title: Evaluating the efficacy and safety of human anti-SARS-CoV-2 convalescent plasma in severely ill adults with COVID-19: A structured summary of a study protocol for a randomized controlled trial

text: OBJECTIVES: The aim of this study is to evaluate the efficacy and safety of human anti-SARS-CoV-2 convalescent plasma in hospitalized adults with severe SARS-CoV-2 infection. TRIAL DESIGN: This is a prospective, single-center, phase 2, randomized, controlled trial that is blinded to participants and clinical outcome assessor. PARTICIPANTS: Eligible participants include adults (≥ 18 years) with evidence of SARS-CoV-2 infection by PCR test of nasopharyngeal or oropharyngeal swab within 14 days of randomization, evidence of infiltrates on chest radiography, peripheral capillary oxygen saturation (SpO2) ≤ 94% on room air, and/or need for supplemental oxygen, non-invasive mechanical ventilation, or invasive mechanical ventilation, who are willing and able to provide written informed consent prior to performing study procedures or who have a legally authorized representative available to do so. Exclusion criteria include participation in another clinical trial of anti-viral agent(s)* for coronavirus disease-2019 (COVID-19), receipt of any anti-viral agent(s)* with possible activity against SARS-CoV-2 <24 hours prior to plasma infusion, mechanical ventilation (including extracorporeal membrane oxygenation [ECMO]) for ≥ 5 days, severe multi-organ failure, history of allergic reactions to transfused blood products per NHSN/CDC criteria, known IgA deficiency, and pregnancy. Included participants will be hospitalized at the time of randomization and plasma infusion. *Use of remdesivir as treatment for COVID-19 is permitted. The study will be undertaken at Columbia University Irving Medical Center in New York, USA. INTERVENTION AND COMPARATOR: The investigational treatment is anti-SARS-CoV-2 human convalescent plasma. To procure the investigational treatment, volunteers who recovered from COVID-19 will undergo testing to confirm the presence of anti-SARS-CoV-2 antibody to the spike trimer at a 1:400 dilution. Donors will also be screened for transfusion-transmitted infections (e.g. HIV, HBV, HCV, WNV, HTLV-I/II, T. cruzi, ZIKV). If donors have experienced COVID-19 symptoms within 28 days, they will be screened with a nasopharyngeal swab to confirm they are SARS-CoV-2 PCR-negative. Plasma will be collected using standard apheresis technology by the New York Blood Center. Study participants will be randomized in a 2:1 ratio to receive one unit (200 - 250 mL) of anti-SARS-CoV-2 plasma versus one unit (200 - 250 mL) of the earliest available control plasma. The control plasma cannot be tested for presence of anti-SARS-CoV-2 antibody prior to the transfusion, but will be tested for anti- SARS-CoV-2 antibody after the transfusion to allow for a retrospective per-protocol analysis. MAIN OUTCOMES: The primary endpoint is time to clinical improvement. This is defined as time from randomization to either discharge from the hospital or improvement by one point on the following seven-point ordinal scale, whichever occurs first. 1. Not hospitalized with resumption of normal activities 2. Not hospitalized, but unable to resume normal activities 3. Hospitalized, not requiring supplemental oxygen 4. Hospitalized, requiring supplemental oxygen 5. Hospitalized, requiring high-flow oxygen therapy or non-invasive mechanical ventilation 6. Hospitalized, requiring ECMO, invasive mechanical ventilation, or both 7. Death This scale, designed to assess clinical status over time, was based on that recommended by the World Health Organization for use in determining efficacy end-points in clinical trials in hospitalized patients with COVID-19. A recent clinical trial evaluating the efficacy and safety of lopinavir- ritonavir for patients hospitalized with severe COVID-19 used a similar ordinal scale, as have recent clinical trials of novel therapeutics for severe influenza, including a post-hoc analysis of a trial evaluating immune plasma. The primary safety endpoints are cumulative incidence of grade 3 and 4 adverse events and cumulative incidence of serious adverse events during the study period. RANDOMIZATION: Study participants will be randomized in a 2:1 ratio to receive anti-SARS-CoV-2 plasma versus control plasma using a web-based randomization platform. Treatment assignments will be generated using randomly permuted blocks of different sizes to minimize imbalance while also minimizing predictability. BLINDING (MASKING): The study participants and the clinicians who will evaluate post-treatment outcomes will be blinded to group assignment. The blood bank and the clinical research team will not be blinded to group assignment. NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): We plan to enroll 129 participants, with 86 in the anti-SARS-CoV-2 arm, and 43 in the control arm. Among the participants, we expect ~70% or n = 72 will achieve clinical improvement. This will yield an 80% power for a one-sided Wald test at 0.15 level of significance under the proportional hazards model with a hazard ratio of 1.5. TRIAL STATUS: Protocol AAAS9924, Version 17APR2020, 4/17/2020 Start of recruitment: April 20, 2020 Recruitment is ongoing. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04359810 Date of trial registration: April 24, 2020 Retrospectively registered FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


title: Comparing the binding interactions in the receptor binding domains of SARS-CoV-2 and SARS-CoV

text: COVID-19, since emerged in Wuhan, China, has been a major concern due to its high infection rate, leaving more than one million infected people around the world. Huge number of studies tried to reveal the structure of the SARS-CoV-2 compared to the SARS-CoV-1, in order to suppress this high infection rate. Some of these studies showed that the mutations in the SARS-CoV-1 Spike protein might be responsible for its higher affinity to the ACE2 human cell receptor. In this work, we used molecular dynamics simulations and Monte Carlo sampling to compare the binding affinities of the spike proteins of SARS-CoV and SARS-CoV-2 to the ACE2. We found that the SARS-CoV-2 binds to ACE2 stronger than SARS-CoV by 7 kcal/mol, due to enhanced electrostatic interactions. The major contributions to the electrostatic binding energies are resulting from the salt-bridges formed between R426 and ACE2-E329 in case of SARS-CoV and K417 and ACE2-D30 for SARS-CoV2. In addition, there is no significant contribution from a single mutant to the binding energies. However, these mutations induce sophisticated structural changes that enhance the binding energies. Our results also indicate that the SARS-CoV-2 is unlikely a lab engineered virus.


title: Comparing the Binding Interactions in the Receptor Binding Domains of SARS-CoV-2 and SARS-CoV

text: SARS-CoV-2, since emerging in Wuhan, China, has been a major concern because of its high infection rate and has left more than six million infected people around the world. Many studies endeavored to reveal the structure of the SARS-CoV-2 compared to the SARS-CoV, in order to find solutions to suppress this high infection rate. Some of these studies showed that the mutations in the SARS-CoV spike (S) protein might be responsible for its higher affinity to the ACE2 human cell receptor. In this work, we used molecular dynamics simulations and Monte Carlo sampling to compare the binding affinities of the S proteins of SARS-CoV and SARS-CoV-2 to the ACE2. Our results show that the protein surface of the ACE2 at the receptor binding domain (RBD) exhibits negative electrostatic potential, while a positive potential is observed for the S proteins of SARS-CoV/SARS-CoV-2. In addition, the binding energies at the interface are slightly higher for SARS-CoV-2 because of enhanced electrostatic interactions. The major contributions to the electrostatic binding energies result from the salt bridges forming between R426 and ACE-2-E329 in the case of SARS-CoV and K417 and ACE2-D30 in the SARS-CoV-2. In addition, our results indicate that the enhancement in the binding energy is not due to a single mutant but rather because of the sophisticated structural changes induced by all these mutations together. This finding suggests that it is implausible for the SARS-CoV-2 to be a lab-engineered virus.


"Social Media Misinformation"-An Epidemic within the COVID-19 Pandemic.


title: Role of electronic media in mitigating the psychological impacts of novel coronavirus (COVID-19)

text: The current research initiative focuses on the role of Pakistani media in eliminating panic and depression among health practitioners and the general public due to the outbreak of novel coronavirus (COVID-19). In Pakistan, electronic media is the most common source of information due to the higher rural population and the lower literacy rate and media's handling of COVID-19 coverage so far creates panic and depression. We suggest that special televised transmissions featuring psychologists and physiatrists should be aired to reduce the panic. Media also mitigates the stress of frontline medical staff by paying special attributes to them.


The Strategy for Return to Work after the COVID-19 Pandemic on Small and Medium-sized Enterprises


Reflection on SARS-CoV-2 infection of container ship seafarers


title: Immune Checkpoint Inhibitors for Cancer Therapy in the COVID-19 Era

text: The potential immune intersection between COVID-19 disease and cancer therapy raises important practical clinical questions and highlights multiple scientific gaps to be filled. Among available therapeutic approaches to be considered, immune checkpoint inhibitors (ICI) seem to require major attention as they may act at the crossroads between cancer treatment and COVID-19 disease, due to their profound immunomodulatory activity. On the basis of available literature evidence, we suggest guidance to consider for treating physicians, and propose areas of clinical and preclinical investigation. Comprehensively, although with the necessary caution, ICI therapy seems to remain a suitable therapeutic option for patients with cancer during the COVID-19 pandemic.


title: Mind the GAP: Security&Privacy Risks of Contact Tracing Apps

text: Contact tracing apps running on mobile devices promise to reduce the manual effort required for identifying infection chains and to increase the tracing accuracy in the presence of COVID-19. Several contract tracing apps have been proposed or deployed in practice. Also Google and Apple have announced their joint effort of providing an API for exposure notification in order to implement decentralized contract tracing apps using Bluetooth Low Energy, the so-called"Google/Apple Proposal", which we abbreviate by"GAP". Some countries have already decided or are planning to base their contact tracing apps on GAP. Several researchers have pointed out potential privacy and security risks related to most of the contact tracing approaches proposed until now, including those that claim privacy protection and are based on GAP. This report makes a first attempt towards providing empirical evidence in real-world scenarios for two such risks discussed in the literature: one concerning privacy, and the other one concerning security. In particular, we focus on a practical analysis of GAP, given that it is the foundation of several tracing apps. We demonstrate that in real-world scenarios the current GAP design is vulnerable to (i) profiling and possibly de-anonymizing infected persons, and (ii) relay-based wormhole attacks that principally can generate fake contacts with the potential of significantly affecting the accuracy of an app-based contact tracing system. For both types of attack, we have built tools that can be easily used on mobile phones or Raspberry Pis (e.g., Bluetooth sniffers). We hope that our findings provide valuable input in the process of testing and certifying contact tracing apps, e.g., as planned for the German Corona-Warn-App, ultimately guiding improvements for secure and privacy-preserving design and implementation of digital contact tracing systems.


title: Clinical evaluation of an immunochromatographic IgM/IgG antibody assay and chest computed tomography for the diagnosis of COVID-19

text: BACKGROUND: We evaluated the clinical performance of an immunochromatographic (IC) IgM/IgG antibody assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) and chest computed tomography (CT) for the diagnosis of Coronavirus disease 2019 (COVID-19). METHODS: We examined 139 serum specimens collected from 112 patients with COVID-19 and 48 serum specimens collected from 48 non-COVID-19 patients. The presence of IgM/IgG antibody for SARS-COV2 was determined using the One Step Novel Coronavirus (COVID-19) IgM/IgG Antibody Test. Chest CT was performed in COVID-19 patients on admission. FINDINGS: Of the139 COVID-19 serum specimens, IgM was detected in 27.8 %, 48.0 %, and 95.8 % of the specimens collected within 1 week, 1-2 weeks, and >2 weeks after symptom onset and IgG was detected in 3.3 %, 8.0 %, and 62.5 %, respectively. Among the 48 non-COVID-19 serum specimens, 1 generated a false-positive result for IgM. Thirty-eight of the 112 COVID-19 patients were asymptomatic, of whom 15 were positive for IgM, and 74 were symptomatic, of whom 22 were positive for IgM and 7 were positive for IgG. The diagnostic sensitivity of CT scan alone and in combination with the IC assay was 57.9 % (22/38) and 68.4 % (26/38) for the asymptomatic patients and 74.3 % (55/74) and 82.4 % (61/74) for the symptomatic patients, respectively. CONCLUSION: The IC assay had low sensitivity during the early phase of infection, and thus IC assay alone is not recommended for initial diagnostic testing for COVID-19. If RT-qPCR is not available, the combination of chest CT and IC assay may be useful for diagnosing COVID-19.


Lupus anticoagulant is frequent in patients with Covid-19


Psychosomatic Medicine and Covid-19 Pandemic


COVID-19: Not a Simple Public Health Emergency


Advanced respiratory monitoring in COVID-19 patients: use less PEEP!


title: Clinical characteristics of COVID-19 patients in three consecutive generations of spread in Zhejiang, China

text: OBJECTIVE: To determine the clinical characteristics of COVID-19 patients as the SARS-CoV-2 virus continues to circulate in the population. METHODS: This is a retrospective, multi-center cohort study. Adult COVID-19 cases from four hospitals in Zhejiang were enrolled and clustered into 3 groups based on epidemiological history. First-generation patients had a travel history to Hubei within 14 days before disease onset; second generation patients had a contact history with first-generation patients; third-generation patients had a contact history with second-generation patients. Demographic, clinical characteristics, clinical outcomes, and duration of viral shedding were analyzed. RESULTS: 171 patients were enrolled, with 83, 44, and 44 patients in the first, second, and third generation, respectively. Compared to first and second generation, third generation patients were older (61.3 vs. 48.3 and 44.0 y, P<0.001), had more coexisting conditions (56.8% vs. 36.1% and 27.3%, P=0.013). At 7±1 days from illness onset, third generation patients had lower lymphocyte (0.6 vs. 0.8 and 0.8×109/L, P=0.007), higher C-reactive protein (29.7 vs. 17.1 and 13.8mg/L, P=0.018) and D-dimer (1066 vs. 412.5 and 549µg/L, P=0.002) and more lesions involving the pulmonary lobes (lobes≥5, 81.8% vs. 53.0% and 34.1%, P<0.001). The proportions of third-generation patients developing severe illness (72.7% vs. 32.5% and 27.3%, P<0.001), critical illness (38.6% vs. 10.8% and 6.8%, P<0.001) and receiving endotracheal intubation (20.5% vs. 3.6% and 2.3%, P=0.002) were higher than the other two groups. CONCLUSION: The third generation patients were older, had more underlying comorbidities and had a higher proportion of severe or critical illness compared to first and second-generation.


title: A Model for COVID-19 Prediction in Iran Based on China Parameters

text: BACKGROUND: The rapid spread of COVID-19 virus from China to other countries and outbreaks of disease require an epidemiological analysis of the disease in the shortest time and an increased awareness of effective interventions. The purpose of this study was to estimate the COVID-19 epidemic in Iran based on the SIR model. The results of the analysis of the epidemiological data of Iran from January 22 to March 24, 2020 were investigated and prediction was made until April 15, 2020. METHODS: By estimating the three parameters of time-dependent transmission rate, time-dependent recovery rate, and timedependent death rate from Covid-19 outbreak in China, and using the number of Covid-19 infections in Iran, we predicted the number of patients for the next month in Iran. Each of these parameters was estimated using GAM models. All analyses were conducted in R software using the mgcv package. RESULTS: Based on our predictions of Iran about 29000 people will be infected from March 25 to April 15, 2020. On average, 1292 people with COVID-19 are expected to be infected daily in Iran. The epidemic peaks within 3 days (March 25 to March 27, 2020) and reaches its highest point on March 25, 2020 with 1715 infected cases. CONCLUSION: The most important point is to emphasize the timing of the epidemic peak, hospital readiness, government measures and public readiness to reduce social contact.


COVID-19 in the pediatric population


Sex hormones signal why virus hits men harder


The possible impact of COVID-19 on colorectal surgery in Italy


title: Natural Products as Potential Leads Against Coronaviruses: Could They be Encouraging Structural Models Against SARS-CoV-2?

text: New coronavirus referred to SARS-CoV-2 has caused a worldwide pandemic (COVID-19) declared by WHO. Coronavirus disease 2019 (COVID-19) is an infectious disease with severe acute respiratory syndrome caused by coronavirus-2 (SARS-CoV-2). SARS-CoV-2 is akin to SARS-CoV, which was the causative agent of severe acute respiratory syndrome (SARS) in 2002 as well as to that of Middle East respiratory syndrome (MERS) in 2012. SARS-CoV-2 has been revealed to belong to Coronaviridiae family as a member of ß-coronaviruses. It has a positive-sense single-stranded RNA with the largest RNA genome. Since its genomic sequence has a notable similarity to that of SARS-CoV, antiviral drugs used to treat SARS and MERS are now being also applied for COVID-19 treatment. In order to combat SARS-CoV-2, many drug and vaccine development studies at experimental and clinical levels are currently conducted worldwide. In this sense, medicinal plants and the pure natural molecules isolated from plants have been reported to exhibit significant inhibitory antiviral activity against SARS-CoV and other types of coronaviruses. In the present review, plant extracts and natural molecules with the mentioned activity are discussed in order to give inspiration to researchers to take these molecules into consideration against SARS-CoV-2.


COVID-19 with abdominal symptoms and acute abdominal pain: a guide to identification for general practice


Covid-19: now is not the time to judge the UK's response


title: Inhibition of cytokine signaling by ruxolitinib and implications for COVID-19 treatment

text: Approximately 15% of patients with coronavirus disease 2019 (COVID-19) experience severe disease, and 5% progress to critical stage that can result in rapid death. No vaccines or antiviral treatments have yet proven effective against COVID-19. Patients with severe COVID-19 experience elevated plasma levels of pro-inflammatory cytokines, which can result in cytokine storm, followed by massive immune cell infiltration into the lungs leading to alveolar damage, decreased lung function, and rapid progression to death. As many of the elevated cytokines signal through Janus kinase (JAK)1/JAK2, inhibition of these pathways with ruxolitinib has the potential to mitigate the COVID-19-associated cytokine storm and reduce mortality. This is supported by preclinical and clinical data from other diseases with hyperinflammatory states, where ruxolitinib has been shown to reduce cytokine levels and improve outcomes. The urgent need for treatments for patients with severe disease support expedited investigation of ruxolitinib for patients with COVID-19.


What is the role of a dermatologist in the battle against COVID-19? The experience from a hospital on the frontline in Milan


title: Impact of temperature on the dynamics of the COVID-19 outbreak in China

text: A COVID-19 outbreak emerged in Wuhan, China at the end of 2019 and developed into a global pandemic during March 2020. The effects of temperature on the dynamics of the COVID-19 epidemic in China are unknown. Data on COVID-19 daily confirmed cases and daily mean temperatures were collected from 31 provincial-level regions in mainland China between Jan. 20 and Feb. 29, 2020. Locally weighted regression and smoothing scatterplot (LOESS), distributed lag nonlinear models (DLNMs), and random-effects meta-analysis were used to examine the relationship between daily confirmed cases rate of COVID-19 and temperature conditions. The daily number of new cases peaked on Feb. 12, and then decreased. The daily confirmed cases rate of COVID-19 had a biphasic relationship with temperature (with a peak at 10 °C), and the daily incidence of COVID-19 decreased at values below and above these values. The overall epidemic intensity of COVID-19 reduced slightly following days with higher temperatures with a relative risk (RR) was 0.96 (95% CI: 0.93, 0.99). A random-effect meta-analysis including 28 provinces in mainland China, we confirmed the statistically significant association between temperature and RR during the study period (Coefficient = -0.0100, 95% CI: -0.0125, -0.0074). The DLNMs in Hubei Province (outside of Wuhan) and Wuhan showed similar patterns of temperature. Additionally, a modified susceptible-exposed-infectious-recovered (M-SEIR) model, with adjustment for climatic factors, was used to provide a complete characterization of the impact of climate on the dynamics of the COVID-19 epidemic.


High SARS-CoV-2 infection rates in respiratory staff nurses and correlation of COVID-19 symptom patterns with PCR positivity and relative viral loads


SARS-CoV-2: March toward adaptation


COVID-19 Pandemic: Negative-pressure tent during atomization of local anesthetic for awake fibreoptic intubation


title: Elective tracheostomy during COVID-19 outbreak: to whom, when, how? Early experience from Venice, Italy

text: PURPOSE: The need for prolonged invasive mechanical ventilation in COVID-19 patients is placing the otorhinolaryngologist in front of an increasing request for tracheostomy. Nowadays, there is uncertainty regarding the timing of tracheostomy, the prognosis of these patients and the safety of healthcare workers. The aim of this study is to evaluate the efficacy and safety of tracheostomy placement in patients with COVID-19. METHODS: A retrospective cohort study on 23 COVID 19 patients, to analyse the timing of tracheostomy, the risk factors associated with in-hospital death and the infection of the involved health care workers. Early tracheostomy was defined as ≤ 10 days and late ones > 10 days. RESULTS: The mortality rate of COVID-19 patients admitted to ICU that underwent tracheostomy was 18%. The overall mortality of patients admitted to ICU was 53%. The univariate analysis revealed that early tracheostomy, SOFA score > 6, and D-dimer level > 4 were significantly associated with a greater risk of death. At the multivariate analysis SOFA score > 6 and D-dimer level > 4 resulted as significant factors for a higher risk of death. No health care workers associated with tracheostomy are confirmed to be infected by SARS-CoV2. CONCLUSION: We suggest to wait at least 14 days to perform tracheostomy. In patients with SOFA score > 6 and D dimer > 4, tracheostomy should not be performed or should be postponed. Optimized procedures and enhanced personal protective equipment can make the tracheostomy safe and beneficial in COVID-19 patients.


Convalescent plasma for patients with COVID-19


Vitreoretinal surgery tip and tricks in the era of COVID-19


Seven tips to manage your mental health and well-being during the COVID-19 outbreak


Prioritizing systemic therapies for genitourinary malignancies: Canadian recommendations during the COVID-19 pandemic


title: Are coinfections with COVID-19 and influenza low or underreported? An observational study examining current published literature including three new unpublished cases

text: As the coronavirus disease-2019 (COVID-19) pandemic continues, one major point of uncertainty is the impact this novel pathogen will have during the upcoming 2020 to 2021 flu season. While the influenza virus is a known contributor to human morbidity and mortality, the question of how a coinfection between COVID-19 and influenza might manifest is of utmost concern. The aim of this study was to review the limited cases of COVID-19/influenza coinfection currently available in the literature, along with cases in the community of El Paso, TX, to determine whether any patterns of clinical presentation and morbidity emerged. An international review of the literature was conducted. Six published articles describing COVID-19/influenza coinfection were identified, with a total of 13 patients described therein. Three additional patients were identified from the El Paso, TX data. The most common presenting symptoms were fever and cough. The most common laboratory findings were elevated C-reactive protein and lymphocytopenia. Thirteen patients presented with viral pneumonia findings on CT, and nine had findings of ground-glass opacity. Finally, complications were reported in six patients, with most common complication being acute respiratory distress syndrome. The results of the review indicate that, due to the similarity in presentation between COVID-19 and influenza, further analysis will be required to understand the effects of coinfection on morbidity and mortality. However, the limited number of coinfection cases in the literature indicates that the implementation of COVID-19 control measures may continue to play a role in limiting the spread of these human respiratory pathogens.


title: Are co-infections with COVID-19 and Influenza low or underreported? An observational study examining current published literature including three new unpublished cases

text: As the COVID-19 pandemic continues, one major point of uncertainty is the impact this novel pathogen will have during the upcoming 2020-2021 flu season. While the influenza virus is a known contributor to human morbidity and mortality, the question of how a coinfection between COVID-19 and influenza might manifest is of utmost concern. The aim of this study was to review the limited cases of COVID-19/influenza coinfection currently available in the literature, along with cases in the community of El Paso, Texas, to determine whether any patterns of clinical presentation and morbidity emerged. An international review of the literature was conducted. Six published articles describing COVID-19/influenza coinfection were identified, with a total of thirteen patients described therein. Three additional patients were identified from the El Paso, Texas data. The most common presenting symptoms were fever and cough. The most common laboratory findings were elevated C-reactive protein and lymphocytopenia. Thirteen patients presented with viral pneumonia findings on CT, and nine had findings of ground-glass opacity. Finally, complications were reported in six patients, with most common complication being acute respiratory distress syndrome (ARDS). The results of the review indicate that, due to the similarity in presentation between COVID-19 and influenza, further analysis will be required to understand the effects of coinfection on morbidity and mortality. However, the limited number of coinfection cases in the literature indicates that the implementation of COVID-19 control measures may continue to play a role in limiting the spread of these human respiratory pathogens. This article is protected by copyright. All rights reserved.


title: "Not Wars, Water pumps" - From emotive to rational language in managing the Covid-19 pandemic

text: At the date of writing this editorial, there is now agreement amongst experts that the first wave of the United Kingdom's (UK) COVID-19 pandemic is in decline (1). The number of deaths reported each day is now around 1% of the cumulative total and falling. In general, the approach to predicting pandemic policy has been through a comparison of inter-country performance in managing this crisis. While all countries are paying a high price in economic slowdown and lives lost, the health consequences in terms of cases and deaths have varied considerably. Countries with lower relative mortality and infection numbers have shown a more structured logical approach to pandemic management.


title: Guillain-Barré Syndrome as a Neurological Complication of Novel COVID-19 Infection: A Case Report and Review of the Literature

text: INTRODUCTION: The novel coronavirus (COVID-19) is a global pandemic. Although the main clinical manifestation of COVID-19 is respiratory involvement, there is evidence suggesting the neuroinvasive potential of COVID-19. There are limited reports of neurological complications of COVID-19 infection in the literature. Herein, we aim to describe 2 members of a family affected by COVID-19, presenting with ascending paresthesia with the final diagnosis of Guillain-Barré syndrome. CASE REPORT: A 38-year-old man presented with a history of ascending paresthesia and bilateral facial droop since 5 days before admission. The medical history was positive for flu-like symptoms affecting all the members of his family. The neurological examination was notable for bilateral peripheral facial paralysis, generalized areflexia, and derceased sensation in distal limbs. The cerebrospinal fluid analysis revealed an albuminocytologic dissociation. In addition, the electromyography-nerve conduction study findings were suggestive of acute axonal-demyelinating polyneuropathy. Meanwhile the patient was treated with a diagnosis of Guillain-Barré syndrome, his 14-year-old daughter presented with a history of progressive paresthesia and weakness. Similar to her father, the paraclinical evaluations were consistent with Guillain-Barré syndrome. Taking into account clinical findings and the outbreak of COVID-19, the suspicion of COVID-19 was proposed. Eventually, on the basis of throat swab samples stand on polymerase chain reaction, the patients were diagnosed with COVID-19. CONCLUSION: Our cases revealed the familial occurrence of Guillain-Barré syndrome after COVID-19 infection. The authors emphasize neurological complications of COVID-19.


title: Preparedness for Coronavirus Disease in Hospitals of Nepal: A Nationwide Survey

text: INTRODUCTION: Coronavirus disease pandemic has affected large number of people globally and has continued to spread. Preparedness of individual nations and the hospitals is important to effectively deal with the surge of cases. We aimed to obtain nation wide data from Nepal, about hospital preparedness for COVID-19. METHODS: Online questionnaire was prepared in accordance with the Center for Disease Control recommendations to assess preparedness of hospitals for COVID-19. The questionnaire was circulated to the over 800 doctors across the nation, who are the life members of six medical societies. RESULTS: We obtained 131 completed responses from all seven provinces. Majority of respondents had anaesthesiology as the primary specialty. Only 52 (39.7%) participants mentioned that their hospital had policy to receive suspected or proven cases with COVID-19. Presence of isolation ward was mentioned by 83 (63.4%) respondents, with only 9 (6.9%)mentioning the presence of airborne isolation. Supply of personal protective equipment (PPE) was inadequate as per 124 (94.7%) respondents. Critical care services for COVID-19 patients were possible only in hospitals of 42 (32.1%)respondents. RT-polymerase chain reaction could be performed only in the hospital of 6 (4.6%) respondents. CONCLUSIONS: It is apparent that most of the hospitals are not well prepared for management of patients with COVID-19. Resource allocation and policy making should be aimed to enhance national preparedness for the pandemic.


習近平とコロナウイルス : トップダウン型危機管理の弊害 (新型ウイルスの封じ込め・管理はできるのか)


title: The Performance of the Iranian Red Crescent by Launching Testing Centers for the Coronavirus Disease

text: The coronavirus disease (COVID-19) screening project has been conducted by the Red Crescent Society for 17 days with the aim of identifying and treating people with COVID-19, reducing road trips, and sensitizing people to the problem. Due to the shortage of testing devices, passengers were screened by measuring skin temperature. In 851 screening posts, 95 371 volunteers of Red Crescent monitored 21 640 866 people.Besides screening people, the stations have had other functions, including urging people to stay at home, restricting road trips, especially during the Iranian New Year holidays, reassuring the people that all relevant organizations are doing their best to respond to COVID-19, and the like. However, future research is still needed to analyze the cost-benefit of this plan and other possible options.


title: Fulminant Acute Kidney Injury in a Young Patient with Novel Coronavirus 2019

text: Coronavirus disease 2019 (COVID-19) is a global pandemic affecting more than 200 countries and 180,000 cases in the United States. While the outbreak began in China, the number of cases outside of China exceeded those in China on March 15, 2020 and are currently rising at an exponential rate. The number of fatalities in the United States are expected to exceed more than Italy and China. The disease is characterized predominantly as an acute respiratory illness. However, preliminary data suggests that kidney is a target for the virus and deterioration of renal function was associated with poor outcomes including in-hospital mortality. We pre-sent a report of a patient with COVID-19 who presented with acute onset of symptoms and normal renal function at baseline but rapidly deteriorated resulting in death. The timing of decline in renal function correlated with his worsening clinical status. He was started on continuous veno-venous hemofiltration without signs of clinical benefit. We also present the possible mechanisms for acute kidney injury in these patients. We performed a review of the emerging literature by searching PubMed, Google Scholar, and EMBASE for studies and/or case series published on this topic. Acute kidney injury might help risk stratify critically ill patients on a fatal course of COVID-19.


title: Pulmonary Thromboembolism as a Potential Cause of Clinical Deterioration in COVID-19 Patients;a Commentary

text: Although the findings of some studies have been indicative of the direct relationship between the severity of clinical findings and imaging, reports have been published regarding inconsistency of clinical findings with imaging and laboratory evidence Physicians treating these patients frequently report cases in which patients, sometimes in the recovery phase and despite improvements in imaging indices, suddenly deteriorate and in some instances suddenly expire This letter aimed to draw attention to the role of pulmonary thromboembolism as a potential and possible cause of clinical deterioration in covid-19 patients


COVID-19-associated nephritis: early warning for disease severity and complications?


title: A structural model for the Coronavirus Nucleocapsid

text: We propose a mesoscale model structure for the coronavirus nucleocapsid, assembled from the high resolution structures of the basic building blocks of the N-protein, CryoEM imaging and mathematical constraints for an overall quasi-spherical particle. The structure is a truncated octahedron that accommodates two layers: an outer shell composed of triangular and quadrangular lattices of the N-terminal domain and an inner shell of equivalent lattices of coiled parallel helices of the C-terminal domain. The model is consistent with the dimensions expected for packaging large viral genomes and provides a rationale to interpret the apparent pleomorphic nature of coronaviruses.


COVID-19 infection and glucocorticoids: update from the Italian Society of Endocrinology Expert Opinion on steroid replacement in adrenal insufficiency


title: Tuberculosis, COVID-19 and migrants: Preliminary analysis of deaths occurring in 69 patients from two cohorts

text: Little is known about the relationship between the COVID-19 and tuberculosis (TB). The aim of this study is to describe a group of patients who died with TB (active disease or sequelae) and COVID-19 in two cohorts. Data from 49 consecutive cases in 8 countries (cohort A) and 20 hospitalised patients with TB and COVID-19 (cohort B) were analysed and patients who died were described. Demographic and clinical variables were retrospectively collected, including co-morbidities and risk factors for TB and COVID-19 mortality. Overall, 8 out of 69 (11.6%) patients died, 7 from cohort A (14.3%) and one from cohort B (5%). Out of 69 patients 43 were migrants, 26/49 (53.1%) in cohort A and 17/20 (85.0%) in cohort B. Migrants: (1) were younger than natives; in cohort A the median (IQR) age was 40 (27-49) VS. 66 (46-70) years, whereas in cohort B 37 (27-46) VS. 48 (47-60) years; (2) had a lower mortality rate than natives (1/43, 2.3% versus 7/26, 26.9%; p-value: 0.002); (3) had fewer co-morbidities than natives (23/43, 53.5% versus 5/26-19.2%) natives; p-value: 0.005). The study findings show that: (1) mortality is likely to occur in elderly patients with co-morbidities; (2) TB might not be a major determinant of mortality and (3) migrants had lower mortality, probably because of their younger age and lower number of co-morbidities. However, in settings where advanced forms of TB frequently occur and are caused by drug-resistant strains of M. tuberculosis, higher mortality rates can be expected in young individuals.


Exercise-related Mental Health Problems and Solutions during the COVID-19 Pandemic


title: Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic for outpatient and hospital practices

text: Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.


Letter to the Editor. COVID-19 and chronic pain


Co-infection with COVID-19 and influenza A virus in two died patients with acute respiratory syndrome, Bojnurd, Iran


Droplet nuclei aerosol and Covid 19 - a risk to healthcare staff


title: Factors associated with duration of viral shedding in adults with COVID-19 outside of Wuhan, China: A retrospective cohort study

text: Objectives: To investigate factors associated with the duration of viral shedding in patients with COVID-19 outside of Wuhan. Methods: In this retrospective cohort study, patients with laboratory-confirmed COVID-19 in Changsha, China were included. Clinical characteristics, laboratory findings, treatment and outcome were retrieved. Univariable and multivariable analysis were performed to explore potential factors. Results: Totally 147 patients with COVID-19 were included. The median duration of viral shedding (the number of days from symptoms onset till the successive negative detection of SARS-CoV-2 RNA) was 17 days (interquartile range [IQR], 12 to 21). Multivariable Logistic regression analysis indicated that the highest temperature at admission (odds ratio [OR], 5.200; 95% confidence interval [CI]: 1.190-22.726; p = 0.028) and time from symptom onset to admission (OR, 1.740; 95% CI: 1.296-2.337; p < 0.001) and hospital length of stay (OR, 1.604; 95% CI: 1.262-2.040; p < 0.001) were risk factors for prolonged duration of viral shedding. Conclusions: This is the study with relatively large sample size that mainly focused on the duration of viral shedding and relevant factors in patients with COVID-19 outside of Wuhan, China. Potential risk factors were identified and should be taken into consideration for the strategy of quarantine of infected patients.


title: COVID-19 e coronaropatia: uso selettivo e collaborativo delle risorse durante le crisi sanitarie./ [COVID-19 and coronary artery disease: selective and collaborative use of resources during public health crisis]

text: The COVID-19 epidemic is one of the most demanding challenges for the public health organizations. The Lombardy region faced firstly this outbreak in Italy and recorded rapidly a saturation of intensive care and internal medicine beds. Consequently, this lack of technical and human resources, together with people mobility restriction to contain virus spreading, determined the interruption of elective surgical and interventional cardiovascular procedures. In addition, the emergency track of acute patients has been rewritten due to limited resources and viral co-infection (pre- or in-hospital). Herein, we describe two cases of acute coronary syndrome with severe coronary artery disease and an indication for coronary artery bypass grafting. The first patient, COVID-19 positive, was treated with transcatheter technique due to symptom instability and underwent temporary circulatory support without intubation. The second patient received an intra-aortic balloon pump and was then transferred, in accordance with government emergency provisions, to a hub hospital to undergo off-pump coronary artery bypass grafting and short intensive care unit stay. These two apparently similar cases were treated differently according to the moving epidemiological and organizational conditions.


The Role of Oral and Maxillofacial Surgeons in COVID-19 Response


title: Amplifying the role of knowledge translation platforms in the COVID-19 pandemic response

text: The COVID-19 pandemic presents the worst public health crisis in recent history. The response to the COVID-19 pandemic has been challenged by many factors, including scientific uncertainties, scarcity of relevant research, proliferation of misinformation and fake news, poor access to actionable evidence, time constraints, and weak collaborations among relevant stakeholders. Knowledge translation (KT) platforms, composed of organisations, initiatives and networks supporting evidence-informed policy-making, can play an important role in providing relevant and timely evidence to inform pandemic responses and bridge the gap between science, policy, practice and politics. In this Commentary, we highlight the emerging roles of KT platforms in light of the COVID-19 pandemic. We also reflect on the lessons learned from the efforts of a KT platform in a middle-income country to inform decision-making and practice during the COVID-19 pandemic. The lessons learned can be integrated into strengthening the role, structures and mandates of KT platforms as hubs for trustworthy evidence that can inform policies and practice during public health crises and in promoting their integration and institutionalisation within the policy-making processes.


title: Case reports study of the first five patients COVID-19 treated with remdesivir in France

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as responsible for the COVID-19 outbreak worldwide. Data on treatment are scare and parallels are made between SARS-CoV-2 and other coronavirus. Remdesivir is a broad spectrum antiviral with efficient in vitro activity against SARS-CoV-2 and controversial evidence of clinical improvement in severe COVID-19 patients. We aimed to describe the clinical outcome and virological monitoring of the first five COVID-19 patients admitted in ICU for severe pneumonia related to SARS-CoV-2 and treated with remdesivir in the University hospital of Bichat, Paris, France. SARS-CoV-2 RT-qPCR in blood plasma, lower and upper respiratory tract were monitored. Among the five treated patients, two needed mechanical ventilation and one high flow cannula oxygen. A significant decrease in SARS-CoV-2 viral load from upper respiratory tract was observed in most cases but two died with active SARS-CoV-2 replication in the lower respiratory tract. Plasma samples were positive for SARS-CoV-2 in only one patient. Remdesivir was interrupted for side effects among four patients, including 2 ALT elevations (3 to 5 N) and 2 renal failures requiring renal replacement. This case series of five COVID-19 patients requiring ICU for a respiratory distress and treated with remdesivir, highlights the complexity of remdesivir use in such critically ill patients.


Sudden olfactory and gustatory dysfunctions: Important red flags in COVID-19


title: Separating NOM from salts in ion exchange brine with ceramic nanofiltration

text: In drinking water treatment, natural organic matter (NOM) is effectively removed from surface water using ion exchange (IEX). A main drawback of using IEX for NOM removal is the production of spent IEX regeneration brine, a polluting waste that is expensive to discharge. In this work, we studied ceramic nanofiltration as a treatment for the spent NOM-rich brine, with the aim to reduce the volume of this waste and to recycle salt. Compared to polymeric nanofiltration, the fouling was limited. When NOM is rejected and concentrated, a clean permeate with the regeneration salt (NaCl) could be produced and reused in the IEX regeneration process. Bench scale studies revealed that NOM could be effectively separated from the NaCl solution by steric effects. However, the separation of NaCl from other salts present in the brine, such as Na2SO4, was not sufficient for reuse purposes. The low sulphate rejection was mainly due to the low zeta potential of the membrane at the high ionic strength of the brine. The permeate of the ceramic nanofiltration should be treated further to obtain a sodium chloride quality that can be recycled as a regenerant solution for ion exchange. Further treatment steps will benefit from the removal of NOM from the brine.


title: How Support of Early Career Researchers Can Reset Science in the Post-COVID19 World

text: The COVID19 crisis has magnified the issues plaguing academic science, but it has also provided the scientific establishment with an unprecedented opportunity to reset. Shoring up the foundation of academic science will require a concerted effort between funding agencies, universities, and the public to rethink how we support scientists, with a special emphasis on early career researchers.


Protect Indigenous peoples from COVID-19


COVID-19 infection in patients following hepato-pancreatico-biliary intervention: An early experience


title: Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020

text: Fear is an adaptive response in the presence of danger. However, when threat is uncertain and continuous, as in the current coronavirus disease (COVID-19) pandemic, fear can become chronic and burdensome. To identify predictors of fear of the coronavirus, we conducted an online survey (N = 439) three days after the World Health Organization declared the coronavirus outbreak a pandemic (i.e., between March 14 and 17, 2020). Fear of the coronavirus was assessed with the newly developed Fear of the Coronavirus Questionnaire (FCQ) consisting of eight questions pertaining to different dimensions of fear (e.g., subjective worry, safety behaviors, preferential attention), and an open-ended question. The predictors included psychological vulnerability factors (i.e., intolerance of uncertainty, worry, and health anxiety), media exposure, and personal relevance (i.e., personal health, risk for loved ones, and risk control). We found four predictors for the FCQ in a simultaneous regression analysis: health anxiety, regular media use, social media use, and risks for loved ones (R2 = .37). Furthermore, 16 different topics of concern were identified based participants' open-ended responses, including the health of loved ones, health care systems overload, and economic consequences. We discuss the relevance of our findings for managing people's fear of the coronavirus.


title: Care of Asymptomatic SARS-CoV-2 positive Kidney Transplant Recipients

text: Sharing of experience amongst transplant community through various platforms and rapid publications has proven invaluable during the COVID-19 pandemic (1-3). The general consensus seemed to be that most kidney transplant recipients would have a moderate or mild course, although some may progress to a more severe disease. It was recommended to stop or decrease the dose of anti-proliferative agents and continue with calcineurin inhibitors (CNIs) and maintenance steroids (4).


Comfort and compliance with the use of facemasks during COVID -19 infection


title: A multi-region discrete time mathematical modeling of the dynamics of Covid-19 virus propagation using optimal control

text: We study in this work a discrete mathematical model that describes the dynamics of transmission of the Corona virus between humans on the one hand and animals on the other hand in a region or in different regions. Also, we propose an optimal strategy to implement the optimal campaigns through the use of awareness campaigns in region j that aims at protecting individuals from being infected by the virus, security campaigns and health measures to prevent the movement of individuals from one region to another, encouraging the individuals to join quarantine centers and the disposal of infected animals. The aim is to maximize the number of individuals subjected to quarantine and trying to reduce the number of the infected individuals and the infected animals. Pontryagin's maximum principle in discrete time is used to characterize the optimal controls and the optimality system is solved by an iterative method. The numerical simulation is carried out using Matlab. The Incremental Cost-Effectiveness Ratio was calculated to investigate the cost-effectiveness of all possible combinations of the four control measures. Using cost-effectiveness analysis, we show that control of protecting susceptible individuals, preventing their contact with the infected individuals and encouraging the exposed individuals to join quarantine centers provides the most cost-effective strategy to control the disease.


title: Not all world leaders use Twitter in response to the COVID-19 pandemic: impact of the way of Angela Merkel on psychological distress, behaviour and risk perception

text: At a time of growing governmental restrictions and 'physical distancing' in order to decelerate the spread of COVID-19, psychological challenges are increasing. Social media plays an important role in maintaining social contact as well as exerting political influence. World leaders use it not only to keep citizens informed but also to boost morale and manage people's fears. However, some leaders do not follow this approach; an example is the German Chancellor. In a large online survey, we aimed to determine levels of COVID-19 fear, generalized anxiety, depression, safety behaviour, trust in government and risk perception in Germany. A total of 12 244 respondents participated during the period of restraint and the public shutdown in March 2020. Concurrent with the German Chancellor's speech, a reduction of anxiety and depression was noticeable in the German population. It appears that, in addition to using social media platforms like Twitter, different-and sometimes more conservative-channels for providing information can also be effective.


title: A Case for Participatory Disease Surveillance of the COVID-19 Pandemic in India

text: The coronavirus disease pandemic requires the deployment of novel surveillance strategies to curtail further spread of the disease in the community. Participatory disease surveillance mechanisms have already been adopted in countries for the current pandemic. India, with scarce resources, good telecom support, and a not-so-robust heath care system, makes a strong case for introducing participatory disease surveillance for the prevention and control of the pandemic. India has just launched Aarogya Setu, which is a first-of-its-kind participatory disease surveillance initiative in India. This will supplement the existing Integrated Disease Surveillance Programme in India by finding missing cases and having faster aggregation, analysis of data, and prompt response measures. This newly created platform empowers communities with the right information and guidance, enabling protection from infection and reducing unnecessary contact with the overburdened health care system. However, caution needs to be exercised to address participation from digitally isolated populations, ensure the reliability of data, and consider ethical concerns such as maintaining individual privacy.


COVID 19 and training in the UK- Correspondence


title: Prone Position in Management of COVID-19 Patients;a Commentary

text: SARS-CoV-2 virus causes a pneumonia that was identified through fever, dyspnea, and acute respiratory symptoms and named COVID-19 This disease exacerbates in a number of patients and causes pulmonary edema, multi-organ failure, and acute respiratory distress syndrome (ARDS) Prevalence of ARDS among COVID-19 patients has been reported to be up to 17% Among the introduced treatment methods for management of ARDS patients, prone position can be used as an adjuvant therapy for improving ventilation in these patients Here we reviewed the literature regarding the role of prone position in management of COVID-19 patients


Call of duty: neuro-oncology outpatient management during the COVID-19 pandemic in Milan, ITALY


title: Use of SARS-CoV-2-infected deceased organ donors: Should we always "just say no?"

text: In the context of a rapidly evolving pandemic, multiple organizations have released guidelines stating that all organs from potential deceased donors with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection should be deferred, including from otherwise medically eligible donors found to have mild or asymptomatic SARS-CoV-2 discovered on routine donor screening. In this article, we critically examine the available data on the risk of transmission of SARS-CoV-2 through organ transplantation. The isolation of SARS-CoV-2 from nonlung clinical specimens, the detection of SARS-CoV-2 in autopsy specimens, previous experience with the related coronaviruses SARS-CoV and MERS-CoV, and the vast experience with other common RNA respiratory viruses are all addressed. Taken together, these data provide little evidence to suggest the presence of intact transmissible SARS-CoV in organs that can potentially be transplanted, specifically liver and heart. Other considerations including ethical, financial, societal, and logistical concerns are also addressed. We conclude that, for selected patients with high waitlist mortality, transplant programs should consider accepting heart or liver transplants from deceased donors with SARS-CoV-2 infection.


"Please doctor, could you tell him that I love him?": Letter from plastic surgeons at the COVID-19 warfront


Implications of SARS CoV-2 positivity in amniotic membranes for ophthalmologists


What Is Needed to Make Interventional Radiology Ready for COVID-19? Lessons from SARS-CoV Epidemic


Efficacy of face masks depends on spatial relation between host and recipient and who is being protected


Chest computed tomography in children with COVID-19


Observations about sexual and other routes of SARS-CoV-2 (COVID-19) transmission and its prevention


title: Addressing the Impact of COVID-19 on the Residency Application Process Through a Virtual Subinternship

text: Senior medical students are facing an unparalleled experiential gap left by COVID-19 restrictions. Due to a shared commitment to safety, equity, and well-being, away rotations are actively being discouraged or even prohibited. As a result, students transitioning to residency encounter reduced clinical training experiences and decreased access to advising, mentorship, and research opportunities. In addition, limited exposure to residency life across subspecialties and institutions poses unique challenges during the current residency application cycle. The otolaryngology-head and neck surgery community has met these unprecedented challenges by producing diverse electronic resources for specialty-specific clinical education, as well as discussing ways to increase access to advising. In this commentary, we review these initiatives and propose an institutional virtual event as a platform for meeting goals previously achieved by visiting subinternships.


Asymptomatic Spread of COVID-19 in 97 Patients at a Skilled Nursing Facility


title: CoVID-19 insights from transfusion medicine

text: The emergence of CoVID-19 infection in the first months of 2020 resulted in a massive surge in admissions to hospitals and intensive care units due to the nature of the respiratory pathophysiology. In some countries, health care systems were rapidly overwhelmed, while in others their hospitals coped with the first wave and all patients received the level of care needed, depending upon both the containment measured and the level of development of the heath care systems.


title: Mentality and behavior in COVID-19 emergency status in Japan: Influence of personality, morality and ideology

text: The COVID-19 pandemic began in December 2019 and severely influenced society. In response, the Japanese government declared a state of emergency on 7th April in seven prefectures. The study conducted an immediate survey on 8th April to record the response of the general public to the first emergency status due to epidemics. The study hypothesized that personality traits, moral foundation, and political ideology can influence people's mentality, cognition, and behavior toward COVID-19. Based on a nationwide dataset of 1856 respondents (male = 56.3%, Mage = 46.7, emergency regions = 49.9%), the study found that personality, morality, and ideology altered mental health status and motivated behaviors toward COVID-19. Neuroticism and avoiding harm involved cognition and behavior through various means. The study also found significant differences among demographic groups. Results are informative and contributive to the governance and management of, and aid for, individual responses to the COVID-19 pandemic.


title: An Evaluation of Cleaning Practices at a Teaching Hospital

text: BACKGROUND: The COVID-19 outbreak has highlighted the role of hospital-acquired infections in spreading epidemics. Adequately cleaning surfaces in patient rooms is an essential part of this fight to reduce the spread. Traditional audits, however, are insufficient. This study assesses surface cleaning practices using UV marker technology and the extent to which this technology can help improve cleaning audits and practices. METHODS: 144 audits (1,235 surfaces) were retrieved. UV marker cleaning audits conducted at a major teaching hospital in 2018 after implementing a new cleaning protocol. In addition, semi-structured interviews were conducted with cleaning staff and supervisors. RESULTS: On average, 63% of surfaces were appropriately cleaned. Toilet handles (80%) and toilet seats underside (83%) scored highest while main room sink fixtures (54%), light switch (55%) and bedrails (56%) scored lowest. Training, staffing and time constraints may play a role in low cleaning rates. DISCUSSION: The high-touch patient surfaces in the bedroom remain neglected and a potential source of infections. UV marker audits provided an objective measure of cleaning practices that managers and staff were unaware of. CONCLUSION: UV markers audits can play a key role in revealing deficiencies in cleaning practices and help in raising awareness of these deficiencies and improving cleaning practices.


Aspiration Pneumonia or COVID-19 Infection: A Diagnostic Challenge


Challenges in evaluating SARS-CoV-2 vaccines during the COVID-19 pandemic


title: Auxiliary Signal-Guided Knowledge Encoder-Decoder for Medical Report Generation

text: Beyond the common difficulties faced in the natural image captioning, medical report generation specifically requires the model to describe a medical image with a fine-grained and semantic-coherence paragraph that should satisfy both medical commonsense and logic. Previous works generally extract the global image features and attempt to generate a paragraph that is similar to referenced reports; however, this approach has two limitations. Firstly, the regions of primary interest to radiologists are usually located in a small area of the global image, meaning that the remainder parts of the image could be considered as irrelevant noise in the training procedure. Secondly, there are many similar sentences used in each medical report to describe the normal regions of the image, which causes serious data bias. This deviation is likely to teach models to generate these inessential sentences on a regular basis. To address these problems, we propose an Auxiliary Signal-Guided Knowledge Encoder-Decoder (ASGK) to mimic radiologists' working patterns. In more detail, ASGK integrates internal visual feature fusion and external medical linguistic information to guide medical knowledge transfer and learning. The core structure of ASGK consists of a medical graph encoder and a natural language decoder, inspired by advanced Generative Pre-Training (GPT). Experiments on the CX-CHR dataset and our COVID-19 CT Report dataset demonstrate that our proposed ASGK is able to generate a robust and accurate report, and moreover outperforms state-of-the-art methods on both medical terminology classification and paragraph generation metrics.


Lymphocytopenia and Radiotherapy Treatment Volumes in the Time of COVID-19


title: Coronavirus disease (COVID-19) and disseminated intravascular coagulation syndrome ;Коронавирусная инфекция (COVID-19) и синдром диссеминированного внутрисосудистого свертывания

text: COVID-19 is an infectious disease caused by the beta coronavirus SARS-CoV-2, which became widespread worldwide in 2020 In most severe patients, the clinical picture begins with respiratory failure, then progressing to polyorgan failure The most adverse prognostic sign is the development of coagulopathy Based on the analysis of clinical data available to date, 71 4% of those who died and 0 6% of those who survived showed signs of explicit disseminated intravascular coagulation syndrome (DIC-syndrome) Monitoring of D-dimer, prothrombin time (PT), platelet and fibrinogen count are important for determining treatment and indications for hospitalization among patients with COVID-19 If these parameters deteriorate, more "aggressive" intensive care should be performed Lowmolecular weight heparin (LMWH) should be administered to all patients with diagnosed COVID-19 infection (including non-critical patients) who require hospitalization if these patients have no contraindications for LMWH ;COVID-19 – инфекционное заболевание, вызываемое бета- коронавирусом SARS-CoV-2, которое получило распространение по всему миру в 2020 году У большинства тяжелых пациентов клиническая картина начинается с дыхательной недостаточности, в последующем прогрессирующей вплоть до полиорганной недостаточности Самым неблагоприятным прогностическим признаком является развитие коагулопатии На основании анализа доступных на сегодняшний день клинических данных у 71,4% погибших и у 0,6% выживших имелись признаки явного ДВС-синдрома Мониторинг D-димера, протромбинового времени (ПВ), количества тромбоцитов и фибриногена важен для определения показаний к назначению лечения и госпитализации у пациентов с COVID-19 При ухудшении этих параметров должна проводиться более «агрессивная» реанимационная помощь Низкомолекулярный гепарин (НМГ) следует назначать всем пациентам с диагностированной инфекцией COVID-19 (включая некритических больных), которым требуется госпитализация, при отсутствии у данных больных противопоказаний к НМГ


title: Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden

text: BACKGROUND: It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic. OBJECTIVE: To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients. METHODS: An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma. RESULTS: Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts. CONCLUSIONS: Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.


Assessment of Treatment response to Sirolimus in pulmonary lymphangioleiomyomatosis by longitudinal quantification of cystic changes using automated post-processing of chest CT-data


Recomendaciones para cirugía en pacientes con patologías oncológicas durante la pandemia COVID-19


title: Why are most COVID-19 infection curves linear?

text: Many countries have passed their first COVID-19 epidemic peak. Traditional epidemiological models describe this as a result of non-pharmaceutical interventions that pushed the growth rate below the recovery rate. In this new phase of the pandemic many countries show an almost linear growth of confirmed cases for extended time-periods. This new containment regime is hard to explain by traditional models where infection numbers either grow explosively until herd immunity is reached, or the epidemic is completely suppressed (zero new cases). Here we offer an explanation of this puzzling observation based on the structure of contact networks. We show that for any given transmission rate there exists a critical number of social contacts, $D_c$, below which linear growth and low infection prevalence must occur. Above $D_c$ traditional epidemiological dynamics takes place, as e.g. in SIR-type models. When calibrating our corresponding model to empirical estimates of the transmission rate and the number of days being contagious, we find $D_c\sim 7.2$. Assuming realistic contact networks with a degree of about 5, and assuming that lockdown measures would reduce that to household-size (about 2.5), we reproduce actual infection curves with a remarkable precision, without fitting or fine-tuning of parameters. In particular we compare the US and Austria, as examples for one country that initially did not impose measures and one that responded with a severe lockdown early on. Our findings question the applicability of standard compartmental models to describe the COVID-19 containment phase. The probability to observe linear growth in these is practically zero.


Human Immunodeficiency Virus Phylogenetics in the United States-and Elsewhere


A cascade of causes that led to the COVID-19 tragedy in Italy and in other European Union countries


People power: How India is attempting to slow the coronavirus


Perioperative Echocardiography: Key Considerations During the Coronavirus Pandemic


title: The role of a Coronavirus disease 2019 pharmacist: an Australian perspective

text: The coronavirus disease 2019 (COVID-19) pandemic has greatly impacted healthcare services around the world. Pharmacists are front-line healthcare professionals and integral members of the healthcare team. The deployment of a specialized 'COVID pharmacist' within our institution has demonstrated that the skills of the pharmacist can be adapted, expanded and utilized to alleviate the pressure of doctor shortages, reduce healthcare worker exposure to infected patients, contribute to therapeutic decisions and work collaboratively to tackle the challenges faced during this pandemic. This commentary details an Australian hospital pharmacy response to the COVID-19 pandemic, describing the unique clinical and practical contributions made by a specialized COVID pharmacist in our institution.


title: Tracheostomy in the COVID-19 era: global and multidisciplinary guidance

text: Global health care is experiencing an unprecedented surge in the number of critically ill patients who require mechanical ventilation due to the COVID-19 pandemic. The requirement for relatively long periods of ventilation in those who survive means that many are considered for tracheostomy to free patients from ventilatory support and maximise scarce resources. COVID-19 provides unique challenges for tracheostomy care: health-care workers need to safely undertake tracheostomy procedures and manage patients afterwards, minimising risks of nosocomial transmission and compromises in the quality of care. Conflicting recommendations exist about case selection, the timing and performance of tracheostomy, and the subsequent management of patients. In response, we convened an international working group of individuals with relevant expertise in tracheostomy. We did a literature and internet search for reports of research pertaining to tracheostomy during the COVID-19 pandemic, supplemented by sources comprising statements and guidance on tracheostomy care. By synthesising early experiences from countries that have managed a surge in patient numbers, emerging virological data, and international, multidisciplinary expert opinion, we aim to provide consensus guidelines and recommendations on the conduct and management of tracheostomy during the COVID-19 pandemic.


title: High-Throughput Transcription-mediated amplification on the Hologic Panther is a highly sensitive method of detection for SARS-CoV-2

text: BACKGROUND: As the demand for laboratory testing for SARS-CoV-2 increases, additional varieties of testing methodologies are being considered. While real time polymerase chain reaction (RT-PCR) has performed as the main method for virus detection, other methods are becoming available, including transcription mediated amplification (TMA). The Hologic Aptima SARS-CoV-2 Assay utilizes TMA as a target amplification mechanism, and it has only recently received Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA). OBJECTIVES: We sought to compare the sensitivity and specificity of the Aptima SARS-CoV-2 Assay to RTPCR as a means of SARS-CoV-2 detection in a diagnostic setting. STUDY DESIGN: We performed a limit-of-detection study (LoD) to assess the analytical sensitivity of TMA and RT-PCR. This preceded a comparison of the methods using previously evaluated clinical specimens (nasopharyngeal swabs) using 116 human specimens tested by both methodologies. Specimens included sixty-one (61) specimens found reactive by real-time PCR, fifty-one (51) found non-reactive, and four (4) deemed inconclusive. RESULTS: The Aptima SARS-CoV-2 Assay showed a markedly higher analytical sensitivity than RT-PCR by LoD study. Evaluation of clinical specimens resulted in fewer inconclusive results by the SARS-CoV-2 assay, leading to potentially higher clinical sensitivity. CONCLUSIONS: Higher analytical sensitivity may explain TMA's ability to ascertain for the presence of SARS-CoV-2 genome in human specimens deemed inconclusive by real-time PCR. TMA provides an effective, highly sensitive means of detection of SARS-CoV-2 in nasopharyngeal specimens.


title: Operating during COVID-19: Is there a risk of viral transmission from surgical smoke during surgery?

text: Summary: The World Health Organization declared a pandemic when coronavirus disease 2019 (COVID-19) started to sweep the globe. Growing concerns for the safety of health care workers was raised when up to 80% of people with COVID-19 showed mild or no symptoms at all. Some surgical procedures will be inevitable during the pandemic, and proper safety measures must be in place to avoid transmission risks. Surgical smoke is a common by-product from the use of energy devices in the operating room. The effects of surgical smoke have been studied for more than 40 years, and potential health hazards have been reported. Chemicals, carcinogens and biologically active materials, such as bacteria and viruses, have been isolated in surgical smoke. To ensure the safety of operating room personnel, we must consider whether there is any concern of viral transmission from the inhalation of surgical smoke.


title: Knowledge synthesis from 100 million biomedical documents augments the deep expression profiling of coronavirus receptors

text: The COVID-19 pandemic demands assimilation of all available biomedical knowledge to decode its mechanisms of pathogenicity and transmission. Despite the recent renaissance in unsupervised neural networks for decoding unstructured natural languages, a platform for the real-time synthesis of the exponentially growing biomedical literature and its comprehensive triangulation with deep omic insights is not available. Here, we present the nferX platform for dynamic inference from over 45 quadrillion possible conceptual associations extracted from unstructured biomedical text, and their triangulation with Single Cell RNA-sequencing based insights from over 25 tissues. Using this platform, we identify intersections between the pathologic manifestations of COVID-19 and the comprehensive expression profile of the SARS-CoV-2 receptor ACE2. We find that tongue keratinocytes and olfactory epithelial cells are likely under-appreciated targets of SARS-CoV-2 infection, correlating with reported loss of sense of taste and smell as early indicators of COVID-19 infection, including in otherwise asymptomatic patients. Airway club cells, ciliated cells and type II pneumocytes in the lung, and enterocytes of the gut also express ACE2. This study demonstrates how a holistic data science platform can leverage unprecedented quantities of structured and unstructured publicly available data to accelerate the generation of impactful biological insights and hypotheses.


COVID-19 diffusion capability is its worst, unpredictable chracateristic. How to visit a patient from a distance


An Early Warning Score to predict ICU admission in COVID-19 positive patients


title: Clinical features, laboratory characteristics, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19): Early report from the United States

text: Background Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2), is an ongoing pandemic that has already affected millions of patients worldwide, and is associated with significant morbidity and mortality burden. Although the clinical and laboratory characteristics of this illness have been reported in patients from China and Europe, data are scant in the United States. Methods We extracted data regarding all patients hospitalized at our hospital with COVID-19 infection between March 1 and April 4, 2020. Presenting signs and symptoms, laboratory and imaging findings, treatment, and complications were recorded from electronic medical records (EMRs). The primary composite endpoint was admission to intensive care unit (ICU), shock, or death. Results We had a total of 43 patients tested for COVID-19 at the emergency room (ER) or during hospitalization, 16 (37%) of whom were admitted with COVID-19 infection. The mean age was 65.5 years and 75% were males. The most common presenting symptoms were fever (94%), cough (88%), and dyspnea (81%). A loss of smell and taste sensations were reported by three (19%) patients. Low oxygen saturation was present in 38% of patients, whilst 31% were hypotensive on admission. Hyponatremia (50%), elevated C-reactive protein (CRP; 100%), and lactate dehydrogenase (LDH; 80%) were common. Acute renal failure, myocardial injury, and elevation in aminotransferases occurred in 69%, 19%, and 38% patients, respectively. The primary composite endpoint occurred in 50% of patients. A total of three patients died; all were aged 70 years or older. Conclusions Laboratory abnormalities and acute renal failure were common in hospitalized patients with SARS-CoV2 infection in our center. Admission to ICU and mechanical ventilation were common.


What evidence-based medicine researchers can do to help clinicians fighting COVID-19?


Cancer Center Recommendations to Mitigate COVID-19 Impact in Patients With Cancer: Low-Resource Settings Version


title: Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China

text: Previous studies suggest that COVID-19 is more likely to infect older adult men, particularly those with chronic comorbidities 2-4 Few infections in children have been reported We identified all infected infants in China and described demographic, epidemiologic, and clinical features


title: Human Mobility in Response to COVID-19 in France, Italy and UK

text: The policies implemented to hinder the COVID-19 outbreak represent one of the largest critical events in history. The understanding of this process is fundamental for crafting and tailoring post-disaster relief. In this work we perform a massive data analysis, through geolocalized data from 13M Facebook users, on how such a stress affected mobility patterns in France, Italy and UK. We find that the general reduction of the overall efficiency in the network of movements is accompanied by geographical fragmentation with a massive reduction of long-range connections. The impact, however, differs among nations according to their initial mobility structure. Indeed, we find that the mobility network after the lockdown is more concentrated in the case of France and UK and more distributed in Italy. Such a process can be approximated through percolation to quantify the substantial impact of the lockdown.


Should qualitative RT-PCR be used to determine release from isolation of COVID-19 patients?


How mental health services are adapting to provide care in the pandemic


Benign course of SARS-CoV-2 infection in a series of pediatric oncology patients


title: Digital health management during and beyond the COVID-19 pandemic: Opportunities, barriers, and recommendations

text: UNSTRUCTURED: During the COVID-19 crisis, digital technologies have become a major route for accessing remote care. Therefore, the need to ensure that these tools are safe and effective has never been greater. We raise five calls to action to ensure the safety, availability and long-term sustainability of theseDuring the COVID-19 crisis, digital technologies have become a major route for accessing remote care. Therefore, the need to ensure that these tools are safe and effective has never been greater. We raise five calls to action to ensure the safety, availability and long-term sustainability of these technologies: (1) Due diligence: Remove harmful health apps from app stores; (2) Data insights: Use relevant health data insights from high-quality digital tools to inform the greater response to COVID-19; (3) Freely available resources: Make high-quality digital health tools available without charge, where possible and for as long as possible, especially to those who are most vulnerable; (4) Digital transitioning: Transform conventional offline mental health services to make them digitally available; and (5) Population self-management: Encourage governments and insurers to work with developers to look at how digital health management could be subsidised or funded. We believe this should be carried out at the population level, rather than at a prescription level.


Covid-19 exposes weaknesses in European response to outbreaks


The urge to implement and expand telepsychiatry during the COVID-19 crisis: Early career psychiatrists' perspective


COVID-19 Pandemic: Considerations for Safe Medication Use in Older Adults with Multimorbidity and Polypharmacy


title: State Estimation-Based Robust Optimal Control of Influenza Epidemics in an Interactive Human Society

text: This paper presents a state estimation-based robust optimal control strategy for influenza epidemics in an interactive human society in the presence of modeling uncertainties. Interactive society is influenced by the random entrance of individuals from other human societies whose effects can be modeled as a non-Gaussian noise. Since only the number of exposed and infected humans can be measured, states of the influenza epidemics are first estimated by an extended maximum correntropy Kalman filter (EMCKF) to provide a robust state estimation in the presence of the non-Gaussian noise. An online quadratic program (QP) optimization is then synthesized subject to a robust control Lyapunov function (RCLF) to minimize susceptible and infected humans, while minimizing and bounding the rates of vaccination and antiviral treatment. The joint QP-RCLF-EMCKF meets multiple design specifications such as state estimation, tracking, pointwise control optimality, and robustness to parameter uncertainty and state estimation errors that have not been achieved simultaneously in previous studies. The uniform ultimate boundedness (UUB)/convergence of error trajectories is guaranteed using a Lyapunov stability argument. The soundness of the proposed approach is validated on the influenza epidemics of an interactive human society with a population of 16000. Simulation results show that the QP-RCLF-EMCKF achieves appropriate tracking and state estimation performance. The robustness of the proposed controller is finally illustrated in the presence of modeling error and non-Gaussian noise.


title: The Phylogeography of MERS-CoV in Hospital Outbreak-Associated Cases Compared to Sporadic Cases in Saudi Arabia

text: This study compared the phylogeography of MERS-CoV between hospital outbreak-associated cases and sporadic cases in Saudi Arabia. We collected complete genome sequences from human samples in Saudi Arabia and data on the multiple risk factors of human MERS-CoV in Saudi Arabia reported from 2012 to 2018. By matching each sequence to human cases, we identified isolates as hospital outbreak-associated cases or sporadic cases. We used Bayesian phylogenetic methods including temporal, discrete trait analysis and phylogeography to uncover transmission routes of MERS-CoV isolates between hospital outbreaks and sporadic cases. Of the 120 sequences collected between 19 June 2012 and 23 January 2017, there were 64 isolates from hospital outbreak-associated cases and 56 from sporadic cases. Overall, MERS-CoV is fast evolving at 7.43 × 10-4 substitutions per site per year. Isolates from hospital outbreaks showed unusually fast evolutionary speed in a shorter time-frame than sporadic cases. Multiple introductions of different MERS-CoV strains occurred in three separate hospital outbreaks. MERS-CoV appears to be mutating in humans. The impact of mutations on viruses transmissibility in humans is unknown.


Use of triiodothyronine to treat critically ill COVID-19 patients: a new clinical trial


COVID-19 pandemic: stop panic abandonment of household pets


Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions


An algorithm for managing QT prolongation in coronavirus disease 2019 (COVID-19) patients treated with either chloroquine or hydroxychloroquine in conjunction with azithromycin: Possible benefits of intravenous lidocaine


title: A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis. METHODS: We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days. RESULTS: We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs. CONCLUSION: Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries.


COVID-19 and orthopaedic and trauma surgery


title: A critical review: traditional uses, phytochemistry, pharmacology and toxicology of Stephania tetrandra S. Moore (Fen Fang Ji)

text: Abstract: Stephania tetrandra S. Moore (S. tetrandra) is distributed widely in tropical and subtropical regions of Asia and Africa. The root of this plant is known in Chinese as "Fen Fang Ji". It is commonly used in traditional Chinese medicine to treat arthralgia caused by rheumatism, wet beriberi, dysuria, eczema and inflamed sores. Although promising reports have been published on the various chemical constituents and activities of S. tetrandra, no review comprehensively summarizes its traditional uses, phytochemistry, pharmacology and toxicology. Therefore, the review aims to provide a critical and comprehensive evaluation of the traditional use, phytochemistry, pharmacological properties, pharmacokinetics and toxicology of S. tetrandra in China, and meaningful guidelines for future investigations.


COVID-19 in Liver Transplant Recipients: An Initial Experience from the U.S. Epicenter


title: The Covid19Impact Survey: Assessing the Pulse of the COVID-19 Pandemic in Spain via 24 questions

text: In this paper, we describe the results of analyzing a large-scale survey, called the Covid19Impact survey, to assess citizens feedback on four areas related to the COVID-19 pandemic in Spain: social contact behavior, financial impact, working situation and health status. A total of 24 questions cover the areas of demographics, their home situation, social contact behavior, personal economic impact, their workplace situation and their health. The survey was responded to by 156,614 participants between the evening of March 28th and April 2nd, 2020. Such a large response enables us to gain new insights, as well as an unprecedented glimpse at respondents personal experiences and concerns during the current COVID-19 pandemic. From the analysis, we draw several implications for the design of public policies related to the management of the COVID-19 pandemic.


The Covid-19 pandemic and people with disability


title: Trend analysis of the COVID-19 pandemic in China and the rest of the world

text: The recent epidemic of Coronavirus (COVID-19) that started in China has already been"exported"to more than 140 countries in all the continents, evolving in most of them by local spreading. In this contribution we analyze the trends of the cases reported in all the Chinese provinces, as well as in some countries that, until March 15th, 2020, have more than 500 cases reported. Notably and differently from other epidemics, the provinces did not show an exponential phase. The data available at the Johns Hopkins University site seem to fit well an algebraic sub-exponential growing behavior as was pointed out recently. All the provinces show a clear and consistent pattern of slowing down with growing exponent going nearly zero, so it can be said that the epidemic was contained in China. On the other side, the more recent spread in countries like, Italy, Iran, and Spain show a clear exponential growth, as well as other European countries. Even more recently, US -which was one of the first countries to have an individual infected outside China (Jan 21st, 2020)- seems to follow the same path. We calculate the exponential growth of the most affected countries, showing the evolution along time after the first local case. We identify clearly different patterns in the analyzed data and we give interpretations and possible explanations for them. The analysis and conclusions of our study can help countries that, after importing some cases, are not yet in the local spreading phase, or have just started.


Coronavirus 2019 Video Conferencing: Preserving Resident Education with Online Meeting Platforms


Impact of cancelling foundation year rotations due to the COVID-19 outbreak in the UK


title: Recovery of severely ill COVID-19 patients by intravenous immunoglobulin (IVIG) treatment: A case series

text: INTRODUCTION: During the recent months, COVID-19 has turned to a global crisis claiming high mortality and morbidity among populations. Despite the high prevalence of the disease, it has currently no definitive treatment. We here reported the effects of intravenous immunoglobulin (IVIG) administration in severely ill COVID-19 patients diagnosed based on PCR and radiology tests. CASE PRESENTATION: Five severely ill COVID-19 patients in whom standard treatments failed were administrated with IVIG which prevented the deterioration of clinical symptoms. All the patients were treated with high-dose IVIG (0.3-0.5 g/kg) for 5 consecutive days so that no patient would receive lower than 25 g of the drug. All the patients showed a desirable therapeutic response and were discharged from the hospital with a stable clinical condition after being recovered. CONCLUSION: Treatment with IVIG at the therapeutic dose of 0.3-0.5 g/kg can improve the clinical condition and O2 saturation and prevent the progression of pulmonary lesions in COVID-19 patients with severe symptoms in whom standard treatments have failed.


title: Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

text: Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25-97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07-5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.


Death threats after a trial on chloroquine for COVID-19


title: Prevision of multidisciplinary head and neck cancer survivorship care during the 2019 novel coronavirus pandemic

text: The 2019 Coronavirus Pandemic challenges the delivery of care for patients with head and neck cancer. An important aspect of this care has been the evolution of enhanced survivorship services, which include surveillance for recurring cancer and prevention of second primaries. The application of evidence-based approaches to the identification and management of treatment and tumor-related toxicities has embraced the use of validated patient-reported outcomes instruments, health promotion, and care coordination. In this manuscript, we describe how our multidisciplinary team of survivorship providers has accommodated to the need to provide patients with social distancing while acknowledging the importance of continued care during treatment and through the spectrum of survivorship.


Coronavirus disease 2019 (COVID-19): angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and cardiovascular disease


title: Privacy in Crisis: A study of self-disclosure during the Coronavirus pandemic

text: We study observed incidence of self-disclosure in a large dataset of Tweets representing user-led English-language conversation about the Coronavirus pandemic in the month between March 1 and April 3, 2020. Using an unsupervised approach to detection of voluntary disclosure of personal information, we provide early evidence that situational factors surrounding the Coronavirus pandemic may impact individuals' privacy calculus. Text analyses reveal topical shift toward supportiveness and support-seeking in self-disclosing conversation on Twitter. We run a comparable analysis of Tweets from Hurricane Harvey to provide context for observed effects and suggest opportunities for further study.


title: Infección por coronavirus en pacientes con diabetes

text: Diabetes mellitus is a complex, multifactorial, chronic disease characterized by impaired metabolism of glucose, fats and proteins Patients who suffer from it frequently have hyperglycemia and coronary artery disease is the leading cause of death The comorbidities associated with diabetes are overweight and obesity, systemic arterial hypertension, atherogenic dyslipidemia and in some patients peripheral vascular disease, kidney damage, neuropathy and retinopathy Chronic lack of control of the disease is associated with increased susceptibility to infections, which generally have few symptoms, but hyperglycemia is generally magnified, which worsens the course of infections Since December 2019, when the disease caused by one of the coronaviruses (coronavirus 2 of severe acute respiratory syndrome, SARS-CoV-2) was identified and has been called coronavirus disease 2019 (COVID-19), there have been some reports that associate the presence of diabetes with an increased risk of mortality In this review article we have focused on four specific points: 1) epidemiology of the prevalence and mortality of COVID 19 in the general population and in the population with type 2 diabetes mellitus;2) pathophysiology related to the binding of SARS-CoV-2 to receptors in subjects with diabetes;3) the immune response induced by SARS-CoV-2, and 4) the outpatient and hospital treatment recommended in patients with diabetes who become infected with SARS-CoV-2


Chloroquine or hydroxychloroquine for prophylaxis of COVID-19


A map of SARS-CoV-2 and host cell interactions