title: SARS-CoV-2 RNA in wastewater anticipated COVID-19 occurrence in a low prevalence area

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused more than 200,000 reported COVID-19 cases in Spain resulting in more than 20,800 deaths as of April 21, 2020. Faecal shedding of SARS-CoV-2 RNA from COVID-19 patients has extensively been reported. Therefore, we investigated the occurrence of SARS-CoV-2 RNA in six wastewater treatments plants (WWTPs) serving the major municipalities within the Region of Murcia (Spain), the area with the lowest COVID-19 prevalence within Iberian Peninsula. Firstly, an aluminum hydroxide adsorption-precipitation concentration method was validated using a porcine coronavirus (Porcine Epidemic Diarrhea Virus, PEDV) and mengovirus (MgV). The procedure resulted in average recoveries of 10 ± 3.5% and 10 ± 2.1% in influent water (n = 2) and 3.3 ± 1.6% and 6.2 ± 1.0% in effluent water (n = 2) samples for PEDV and MgV, respectively. Then, the method was used to monitor the occurrence of SARS-CoV-2 from March 12 to April 14, 2020 in influent, secondary and tertiary effluent water samples. By using the real-time RT-PCR (RT-qPCR) Diagnostic Panel validated by US CDC that targets three regions of the virus nucleocapsid (N) gene, we estimated quantification of SARS-CoV-2 RNA titers in untreated wastewater samples of 5.4 ± 0.2 log10 genomic copies/L on average. Two secondary water samples resulted positive (2 out of 18) and all tertiary water samples tested as negative (0 out 12). This environmental surveillance data were compared to declared COVID-19 cases at municipality level, revealing that members of the community were shedding SARS-CoV-2 RNA in their stool even before the first cases were reported by local or national authorities in many of the cities where wastewaters have been sampled. The detection of SARS-CoV-2 in wastewater in early stages of the spread of COVID-19 highlights the relevance of this strategy as an early indicator of the infection within a specific population. At this point, this environmental surveillance could be implemented by municipalities right away as a tool, designed to help authorities to coordinate the exit strategy to gradually lift its coronavirus lockdown.


El papel del habla en la transmisión de SARSCoV- 2: recomendaciones para espacios confinados./ [The role of speech in the transmission of SARSCoV-2: recommendations for confined spaces]


Prisons and the COVID-19 pandemic


Prioritising paediatric surveillance during the COVID-19 pandemic


title: Progress Toward Polio Eradication - Worldwide, January 2018-March 2020

text: Since the Global Polio Eradication Initiative (GPEI) was established in 1988, two of the three wild poliovirus (WPV) serotypes (types 2 and 3) have been eradicated.* Transmission of WPV type 1 (WPV1) remains uninterrupted only in Afghanistan and Pakistan. This report summarizes progress toward global polio eradication during January 1, 2018-March 31, 2020 and updates previous reports (1,2). In 2019, Afghanistan and Pakistan reported the highest number of WPV1 cases (176) since 2014. During January 1-March 31, 2020 (as of June 19), 54 WPV1 cases were reported, an approximate fourfold increase from 12 cases during the corresponding period in 2019. Paralytic poliomyelitis can also be caused by circulating vaccine-derived poliovirus (cVDPV), which emerges when attenuated oral poliovirus vaccine (OPV) virus reverts to neurovirulence following prolonged circulation in underimmunized populations (3). Since the global withdrawal of type 2-containing OPV (OPV2) in April 2016, cVDPV type 2 (cVDPV2) outbreaks have increased in number and geographic extent (4). During January 2018-March 2020, 21 countries reported 547 cVDPV2 cases. Complicating increased poliovirus transmission during 2020, the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts have resulted in suspension of immunization activities and disruptions to poliovirus surveillance. When the COVID-19 emergency subsides, enhanced support will be needed to resume polio eradication field activities.


Melatonin, coronavirus, cardiovascular disease, and the geriatric emergency: let's use everything we have!


title: Infection risk of dermatologic therapeutics during the COVID-19 pandemic: an evidence-based recalibration

text: Recommendations were made recently to limit or stop the use of oral and systemic immunotherapies for skin diseases due to potential risks to the patients during the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 pandemic. Herein, we attempt to identify potentially safe immunotherapies that may be used in the treatment of cutaneous diseases during the current COVID-19 pandemic. We performed a literature review to approximate the risk of SARS-CoV-2 infection, including available data on the roles of relevant cytokines, cell subsets, and their mediators in eliciting an optimal immune response against respiratory viruses in murine gene deletion models and humans with congenital deficiencies were reviewed for viral infections risk and if possible coronaviruses specifically. Furthermore, reported risk of infections of biologic and non-biologic therapeutics for skin diseases from clinical trials and drug data registries were evaluated. Many of the immunotherapies used in dermatology have data to support their safe use during the COVID-19 pandemic including the biologics that target IgE, IL-4/13, TNF-α, IL-17, IL-12, and IL-23. Furthermore, we provide evidence to show that oral immunosuppressive medications such as methotrexate and cyclosporine do not significantly increase the risk to patients. Most biologic and conventional immunotherapies, based on doses and indications in dermatology, do not appear to increase risk of viral susceptibility and are most likely safe for use during the COVID-19 pandemic. The limitation of this study is availability of data on COVID-19.


Rapid Implementation of Service Delivery Changes to Mitigate COVID-19 and Maintain Access to Methadone Among Persons with and at High-Risk for HIV in an Opioid Treatment Program


title: Artificial Intelligence and the Future of Psychiatry

text: An estimated 792 million people live with mental health disorders worldwide-more than one in ten people-and this number is expected to grow in the shadow of the Coronavirus disease 2019 (COVID-19) pandemic. Unfortunately, there aren't enough mental health professionals to treat all these people. Can artificial intelligence (AI) help? While many psychiatrists have different views on this question, recent developments suggest AI may change the practice of psychiatry for both clinicians and patients.


title: SARS-CoV-2 mortality in blacks and temperature-sensitivity to an angiotensin-2 receptor blocker

text: Tropical climates provoke adaptations in skin pigmentation and in mechanisms controlling the volume, salt-content and pressure of body fluids. For many whose distant ancestors moved to temperate climes, these adaptations proved harmful: pigmentation decreased by natural selection and susceptibility to hypertension emerged. Now an added risk is lung inflammation from coronavirus that may be furthered by innate immune differences. Hypertension and coronavirus have in common angiotensin converting enzyme 2 (ACE2), which decreases blood pressure and mediates virus entry. In keeping with less detailed studies, a long-term case-report shows that decreased blood pressure induced by blocking a primary angiotensin receptor is supplemented, above critical blocker dosage, by a further temperature-dependent fall, likely mediated by ACE2 and secondary angiotensin receptors. Temperature-dependence suggests a linkage with tropical heritage and an influence of blockers on the progress of coronavirus infections. Positive therapeutic results should result from negation of host pro-inflammatory effects mediated by the primary angiotensin receptor and concomitant promotion of countervailing anti-inflammatory effects mediated by ACE2 through other receptors. These effects may involve components of the lectin complement pathway. Black vulnerability, more likely based on physiological than on socioeconomic differences, provides an important clue that may guide treatments.


title: Cancer patients affected by COVID-19: Experience from Milan, Lombardy

text: OBJECTIVE: SARS-CoV-2 pandemic is continuing to spread. There are growing concerns on the impact of COVID-19 in cancer patients. Several papers reporting recommendations and guidelines are published. But few data on cancer patients affected by COVID-19 are available. METHODS: This is a retrospective study including all consecutive patients affected by gynecological cancer who developed COVID-19. All patients were treated in an academic setting (in Milan, Lombardy, Italy) between February and March 2020. RESULTS: Overall, 355 patients had active treatment during the study period due to newly diagnosed or recurrent gynecological disease. Among those, 19 (5.3%) patients affected developed COVID-19. All patients were asymptomatic at the time of COVID-19 detection. Six patients were diagnosed before starting planned treatments; while the remaining 13 were diagnosed for COVID-19 after their started their treatments. Considering the first group of six patients, one patient died due to COVID-19 3 days after the diagnosis; while the other patients recovered from COVID-19 after a median of three weeks. The latter group of 13 patients (treatments started) included five patients who underwent surgery and eight patients who underwent chemotherapy. Focusing on five patients who were diagnosed after surgery, we observed that two patients died during postoperative course, while in other two cases prolonged hospitalization was needed. One patient had no issues. Chemotherapy was delayed for the remaining patents without sequelae. CONCLUSIONS: Our report highlights that COVID-19 impacts the quality of treatments for cancer patients. Mortality rate is high, especially after surgery. More important, patients under active treatment for cancer are at high risk of developing severe evolution of COVID-19. Prioritizing patients journey during COVID-19 is of paramount importance.


title: Far from Home

text: A flight nurse cares for one of COVID-19's many 'peripheral victims.'


title: Cutaneous manifestations of COVID-19: Report of three cases and a review of literature

text: BACKGROUND: Various cutaneous manifestations have been observed in patients with COVID-19 infection. However, overall similarities in the clinical presentation of these dermatological manifestations have not yet been summarized. OBJECTIVE: This review aims to provide an overview of various cutaneous manifestations in patients with COVID-19 through three case reports and a literature review. METHODS: A literature search was conducted using PubMed, OVID, and Google search engines for original and review articles. Studies written in the English language that mentioned cutaneous symptoms and COVID-19 were included. RESULTS: Eighteen articles and three additional cases reported in this paper were included in this review. Of these studies, 6 are case series and 12 are case report studies. The most common cutaneous manifestation of COVID-19 was found to be maculopapular exanthem (morbilliform), presenting in 36.1% (26/72) patients. The other cutaneous manifestations included: a papulovesicular rash (34.7%, 25/72), urticaria (9.7%, 7/72), painful acral red purple papules (15.3%, 11/72) of patients, livedo reticularis lesions (2.8%, 2/72) and petechiae (1.4%, 1/72). Majority of lesions were localized on the trunk (66.7%, 50/72), however, 19.4% (14/72) of patients experienced cutaneous manifestations in the hands and feet. Skin lesion development occurred before the onset of respiratory symptoms or COVID-19 diagnosis in 12.5% (9/72) of the patients, and lesions spontaneously healed in all patients within 10 days. Majority of the studies reported no correlation between COVID-19 severity and skin lesions. CONCLUSION: Infection with COVID-19 may result in dermatological manifestations with various clinical presentations, which may aid in the timely diagnosis of this infection.


Consider pregnancy in COVID-19 therapeutic drug and vaccine trials


title: Reverse-Transcription Recombinase-Aided Amplification Assay for Rapid Detection of the 2019 Novel Coronavirus (SARS-CoV-2)

text: A novel coronavirus (SARS-CoV-2) was recently identified in patients with acute respiratory disease and spread quickly worldwide. A specific and rapid diagnostic method is important for early identification. The reverse-transcription recombinase-aided amplification (RT-RAA) assay is a rapid detection method for several pathogens. Assays were performed within 5-15 min as a one-step single tube reaction at 39 °C. In this study, we established two RT-RAA assays for the S and orf1ab gene of SARS-CoV-2 using clinical specimens for validation. The analytical sensitivity of the RT-RAA assay was 10 copies for the S and one copy for the orf1ab gene per reaction. Cross-reactions were not observed with any of the other respiratory pathogens. A 100% agreement between the RT-RAA and real-time PCR assays was accomplished after testing 120 respiratory specimens. These results demonstrate that the proposed RT-RAA assay will be beneficial as it is a faster, more sensitive, and more specific tool for the detection of SARS-CoV-2.


The potential role of nanomedicine on COVID-19 therapeutics


COVID-19 symptoms masking inaugural ketoacidosis of type 1 diabetes


title: On the predictability of infectious disease outbreaks

text: Infectious disease outbreaks recapitulate biology: they emerge from the multi-level interaction of hosts, pathogens, and their shared environment. As a result, predicting when, where, and how far diseases will spread requires a complex systems approach to modeling. Recent studies have demonstrated that predicting different components of outbreaks--e.g., the expected number of cases, pace and tempo of cases needing treatment, importation probability etc.--is feasible. Therefore, advancing both the science and practice of disease forecasting now requires testing for the presence of fundamental limits to outbreak prediction. To investigate the question of outbreak prediction, we study the information theoretic limits to forecasting across a broad set of infectious diseases using permutation entropy as a model independent measure of predictability. Studying the predictability of a diverse collection of historical outbreaks--including, gonorrhea, influenza, Zika, measles, polio, whooping cough, and mumps--we identify a fundamental entropy barrier for time series forecasting. However, we find that for most diseases this barrier to prediction is often well beyond the time scale of single outbreaks, implying prediction is likely to succeed. We also find that the forecast horizon varies by disease and demonstrate that both shifting model structures and social network heterogeneity are the most likely mechanisms for the observed differences in predictability across contagions. Our results highlight the importance of moving beyond time series forecasting, by embracing dynamic modeling approaches to prediction and suggest challenges for performing model selection across long disease time series. We further anticipate that our findings will contribute to the rapidly growing field of epidemiological forecasting and may relate more broadly to the predictability of complex adaptive systems.


Not a luxury: a call to maintain sexual and reproductive health in humanitarian and fragile settings during the COVID-19 pandemic


African nations missing from coronavirus trials


title: COVID-19, frailty and long-term care: Implications for policy and practice

text: Older adults have been disproportionately affected by the COVID-19 pandemic, with many outbreaks occurring in Long Term Care Facilities (LTCFs). We discuss this vulnerability among LTCF residents using an ecological framework, on levels spanning from the individual to families and caregivers, institutions, health services and systems, communities, and contextual government policies. Challenges abound for fully understanding the burden of COVID-19 in LTCF, including differences in nomenclature, data collection systems, cultural differences, varied social welfare models, and (often) under-resourcing of the LTC sector. Registration of cases and deaths may be limited by testing capacity and policy, record-keeping and reporting procedures. Hospitalization and death rates may be inaccurate depending on atypical presentations and whether or not residents' goals of care include escalation of care and transfer to hospital. Given the important contribution of frailty, use of the Clinical Frailty Scale (CFS) is discussed as a readily implementable measure, as are lessons learned from the study of frailty in relation to influenza. Biomarkers hold emerging promise in helping to predict disease severity and address the puzzle of why some frail LTCF residents are resilient to COVID-19, either remaining test-negative despite exposure or having asymptomatic infection, while others experience the full range of illness severity including critical illness and death. Strong and coordinated surveillance and research focused on LTCFs and their frail residents is required. These efforts should include widespread assessment of frailty using feasible and readily implementable tools such as the CFS, and rigorous reporting of morbidity and mortality in LTCFs.


Screening for Covid-19 in Skilled Nursing Facilities


title: SARS-CoV2: should inhibitors of the renin–angiotensin system be withdrawn in patients with COVID-19? ;European Heart Journal ;Oxford Academic

text: In a rapid response published online by the British Medical Journal, Sommerstein and Gräni1 pushed forward the hypothesis that angiotensin-converting enzyme (ACE) inhibitors (ACE-Is) could act as a potential risk factor for fatal Corona virus disease 2019 (COVID-19) by up-regulating ACE2 This notion was quickly picked up by the lay press and sparked concerns among physicians and patients regarding the intake of inhibitors of the renin–angiotensin–aldosterone system (RAAS) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infected individuals 1 In this article, we try to shed light on what is known and unknown regarding the RAAS and SARS-CoV2 interaction We find translational evidence for diverse roles of the RAAS, which allows to formulate also the opposite hypothesis, i e that inhibition of the RAAS might be protective in COVID-19 [Truncated]


SARS-CoV2: should inhibitors of the renin-angiotensin system be withdrawn in patients with COVID-19?


title: Biotreatment and bacterial succession in an upflow immobilized cell bioreactor fed with fludioxonil wastewater

text: The large quantities and the persistent nature of fungicide wastewaters have increased the efforts towards a sustainable technological solution. In this context, fludioxonil-contaminated wastewater was treated in an upflow immobilized cell bioreactor, resulting in chemical oxygen demand (COD) removal efficiency even higher than 80%, whereas the electrical conductivity (EC) of the effluent was gradually increased. Organic-F was mineralized by 94.0 ± 5.2%, which was in accordance with the high fludioxonil removal efficiency (95.4 ± 4.0%). In addition, effluent total Kjeldahl nitrogen (TKN) concentration reduced significantly during bioprocessing. A strong relationship among COD removal, TKN/total nitrogen removal, and effluent EC increase (p < 0.01) was identified. Despite the adequate aeration provided, effluent nitrite and nitrate concentrations were negligible. Illumina sequencing revealed a reduction in the relative abundances of Betaproteobacteria, Chloroflexi, Planctomycetes, and Firmicutes and an increase in the proportion of Alphaproteobacteria and Actinobacteria. A shift in bacterial communities occurred during fludioxonil treatment, resulting in the significant increase of the relative abundances of Empedobacter, Sphingopyxis, and Rhodopseudomonas (from 0.67 ± 0.13% at the start-up to 34.34 ± 1.60% at the end of biotreatment). In conclusion, the immobilized cell bioreactor permitted the proliferation of specialized activated sludge microbiota with an active role in the depuration of postharvest fungicides.


title: A new regularization method for dynamic load identification

text: Dynamic forces are very important boundary conditions in practical engineering applications, such as structural strength analysis, health monitoring and fault diagnosis, and vibration isolation. Moreover, there are many applications in which we have found it very difficult to directly obtain the expected dynamic load which acts on a structure. Some traditional indirect inverse analysis techniques are developed for load identification by measured responses. These inverse problems about load identification mentioned above are complex and inherently ill-posed, while regularization methods can deal with this kind of problem. However, most of regularization methods are only limited to solve the pure mathematical numerical examples without application to practical engineering problems, and they should be improved to exclude jamming of noises in engineering. In order to solve these problems, a new regularization method is presented in this article to investigate the minimum of this minimization problem, and applied to reconstructing multi-source dynamic loads on the frame structure of hydrogenerator by its steady-state responses. Numerical simulations of the inverse analysis show that the proposed method is more effective and accurate than the famous Tikhonov regularization method. The proposed regularization method in this article is powerful in solving the dyanmic load identification problems.


title: Are dental schools adequately preparing dental students to face outbreaks of infectious diseases such as COVID-19?

text: The recent 2019-novel coronavirus (2019-nCoV, also known as SARS-CoV-2) has caused >2,622,571 confirmed cases of coronavirus disease 2019 (COVID-19) in >185 countries, and >182,359 deaths globally. More than 9000 healthcare workers have also been infected by 2019-nCoV. Prior to the present pandemic of COVID-19, there have been multiple large-scale epidemics and pandemics of other viral respiratory infections, such as seasonal flu, Spanish flu (H1N1), severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and others. Dental professionals are at an increased risk for contracting these viruses from dental patients, as dental practice involves face-to-face communication with the patients and frequent exposure to saliva, blood, and other body fluids. Dental education can play an important role in the training of dentists, helping them to adopt adequate knowledge and attitudes related to infection control measures. The current dental curriculum does not cover infection control adequately, especially from airborne pathogens. Infection control education needs to be included in the dental curriculum itself, and students should be trained adequately to protect them and prevent the infection from disseminating even before they see their first patient.


title: Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients

text: The development of COVID-19 syndrome in anticoagulated patients, and especially their admission to intensive-care units with acute severe respiratory syndrome (SARS-CoV-2), expose them to specific problems related to their therapy, in addition to those associated with the acute viral infection. Patients on VKA hospitalized with SARS-CoV-2 show high instability of PT INR due to the variability of vitamin K metabolism, diet, fasting, co-medications, liver impairment, and heart failure. Patients on DOAC are exposed to under/over treatment caused by significant pharmacological interferences. In consideration of the pharmacological characteristics of oral anticoagulant drugs, the multiple pharmacological interactions due to the treatment of acute disease and the possible necessity of mechanical ventilation with hospitalization in intensive-care units, we suggest replacing oral anticoagulant therapies (VKA and DOAC) with parenteral heparin to avoid the risk of over/under treatment.


title: Severe Acute Respiratory Syndrome Coronavirus 2 Infection and the Upper Limb Deep Vein Thrombosis Risk

text: Little or nothing is known about the correlation between the upper limb deep vein thrombosis (UL-DVT) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe the increased risk of UL-DVT in 3 patients with SARS-CoV-2 who require continuous positive airway pressure with a hood and the need for early adequate antithrombotic prophylaxis.


title: Quarantäne alleine oder in Kombination mit weiteren Public-Health-Maßnahmen zur Eindämmung der COVID-19 Pandemie: Ein Cochrane Rapid Review./ [Quarantine Alone or in Combination with Other Public Health Measures to Control COVID-19: A Rapid Review (Review)]

text: BACKGROUND: COVID-19 (coronavirus disease 2019) is a new, rapidly emerging zoonotic infectious disease, that was reported to the World Health Organization for the first time on 31 December 2019. Currently, no effective pharmacological interventions or vaccines are available to treat or prevent COVID-19, therefore nonpharmacological public health measures are more in focus. OBJECTIVES: The aim was to assess the effects of quarantine - alone or in combination with other measures - during coronavirus outbreaks. METHODS: Because of the current COVID-19 pandemic, WHO commissioned a rapid review. To save time, the method of systematic reviews was slightly and with caution modified. This publication is a summary of the most important aspects of the rapid review, translated into German by members of the WHO Collaborating Centre at the Danube University Krems (Austria). RESULTS: Overall, 29 studies were included. Ten modeling studies focused on COVID-19, 4 observational studies and 15 modeling studies focused on SARS and MERS. The modeling studies consistently reported a benefit of the simulated quarantine measures. For example, the models estimated that quarantine of people exposed to confirmed or suspected cases of COVID-19 prevented between 44 and 81% of the cases that would otherwise have happened and 31 to 63% of the deaths, when compared to no such measures. In regard to costs, the earlier the quarantine measures are implemented, the greater the cost savings will be. CONCLUSION: Our confidence in the evidence is very limited. This is mainly because the COVID-19 studies based their models on the limited data that have been available in the early weeks of the pandemic and made different assumptions about the virus. The studies of SARS and MERS are not completely generalizable to COVID-19. Despite only having limited evidence, all the studies found quarantine to be important for controlling the spread of severe coronavirus diseases. Looking to the coming months, in order to maintain the best possible balance of measures, decision makers must continue to constantly monitor the outbreak situation and the impact of the measures they implement.


Inclusion of biopsies in clinical trials of oncology drugs


New challenges in the COVID-19 pandemic


title: A Retrospective Review of Memantine Use and COVID-19-associated Mortality from a National Database

text: We read with interest the recent papers by Brenner and Cimolai regarding the therapeutic potential of memantine for coronavirus disease (COVID-19). In this retrospective, we investigated the relationship between treatment with memantine and COVID-19-associated mortality in 5,726 patients with COVID-19, of whom 140 had died. Our analysis revealed no association between memantine treatment and mortality in patients with COVID-19. However, we must explore all feasible options for preventing and treating COVID-19 due to the current lack of licensed vaccines or therapeutics for the disease. This article is protected by copyright. All rights reserved.


title: In the pipeline Derek Lowe's commentary on drug discovery and the pharma industry. An editorially independent blog from the publishers of Science Translational Medicine. All content is Derek’s own, and he does not in any way speak for his employer

text: Let’s take inventory on the therapies that are being developed for the coronavirus epidemic Here is a very thorough list of at Biocentury, and I should note that (like Stat and several other organizations) they’re making all their Covid-19 content free to all readers during this crisis I’d like to zoom in today on the potential small-molecule therapies, since some of these have the most immediate prospects for use in the real world The ones at the front of the line are repurposed drugs that are already approved for human use, for a lot of obvious reasons The Biocentury list doesn’t cover these, but here’s an article at Nature Biotechnology that goes into detail Clinical trials are a huge time sink – they sort of have to be, in most cases, if they’re going to be any good – and if you’ve already done all that stuff it’s a huge leg up, even if the drug itself is not exactly a perfect fit for the disease So what do we have? The compound that is most advanced is probably remdesivir from Gilead, at right This has been in development for a few years as an RNA virus therapy – it was originally developed for Ebola, and has been tried out against a whole list of single-strand RNA viruses That includes the related coronaviruses SARS and MERS, so Covid-19 was an obvious fit The compound is a prodrug – that phosphoramide gets cleaved off completely, leaving the active 5-OH compound GS-44-1524 It mechanism of action is to get incorporated into viral RNA, since it’s taken up by RNA polymerase and it largely seems to evade proofreading This causes RNA termination trouble later on, since that alpha-nitrile C-nucleoside is not exactly what the virus is expecting in its genome at that point, and thus viral replication is inhibited


title: Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu

text: BACKGROUND: In December 2019, Wuhan, China, experienced an outbreak of coronavirus (COVID-19). The number of cases has increased rapidly, but information on the clinical characteristics remains limited. OBJECTIVES: This paper describes the epidemiological and clinical characteristics of COVID-19. Early detection and identification of critically ill patients is necessary to facilitate scientific classification and treatment. STUDY DESIGN: This study included a retrospective, single-center case series of 99 consecutively hospitalized patients with confirmed COVID-19 at Chengdu Public Health Clinical Medical Center in Chengdu, China, from January 16 to February 20, 2020. The final date of follow-up was February 23, 2020. We collected and analyzed epidemiological, demographic, clinical, laboratory, radiological, and treatment data. We compared outcomes of critically ill patients and noncritically ill patients. RESULTS: Of the 99 hospitalized patients with COVID-19, the median age was 49 years (minimum, 3 months; maximum, 87 years) and 51 (52 %) were men; 42 (42 %) had traveled to or lived in Wuhan and 48 (49 %) had come into close contact with patients with new coronavirus pneumonia; 41 (41 %) patients had underlying disease. Common symptoms included fever (85 [86 %]), dry cough (84 [85 %]), and fatigue (72 [73 %]). We analyzed the clinical characteristics of patients. We expressed the measurement data as meanâ¯±â¯standard deviation. We collected data for age (49.39â¯±â¯18.45 years), number of hospital days (12.32â¯±â¯6.70 days), and laboratory indicators. We compared critically ill and noncritically ill patients: p-values for age, C-reactive protein, high-sensitivity troponin T, prothrombin time, fibrin degradation products, D-Dimer, and CD4+ count were pâ¯<â¯0.001; and p-values for hospital days, white blood cell, neutrophil, lymphocyte, creatine kinase isoenzyme, myoglobin, N-terminal brain natriuretic peptide, and CD8+ count were pâ¯<â¯0.05. CONCLUSIONS: We collected data from a single-center case series of 32 hospitalized patients who were critically ill with confirmed COVID-19 in Chengdu, China, and compared data with 67 noncritically ill patients. Elderly patients had chronic underlying diseases, notably cardiovascular disease. Higher C-reactive protein levels, higher levels of myocardial damage, and higher brain natriuretic peptide levels; lower white blood cells, neutrophils, and lymphocytes; and lower CD4 and CD8 counts could be used for early detection and identification of critically ill patients, and dynamic Data observation was more important than at a single moment.


title: Cuidados enfermeros orientados a mitigar la transmisión del coronavirus en caso de positivos: una revisión narrativa./ [Nursing care for controlling coronavirus infections in positive cases: a narrative review.]

text: OBJECTIVE: This review aims to map scientific evidence in nursing care aimed at controlling coronavirus infections. METHODS: A bibliographic search was conducted in the Medline, CINAHL, Scopus and WOS main databases, with no date limit and using the keywords "transmission", "infection", "contagious", "spreads", "coronavirinae", "coronavirus", "COVID 19", "sars cov 2", "nurses" and "nursing". Initially, 154 studies were identified and, after selecting them according to eligibility criteria, 16 were included. RESULTS: Among the main recommendations according to the available evidence are air exchange in rooms as a measure to reduce the risk of infection among patients; reinforcement of measures in intensive care units; follow-up of positive case contacts; and adequate training of professionals. DISCUSSION AND CONCLUSIONS: The studies included in the review addressed infection prevention and control practices by analyzing risks associated with exposure and listing actions to avoid complications in critically ill patients. Patterns of case transmission, contacts and associated factors were identified. Professional knowledge and attitudes were also studied, showing the importance of good infection control training, and of sufficient equipment and adequate infrastructure.Nurses are important vectors of spread. Although there is little evidence available on the effectiveness of care to prevent the spread of SARS-CoV-2, published studies on the prevention and control of previous outbreaks of coronavirus are of considerable value.


title: Surgery in times of COVID-19-recommendations for hospital and patient management

text: BACKGROUND: The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has escalated rapidly to a global pandemic stretching healthcare systems worldwide to their limits. Surgeons have had to immediately react to this unprecedented clinical challenge by systematically repurposing surgical wards. PURPOSE: To provide a detailed set of guidelines developed in a surgical ward at University Hospital Wuerzburg to safely accommodate the exponentially rising cases of SARS-CoV-2 infected patients without compromising the care of emergency surgery and oncological patients or jeopardizing the well-being of hospital staff. CONCLUSIONS: The dynamic prioritization of SARS-CoV-2 infected and surgical patient groups is key to preserving life while maintaining high surgical standards. Strictly segregating patient groups in emergency rooms, non-intensive care wards and operating areas prevents viral spread while adequately training and carefully selecting hospital staff allow them to confidently and successfully undertake their respective clinical duties.


title: COVID-19 scenario modelling for the mitigation of capacity-dependent deaths in intensive care

text: Managing healthcare demand and capacity is especially difficult in the context of the COVID-19 pandemic, where limited intensive care resources can be overwhelmed by a large number of cases requiring admission in a short space of time. If patients are unable to access this specialist resource, then death is a likely outcome. In appreciating these 'capacity-dependent' deaths, this paper reports on the clinically-led development of a stochastic discrete event simulation model designed to capture the key dynamics of the intensive care admissions process for COVID-19 patients. With application to a large public hospital in England during an early stage of the pandemic, the purpose of this study was to estimate the extent to which such capacity-dependent deaths can be mitigated through demand-side initiatives involving non-pharmaceutical interventions and supply-side measures to increase surge capacity. Based on information available at the time, results suggest that total capacity-dependent deaths can be reduced by 75% through a combination of increasing capacity from 45 to 100 beds, reducing length of stay by 25%, and flattening the peak demand to 26 admissions per day. Accounting for the additional 'capacity-independent' deaths, which occur even when appropriate care is available within the intensive care setting, yields an aggregate reduction in total deaths of 30%. The modelling tool, which is freely available and open source, has since been used to support COVID-19 response planning at a number of healthcare systems within the UK National Health Service.


Labs rush to study coronavirus in transgenic animals - some are in short supply


COVID-19, Medication-Assisted Treatment, and Increased Risk for Further Respiratory Depression


Renewed KIDS SAVE LIVES campaign to further increase awareness and fight sudden cardiac death in the era of COVID-19


title: Estimating The Infection Fatality Rate Among Symptomatic COVID-19 Cases In The United States

text: Knowing the infection fatality rate (IFR) of novel coronavirus (SARS-CoV-2) infections is essential for the fight against the coronavirus disease (COVID-19) pandemic. Using data through April 20, 2020, I fit a statistical model to COVID-19 case fatality rates over time at the US county level to estimate the COVID-19 IFR among symptomatic cases (IFR-S) as time goes to infinity. The IFR-S in the US was estimated to be 1.3 percent. County-specific rates varied from 0.5 percent to 3.6 percent. The overall IFR for COVID-19 should be lower when I account for cases where patients are asymptomatic and recover without symptoms. When used with other estimating approaches, my model and estimates can help disease and policy modelers obtain more accurate predictions for the epidemiology of the disease and the impact of various policy levers to contain the pandemic. The model could also be used with future pandemics to get an early sense of the magnitude of symptomatic infection at the population level before other direct estimates are available. Substantial variation across patient demographics likely exists and should be the focus of future studies.


text: Knowing the infection fatality rate (IFR) of SARS-CoV and SARS-CoV-2 infections is essential for the fight against the COVID-19 pandemic. Using data through April 20, 2020, we fit a statistical model to COVID-19 case fatality rates over time at the US county level to estimate the COVID-19 IFR among symptomatic cases (IFR-S) as time goes to infinity. The IFR-S in the US was estimated to be 1.3% (95% central credible interval: 0.6% to 2.1%). County-specific rates varied from 0.5% to 3.6%. The overall IFR for COVID-19 should be lower when we account for cases that remain and recover without symptoms. When used with other estimating approaches, our model and our estimates can help disease and policy modelers to obtain more accurate predictions for the epidemiology of the disease and the impact of alternative policy levers to contain this pandemic. The model could also be used with future epidemics to get an early sense of the magnitude of symptomatic infection at the population-level before more direct estimates are available. Substantial variation across patient demographics likely exists and should be the focus of future studies. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the peer-reviewed manuscript. The final edited version will appear in an upcoming issue of Health Affairs.].


title: Cognitive load and performance of health care professionals in donning and doffing PPE before and after a simulation-based educational intervention and its implications during the COVID-19 pandemic for biosafety

text: INTRODUCTION: The Personal Protective Equipment (PPE) is essential to avoid the COVID-19 spread to health care workers. Its use can be difficult, posing a high risk of contamination, mainly during doffing, then with the risk of becoming infected. METHODS: We conducted a prospective before-and-after design that used clinical simulation as a research methodology in a clinical simulation center of Colombia. A simulation-based educational intervention with two cases related to COVID-19 was proposed in the emergency room and the intensive care unit. We conducted A workshop for donning and doffing of personal protective equipment (PPE) and a debriefing after the first case. RESULTS: In the pre-test, 100% of participants failed donning and doffing PPE, 98.4% were contaminated, only one-person did not contaminate out of. The mean cognitive load was high (7.43±0.9 points). In the post-test, 100% were successful in donning the PPE and 94.8% in doffing; only 9.8% were contaminated. The mean of the cognitive load was low (4.1±1.4 points), and the performance was high (7.9±1.1). Of the total, 73.8% of participants reported overload in the doffing. The most difficulties were in gown/overall, and N95 mask removal. DISCUSSION: The PPE donning and doffing is critical and may be changed significantly by active training. In responding to the current COVID-19 pandemic in 2020, activities of training in donning and doffing PPE would provide a means of training personnel, reducing the cognitive load and maybe the risk of contamination and infection of health care workers.


Re: "Exosomes Derived from Bone Marrow Mesenchymal Stem Cells as Treatment for Severe COVID-19" by Sengupta et al


title: A kinetic model for qualitative understanding and analysis of the effect of complete lockdown imposed by India for controlling the COVID-19 disease spread by the SARS-CoV-2 virus

text: The present ongoing global pandemic caused by SARS-CoV-2 virus is creating havoc across the world. The absence of any vaccine as well as any definitive drug to cure, has made the situation very grave. Therefore only few effective tools are available to contain the rapid pace of spread of this disease, named as COVID-19. On 24th March, 2020, the the Union Government of India made an announcement of unprecedented complete lockdown of the entire country effective from the next day. No exercise of similar scale and magnitude has been ever undertaken anywhere on the globe in the history of entire mankind. This study aims to scientifically analyze the implications of this decision using a kinetic model covering more than 96% of Indian territory. This model was further constrained by large sets of realistic parameters pertinent to India in order to capture the ground realities prevailing in India, such as: (i) true state wise population density distribution, (ii) accurate state wise infection distribution for the zeroth day of simulation (20th March, 2020), (iii) realistic movements of average clusters, (iv) rich diversity in movements patterns across different states, (v) migration patterns across different geographies, (vi) different migration patterns for pre- and post-COVID-19 outbreak, (vii) Indian demographic data based on the 2011 census, (viii) World Health Organization (WHO) report on demography wise infection rate and (ix) incubation period as per WHO report. This model does not attempt to make a long-term prediction about the disease spread on a standalone basis; but to compare between two different scenarios (complete lockdown vs. no lockdown). In the framework of model assumptions, our model conclusively shows significant success of the lockdown in containing the disease within a tiny fraction of the population and in the absence of it, it would have led to a very grave situation.


Incidence of COVID-19 among immigration police: Observation from Thailand


title: COVID-19-driven endothelial damage: complement, HIF-1, and ABL2 are potential pathways of damage and targets for cure

text: COVID-19 pandemia is a major health emergency causing hundreds of deaths worldwide. The high reported morbidity has been related to hypoxia and inflammation leading to endothelial dysfunction and aberrant coagulation in small and large vessels. This review addresses some of the pathways leading to endothelial derangement, such as complement, HIF-1α, and ABL tyrosine kinases. This review also highlights potential targets for prevention and therapy of COVID-19-related organ damage and discusses the role of marketed drugs, such as eculizumab and imatinib, as suitable candidates for clinical trials.


title: COVID-19 and food allergy in children

text: In children with food allergy the visits should be limited to those that are unequivocally needed on clinical basis. Food challenge can be performed in selected situations, taking a more detailed history to make sure that patients provide whatever information we need. The maintenance of a safe diet can be hampered by several factors. Nutritional supplementation may be necessary.


Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19


Overcoming fragmentation of health research in Europe: lessons from COVID-19


title: Saliva as a Potential Diagnostic Specimen for COVID-19 Testing

text: The current outbreak of the highly contagious, animal origin SARS-CoV-2 virus causes the disease COVID-19. The disease is globally pandemic and as per World Health Organization (WHO) has spread to 235 countries. There is global lockdown for containment of the virus transmission. Testing of symptomatic patients, healthcare workers and suspected individuals and mass screening is vital. WHO recommends nasopharyngeal (NP) and oropharyngeal (OP) swab for the quantitative assessment of SARS-CoV-2 RNA level through real-time reverse transcription polymerase chain reaction (rRT-PCR). The virus is shown to be consistently present in saliva and rRTPCR of saliva specimens and have advantages over NP and OP swabs such as self-collection of saliva, avoidance of healthcare workers for specimen collection, cost-effectiveness, etc. This article explores the current literature and suggests saliva as an emerging potential diagnostic specimen for COVID-19 testing.


title: A Proposed Plan for Prenatal Care to Minimize Risks of COVID-19 to Patients and Providers: Focus on Hypertensive Disorders of Pregnancy

text: Hypertensive disorders are the most common medical complications of pregnancy and a major cause of maternal and perinatal morbidity and death. The detection of elevated blood pressure during pregnancy is one of the cardinal aspects of optimal antenatal care. With the outbreak of novel coronavirus disease 2019 (COVID-19) and the risk for person-to-person spread of the virus, there is a desire to minimize unnecessary visits to health care facilities. Women should be classified as low risk or high risk for hypertensive disorders of pregnancy and adjustments can be accordingly made in the frequency of maternal and fetal surveillance. During this pandemic, all pregnant women should be encouraged to obtain a sphygmomanometer. Patients monitored for hypertension as an outpatient should receive written instructions on the important signs and symptoms of disease progression and provided contact information to report the development of any concern for change in status. As the clinical management of gestational hypertension and preeclampsia is the same, assessment of urinary protein is unnecessary in the management once a diagnosis of a hypertensive disorder of pregnancy is made. Pregnant women with suspected hypertensive disorders of pregnancy and signs and symptoms associated with the severe end of the disease spectrum (e.g., headaches, visual symptoms, epigastric pain, and pulmonary edema) should have an evaluation including complete blood count, serum creatinine level, and liver transaminases (aspartate aminotransferase and alanine aminotransferase). Further, if there is any evidence of disease progression or if acute severe hypertension develops, prompt hospitalization is suggested. Current guidelines from the American College of Obstetricians and Gynecologists (ACOG) and The Society for Maternal-Fetal Medicine (SMFM) for management of preeclampsia with severe features suggest delivery after 34 0/7 weeks of gestation. With the outbreak of COVID-19, however, adjustments to this algorithm should be considered including delivery by 30 0/7 weeks of gestation in the setting of preeclampsia with severe features. KEY POINTS: · Outbreak of novel coronavirus disease 2019 (COVID-19) warrants fewer office visits.. · Women should be classified for hypertension risk in pregnancy.. · Earlier delivery suggested with COVID-19 and hypertensive disorder..


COVID-19 y tratamiento guiado con tests de diagnóstico bioquímicos y moleculares para reducir el daño cardiaco y la cardiotoxicidad./ [COVID-19 and treatment guided by biochemical and molecular diagnostic tests to reduce myocardial damage and cardiotoxicity]


title: Erratum: Epidemiologic and Clinical Characteristics of 26 Cases of COVID-19 Arising from Patient-to-Patient Transmission in Liaocheng, China [Corrigendum]

text: [This corrects the article DOI: 10.2147/CLEP.S249903.].


title: The absence of coronavirus in expressed prostatic secretion in COVID-19 patients in Wuhan city

text: Due to the cellular entry of the novel coronavirus (SARS-CoV-2) modulated by angiotensin converting enzyme 2 (ACE2), the ACE2 bearing prostate is therefore hypothesized as a susceptible organ to COVID-19. To delineate whether the pathogenic SARS-CoV-2 of the coronavirus disease (COVID-19) could be detected in the expressed prostatic secretion (EPS), a total of ten male patients with confirmed COVID-19 were recruited. All patients were stratified into two groups: one group with positive nasopharyngeal swabbing SARS-CoV-2 within 3 days of the EPS taken day (PNS group, n = 3) and the other group with previously positive nasopharyngeal swabbing SARS-CoV-2 but turned negative before the taken day (PNNS group, n = 7). The COVID-19 patients showed elevated inflammatory indictors, i.e. C-reaction protein (3.28 (1.14, 33.33) mg/L), erythrocyte sedimentation rate (22.50 (8.00, 78.50) mm/h), and interleukin-6 (6.49 (4.96, 21.09) pg/ml). Serum IgM against SARS-CoV-2 was only positive in the PNS group, whereas serum IgG was positive for all patients. Furthermore, our data showed for the first time that none of the COVID-19 patients had positive SARS-CoV-2 RNA in EPS. To this end, this study found the negativity of SARS-CoV-2 in EPS and possibly exclude the sexual transmission of COVID-19.


title: Management strategies for children with COVID-19: ESPR practical recommendations

text: During the outbreak of the COVID-19 pandemic, guidelines have been issued by international, national and local authorities to address management and the need for preparedness. Children with COVID-19 differ from adults in that they are less often and less severely affected. Additional precautions required in the management of children address their increased radiosensitivity, need for accompanying carers, and methods for dealing with children in a mixed adult-paediatric institution. In this guidance document, our aim is to define a pragmatic strategy for imaging children with an emphasis on proven or suspected COVID-19 cases. Children suspected of COVID-19 should not be imaged routinely. Imaging should be performed only when expected to alter patient management, depending on symptoms, preexisting conditions and clinical evolution. In order to prevent disease transmission, it is important to manage the inpatient caseload effectively by triaging children and carers outside the hospital, re-scheduling nonurgent elective procedures and managing symptomatic children and carers as COVID-19 positive until proven otherwise. Within the imaging department one should consider conducting portable examinations with COVID-19 machines or arranging dedicated COVID-19 paediatric imaging sessions and performing routine nasopharyngeal swab testing before imaging under general anaesthesia. Finally, regular personal hygiene, appropriate usage of personal protective equipment, awareness of which procedures are considered aerosol generating and information on how to best disinfect imaging machinery after examinations should be highlighted to all staff members.


Impact of COVID-19 on Pediatric Dental Practice in the United States


New editors, COVID-19, TURKMI, ATA study, and more


title: Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium

text: The COVID-19 pandemic presents clinicians a unique set of challenges in managing breast cancer (BC) patients. As hospital resources and staff become more limited during the COVID-19 pandemic, it becomes critically important to define which BC patients require more urgent care and which patients can wait for treatment until the pandemic is over. In this Special Communication, we use expert opinion of representatives from multiple cancer care organizations to categorize BC patients into priority levels (A, B, C) for urgency of care across all specialties. Additionally, we provide treatment recommendations for each of these patient scenarios. Priority A patients have conditions that are immediately life threatening or symptomatic requiring urgent treatment. Priority B patients have conditions that do not require immediate treatment but should start treatment before the pandemic is over. Priority C patients have conditions that can be safely deferred until the pandemic is over. The implementation of these recommendations for patient triage, which are based on the highest level available evidence, must be adapted to current availability of hospital resources and severity of the COVID-19 pandemic in each region of the country. Additionally, the risk of disease progression and worse outcomes for patients need to be weighed against the risk of patient and staff exposure to SARS CoV-2 (virus associated with the COVID-19 pandemic). Physicians should use these recommendations to prioritize care for their BC patients and adapt treatment recommendations to the local context at their hospital.


title: Superposition of waves for modeling COVID-19 epidemic in the world and in the countries with the maximum number of infected people in the first half of 2020

text: On the base of logic discrete equations system mathematical modeling of COVID-19 epidemic spread was carried out in the world and in the countries with the largest number of infected people such as the USA, Brasil, Russia and India in the first half of 2020. It was shown that for the countries with strong restrictive measures the spread of COVID-19 fit on a single wave with small capacity as for a number of countries with violation of restrictive measures the spread of the epidemic fit on a waves superposition. For countries with large population mixing, the spread of the epidemic today also fits into a single wave, but with a huge capacity value (for Brazil - 80 million people, for India - 40 million people). We estimated that the epidemic spread in the world today fits into 5 waves. The first two waves are caused by the epidemic spread in China (the first - in Wuhan), the third - by the epidemic spread in European countries, the fourth mainly by the epidemic spread in Russia and the USA, the fifth wave is mainly caused by the epidemic spread in Latin America and South Asia. It was the fifth wave that led to the spread of the coronavirus epidemic COVID-19 entering a new phase, with an increase in the number of infected more than 100 thousand inhabitants. For all the studied countries and the world, for each of the superposition waves, the wave capacities and growth indicators were calculated. The local peaks of the waves and their ending times are determined. It was the fifth wave that led to the fact that COVID-19 spread is entering a new phase, with the increase in the number of infected people being more than 100 thousand inhabitants. For all the countries being examined and for the whole world, for each of the superposition waves we calculated the waves capacities and index of infected people growth.


title: When cancer encounters COVID-19 in China: what have we suffered, experienced and learned

text: The outbreak of the coronavirus disease (COVID-19) occurred in Wuhan, China, in December 2019. As of 21 March 2020, this epidemic has spread to 179 countries with more than 200 000 confirmed cases and 8578 deaths. The outbreak has put enormous pressure on the medical establishment and even led to exhaustion of medical resources in the most affected areas. Other medical work has been significantly affected in the context of COVID-19 epidemic. In order to reduce or avoid cross-infection with COVID-19, many hospitals have taken measures to limit the number of outpatient visits and inpatients. For example, emergency surgery can only be guaranteed, and most other surgeries can be postponed. Patients with cancer are one of the groups most affected by the epidemic because of their systematic immunosuppressive state and requirement of frequent admission to hospital. Consequently, specific adjustments for their treatment need to be made to cope with this situation. Therefore, it is of significance to summarize the relevant experience of China in the prevention and control of COVID-19 infection and treatment of patients with cancer during the epidemic.


COVID-19, Prison Visits, and the Value of a Cup of Coffee


Dermatological findings in COVID-19 patients: Mexican experience


title: What do surgeons need to know about the digestive disorders and paraclinical abnormalities induced by COVID-19?

text: The symptoms associated with COVID-19 are mainly characterized by a triad composed of fever, dry cough and dyspnea. However, digestive symptoms have also been reported. At first considered as infrequent, they in fact seem to affect more than half of patients. The symptoms mainly include anorexia, diarrhea, nausea and/or vomiting and abdominal pain. Even though prognosis is associated with lung injury, digestive symptoms seem significantly more frequent in patients presenting with severe COVID-19 infection. Digestive presentations, which may be isolated or which can precede pulmonary symptoms, have indeed been reported, with diarrhea as a leading clinical sign. The main biological abnormalities that can suggest COVID-19 infection at an early stage are lymphopenia, elevated CRP and heightened ASAT transaminases. Thoraco-abdominal scan seems useful as a means of on the one hand ruling out digestive pathology not connected with coronavirus and on the other hand searching for pulmonary images consistent with COVID-19 infection. No data exist on the value of digestive endoscopy in cases of persistent digestive symptoms. Moreover, the endoscopists may themselves be at significant risk of contamination. Fecal-oral transmission of the infection is possible, especially insofar as viral shedding in stools seems frequent and of longer duration than at the ENT level, including in patients with negative throat swab and without digestive symptoms. In some doubtful cases, virologic assessment of stool samples can yield definitive diagnosis. In the event of prolonged viral shedding in stools, a patient's persistent contagiousness is conceivable but not conclusively established. Upcoming serology should enable identification of the patients having been infected by the COVID-19 epidemic, particularly among previously undetected pauci-symptomatic members of a health care staff. Resumption of medico-surgical activity should be the object of a dedicated strategy preceding deconfinement.


title: Impacto del COVID-19 (SARS-CoV-2) a Nivel Mundial, Implicancias y Medidas Preventivas en la Práctica Dental y sus Consecuencias Psicológicas en los Pacientes/ Global Impact of COVID-19 (SARS-CoV-2), Implications and Preventive Measures in Dental Practice and its Psychological Consequences in Patients

text: En diciembre de 2019, en China surgió un nuevo brote de neumonía la cual fue identificada como SARS-CoV-2 el cual tiene una rápida propagación al ser trasmitido principalmente mediante tos, estornudo o contacto. Presenta diversos síntomas como fiebre, tos seca y mialgia. Puede afectar a cualquier edad siendo principalmente leve y con resolución espontánea, pero en personas mayores y/o con comorbilidades puede presentar un curso severo o mortal. Para su diagnóstico es importante evaluar la presencia de fiebre, realizar una historia epidemiológica, TC de tórax y pruebas de laboratorio como RT-PCR o muestras del tracto respiratorio.Se realizó una revisión sistemática cualitativa realizando una búsqueda en las bases de datos Medline y ClinicalKey, se encontraron 72 artículos, los cuales se leyeron por completo, de ellos 16 cumplieron los criterios de inclusión y exclusión. La gran parte de las acciones odontológicas producen gotas o aerosoles, por esta razón se deben tomar medidas de protección, selección de pacientes y tipos de tratamientos para disminuir la posibilidad de infecciones en el personal de salud y pacientes, evaluar el uso de goma dique y colutorios previos a la atención, evitar instrumental generador de aerosoles, postergar atenciones electivas, tratar solamente emergencias dentales y extremar las medidas de desinfección de las instalaciones utilizando agentes biocidas efectivos contra el coronavirus. La trasmisión por fómites y aerosoles está comprobada por lo que debemos extremar precauciones. En situaciones de pandemia hay que considerar entregar un soporte psicológico a los pacientes, especialmente con patologías orales psicosomáticas las que pueden empeorar. La posibilidad de trasmisión en el periodo de recuperación no está comprobada ni descartada.


title: A broadband high frequency laser interferometer gravitational wave detector

text: The gravitational wave detector of higher sensitivity and greater bandwidth is required for future gravitational wave astronomy and cosmology. Here we present a new type broadband high frequency laser interferometer gravitational wave detector utilizing polarization of light as signal carrier. Except for Fabry-Perot cavity arms we introduce dual power recycling to further amplify the gravitational wave signals. A novel method of weak measurement amplification is used to amplify signals for detection and to guarantee the long-term run of detector. Equipped with squeezed light, the proposed detector is shown sensitive enough within the window from 100Hz to several kHz, making it suitable for the study of high frequency gravitational wave sources. With zero-area Sagnac topology, the detector has the potential to realize quantum non-demolition measurement. The detector presented here is expected to provide an alternative way of exploring the possible ground-base gravitational wave detector for the need of future research.


title: [Management and prevention of dental emergency during corona virus disease 2019 (COVID-19) epidemic]

text: The outbreak of corona virus disease 2019 (COVID-19) has developed rapidly and the situation of prevention and control is severe During the epidemic period of COVID-19, due to the particularity of diagnosis and treatment of oral diseases, there is great challenges for how to deal with various types of dental emergency In order to prevent and control the epidemic situation strictly, and to perform a scientific and orderly clinical diagnosis and treatment of dental emergency, this article provided suggestions on personnel management training, procedures and treatment, protection and disinfection of dental emergency during COVID-19 epidemic, and reference for dental institutions and medical staff


title: Usefulness of bronchoalveolar lavage in the management of patients presenting with lung infiltrates and suspect COVID-19-associated pneumonia: A case report

text: OBJECTIVE: To report a clinical case of a patient with a compatible HRCT scan and two negative SARS-CoV-2 RNA upper respiratory tract specimens but with a confirmed viral infection by BAL (19 days after symptom onset). METHODS: Revision of a patient's clinical charts with COVID-19 admitted at INMI L. Spallanzani Hospital RESULTS: Two oropharyngeal swab tests of SARS-CoV-2 by qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay were performed at admission (17 days from symptoms onset) and a day apart and were found negative. BAL fluid collected 19 days after symptoms onset was positive for SARS-CoV-2. CONCLUSION: This case highlights importance of clinical suspicion of SARS-CoV-2 infection in diagnosis and infectivity assessment. We suggest collection of BAL fluid when consecutive nasopharyngeal swabs are negative, to confirm or exclude the diagnosis of COVID-19-associated pneumonia. Healthcare workers should perform aerosol-generating procedures in an adequately ventilated room and should wear adequate PPE.


COVID-19: Perspectives from people with diabetes


Ending US health inequalities needs multiple approaches, panel says


Variability between testing methods for SARS-CoV-2 nucleic acid detection 16 days post-discharge: a case report


title: The psychological state and changes in the routine of the patients with rheumatic diseases during the coronavirus disease (COVID-19) outbreak in Turkey: a web-based cross-sectional survey

text: We hypothesized that patients with rheumatic diseases (RD) would have increased psychological distress during the COVID-19 outbreak; therefore, assessed their psychological symptoms and changes in their routine. A web-based questionnaire survey was conducted in a cross-sectional design in three groups of participants: (1.) patients with RD, (2.) hospital workers, and (3.) high-school teachers/academic staff. Psychiatric status was evaluated using Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised scale. Overall response rate was 34.7%. We studied 771 patients with RD, 535 hospital workers, and 917 teachers/academic staff. Most of the patients with RD were unwilling to go to the hospital (86%), while 22% discontinued their medications. Biological DMARDS were the most frequent drugs whose doses were altered. Only 4% were willing to take hydroxychloroquine for protection. Moreover, the frequency of anxiety (20%), depression (43%), and post-traumatic stress (28%) among patients with RD were found to be comparable to that found among the teachers/academic staff (23%, 43% and 29%, respectively), whereas significantly less than that observed among the hospital workers (40%, 62%, and 46%, respectively) (p < 0.001). Female gender, use of social media, having a comorbid disease, or a psychiatric disorder were found to be independently associated with psychiatric symptoms in total study population. The majority of the patients were unwilling to attend outpatient visits and one-fifth skipped or stopped their immunosuppressive agents. Psychiatric symptoms in patient's and teacher's populations were of considerable clinical concern, despite being significantly lower than that observed among the hospital workers.


title: Combating devastating COVID-19 by drug repurposing

text: Despite advances in drug discovery, viral infections remain a major challenge for scientists across the globe. The recent pandemic of COVID-19 (coronavirus disease 2019), caused by a viral infection with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has created a disastrous situation all over the world. As no drugs are available to treat this life-threatening disease and the mortality rate due to COVID-19 is high, there is an utmost need to attempt to treat the infection using drug repurposing. Some countries are against the use of these drugs because of adverse effects associated with drug repurposing and lack of statistically significant clinical data, but they have been found to be effective in some countries to treat COVID-19 patients (off-label/investigational). This article emphasises possible drug candidates in the treatment of COVID-19. Most of these drugs were found to be effective in in vitro studies. There is a need to re-assess in vitro data and to carry out randomised clinical trials. Further investigations of these drugs are recommended on a priority basis.


title: COVID-19, Cancer, and Financial Toxicity

text: When I first started this editorial in early March, I was writing from my usual coffee shop location, and the media was starting to focus on COVID-19. The incidence of the virus was increasing across the world, and the word "pandemic"-although debated passionately at the time-was beginning to gain traction. All signs pointed to a disruption; however, the scale of that change has exceeded what most of us could have imagined in early March. Now, millions of Americans and people around the world are in self-isolation, quarantine, or lockdown. There have been roughly 1.4 million cases of COVID-19 and more than 83,000 deaths worldwide at the time of this writing (Johns Hopkins University and Medicine, 2020). Like most, with the exception of essential personnel, I am at home wondering what is going to happen next and trying to find any positive outcome to this crisis.


title: SARS-CoV-2 RNA Detection on Disposable Wooden Chopsticks, Hong Kong

text: We detected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA on disposable wooden chopsticks used by 5 consecutive asymptomatic and postsymptomatic patients admitted for isolation and care at our hospital. Although we did not assess virus viability, our findings may suggest potential for transmission through shared eating utensils.


A glance at the prevalence of coronavirus disease 19 (COVID-19) in Iran: Strengths and weaknesses


title: Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder

text: BACKGROUND: Chronic feelings of emptiness is an under-researched symptom of borderline personality disorder (BPD), despite indications it may be central to the conceptualisation, course, and outcome of BPD treatment. This systematic review aimed to provide a comprehensive overview of chronic feelings of emptiness in BPD, identify key findings, and clarify differences between chronic feelings of emptiness and related constructs like depression, hopelessness, and loneliness. METHOD: A PRISMA guided systematic search of the literature identified empirical studies with a focus on BPD or BPD symptoms that discussed chronic feelings of emptiness or a related construct. RESULTS: Ninety-nine studies met criteria for inclusion in the review. Key findings identified there were significant difficulties in defining and measuring chronic emptiness. However, based on the studies reviewed, chronic emptiness is a sense of disconnection from both self and others. When experienced at frequent and severe levels, it is associated with low remission for people with BPD. Emptiness as a construct can be separated from hopelessness, loneliness and intolerance of aloneness, however more research is needed to explicitly investigate these experiences. Chronic emptiness may be related to depressive experiences unique to people with BPD, and was associated with self-harm, suicidality, and lower social and vocational function. CONCLUSIONS AND IMPLICATIONS: We conclude that understanding chronic feelings of emptiness is central to the experience of people with BPD and treatment focusing on connecting with self and others may help alleviate a sense of emptiness. Further research is required to provide a better understanding of the nature of chronic emptiness in BPD in order to develop ways to quantify the experience and target treatment. Systematic review registration number: CRD42018075602.


title: CSCO ablation expert workshop report: Recommendations for the management of tumor ablation during the coronavirus disease 2019 epidemic

text: The coronavirus disease 2019 (COVID-19) has become a global pandemic since its outbreak in December 2019, which posed a threat to the safety and well-being of people on a global scale. Cancer patients are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and their critical morbidity and case fatality rates are high. The ablation expert committee of the Chinese Society of Clinical Oncology compiled corresponding expert recommendations. These recommendations summarize the preventive measures and management of tumor ablation treatment in medical institutions, including outpatient clinics, oncology wards, ablation operation room, and postablation follow-ups in accordance with the guidelines and protocols imposed by the National Health Commission of the People's Republic of China and the experience in management and prevention according to various hospitals. This consensus aims to reduce and prevent the spread of SARS-CoV-2 and its cross-infection between cancer patients in hospitals and provide regulatory advice and guidelines for medical personnel.


Risk for COVID-19 Resurgence Related to Duration and Effectiveness of Physical Distancing in Ontario, Canada


Neurologie et COVID-19


Implications of COVID-19 on urological laparoscopic surgery


title: Practical indications for the prevention and management of SARS-CoV-2 in ambulatory dialysis patients: lessons from the first phase of the epidemics in Lombardy

text: Confronting the SARS-CoV-2 outbreak has allowed us to appreciate how efficiently highly-resourced settings can respond to crises. However even such settings are not prepared to deal with the situation, and lessons are only slowly being learnt. There is still an urgent need to accelerate protocols that lead to the implementation of rapid point-of-care diagnostic testing and effective antiviral therapies. In some high-risk populations, such as dialysis patients, where several individuals are treated at the same time in a limited space and overcrowded areas, our objective must be to ensure protection to patients, the healthcare team and the dialysis ward. The difficult Italian experience may help other countries to face the challenges. The experience of the Lombardy underlines the need for gathering and sharing our data to increase our knowledge and support common, initially experience-based, and as soon as possible evidence-based position to face this overwhelming crisis.


Kawasaki-like disease: emerging complication during the COVID-19 pandemic


title: Glycerol-preserved corneal tissue in emergency corneal transplantation: An alternative for fresh corneal tissue in COVID-19 crisis

text: Purpose: Due to the COVID-19 pandemic, most of the eye banks have limited/stopped corneal collection, as this is a highly contagious disease. This has led to shortage of donor corneas worldwide. Glycerol preservation of tissue remains a viable option in this scenario. The objective is to compare fresh corneal tissue (FCT) with glycerol-preserved cornea (GPC) in emergency corneal transplantation. Methods: This was a retrospective cohort study conducted in a tertiary care centre of Uttarakhand. Medical records of the patients who underwent therapeutic penetrating keratoplasty (TPK) were reviewed. FCT group included patients who underwent TPK with fresh corneal tissue and GPC group included patients who underwent TPK with glycerol preserved cornea. The indications and outcomes of TPK in the terms of therapeutic success were analysed and compared between both the groups. Results: A total of 94 eyes of 91 patients underwent TPK from October 2011 to August 2017. FCT group included 60 eyes of 57 patients and GPC group included 34 eyes of 34 patients. The primary indication of TPK was infectious keratitis in both the groups (FCT-81.6%; GPC - 91.2%) There was no significant difference in the therapeutic success in both the groups (P = 0.741, Odds ratio- 1.59 with 95% CI- 0.39-6.44). Complications included glaucoma (FCT-21.7%; GPC- 35.2%) graft infection (FCT- 18.33% GPC- 2.9%); graft rejection (FCT-11.66%, GPC- 0%); and graft failure (FCT-88.33%, GPC-100%). Conclusion: The GPC is comparable to FCTs in therapeutic transplant and can be a useful interim procedure in saving the eyes in cases of infective keratitis in the time of crisis.


Aspartate aminotransferase: A prognostic marker rather than a specific liver injury marker in COVID-19


title: The examination of sleep quality for frontline healthcare workers during the outbreak of COVID-19

text: PURPOSE: Few studies have addressed the sleep disturbances of healthcare workers during crisis events of public health. This study aimed to examine the sleep quality of frontline healthcare workers (FLHCW) in Bahrain during the COVID-19 pandemic, and compare it with the sleep quality of non-frontline healthcare workers (NFLHCW). METHODS: Healthcare workers (n = 280) from multiple facilities belonging to the Ministry of Health, Bahrain, were invited to participate in this cross-sectional study. An online questionnaire, including socio-demographics, the Pittsburgh Sleep Quality Index (PSQI), and the Perceived Stress Scale (PSS), was used to evaluate sleep disturbances and stress levels of healthcare workers. Poor sleep quality was defined as PSQI ≥ 5 and moderate-severe stress as PSS ≥ 14. Descriptive statistics were used to compare the scores of FLHCW and NFLHCW. Univariate and multivariate binary logistic regressions were used to identify predictors of poor sleep quality, moderate-severe stress, and the combined problem of poor sleep quality and moderate-severe stress. RESULTS: A total of 257 participants (129 FLHCW and 128 NFLHCW) provided usable responses. The overall PSQI and PSS scores were 7.0 ± 3.3 and 20.2 ± 7.1, respectively. The FLHCW scored higher in the PSQI and PSS compared with the NFLHCW; however, the differences in the PSQI and PSS scores were not statistically significant. For the FLHCW, 75% were poor sleepers, 85% had moderate-severe stress, and 61% had both poor sleep quality and moderate-severe stress. For the NFLHCW, 76% were poor sleepers, 84% had moderate-severe stress, and 62% had both poor sleep quality and moderate-severe stress. Female sex and professional background were the predictors of poor sleep quality and stress. CONCLUSIONS: Poor sleep quality and stress are common during the COVID-19 crisis. Approximately, 60% of both FLHCW and NFLHCW have poor sleep quality combined with moderate-severe stress.


title: Simultaneous and rapid determination of sesamin and sesamolin in sesame oils using excitation-emission matrix fluorescence coupling with self-weighted alternating trilinear decomposition

text: BACKGROUND: Sesamin and sesamolin are two typical and major lignans isolated from sesame oil. Various researches have shown the bioactivity, physiological activity and potential health benefits of the two components. In this study, a simultaneous and rapid method for determination of sesamin and sesamolin in sesame oils was proposed. The excitation-emission fluorescence spectra of the oils were obtained after a simple pretreatment method, then the self-weighted alternating trilinear decomposition were adopted to extract the quantitative information from the highly overlapped spectra. RESULTS: It was found that reasonable quantification results can be obtained with the limits of detection for the two lignans were 0.05 mg/g and 0.24 mg/g, while limits of quantitation were 0.14 mg/g and 0.74 mg/g, respectively. In addition, the average recoveries for sesamin and sesamolin were 99.05% and 94.97%. CONCLUSION: The results indicate that with simple sample pretreatment, the application for combining excitation-emission fluorescence spectra and self-weighted alternating trilinear decomposition can be a useful and sensitive tool for the determination of lignans in sesame oil. This article is protected by copyright. All rights reserved.


title: Coronavirus pandemic: applying a whole-of-society model for the whole-of-the world

text: During a pandemic, a national government is often considered solely responsible for dealing with the outbreak with local-based policies. A whole-of-society approach to a pandemic is evidence-based and used successfully in countries with a history of pandemic infections. This collaborative approach assumes that no single entity has the capacity to successfully manage the dynamic, complex problems that arise in a pandemic environment. Application of the whole-of-society model globally would provide a more harmonious and concerted response with mutual and synergistic benefits to all affected nations. Central entities within the model include; Civil society, business and government. These are addressed at the community, local government and sub-national level. Nine essential services are also identified including Health, Defence, Law & Order, Finance, Transport, Telecommunication, Energy, Food, and Water. A continuing cycle of readiness, response and recovery of services encapsulates this model. Pandemics affect the whole of the world, a global whole-of-society approach is therefore needed to tackle them.


title: Asymptomatic carriers of COVID-19 as a concern for disease prevention and control: more testing, more follow-up

text: Following a containment phase of two months, China has transitioned to the mitigation phase. However, China still faces the risk of COVID-19 spreading due to not only to sporadic new cases and imported cases but also asymptomatic carriers. According to daily reports from the National Health Commission of the People's Republic of China from March 31, 2020 to April 7, 2020, the number of new asymptomatic cases reported daily greatly exceeded that of new imported cases. As of 24:00 on April 7, there were a total of 1,095 asymptomatic cases with COVID-19 under medical observation on the Chinese mainland, including 358 imported cases. A growing number of studies have indicated that asymptomatic carriers are infectious to an extent and can potentially transmit COVID-19. At present, China's measures for managing asymptomatic carriers are 14 days of centralized quarantine and observation; in principle, people with two consecutive negative nucleic acid tests (at an interval of at least 24 hours) can be released from quarantine. However, asymptomatic carriers will not be included in confirmed cases unless they develop clinical manifestations while in quarantine. As "silent spreaders", asymptomatic carriers warrant attention as part of disease prevention and control. The testing and follow-up of asymptomatic carriers should be expanded to include people in close contact with patients with confirmed COVID-19 and asymptomatic cases, clusters of outbreaks, and key areas and populations with a high risk of infection.


title: Case report of chloroquine therapy and hypoglycaemia in type 1 diabetes: What should we have in mind during the COVID-19 pandemic?

text: A type 1 diabetes patient experienced remission associated with chloroquine therapy while travelling to a malaria-endemic area. Chloroquine has immunomodulatory and hypoglycaemic effects and may become more frequently used due to the COVID-19 pandemic. Patients with type 1 diabetes treated with chloroquine should be monitored for hypoglycaemia, even after recovery.


title: The epidemiology and clinical characteristics of co-infection of SARS-CoV-2 and influenza viruses in patients during COVID-19 outbreak

text: In this study, we performed a single-centered study of 307 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients. It was found that co-infection of SARS-CoV-2 and influenza virus was common during COVID-19 outbreak. And patients coinfected with SARS-CoV-2 and influenza B virus have a higher risk of developing poor outcomes so a detection of both viruses was recommended during COVID-19 outbreak.


text: In this study, we performed a single-centred study of 307 SARS-CoV-2 infected patients. It was found that co-infection of SARS-CoV-2 and influenza virus was common during COVID-19 outbreak. And patients co-infected with SARS-CoV-2 and influenza B virus have a higher risk of developing poor outcomes so a detection of both viruses was recommended during COVID-19 outbreak. This article is protected by copyright. All rights reserved.


Management of mild cases of COVID-19 in low-resource countries: An experience in Vietnam


title: Fragment tailoring strategy to design novel chemical entities as potential binders of novel corona virus main protease

text: The recent pandemic of severe acute respiratory syndrome-coronavirus2 (SARS-CoV-2) infection (COVID-19) has put the world on serious alert. The main protease of SARS-CoV-2 (SARS-CoV-2-MPro) cleaves the long polyprotein chains to release functional proteins required for replication of the virus and thus is a potential drug target to design new chemical entities in order to inhibit the viral replication in human cells. The current study employs state of art computational methods to design novel molecules by linking molecular fragments which specifically bind to different constituent sub-pockets of the SARS-CoV-2-MPro binding site. A huge library of 191678 fragments was screened against the binding cavity of SARS-CoV-2-MPro and high affinity fragments binding to adjacent sub-pockets were tailored to generate new molecules. These newly formed molecules were further subjected to molecular docking, ADMET filters and MM-GBSA binding energy calculations to select 17 best molecules (named as MP-In1 to MP-In17), which showed comparable binding affinities and interactions with the key binding site residues as the reference ligand. The complexes of these 17 molecules and the reference molecule with SARS-CoV-2-MPro, were subjected to molecular dynamics simulations, which assessed the stabilities of their binding with SARS-CoV-2-MPro. Fifteen molecules were found to form stable complexes with SARS-CoV-2-MPro. These novel chemical entities designed specifically according to the pharmacophoric requirements of SARS-CoV-2-MPro binding pockets showed good synthetic feasibility and returned no exact match when searched against chemical databases. Considering their interactions, binding efficiencies and novel chemotypes, they can be further evaluated as potential starting points for SARS-CoV-2 drug discovery. [Formula: see text]Communicated by Ramaswamy H. Sarma.


title: Effect of a bundle of intervention strategies for the control of COVID-19 in Henan, a neighboring province of Wuhan, China

text: The novel coronavirus disease 2019 (COVID-19) occurred in China (mainly in Wuhan, Hubei Province) at the end of December 2019. Henan province is located in the center of China, borders on Hubei province by land in the south with the nearest distance of 200 kilometers to Wuhan. As the inland provinces in mainland China, frequent communication in transportation and population flow make it difficult to confine the pandemic, which is similar to that in the landlocked countries in Europe. The expected cases in Henan were mainly imported. A bundle of intervention strategies were adopted from 26 January 2020 to cut off the spread between the infected patients and the native residents. The pandemic was controlled 2 month later after the bundle of strategies was adopted although the number of cases continued to increase explosively during the first 10 days. A total of 1273 cases were confirmed, 1251 patients were cured, 22 patients died, and 1 patient was still in hospital until 29 March 2020. The peak of daily increased cases was 109 cases. Our data show that COVID-19 is highly infectious and easy to cause an outbreak, but it can be controlled by early effective interventions. A bundle of strategies according to the specific situation of each country is suggested to be implemented as early as possible.


Critical Supply Shortages - The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic


What can we do for part-time nursing students during the COVID-19 pandemic?


title: Challenges and strategies to research ethics in conducting COVID-19 research

text: The number of research involving human subjects on coronavirus disease 2019 (COVID-19) is surging, bringing challenges to the ethical review committee (ERC) in terms of reviewing speed and special ethical considerations under the pandemic. However, the existing ethical review system and regulations have their limitations to meet the demand for a prompt and efficient epidemic control. Since the research under the public health emergency is different from that carried out in familiar situations to design and implementation, the strategy for a satisfactory ERC response should balance the duty of protecting individual participants as well as the special public needs derived from the disease control. It is suggested that the ethical review-related regulations need to be updated, and a unified supervision system to the overall ERC is required. ERC collaboration, capacity-improving and efficiency-improving measures need to be taken. With respect to the reviewing guidelines, it is suggested that the international norms should be explained with more consideration of the local condition and the exceptional circumstances in this public health emergency. A joint effort needs to be taken for better research conduction.


title: CNS Penetration Ability: A Critical Factor for Drugs in the Treatment of SARS-CoV-2 Brain Infection

text: Now, it has been evidenced that Covid19 (SARS-CoV-2) infects the brain tissues. Along with this, a challenge has been raised for research professionals to find effective drugs for its treatment since the recent spread of this virus from Wuhan, China. Targeting the treatment of brain infection, it has also been a challenge that the clinical drug should have good CNS penetration ability to cross the blood-brain barrier.


title: Die COVID-19-Pandemie und das HNO-Fachgebiet: Worauf kommt es aktuell an?/ [The COVID-19 pandemic and otolaryngology: What it comes down to?]

text: Here, we review the most recent findings on the effects COVID-19 pandemic for the work of otolaryngologists. The role of anosmia and hyposmia as a potential COVID-19 related symptom is presented. We discuss the clinical management of all ENT patients, but especially of COVID-19 patients from the ENT perspective. The impact of the infection on the ENT examination and ENT surgery is summarized.


Coronavirus vaccine trials have delivered their first results - but their promise is still unclear


COVID-19 Real-Time RT-PCR: Does Positivity on Follow-up RT-PCR Always Imply Infectivity?


COVID-19 Real-time RTPCR: Does Positivity on Follow up RTPCR Always Imply Infectivity?


title: Saliva-based PCR tests for SARS-CoV-2 detection

text: The outbreak of novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Nasopharyngeal swabs are widely used in polymerase chain reaction (PCR) test to detect SARS-CoV-2. However, the collection of nasopharyngeal swabs has a series of drawbacks concerning exposure of healthcare staff, difficulty in collection, and discomfort of patients. Therefore, an alternative noninvasive sample for diagnostic of emerging viral diseases is required. The usefulness of saliva screening tests is compared to conventional swab tests in this report. The results suggest that saliva could be a reliable sample for detecting SARS-CoV-2.


title: Modeling in the Time of COVID-19: Statistical and Rule-based Mesoscale Models

text: We present a new technique for rapid modeling and construction of scientifically accurate mesoscale biological models. Resulting 3D models are based on few 2D microscopy scans and the latest knowledge about the biological entity represented as a set of geometric relationships. Our new technique is based on statistical and rule-based modeling approaches that are rapid to author, fast to construct, and easy to revise. From a few 2D microscopy scans, we learn statistical properties of various structural aspects, such as the outer membrane shape, spatial properties and distribution characteristics of the macromolecular elements on the membrane. This information is utilized in 3D model construction. Once all imaging evidence is incorporated in the model, additional information can be incorporated by interactively defining rules that spatially characterize the rest of the biological entity, such as mutual interactions among macromolecules, their distances and orientations to other structures. These rules are defined through an intuitive 3D interactive visualization and modeling feedback loop. We demonstrate the utility of our approach on a use case of the modeling procedure of the SARS-CoV-2 virus particle ultrastructure. Its first complete atomistic model, which we present here, can steer biological research to new promising directions in fighting spread of the virus.


Caring for Patients With Cancer During the COVID-19 Outbreak in Italy


Terra incognita: clinically suspected myocarditis in a patient with severe acute respiratory syndrome coronavirus 2 infection


COVID-19 and liver cancer clinical trials: Not everything is lost


Prevalence of mental health symptoms in residential healthcare workers in Michigan during the covid-19 pandemic


Re: Profile of specific antibodies to SARS-CoV-2: The first report


title: Atypical skin manifestations during immune checkpoint blockage in COVID19-infected lung cancer patients

text: A new coronavirus, named SARS-CoV-2 by the World Health Organization (WHO), has rapidly spread around the world since its first reported case in late December of 2019 from Wuhan, China. As of mid-April 2020, this virus has affected more than 180 countries and territories, infecting more than 1,650,000 individuals and causing over 100.000 deaths. With ≈20 million new cases per year globally, cancer affects a significant portion of the population. Individuals affected by cancer are more susceptible to infections due to coexisting chronic diseases (cardiovascular, pulmonary and diabetes), overall poor health status, and systemic immunosuppressive states caused by both cancer and anticancer treatments. As a consequence, patients with malignancies, and especially with lung cancer who develop COVID19 experience more difficult outcomes. A recent multicenter study developed by the Hubei Anti-Cancer Association also documented that lung cancer patients had an increased risk of death, ICU requirement, risk of presenting severe or critical symptoms, and use of invasive mechanical ventilation. Here we present two representative cases of patients with lung cancer and COVID19 without respiratory compromise and with atypical and severe skin manifestations, findings that could be influenced by the chronic use of anti-PD1 antibodies.


title: Evolutionary analysis of SARS-CoV-2: how mutation of Non-Structural Protein 6 (NSP6) could affect viral autophagy

text: BACKGROUND: SARS-CoV-2 is a new coronavirus that has spread globally, infecting more than 150000 people, and being declared pandemic by the WHO. We provide here bio-informatic, evolutionary analysis of 351 available sequences of its genome with the aim of mapping genome structural variations and the patterns of selection. METHODS: A Maximum likelihood tree has been built and selective pressure has been investigated in order to find any mutation developed during the SARS-CoV-2 epidemic that could potentially affect clinical evolution of the infection. FINDING: We have found in more recent isolates the presence of two mutations affecting the Non-Structural Protein 6 (NSP6) and the Open Reding Frame10 (ORF 10) adjacent regions. Amino acidic change stability analysis suggests both mutations could confer lower stability of the protein structures. INTERPRETATION: One of the two mutations, likely developed within the genome during virus spread, could affect virus intracellular survival. Genome follow-up of SARS-CoV-2 spread is urgently needed in order to identify mutations that could significantly modify virus pathogenicity.


New data emerging on outcomes for patients with COVID-19 and rheumatic diseases


Methodological Problems and Solutions for Sampling in Epidemiological SARS-CoV-2 Research Reply


The role of close contacts tracking management in COVID-19 prevention: A cluster investigation in Jiaxing, China


title: COVID-19: viral-host interactome analyzed by network based-approach model to study pathogenesis of SARS-CoV-2 infection

text: BACKGROUND: Epidemiological, virological and pathogenetic characteristics of SARS-CoV-2 infection are under evaluation. A better understanding of the pathophysiology associated with COVID-19 is crucial to improve treatment modalities and to develop effective prevention strategies. Transcriptomic and proteomic data on the host response against SARS-CoV-2 still have anecdotic character; currently available data from other coronavirus infections are therefore a key source of information. METHODS: We investigated selected molecular aspects of three human coronavirus (HCoV) infections, namely SARS-CoV, MERS-CoV and HCoV-229E, through a network based-approach. A functional analysis of HCoV-host interactome was carried out in order to provide a theoretic host-pathogen interaction model for HCoV infections and in order to translate the results in prediction for SARS-CoV-2 pathogenesis. The 3D model of S-glycoprotein of SARS-CoV-2 was compared to the structure of the corresponding SARS-CoV, HCoV-229E and MERS-CoV S-glycoprotein. SARS-CoV, MERS-CoV, HCoV-229E and the host interactome were inferred through published protein-protein interactions (PPI) as well as gene co-expression, triggered by HCoV S-glycoprotein in host cells. RESULTS: Although the amino acid sequences of the S-glycoprotein were found to be different between the various HCoV, the structures showed high similarity, but the best 3D structural overlap shared by SARS-CoV and SARS-CoV-2, consistent with the shared ACE2 predicted receptor. The host interactome, linked to the S-glycoprotein of SARS-CoV and MERS-CoV, mainly highlighted innate immunity pathway components, such as Toll Like receptors, cytokines and chemokines. CONCLUSIONS: In this paper, we developed a network-based model with the aim to define molecular aspects of pathogenic phenotypes in HCoV infections. The resulting pattern may facilitate the process of structure-guided pharmaceutical and diagnostic research with the prospect to identify potential new biological targets.


Human Vaccines & Immunotherapeutics: news


Governmental Public Health Powers During the COVID-19 Pandemic: Stay-at-home Orders, Business Closures, and Travel Restrictions