating COVID-19 from influenza pneumonia was evaluated with univariate analysis. The corresponding area under the curve (AUC), accuracy, specificity, sensitivity and threshold were reported. Results: The ground-glass opacification (GGO) was the most common imaging feature in COVID-19, including pure-GGO (75.3%) and mixed-GGO (78.1%), mainly in peripheral distribution. For clinical features, most COVID-19 patients presented normal white blood cell (WBC) count (89.04%) and neutrophil count (84.93%). Twenty imaging features and 6 clinical features were identified to be significantly different between the two diseases. The diagnosis outcomes correlated significantly with the WBC count (r=-0.526, P<0.001) and neutrophil count (r=-0.500, P<0.001). Four CT imaging features had absolute correlations coefficients higher than 0.300 (P<0.001), including crazy-paving pattern, mixed-GGO in peripheral area, pleural effusions, and consolidation. Conclusions: Among a total of 1537 lesions and 62 imaging and clinical features, 26 features were demonstrated to be significantly different between COVID-19 and influenza pneumonia. The crazy-paving pattern was recognized as the most powerful imaging feature for the differential diagnosis in the early stage, while WBC count yielded the highest diagnostic efficacy in clinical manifestations.


title: Coronavirus (COVID-19): A Review of Clinical Features, Diagnosis, and Treatment

text: Coronavirus (COVID-19) is an enveloped RNA virus that is diversely found in humans and wildlife. A total of six species have been identified to cause disease in humans. They are known to infect the neurological, respiratory, enteric, and hepatic systems. The past few decades have seen endemic outbreaks in the form of Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome related coronavirus (SARS-CoV). Yet again, we see the emergence of another outbreak due to a new strain called the SARS-CoV-2 virus. The most recent outbreak initially presented as pneumonia of unknown etiology in a cluster of patients in Wuhan, China. The epicenter of infection was linked to seafood and exotic animal wholesale markets in the city. SARS-CoV-2 is highly contagious and has resulted in a rapid pandemic of COVID-19. As the number of cases continues to rise, it is clear that these viruses pose a threat to public health. This review will introduce a general overview of coronavirus and describe the clinical features, evaluation, and treatment of COVID-19 patients. It will also provide a means to raise awareness among primary and secondary healthcare providers during the current pandemic. Furthermore, our review focuses on the most up-to-date clinical information for the effective management, prevention, and counseling of patients worldwide.


title: Anosmia in COVID-19 patients

text: Objectives: Coronaviruses (CoVs) have a neuroinvasive propensity, and the frequently reported symptoms of smelling and taste dysfunction in many COVID-19 patients may be related to the respective capability of SARS-CoV2, the cause of the current pandemic. In this study we objecti-fied and quantified the magnitude and underreporting of the smelling dysfunction caused by COVID-19 using a standardized test. Methods: We conducted a prospective cross-sectional study comparing the proportion of anos-mia using Sniffin-sticks in those reporting a loss of smell, in those who did not as well as in unin-fected controls. The outcome of anosmic versus not anosmic patients were recorded during hospital stay and at day 15 on a six-category ordinal scale. The study was approved by the insti-tutional review board, all participants consented to the study. Results: 40% of 45 consecutive hospitalized COVID-19 patients and 0% of 45 uninfected con-trols consenting were diagnosed with anosmia. 44% of anosmic and 50% of hyposmic patients did not report having smelling problems. Anosmia or hyposmia was not predictive of a severe COVID-19 manifestation. Conclusions: The majority of COVID-19 patients have an objective anosmia and hyposmia, which often occurs unnoticed. These symptoms may be related to the neuroinvasive propensity of SARS-COV-2 and the unusual presentation of COVID-19 disease manifestations.


title: Bereavement, grief, and consolation: Emotional-affective geographies of loss during COVID-19

text: COVID-19 has resulted in new global geographies of death ranging from cellular to global scales. These geographies are uneven, reflecting existing inequalities and failures of governance. In addition to death and bereavement, the pandemic has generated varied forms of loss and consolation, as well as negative and positive affective atmospheres, whereby emotions are mobilised and politicised. Understanding these emotional-affective topographies and ‘emotional-viral-loads’ is vital to wellbeing, resilience, and unfolding policy interventions locally and globally.


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