title: Significant changes in the chemical compositions and sources of PM2.5 in Wuhan since the city lockdown as COVID-19

text: Wuhan was the first city to adopt the lockdown measures to prevent COVID-19 spreading, which improved the air quality accordingly. This study investigated the variations in chemical compositions, source contributions, and regional transport of fine particles (PM2.5) during January 23-February 22 of 2020, compared with the same period in 2019. The average mass concentration of PM2.5 decreased from 72.9 µg m-3 (2019) to 45.9 µg m-3 (2020), by 27.0 µg m-3. It was predominantly contributed by the emission reduction (92.0%), retrieved from a random forest tree approach. The main chemical species of PM2.5 all decreased with the reductions ranging from 0.85 µg m-3 (chloride) to 9.86 µg m-3 (nitrate) (p < 0.01). Positive matrix factorization model indicated that the mass contributions of seven PM2.5 sources all decreased. However, their contribution percentages varied from -11.0% (industrial processes) to 8.70% (secondary inorganic aerosol). Source contributions of PM2.5 transported from potential geographical regions showed reductions with mean values ranging from 0.22 to 4.36 µg m-3. However, increased contributions of firework burning, secondary inorganic aerosol, road dust, and vehicle emissions from transboundary transport were observed. This study highlighted the complex and nonlinear response of chemical compositions and sources of PM2.5 to air pollution control measures, suggesting the importance of regional-joint control.


The acute effects of the COVID-19 pandemic on insomnia and psychological symptoms


Engaging students during the COVID-19 pandemic


Chilblain acral lesions in the COVID-19 era. Are they marker of infection in asymptomatic patients?


title: Patient flow in the largest French psychiatric emergency centre in the context of the COVID-19 pandemic

text: To date, we have no French data about the psychiatric consequences of the Covid-19 pandemic and the confinement. In the largest French psychiatric emergency centre, we compared the average number of consultations per day during the confinement with the same period preceding the confinement and with the same periods of previous years, and we observed a significant drop in attendance. Our team had to adapt promptly to these changes in public mental health services, and we set up a telephone hotline dedicated to psychiatric patients and their families, in order to prevent a secondary psychiatric crisis.


title: Impact of COVID-19 on dental education in the United States

text: Dental institutions in the United States are reeling from the consequences of the novel SARS-CoV2 coronavirus, the causative agent of CODIV-19. As oral health care providers, we have been trained on prevention of aerosol transmissible diseases, but we are still grappling with many unknown factors regarding COVID-19. While the Centers for Disease Control and Prevention (CDC), American Dental Association (ADA), and local state agencies are releasing updates on guidelines for dentists and patients, no official information exists for dental institutions on how to effectively follow the recommended guidelines including "shelter in place" with social distancing to protect students, faculty, staff, and patients, and still ensure continuity of dental education. This article discusses the challenges that we face currently and offers some simple strategies to bridge the gaps in dental education to overcome this emergency.


title: An update on the 2019-nCoV outbreak

text: Cases of 2019-nCoV are now being reported in different regions around the globe, concerning for a possible SARS like epidemic that infected for than 8000 people in 2002-03. Though, major health authorities are still working on understanding the virus and its transmission, here we present a brief report regarding the 2019-nCoV outbreak and what is known so far.


title: Characterizing the spatiotemporal envelope of the human visual system through the visibility of temporal aliasing artifacts

text: Previous studies have demonstrated that the onset of temporal aliasing artifacts occurs when the spatial displacement between samples reaches a critical distance, and that subsequently a linear relationship exists between stimulus speed and critical sampling rates. In this paper, we carry out further experimentation using a novel experimental setup, in which a strobe light is used to emulate impulsive temporal sampling, in order to investigate the spatiotemporal envelope of the human visual system and the effect of a stimulus. For non-periodic stimuli, experimental results show that critical sampling rates increase with motion speed and decrease with stimulus width. These interactions can be described using simple log-linear models, and characterized using the temporal aliasing visibility function, where maximum critical frame rates up to 1500 Hz are predicted. For periodic stimuli, we demonstrate that both perceptible temporal aliasing artifacts and stimulus aliasing can cause stroboscopic effects.


title: A hybrid post-Newtonian -- effective-one-body scheme for spin-precessing compact-binary waveforms

text: We introduce \texttt{TEOBResumSP}: an efficient yet accurate hybrid scheme for generating gravitational waveforms from spin-precessing compact binaries. Our approach Euler-rotates aligned-spin \texttt{TEOBResumS} effective-one-body waveforms from a precessing frame to an inertial frame. We obtain the Euler angles by solving the post-Newtonian precession equations expanded to (next-to)$^4$ leading (second post-Newtonian) order and use them in the waveform mode rotations to extend non-precessing \texttt{TEOBResumS} waveforms to generic spin configurations. The scheme is compared to current state-of-the-art precessing approximants \texttt{NRSur7dq4} and \texttt{SEOBNRv4PHM} in terms of frequency-domain matches of the $\ell=2$ gravitational-wave strain for 200 and 1100 binaries, respectively, with the initial gravitational-wave frequencies between 20 and 50 Hz and the precessing spin parameter $\chi_p$ ranging up to one. The matches are better than $0.965$ for 85\% of the \texttt{NRSur7dq4} and 75\% of the \texttt{SEOBNRv4PHM} sets. The largest disagreements occur for large mass ratios and for large spin components along the orbital plane quantified in terms of a new parameter, $S_{\perp,\text{max}}$, that we introduce. The disagreements stem from Euler-rotating non-precessing waveforms with constant spins, which can be replaced by time-varying $z$-components of spins. Our scheme provides a robust alternative precessing approximant to be employed in the parameter estimation of generic-spin compact binaries with \texttt{TEOBResumSP} waveforms.


title: Brain Imaging Use and Findings in COVID-19: A Single Academic Center Experience in the Epicenter of Disease in the United States

text: Coronavirus disease 2019 (COVID-19) is a serious public health crisis and can have neurologic manifestations. This is a retrospective observational case series performed March 1-31, 2020, at New York University Langone Medical Center campuses. Clinical and imaging data were extracted, reviewed, and analyzed. Two hundred forty-two patients with COVID-19 underwent CT or MRI of the brain within 2 weeks after the positive result of viral testing (mean age, 68.7 ± 16.5 years; 150 men/92 women [62.0%/38.0%]). The 3 most common indications for imaging were altered mental status (42.1%), syncope/fall (32.6%), and focal neurologic deficit (12.4%). The most common imaging findings were nonspecific white matter microangiopathy (134/55.4%), chronic infarct (47/19.4%), acute or subacute ischemic infarct (13/5.4%), and acute hemorrhage (11/4.5%). No patients imaged for altered mental status demonstrated acute ischemic infarct or acute hemorrhage. White matter microangiopathy was associated with higher 2-week mortality (P < .001). Our data suggest that in the absence of a focal neurologic deficit, brain imaging in patients with early COVID-19 with altered mental status may not be revealing.


The epidemiology of trauma during a pandemic


Advantages of delayed sequence intubation in selected patients with coronavirus disease (COVID-19)


title: Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed COVID-19 Orthopaedic Patients: Operating Room Protocols and Recommendations in the Current COVID-19 Pandemic

text: By April 7, 2020, severe acute respiratory syndrome coronavirus 2 was responsible for 1,383,436 confirmed cases of Coronavirus disease 2019 (COVID-19), involving 209 countries around the world; 378,881 cases have been confirmed in the United States. During this pandemic, the urgent surgical requirements will not stop. As an example, the most recent Centers of Disease Control and Prevention reports estimate that there are 2.8 million trauma patients hospitalized in the United States. These data illustrate an increase in the likelihood of encountering urgent surgical patients with either clinically suspected or confirmed COVID-19 in the near future. Preparation for a pandemic involves considering the different levels in the hierarchy of controls and the different phases of the pandemic. Apart from the fact that this pandemic certainly involves many important health, economic, and community ramifications, it also requires several initiatives to mandate what measures are most appropriate to prepare for mitigating the occupational risks. This article provides evidence-based recommendations and measures for the appropriate personal protective equipment for different clinical and surgical activities in various settings. To reduce the occupational risk in treating suspected or confirmed COVID-19 urgent orthopaedic patients, recommended precautions and preventive actions (triage area, emergency department consultation room, induction room, operating room, and recovery room) are reviewed.


Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline


title: Nanopore Targeted Sequencing for the Accurate and Comprehensive Detection of SARS-CoV-2 and Other Respiratory Viruses

text: The ongoing global novel coronavirus pneumonia COVID-19 outbreak has engendered numerous cases of infection and death. COVID-19 diagnosis relies upon nucleic acid detection; however, currently recommended methods exhibit high false-negative rates and are unable to identify other respiratory virus infections, thereby resulting in patient misdiagnosis and impeding epidemic containment. Combining the advantages of targeted amplification and long-read, real-time nanopore sequencing, herein, nanopore targeted sequencing (NTS) is developed to detect SARS-CoV-2 and other respiratory viruses simultaneously within 6-10 h, with a limit of detection of ten standard plasmid copies per reaction. Compared with its specificity for five common respiratory viruses, the specificity of NTS for SARS-CoV-2 reaches 100%. Parallel testing with approved real-time reverse transcription-polymerase chain reaction kits for SARS-CoV-2 and NTS using 61 nucleic acid samples from suspected COVID-19 cases show that NTS identifies more infected patients (22/61) as positive, while also effectively monitoring for mutated nucleic acid sequences, categorizing types of SARS-CoV-2, and detecting other respiratory viruses in the test sample. NTS is thus suitable for COVID-19 diagnosis; moreover, this platform can be further extended for diagnosing other viruses and pathogens.


title: From Fear to Hate: How the Covid-19 Pandemic Sparks Racial Animus in the United States

text: We estimate the effect of the Coronavirus (Covid-19) pandemic on racial animus, as measured by Google searches and Twitter posts including a commonly used anti-Asian racial slur. Our empirical strategy exploits the plausibly exogenous variation in the timing of the first Covid-19 diagnosis across regions in the United States. We find that the first local diagnosis leads to an immediate increase in racist Google searches and Twitter posts, with the latter mainly coming from existing Twitter users posting the slur for the first time. This increase could indicate a rise in future hate crimes, as we document a strong correlation between the use of the slur and anti-Asian hate crimes using historic data. Moreover, we find that the rise in the animosity is directed at Asians rather than other minority groups and is stronger on days when the connection between the disease and Asians is more salient, as proxied by President Trump's tweets mentioning China and Covid-19 at the same time. In contrast, the negative economic impact of the pandemic plays little role in the initial increase in racial animus. Our results suggest that de-emphasizing the connection between the disease and a particular racial group can be effective in curbing current and future racial animus.


title: Coincidence of COVID-19 Infection and Smell: Taste Perception Disorders

text: Many reports by physicians and patients during the 2019 to 2020 pandemic indicate that COVID-19 is associated with elevated levels of odor and taste perception disorders (anosmia, hyposmia, ageusia, and/or dysgeusia). Recent increase in olfactory dysfunction in patients referred to ear nose and throat clinics and COVID-19 infection at the same time encouraged us to examine anosmic/hyposmic patients to establish any association between these signs. It has been shown that the COVID-19 virus exploits the uses angiotensin-converting enzyme 2 receptor to obtain cell entry. This result increases the interest to examine the expression of angiotensin-converting enzyme 2 in neurological tissue, and to assess the possible contribution of damage. This mini review provides fundamental knowledge on coincidence of COVID-19 infection and smell-taste perception disorders from an objective perspective.


title: Evaluation of Pool-based Testing Approaches to Enable Population-wide Screening for COVID-19

text: Background: Rapid testing for an infection is paramount during a pandemic to prevent continued viral spread and excess morbidity and mortality. This study aimed to determine whether alternative testing strategies based on sample pooling can increase the speed and throughput of screening for SARS-CoV-2. Methods: A mathematical modelling approach was chosen to simulate six different testing strategies based on key input parameters (infection rate, test characteristics, population size, testing capacity etc.). The situations in five countries (US, DE, UK, IT and SG) currently experiencing COVID-19 outbreaks were simulated to reflect a broad variety of population sizes and testing capacities. The primary study outcome measurements that were finalised prior to any data collection were time and number of tests required; number of cases identified; and number of false positives. Findings: The performance of all tested methods depends on the input parameters, i.e. the specific circumstances of a screening campaign. To screen one tenth of each country's population at an infection rate of 1% - e.g. when prioritising frontline medical staff and public workers -, realistic optimised testing strategies enable such a campaign to be completed in ca. 29 days in the US, 71 in the UK, 25 in Singapore, 17 in Italy and 10 in Germany (ca. eight times faster compared to individual testing). When infection rates are considerably lower, or when employing an optimal, yet logistically more complex pooling method, the gains are more pronounced. Pool-based approaches also reduces the number of false positive diagnoses by 50%. Interpretation: The results of this study provide a clear rationale for adoption of pool-based testing strategies to increase speed and throughput of testing for SARS-CoV-2. The current individual testing approach unnecessarily wastes valuable time and resources.


title: Erratum: Guidance for building a dedicated health facility to contain the spread of the 2019 novel coronavirus outbreak

text: [This corrects the article DOI: 10.4103/ijmr.IJMR_518_20].


title: Learning from the Italian experience in coping with COVID-19

text: INTRODUCTION: In March 2020, the rapid increase in COVID-19 cases overburdened the Italian health system, with the country becoming the pandemic's epicenter. METHODS: We present a narrative review based on manuscripts, official documents, and newspaper articles regarding COVID-19 in Italy. RESULTS: Characteristics of the epidemic, possible causes for its worsening, and the measures adopted across Italian regions are presented. CONCLUSIONS: In the early stages of an epidemic, effective decision-making is essential to contain the number of cases. Medical support for patients and social isolation measures are the most appropriate strategies currently available to reduce the spread and lethality of COVID-19.


title: Full-genome sequences of the first two SARS-CoV-2 viruses from India

text: Background & objectives: Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has globally affected 195 countries. In India, suspected cases were screened for SARS-CoV-2 as per the advisory of the Ministry of Health and Family Welfare. The objective of this study was to characterize SARS-CoV-2 sequences from three identified positive cases as on February 29, 2020. Methods: Throat swab/nasal swab specimens for a total of 881 suspected cases were screened by E gene and confirmed by RdRp (1), RdRp (2) and N gene real-time reverse transcription-polymerase chain reactions and next-generation sequencing. Phylogenetic analysis, molecular characterization and prediction of B- and T-cell epitopes for Indian SARS-CoV-2 sequences were undertaken. Results: Three cases with a travel history from Wuhan, China, were confirmed positive for SARS-CoV-2. Almost complete (29,851 nucleotides) genomes of case 1, case 3 and a fragmented genome for case 2 were obtained. The sequences of Indian SARS-CoV-2 though not identical showed high (~99.98%) identity with Wuhan seafood market pneumonia virus (accession number: NC 045512). Phylogenetic analysis showed that the Indian sequences belonged to different clusters. Predicted linear B-cell epitopes were found to be concentrated in the S1 domain of spike protein, and a conformational epitope was identified in the receptor-binding domain. The predicted T-cell epitopes showed broad human leucocyte antigen allele coverage of A and B supertypes predominant in the Indian population. Interpretation & conclusions: The two SARS-CoV-2 sequences obtained from India represent two different introductions into the country. The genetic heterogeneity is as noted globally. The identified B- and T-cell epitopes may be considered suitable for future experiments towards the design of vaccines and diagnostics. Continuous monitoring and analysis of the sequences of new cases from India and the other affected countries would be vital to understand the genetic evolution and rates of substitution of the SARS-CoV-2.


Reply to: Endonasal drilling may be employed safely in the COVID-19 era


title: Herbal drugs having antiviral potency can be used in treatment of corona virus disease

text: During the past few years herbal medicine has gained exponential growth in the field of medicine in all over the world In comparison to other countries India is the largest producer of herbal medicine The current review focuses on herbal preparation and plant recently evaluated having antiviral potency in the world This paper until focus on different beneficial aspects of herbal medicine as Antiviral activity and these herbal drugs can be used for the treatment of Corona virus disease


title: Modelling of SARS for Hong Kong

text: A simplified susceptible-infected-recovered (SIR) epidemic model and a small-world model are applied to analyse the spread and control of Severe Acute Respiratory Syndrome (SARS) for Hong Kong in early 2003. From data available in mid April 2003, we predict that SARS would be controlled by June and nearly 1700 persons would be infected based on the SIR model. This is consistent with the known data. A simple way to evaluate the development and efficacy of control is described and shown to provide a useful measure for the future evolution of an epidemic. This may contribute to improve strategic response from the government. The evaluation process here is universal and therefore applicable to many similar homogeneous epidemic diseases within a fixed population. A novel model consisting of map systems involving the Small-World network principle is also described. We find that this model reproduces qualitative features of the random disease propagation observed in the true data. Unlike traditional deterministic models, scale-free phenomena are observed in the epidemic network. The numerical simulations provide theoretical support for current strategies and achieve more efficient control of some epidemic diseases, including SARS.


Response to: Bioactive Lipids and Coronavirus (COVID-19)-further Discussion


A Policy to Do Better Next Time: Lessons Learned From the COVID-19 Pandemic


Meaningful Engagement of Older Adults in Long-Term Care: A Call for Action


title: An Interactive Data Visualization and Analytics Tool to Evaluate Mobility and Sociability Trends During COVID-19

text: The COVID-19 outbreak has dramatically changed travel behavior in affected cities. The C2SMART research team has been investigating the impact of COVID-19 on mobility and sociability. New York City (NYC) and Seattle, two of the cities most affected by COVID-19 in the U.S. were included in our initial study. An all-in-one dashboard with data mining and cloud computing capabilities was developed for interactive data analytics and visualization to facilitate the understanding of the impact of the outbreak and corresponding policies such as social distancing on transportation systems. This platform is updated regularly and continues to evolve with the addition of new data, impact metrics, and visualizations to assist public and decision-makers to make informed decisions. This paper presents the architecture of the COVID related mobility data dashboard and preliminary mobility and sociability metrics for NYC and Seattle.


title: Can the summer temperatures reduce COVID-19 cases?

text: OBJECTIVE: Despite huge global, national, and local preventive measures including travel restriction, social distancing, and quarantines, the outbreak of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) develops the coronavirus disease 2019 (COVID-19) worldwide pandemic. SARS-CoV-2 emerging from Wuhan, China, took only three months to cover >200 countries worldwide by infecting more than 2.4 million people and killing more than 150,000 people. Although this infection at the early stage creates seasonal flu-like symptoms with a higher illness, it eventually causes a higher mortality. Epidemiological studies not only find the causes of many health issues but also suggest preventive measures. This study aimed to see the link between environment temperature and COVID-19 cases. STUDY DESIGN: The monthly average environment temperature (MAET) and various COVID-19 cases of a country were collected and analyzed to see the relationship between these parameters. METHODS: Univariate analysis and statistical modeling were used to determine the relationship between environment temperature and different COVID-19 cases. RESULTS: This study found that the majorities of the countries having higher COVID-19 cases are located in the higher latitude (colder region) in the globe. As of 20th April data available, statistical analyses by various methods have found that strong negative correlations with statistical significance exist between MAET and several COVID-19 cases including total cases, active cases, and cases per million of a country (Spearman correlation coefficients were -0.45, -0.42, and -0.50 for total cases, active cases, and cases/per million, respectively). Analysis by the statistical log-linear regression model further supports that the chance of patients to contract COVID-19 is less in warmer countries than in colder countries. CONCLUSION: This pilot study proposes that cold environment may be an additional risk factor for COVID-19 cases.


The COVID Grim Reaper


Coronavirus disease 2019 and allergen immunotherapy: Theoretical benefits invite to adjustments in practice recommendations


title: Medical masks and Respirators for the Protection of Healthcare Workers from SARS-CoV-2 and other viruses

text: The use of medical masks and respirators as personal protective equipment is pivotal to reducing the level of biological hazard to which healthcare workers are exposed during the outbreak of highly diffusible pathogens, such as the recent novel coronavirus SARS-CoV-2. Unfortunately, during this pandemic, supplies are rapidly running out worldwide, with potential consequences for the rate of occupational infections. Also, knowledge about specific characteristics of respirators is of utmost importance to select the proper type according to the clinical setting. A wide variety of literature is available on the topic, but mostly based on Influenza viruses infection models. Clinical evidence on the use of respirators is poor and interest in the topic has not been constant over time. A better understanding of SARS-CoV-2 transmission is needed, together with high-quality clinical data on the use of respirators or alternative devices. Moreover, healthcare workers, regardless of their level of experience, should receive specific training. This review aims to summarize the available evidence on the use of medical masks and respirators in the context of viral infections, especially the current coronavirus disease 2019 (COVID-19).


The Potential Role of Smartphone-Based Microfluidic Systems for Rapid Detection of COVID-19 Using Saliva Specimen


title: COVID-19, interferons, and depression: A commentary

text: An option currently being explored for the treatment of COVID-19 is the use of interferons (INFs), either alone or in combination with other antiviral agents. INFs are known to shift the metabolism of tryptophan (TRP) away from its role as a precursor of serotonin. For some patients, reduction in TRP levels may either expose an underlying vulnerability to depression or trigger a de novo episode of depression. This Commentary discusses the pathway involved and recommends in-hospital augmentation with foods or supplements that increase TRP levels for COVID-19 patients treated with INFs. Selective serotonin reuptake inhibitors may also be tried if the depressive symptomatology is not short-lived.


Annals On Call - Disparities and COVID-19


The Island


title: Complex emergencies of COVID-19: management and experience in Zhuhai, China

text: The impact of communicable diseases (infectious diseases) on human health is obvious. The sudden outbreak of COVID-19 (Corona Virus Disease 2019) has made people realise the threat of communicable diseases to mankind. As a city of many migrants, Zhuhai Special Economic Zone experienced great challenges brought about by the COVID-19 epidemic. Experience has been acquired from all aspects of this. A highly reactive, multifunctional and efficient emergency management system should be established, and the significance of information communication should be fully understood for the future.


Covid-19 e inquinamento atmosferico: comunicare i risultati di studi di correlazione geografica./ Covid-19 and air pollution: communicating the results of geographic correlation studies


title: Cutaneous manifestations in patients with COVID-19: a preliminary review of an emerging issue

text: BACKGROUND: The infection caused by the recently identified SARS-CoV-2, called coronavirus disease-19 (COVID-19), has rapidly spread throughout the world. With the exponential increase of patients worldwide, the clinical spectrum of COVID-19 is being better defined and new symptoms are emerging. Numerous reports are documenting the occurrence of different cutaneous manifestations in patients with COVID-19. OBJECTIVES: To provide a brief overview of cutaneous lesions associated with COVID-19. METHODS: A literature search was performed in the PubMed, Scopus and Web of Science databases up to 30 April 2020. This narrative review summarizes the available data regarding the clinical and histological features of COVID-19-associated skin manifestations. RESULTS: The literature reports showed a great heterogeneity in COVID-19-associated cutaneous manifestations, as well as in their latency periods and associated extracutaneous symptoms. Pathogenic mechanisms are unknown, although the roles of a hyperactive immune response, complement activation and microvascular injury have been hypothesized. Based on our experience and the literature data, we subdivided the reported cutaneous lesions into six main clinical patterns: (i) urticarial rash; (ii) confluent erythematous-maculopapular-morbilliform rash; (iii) papulovesicular exanthem; (iv) chilblain-like acral pattern; (v) livedo reticularis-livedo racemosa-like pattern; and (vi) purpuric 'vasculitic' pattern. These six patterns can be merged into two main groups: the first - inflammatory and exanthematous - includes the first three groups listed above, and the second includes the vasculopathic and vasculitic lesions of the last three groups. CONCLUSIONS: The possible presence of cutaneous findings leading to suspect COVID-19 puts dermatologists in a relevant position. Further studies are needed to delineate the diagnostic and prognostic values of such cutaneous manifestations.


Will the COVID-19 pandemic worsen the obesity epidemic?


Beyond tropes: Towards a new image of nursing in the wake of COVID-19


title: Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020

text: A remarkable excess mortality has coincided with the COVID-19 pandemic in Europe. We present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March-April 2020. Excess mortality particularly affected ≥ 65 year olds (91% of all excess deaths), but also 45-64 (8%) and 15-44 year olds (1%). No excess mortality was observed in 0-14 year olds.


Letter: Rongeurs, Neurosurgeons, and COVID-19: How Do We Protect Health Care Personnel During Neurosurgical Operations in the Midst of Aerosol-Generation From High-Speed Drills?


The fate of house cats during the COVID-19 pandemic


title: A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

text: BACKGROUND: An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. METHODS: In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. FINDINGS: From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36-66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3-6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6-10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. INTERPRETATION: Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. FUNDING: The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).


A COVID-19 Rapid-Response Research Agenda


title: Pharmacists' readiness to deal with the coronavirus pandemic: Assessing awareness and perception of roles

text: BACKGROUND: The 2019 Coronavirus infection (COVID-19) caused by a novel strain of coronavirus was detected in China in December 2019, and declared a public health emergency of international concern on January 30, 2020. Community pharmacists have an important role in supporting the local health emergency preparedness and response arrangements. OBJECTIVES: To investigate pharmacists and pharmacy students' awareness and source of their information regard the management of the coronavirus pandemic, and their perspective of their role during this emergent situation. METHODS: This descriptive cross-sectional online survey study was conducted in Jordan during the COVID-19 outbreak (from 15 to 30 March 2020). A validated online questionnaire addressing participants' current awareness about epidemics/pandemics and COVID-19, source of information and their perspectives of their role. Data were analyzed using statistical package for social science (SPSS). RESULTS: Participants (n = 726) had a mean age of 26.9 (8.0) years with 71.9% females. Pharmacy students made 35.3% of the sample while the rest were pharmacists. Only 54.3% of participants believed that they got enough education about epidemics/pandemics, and 94.6% of them follow on the latest coronavirus updates on treatments, and that is mainly from the media (59.5%) followed by the World Health Organization reports (58.7%) and then the published researches (57%). Awareness score (out of 20) of pharmacists (n = 470) was significantly higher (p < 0.001) than that of students (n = 256). Better Awareness scores were also associated with higher age of participants, graduating from a public versus a private university, and attending more educational workshops. CONCLUSION: The majority of pharmacists and pharmacy students reported that they have a major role in the management of epidemics/pandemics through the community pharmacies but the majority follow on the latest coronavirus updates from the media. This fact rings bills considering the numerous conflicting messages publicized during the pandemic through the media.


title: Electric Vehicle transition in the UK

text: This paper provides an overview of the electric vehicle transition in the UK. The spatial disparity in the uptake of BEVs across the different regions is analysed using historic BEV sales. A forecast for future growth in BEVs (ignoring the impact of Covid-19) is performed using an s-curve model. Currently, South East England and Greater London have the highest BEV sales as a percentage of new vehicle sales. The spatial distribution of EV chargers across the different regions is also analysed. The spatial analysis clearly shows the regional disparity in the uptake of EV. South East England has the highest number of public chargers excluding Greater London. However, if we consider the number of EVs in that region, it has the second-lowest ratio of approx. 1 charger per 10 BEV. The lowest ratio being 0.8 in the West Midlands.


title: Early-stage predictors of the acute phase duration in uncomplicated COVID-19 pneumonia

text: OBJECTIVE: In this study, we aimed to highlight the common early-stage clinical and laboratory variables independently related to the acute phase duration in patients with uncomplicated coronavirus disease (COVID-19) pneumonia. METHODS: In hospitalized patients, the acute phase disease duration was followed using the Brescia-COVID respiratory severity scale (BCRSS). Noninvasive ventilation was administered based on clinical judgment. Patients requiring oropharyngeal intubation were excluded from the study. For parameters to be measured at the hospital entrance, age, clinical history, National Early Warning Score2 (NEWS2, a multiparametric score system), partial pressure of oxygen in arterial blood/fraction of inspired oxygen (P/F ratio), C-reactive protein, and blood cell count were selected. RESULTS: In 64 patients, age (direct relationship), P/F, and platelet number (inverse relationship) independently accounted for 43% of the acute phase duration of the disease (p<0.001). CONCLUSIONS: For the first time, the present results revealed that the acute phase duration of non-complicated pneumonia, resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is independently predicted from a patient's age, as well as based on the hospital entrance values of P/F ratio and peripheral blood platelet count. This article is protected by copyright. All rights reserved.


title: Evaluation of the EUROIMMUN Anti-SARS-CoV-2 ELISA Assay for detection of IgA and IgG antibodies

text: As the Coronavirus 2019 (COVID-19) pandemic evolves, the development of immunoassays to help determine exposure and potentially predict immunity has become a pressing priority. In this report we present the performance of the EUROIMMUN enzyme-linked immunosorbent assay (ELISA) for semi-quantitative detection of IgA and IgG antibodies in serum and plasma samples using recombinant S1 domain of the SARS-CoV-2 spike protein as antigen. Specimens from patients, with and without COVID-19 infection, were tested at the University of Chicago Clinical Microbiology and Immunology Laboratory. Of 86 samples from SARS-CoV-2 PCR-negative patients, including 28 samples positive for common human coronavirus strains, 76 tested negative and 10 tested positive for IgA (88.4% agreement, 95% CI: 79.9-93.6) while 84 tested negative and 2 tested positive for IgG (97.7% agreement, 95% CI: 91.9-99.6). Of 82 samples from SARS-CoV-2 PCR-positive patients, 14 tested negative and 68 tested positive for IgA (82.9% agreement, 95% CI: 73.4-89.5) while 27 tested negative and 55 tested positive for IgG (67.1% agreement, 95% CI: 56.3-76.3). Of samples collected ≥4 days after positive PCR, 38 of 42 (90.5% agreement, 95% CI: 77.9-96.2) were positive for IgA, and 42 of 42 (100% agreement, 95% CI: 91.6-100) were positive for IgG, respectively. The EUROIMMUN Anti-SARS-CoV-2 ELISA Assay demonstrated good sensitivity for detection of IgA and excellent sensitivity for detection of IgG antibodies from samples collected ≥4 days, after COVID-19 diagnosis by PCR. This assay demonstrated good specificity for IgA and excellent specificity for IgG and demonstrated only borderline cross reaction in 2 of the 28 samples from patients with common human coronaviruses infection, types NL63 and OC43.


title: MiR-210-3p Inhibits Proliferation and Migration of C6 Cells by Targeting Iscu

text: Glioma is the most common primary brain tumor and the most malignant type of glioma is glioblastoma with the character of high mortality, high recurrence rate and poor prognosis. MicroRNAs act as an important component in glioma development and thus may be a potential target for the treatment of glioma. There were some researches indicated that miR-210-3p played a role in glioma development, but if it can inhibit glioma growth, as well as the underlying mechanism, is still uncertain. In the present study, we investigated the effects of miR-210-3p and its potential target gene Iscu on glioma (C6) cells proliferation and migration in vitro as well as the influence of miR-210-3p on glioma growth in vivo. The results showed that miR-210-3p inhibited the proliferation and migration of C6 cells by regulating the expression of its target gene Iscu in vitro. We also demonstrated that glioma growth was suppressed in immunodeficient mice when they were implanted with C6 cells overexpressing miR-210-3p. Our data indicated that miR-210-3p played an important role in the prevention of glioma growth by targeting Iscu and so miR-210-3p/Iscu axis might be a potential target for the treatment of glioma.


title: BEHRT: Transformer for Electronic Health Records

text: Today, despite decades of developments in medicine and the growing interest in precision healthcare, vast majority of diagnoses happen once patients begin to show noticeable signs of illness. Early indication and detection of diseases, however, can provide patients and carers with the chance of early intervention, better disease management, and efficient allocation of healthcare resources. The latest developments in machine learning (more specifically, deep learning) provides a great opportunity to address this unmet need. In this study, we introduce BEHRT: A deep neural sequence transduction model for EHR (electronic health records), capable of multitask prediction and disease trajectory mapping. When trained and evaluated on the data from nearly 1.6 million individuals, BEHRT shows a striking absolute improvement of 8.0-10.8%, in terms of Average Precision Score, compared to the existing state-of-the-art deep EHR models (in terms of average precision, when predicting for the onset of 301 conditions). In addition to its superior prediction power, BEHRT provides a personalised view of disease trajectories through its attention mechanism; its flexible architecture enables it to incorporate multiple heterogeneous concepts (e.g., diagnosis, medication, measurements, and more) to improve the accuracy of its predictions; and its (pre-)training results in disease and patient representations that can help us get a step closer to interpretable predictions.


text: Today, despite decades of developments in medicine and the growing interest in precision healthcare, vast majority of diagnoses happen once patients begin to show noticeable signs of illness. Early indication and detection of diseases, however, can provide patients and carers with the chance of early intervention, better disease management, and efficient allocation of healthcare resources. The latest developments in machine learning (including deep learning) provides a great opportunity to address this unmet need. In this study, we introduce BEHRT: A deep neural sequence transduction model for electronic health records (EHR), capable of simultaneously predicting the likelihood of 301 conditions in one's future visits. When trained and evaluated on the data from nearly 1.6 million individuals, BEHRT shows a striking improvement of 8.0-13.2% (in terms of average precision scores for different tasks), over the existing state-of-the-art deep EHR models. In addition to its scalability and superior accuracy, BEHRT enables personalised interpretation of its predictions; its flexible architecture enables it to incorporate multiple heterogeneous concepts (e.g., diagnosis, medication, measurements, and more) to further improve the accuracy of its predictions; its (pre-)training results in disease and patient representations can be useful for future studies (i.e., transfer learning).


title: Self-care of medical staff in primary care: An issue that needs attention during the COVID-19 outbreak

text: Self-care is essential for primary care professionals who are at risk of COVID-19.


title: Evaluation of Patient's Perceptions, Healing, and Reattachment After Conventional and Diode Laser Frenectomy: A Three-Arm Randomized Clinical Trial

text: Objective: The aim of this study is to compare the conventional and diode laser techniques in terms of patient's perceptions, epithelization, reattachment, and periodontal clinical parameters in the treatment of abnormal papillary frenum. Materials and methods: Forty-eight patients with abnormal papillary frenum were enrolled in the study. Patients were randomly assigned into three groups; conventional frenectomy operation (C group), diode laser-assisted frenectomy (L group), and diode laser-assisted frenectomy with conventional horizontal incision on the periosteum (L + P group). Post-operative pain, discomfort in speaking, and chewing scores were assessed with visual analogue scale (VAS) at post-operative 3rd hour and on days 1, 7, 14, 21, and 45. Epithelialization process of the wound surface was evaluated by hydrogen peroxide solution applied to the wound on days 7, 14, 21, and 45 following operations. The distance between the frenum attachment point and mucogingival junction (FMGJ) was recorded at baseline, post-operative 45th day, and 6th month to assess the reattachment of the frenum. Plaque index, gingival index, bleeding on probing, and probing depth were recorded at baseline and post-operative 7th, 14th, 21st, and 45th days. Results: On the 1st and 7th day after operation, VAS pain score in the C group was significantly higher than in the L and L + P groups (p < 0.017). Difficulty in speaking and chewing scores were significantly lower in the L and L + P groups compared to the C group at post-operative 3rd hour and 7th day (p < 0.017). The FMGJ and epithelization period demonstrated no difference among the groups at any time point (p > 0.05). Conclusions: Our results suggest that diode laser provides better post-operative patient's perceptions than the conventional technique in frenectomy operation. In addition, both conventional and laser-assisted frenectomy surgeries prevent the frenum reattachment regardless of periosteal horizontal incision.


title: The Lateral Antebrachial Neurocutaneous Flap: A Cadaveric Study and Clinical Applications

text: BACKGROUND: The neurocutaneous flap is an axial pattern flap that receives a vascular supply from a vessel along its cutaneous nerve and has favorable outcomes when used for soft tissue reconstruction in the upper extremities. The neurocutaneous flap depends on the lateral antebrachial cutaneous nerve (LACN) and its retrograde-flow has been studied via cadaveric dissection. The aim of this study is to prove the vascularity of the lateral antebrachial neurocutaneous (LABN) flap. METHODS: The distally based LABN flap was created in 18 upper limbs (12 cadavers). The skin flap was dissected at the proximal half of the forearm and then diluted methylene blue was injected through the brachial artery. The pedicle of the flap on the distal half of the forearm was dissected along the LACN for the anatomical study of the perforating branches, paraneural vessels, and flap territory. RESULTS: The mean age of cadavers was 74.1 years (nine males). The mean distance of most distal and proximal perforating branches from the radial styloid process were 2.32 ± 0.59 and 11.17 ± 1.72 cm, respectively. The mean total number of perforating branches was 7.4, which abundantly appeared approximately 4 to 5 cm from the radial styloid process. The mean flap territory was 8.64 ± 0.82 cm in width and 10.50 ± 1.90 cm in length. The mean forearm circumference was 24.84 ± 1.52 cm, and mean forearm length was 24.74 ± 1.8 cm. CONCLUSION: This study ensured that retrograde-flow via the neurocutaneous artery could be provided through the vascularity of the LABN flap, which suggests that the pivot point of the flap should not extend beyond 5 cm proximal to the radial styloid process. The LABN flap is a useful alternative method for performing soft tissue reconstruction in hand and wrist defects without sacrificing the major vessels.


title: Clinical characteristics of the coronavirus disease 2019 (COVID-19) outbreak on a cruise ship

text: BACKGROUND: A large COVID-19 outbreak occurred on the cruise ship Diamond Princess in February 2020. Little information has been reported about the clinical characteristics of the patients. METHODS: This single-center, retrospective, observational study was conducted in Yokohama, Japan. We included symptomatic patients who were infected on the ship and admitted to our hospital between 5 and 19 February 2020. All the cases were confirmed with SARS-CoV-2 infection by polymerase chain reaction (PCR). RESULTS: We confirmed 17 cases. The average age was 69 years; 10 patients were Asian and 7 were Caucasian. Eleven patients had one or more chronic diseases. The major symptoms were cough and fever. Chest computed tomography (CT) scans found bilateral ground-glass opacities predominantly in the peripheral area, which were similar to reports from cases in China. C-reactive protein (CRP) levels were higher in severe and critical cases than in mild to moderate cases. The moderate to severe cases reached symptomatic resolution; one of the three critical cases resulted in death due to multiple organ failure. SARS-CoV-2 was detected by PCR at an average of 7 days after symptomatic resolution. CONCLUSIONS: Cough and fever, increased blood CRP levels, and CT findings of bilateral ground-glass opacities predominantly in the peripheral lung were characteristic of the COVID-19 cases in this study. These findings were compatible with those of previous reports.


title: El servicio de farmacia frente a la logística de adquisición de medicamentos./ Hospital Pharmacy Service: Facing the logistics of medicines procurement

text: COVID crisis has abruptly broken into our hospitals, and many difficulties have emerged, including those related to supply logistics. A huge number of new patients, a fast internal reorganization process and many other changes were suddenly established. These circumstances revealed the need to increase stocks of drugs, both for basic treatment as well as for specific SARS-CoV-2 infection management. At the same time, other problems (shortages, new and complex purchasing procedures, etc.) surfaced, so they could risk safety along the pharmacotherapeutic process. The main objective was to develop and implement all the necessary measures within the logistics circuit in order to ensure the availability of medicines for patients, as safely and effectively as possible, during the Coronavirus crisis. Firstly, two pharmacists were appointed to coordinate the whole process, and a preliminary analysis of the following aspects was carried out an estimation of needs to make an initial drug provisioning, a storage feasibility study and a global analysis of the logistics process to detect critical points. Three different circuits for medicines supply were established as some drugs were operated by Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) or Servicio Madrileño de Salud (SERMAS), and others were under no restrictions. For stocks control, inventory was frequently reviewed and monitoring of prescription trends was implemented. For all new medicinal products, compliance with security standards was reviewed and relabeling was carried out if necessary. Criteria were defined for the storage of overstocks and it was placed an isolated area for quarantined drugs. Shortages inevitably occurred but their effects were partly mitigated by AEMPS and SERMAS. After all, we consider that the implemented procedure for logistics management may be reproducible, and the key points we have identified are the following: to enhance our quality management system, to develop an Action Plan for Healthcare Emergencies and to ensure the adequate training for all pharmacy staff. Furthermore, we also should address other aspects: to establish storage optimization strategies, to focus on a more advanced logistics management model, as well as to take advantage of the extraordinary multidisciplinary network, which has been consolidated during this COVID pandemic.


title: The Global Phosphorylation Landscape of SARS-CoV-2 Infection

text: The causative agent of the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected millions and killed hundreds of thousands of people worldwide, highlighting an urgent need to develop antiviral therapies. Here we present a quantitative mass spectrometry-based phosphoproteomics survey of SARS-CoV-2 infection in Vero E6 cells, revealing dramatic rewiring of phosphorylation on host and viral proteins. SARS-CoV-2 infection promoted casein kinase II (CK2) and p38 MAPK activation, production of diverse cytokines, and shutdown of mitotic kinases, resulting in cell cycle arrest. Infection also stimulated a marked induction of CK2-containing filopodial protrusions possessing budding viral particles. Eighty-seven drugs and compounds were identified by mapping global phosphorylation profiles to dysregulated kinases and pathways. We found pharmacologic inhibition of the p38, CK2, CDK, AXL, and PIKFYVE kinases to possess antiviral efficacy, representing potential COVID-19 therapies.


title: Thrombotic circuit complications during venovenous extracorporeal membrane oxygenation in COVID-19

text: The novel coronavirus SARS-CoV-2 and the resulting disease COVID-19 causes pulmonary failure including severe courses requiring venovenous extracorporeal membrane oxygenation (V-V ECMO). Coagulopathy is a known complication of COVID-19 leading to thrombotic events including pulmonary embolism. It is unclear if the coagulopathy also increases thrombotic circuit complications of the ECMO. Aim of the present study therefor was to investigate the rate of V-V ECMO complications in COVID-19. We conducted a retrospective registry study including all patients on V-V ECMO treated at our centre between 01/2018 and 04/2020. COVID-19 cases were compared non- COVID-19 cases. All circuit related complications resulting in partial or complete exchange of the extracorporeal system were registered. In total, 66 patients were analysed of which 11 (16.7%) were SARS-CoV-2 positive. The two groups did not differ in clinical parameters including age (COVID-19 59.4 vs. non-COVID-19 58.1 years), gender (36.4% vs. 40%), BMI (27.8 vs. 24.2) and severity of illness as quantified by the RESP Score (1pt. vs 1pt.). 28 days survival was similar in both groups (72.7% vs. 58.2%). While anticoagulation was similar in both groups (p = 0.09), centrifugal pump head thrombosis was more frequent in COVID-19 (9/11 versus 16/55 p < 0.01). Neither the time to first exchange (p = 0.61) nor blood flow at exchange (p = 0.68) did differ in both groups. D-dimer levels prior to the thrombotic events were significantly higher in COVID-19 (mean 15.48 vs 26.59, p = 0.01). The SARS-CoV-2 induced infection is associated with higher rates of thrombotic events of the extracorporeal system during V-V ECMO therapy.


Patient´s perspective: psychological burden of the COVID-19 pandemic in 146 psoriatic patients treated with biological drugs and small molecules in real clinical practice


Comment on "The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis"


title: How COVID-19 public interest in the United States fluctuated: A Google Trends Analysis

text: BACKGROUND: In the absence of vaccines and established treatments, nonpharmaceutical interventions (NPIs) are fundamental tools to control coronavirus disease 2019 (COVID-19) transmission. NPIs require public interest in order to be successful. In the United States, there is a lack of published research on the factors that influenced public interest in COVID-19. Using Google Trends, we examined the US level of public interest in COVID-19 and how it correlated to testing and other countries. OBJECTIVE: To determine how public interest in COVID-19 in the US changed over time and the key factors driving this change, such as testing. US COVID-19 public interest was compared to countries that have been more successful in their containment and mitigation strategies. METHODS: In this retrospective study, Google Trends was used to analyze the volume of internet searches within the US relating to COVID-19, focusing on dates between December 31, 2019 to March 24, 2020. Volume of internet searches related to COVID-19 was compared to other countries. RESULTS: Within the US throughout January and February 2020, there was limited search interest in COVID-19. Interest declined for the first 21 days of February. A similar decline was seen in geographical regions that were later found to be experiencing undetected community transmission in February. Between March 9 and March 12, there was a rapid rise in search interest. This rise in search interest was positively correlated with the rise of positive tests for SARS-CoV-2 (6.3, 95% CI -2.9 to 9.7; P <.001). Within the US, it took 52 days for search interest to rise substantially from first positive case; in countries with more successful outbreak control it took less than 15 days. CONCLUSIONS: Containment and mitigation strategies require public interest in order for them to be successful. The initial US level of COVID-19 public interest was limited, and even fell during a time when containment and mitigation strategies were being put in place. A lack of US public interest in COVID-19 existed when containment and mitigation policies were in place. Based on our analysis, it is clear policy makers need to develop novel methods of communicating COVID-19 public health initiatives.


title: Is There an Association Between COVID-19 Mortality and the Renin-Angiotensin System-a Call for Epidemiologic Investigations

text: Mortality from coronavirus disease 2019 (COVID-19) is strongly associated with cardiovascular disease, diabetes, and hypertension. These disorders share underlying pathophysiology related to the renin-angiotensin system (RAS) that may be clinically insightful. In particular, activity of the angiotensin-converting enzyme 2 (ACE2) is dysregulated in cardiovascular disease, and this enzyme is used by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to initiate the infection. Cardiovascular disease and pharmacologic RAS inhibition both increase ACE2 levels, which may increase the virulence of SARS-CoV-2 within the lung and heart. Conversely, mechanistic evidence from related coronaviruses suggests that SARS-CoV-2 infection may downregulate ACE2, leading to toxic overaccumulation of Angiotensin II that induces acute respiratory distress syndrome and fulminant myocarditis. RAS inhibition could mitigate this effect. With conflicting mechanistic evidence, we propose key clinical research priorities necessary to clarify the role of RAS inhibition in COVID-19 mortality that could be rapidly addressed by the international research community.


title: Probability of symptoms and critical disease after SARS-CoV-2 infection

text: We quantified the probability of developing symptoms (respiratory or fever \geq 37.5 {\deg}C) and critical disease (requiring intensive care or resulting in death) of SARS-CoV-2 positive subjects. 5,484 contacts of SARS-CoV-2 index cases detected in Lombardy, Italy were analyzed, and positive subjects were ascertained via nasal swabs and serological assays. 73.9% of all infected individuals aged less than 60 years did not develop symptoms (95% confidence interval: 71.8-75.9%). The risk of symptoms increased with age. 6.6% of infected subjects older than 60 years had critical disease, with males at significantly higher risk.


title: Inverse Folding of RNA Pseudoknot Structures

text: Background: RNA exhibits a variety of structural configurations. Here we consider a structure to be tantamount to the noncrossing Watson-Crick and \pairGU-base pairings (secondary structure) and additional cross-serial base pairs. These interactions are called pseudoknots and are observed across the whole spectrum of RNA functionalities. In the context of studying natural RNA structures, searching for new ribozymes and designing artificial RNA, it is of interest to find RNA sequences folding into a specific structure and to analyze their induced neutral networks. Since the established inverse folding algorithms, {\tt RNAinverse}, {\tt RNA-SSD} as well as {\tt INFO-RNA} are limited to RNA secondary structures, we present in this paper the inverse folding algorithm {\tt Inv} which can deal with 3-noncrossing, canonical pseudoknot structures. Results: In this paper we present the inverse folding algorithm {\tt Inv}. We give a detailed analysis of {\tt Inv}, including pseudocodes. We show that {\tt Inv} allows to design in particular 3-noncrossing nonplanar RNA pseudoknot 3-noncrossing RNA structures--a class which is difficult to construct via dynamic programming routines. {\tt Inv} is freely available at \url{http://www.combinatorics.cn/cbpc/inv.html}. Conclusions: The algorithm {\tt Inv} extends inverse folding capabilities to RNA pseudoknot structures. In comparison with {\tt RNAinverse} it uses new ideas, for instance by considering sets of competing structures. As a result, {\tt Inv} is not only able to find novel sequences even for RNA secondary structures, it does so in the context of competing structures that potentially exhibit cross-serial interactions.


title: Inverse folding of RNA pseudoknot structures

text: Background: RNA exhibits a variety of structural configurations. Here we consider a structure to be tantamount to the noncrossing Watson-Crick and \pairGU-base pairings (secondary structure) and additional cross-serial base pairs. These interactions are called pseudoknots and are observed across the whole spectrum of RNA functionalities. In the context of studying natural RNA structures, searching for new ribozymes and designing artificial RNA, it is of interest to find RNA sequences folding into a specific structure and to analyze their induced neutral networks. Since the established inverse folding algorithms, {\tt RNAinverse}, {\tt RNA-SSD} as well as {\tt INFO-RNA} are limited to RNA secondary structures, we present in this paper the inverse folding algorithm {\tt Inv} which can deal with 3-noncrossing, canonical pseudoknot structures. Results: In this paper we present the inverse folding algorithm {\tt Inv}. We give a detailed analysis of {\tt Inv}, including pseudocodes. We show that {\tt Inv} allows to design in particular 3-noncrossing nonplanar RNA pseudoknot 3-noncrossing RNA structures-a class which is difficult to construct via dynamic programming routines. {\tt Inv} is freely available at \url{http://www.combinatorics.cn/cbpc/inv.html}. Conclusions: The algorithm {\tt Inv} extends inverse folding capabilities to RNA pseudoknot structures. In comparison with {\tt RNAinverse} it uses new ideas, for instance by considering sets of competing structures. As a result, {\tt Inv} is not only able to find novel sequences even for RNA secondary structures, it does so in the context of competing structures that potentially exhibit cross-serial interactions.


What the oncologist needs to know about COVID-19 infection in cancer patients


title: The potential of JAK/STAT pathway inhibition by ruxolitinib in the treatment of COVID-19

text: Ruxolitinib is the first approved JAK1 and JAK2 inhibitor, and is known to interfere with the JAK / STAT signaling pathway, one of the critical cellular signaling pathways involved in the inflammatory response. This review presents an overview of SARS-CoV-2 and the COVID-19 pandemic, and then focuses on the potential efficacy of ruxolitinib in this infection. The potential targets of ruxolitinib were determined by using genetic alterations that have been reported in COVID-19 patients. The potential effectiveness of ruxolitinib is suggested by evaluating the interactions of these potential targets with ruxolitinib or JAK/STAT pathway.


Biological treatment use amid the COVID-19 era, a close look at the unresolved perplexity


Usefulness of an Online Preliminary Questionnaire under the COVID-19 Pandemic


Haemophagocytosis in bone marrow aspirates in patients with COVID-19


Methodological challenges of analysing COVID-19 data during the pandemic


title: Robotic-assisted percutaneous coronary intervention in a COVID-19 patient

text: Coronavirus disease-2019 (COVID-19) pandemic is the biggest global health threat in the 21st century. We describe a case of a patient with suspected COVID-19 who needed urgent coronary artery interrogation, in which we utilized robotic assistance to minimize the risk of exposure to COVID-19 and reduced personal protective equipment needed by the procedural team.


title: Determination of the reference interval for the activity of NAcetyl-ß-D-glucosaminidase (NAG) in urine of healthy dogs/ Determinação de intervalo de referência para a atividade da NAcetyl-ß-D-glucosaminidase (NAG) na urina de cães sadios

text: The diagnosis of acute kidney injury by evaluating the activity of urinary enzymes is an important tool especially for its precocity in relation to methods of assessment of renal function considered late as the installation of injury precedes the function change. This study was performed to determine the reference interval for urinary NAG activity (N-Acetyl-β-D-glucosaminidase) in urine of healthy dogs of different breeds, ages and sexes. It was utilized an automated method for the determination of NAG activity standardized for dog urine samples. Through statistical analysis it was observed that NAG is positively correlated with the age of the animal and urine specific gravity but is not interfered by sex or weight. Based on the determination of urinary activity and after correcting the values for a 1,025 urine specific gravity was obtained an reference interval of X '= 3.62U/L±0.66U/L.(AU)


title: Blockchain and Artificial Intelligence Technology for Novel Coronavirus Disease-19 Self-Testing

text: The novel coronavirus disease 19 (COVID-19) is rapidly spreading with a rising death toll and transmission rate reported in high income countries rather than in low income countries. The overburdened healthcare systems and poor disease surveillance systems in resource-limited settings may struggle to cope with this COVID-19 outbreak and this calls for a tailored strategic response for these settings. Here, we recommend a low cost blockchain and artificial intelligence-coupled self-testing and tracking systems for COVID-19 and other emerging infectious diseases. Prompt deployment and appropriate implementation of the proposed system have the potential to curb the transmissions of COVID-19 and the related mortalities, particularly in settings with poor access to laboratory infrastructure.


Learning From COVID-19 and Looking to Technology Ahead


SARS-CoV-2 and Eosinophilia


title: More advice on the use of ibuprofen for COVID-19

text: Overview of: Commission of Human Medicines. Commission on Human Medicines advice on ibuprofen and coronavirus (COVID-19). CEM/CMO/2020/017.


Statement in support of the scientists, public health professionals, and medical professionals of China combatting COVID-19


Ophthalmic manifestations of novel coronaviruses: precautionary measures and diagnostic possibilities


Potential implications of COVID-19 in non-alcoholic fatty liver disease


Electroconvulsive Therapy During COVID-19-Times: Our Patients Cannot Wait


Surgical mask dermatitis caused by formaldehyde (releasers) during the COVID-19 pandemic


Do Not Neglect the Children: Considerations for COVID-19 Pandemic


title: Environmental contamination of SARS-CoV-2 during the COVID-19 outbreak in South Korea

text: OBJECTIVES: Although contact precaution is generally recommended in situations where coronavirus disease 2019 (COVID-19) is suspected, there is limited evidence on environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, we conducted environmental surveillance on SARS-CoV-2 contamination in 2 different healthcare settings. METHODS: Viral contamination was investigated on the environment of 2 hospitals that had admitted 13 COVID-19 patients. In hospital A, 5 patients with pneumonia occupied negative pressure rooms. In hospital B, 8 asymptomatic patients shared 2 common 4-bed rooms. Most rooms were poorly cleaned or disinfected. Environmental swab were collected from inside and outside the rooms and were tested using real-time RT-PCR for the detection of SARS-CoV-2. RESULTS: In hospital A, SARS-CoV-2 was detected in 10 of 57 (17.5%) samples from inside the rooms including the Ambu bag and infusion pump. Two samples obtained at more than 2 m from the patients showed positive results. In hospital B, 3 of 22 (13.6%) samples from inside the rooms were positive. Areas outside the rooms, such as the anteroom, corridor, and nursing station, were all negative in both hospitals. CONCLUSIONS: Hospital surfaces surrounding patients were contaminated by SARS-CoV-2. Our findings support the value of strict contact precaution, routine cleaning, and disinfection in the management of COVID-19 patients.


Hospital in the home: needed now more than ever


Convalescent Plasma and COVID-19


Statins as early therapy to mitigate COVID-19 (SARS-CoV-2)-associated ARDS and cytokine storm syndrome - time is of the essence


title: The computation of case fatality rate for novel coronavirus (COVID-19) based on Bayes theorem: An observational study

text: BACKGROUND: When a new disease such starts to spread, the commonly asked questions are how deadly is it? and how many people are likely to die of this outbreak? The World Health Organization (WHO) announced in a press conference on January 29, 2020 that the death rate of COVID-19 was 2% on the case fatality rate (CFR). It was underestimated assuming no lag days from symptom onset to deaths while many CFR formulas have been proposed, the estimation on Bays theorem is worthy of interpretation. Hence, it is hypothesized that the over-loaded burdens of treating patients and capacities to contain the outbreak (LSBHRS) may increase the CFR. METHODS: We downloaded COVID-19 outbreak numbers from January 21 to February 14, 2020, in countries/regions on a daily basis from Github that contains information on confirmed cases in >30 Chinese locations and other countries/regions. The pros and cons were compared among the 5 formula of CFR, including [A] deaths/confirmed; [B] deaths/(deathsâ+ârecovered); [C] deaths/(cases x days ago); [D] Bayes estimation based on [A] and the outbreak (LSBHRS) in each country/region; and [E] Bayes estimation based on [C] deaths/(cases x days ago). The coefficients of variance (CVâ=âthe ratio of the standard deviation to the mean) were applied to measure the relative variability for each CFR. A dashboard was developed for daily display of the CFR across each region. RESULTS: The Bayes based on (A)[D] has the lowest CV (=0.10) followed by the deaths/confirmed (=0.11) [A], deaths/(deathsâ+ârecoveries) (=0.42) [B], Bayes based on (C) (=0.49) [E], and deaths/(cases x days ago) (=0.59) [C]. All final CFRs will be equal using the formula (from, A to E). A dashboard was developed for the daily reporting of the CFR. The CFR (3.7%) greater than the prior CFR of 2.2% was evident in LSBHRS, increasing the CFR. A dashboard was created to present the CFRs on COVID-19. CONCLUSION: We suggest examining both trends of the Bayes based on both deaths/(cases 7 days ago) and deaths/confirmed cases as a reference to the final CFR. An app developed for displaying the provisional CFR with the 2 CFR trends can improve the underestimated CFR reported by WHO and media.


U.S. Chinese Distrust Is Inviting Dangerous Coronavirus Conspiracy Theories And Undermining Efforts to Contain the Epidemic


title: Exergames as Coping Strategies for Anxiety Disorders During the COVID-19 Quarantine Period

text: The COVID-19 outbreak has led to wide-scale self-isolation, as a result of the quarantine period recommended by the World Health Organization. Consequently, people's mental health, including their anxiety levels, may be becoming impaired. To cope with the situation, the exergame appears to be an enjoyable easy-to-use tool for reducing social isolation, as well as an interesting mode of home-based exercise for tackling anxiety disorders and sedentary behavior. This article critically appraises the opportunities and challenges exergames present for the prevention and treatment of anxiety disorders in a home-based environment during the COVID-19 quarantine period.


title: Emerging prophylaxis strategies against COVID-19

text: The Novel corona virus 2019 which started as an outbreak in China in December 2019 has rapidly spread all over the world, such that on 11th March 2020 WHO declared this disease as pandemic. The emergency that the world faces today demands that we develop urgent and effective measures to protect people at high risk of transmission. WHO has accelerated research in diagnostics, vaccines and therapeutics for this novel coronavirus.


Deciphering the power of isolation in controlling COVID-19 outbreaks


Consequences of the COVID-19 Pandemic: Reduced Hemoglobin A1c Diabetes Monitoring


Clinical chemistry tests for patients with COVID-19 - important caveats for interpretation


title: COVID-19 and fiscal space for health system in Pakistan: It is time for a policy decision

text: Most developing countries with weak economies and low GDPs strive to invest an optimal amount of budget to health sector. Compounding on this state of affairs is their inherent inefficiency to spend even that meager amount on the welfare of the patients, improving service delivery, motivating their workforce and making their health systems responsive to the needs of the people they serve. With weak fiscal base and inelasticity in budget spending, when these countries face a catastrophe like COVID-19, there is a whole situation of havoc and lack of finances emerges as the biggest issue in such crises. Pakistan has been no exception to this kind of situation. Government funds allocated to other public sector development schemes are diverted to deal with the health emergency. Hence, the result is an overall socioeconomic shock that a country has to face. Amid such crises, other international commitments also face a state of uncertainty. With the changing disease patterns all over the world, the public financial management system for health sector needs to be revisited to devise a more sustainable and resilient mechanism not only to absorb shocks like COVID-19 but also to meet the international health commitments.


Comment on "Minimally Invasive Surgery and the Novel Coronavirus Outbreak: Lessons Learned in China and Italy"


Imaging and COVID-19


title: Strategies for liver transplantation during the SARS-CoV-2 outbreak: Preliminary experience from a single center in France

text: Liver transplantation (LT) during the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is challenging given the urgent need to reallocate resources to other areas of patient care. Available guidelines recommend reorganizing transplant care, but data on clinical experience in the context of SARS-CoV-2 pandemic are scarce. Thus, we report strategies and preliminary results in LT during the peak of the SARS-CoV-2 pandemic from a single center in France. Our strategy to reorganize the transplant program included 4 main steps: optimization of available resources, especially intensive care unit capacity; multidisciplinary risk stratification of LT candidates on the waiting list; implementation of a systematic SARS-CoV-2 screening strategy prior to transplantation; and definition of optimal recipient-donor matching. After implementation of these 4 steps, we performed 10 successful LTs during the peak of the pandemic with a short median intensive care unit stay (2.5 days), benchmark posttransplant morbidity, and no occurrence of SARS-CoV-2 infection during follow-up. From this preliminary experience we conclude that efforts in resource planning, optimal recipient selection, and organ allocation strategy are key to maintain a safe LT activity. Transplant centers should be ready to readapt their practices as the pandemic evolves.


title: COVID-19 pandemic and management of GIMEMA clinical trials: changes and challenges

text: With the outbreak of COVID-19 pandemic (Wang et al, 2020), Italy - and in particular the largest Northern regions - became disease epicenter with a dramatic raise in infections and deaths in the month of March.


title: Emergency mental health legislation in response to the Covid-19 (Coronavirus) pandemic in Ireland: Urgency, necessity and proportionality

text: Many countries have enacted, or are in the process of enacting, emergency mental health legislation in response to the global pandemic of Covid-19 (coronavirus). In Ireland, the Emergency Measures in the Public Interest (Covid-19) Act, 2020 amends the Mental Health Act 2001 to permit the Mental Health Commission to request an independent psychiatric report about an involuntary patient from any consultant psychiatrist who is not treating the patient (and not just those on its designated panel). This independent examination may occur 'in person', 'by other appropriate means', or even, 'due to the exigencies of the public health emergency', not occur at all, once this is explained in the resultant report. The 2020 Act acknowledges that 'the exigencies of the public health emergency' might hamper the independent psychiatrist's work and requires a written report from the patient's treating psychiatrist 'no earlier than the day before' the tribunal, in lieu of the psychiatrist physically attending a tribunal hearing, although, if possible, they will attend (i.e. phone in to) a tribunal held by conference call. The 2020 Act permits the Mental Health Commission to, if necessary, appoint tribunals 'consisting of one member who shall be a practising barrister or solicitor'. Such a tribunal shall, if possible, consult with a consultant psychiatrist if the reports from the independent psychiatrist and treating psychiatrist conflict or if it is otherwise 'necessary in the interest of the patient'. A tribunal can extend an involuntary order by a second period of 14 days 'of its own motion if the tribunal, having due regard to the interest of the patient, is satisfied that it is necessary'. Tribunals for current involuntary patients will be prioritised over retrospective tribunals for discharged patients; a tribunal can direct a witness to provide 'a written statement' rather than attending; and the patient can make written representation to the tribunal instead of physically attending a tribunal hearing, although they may attend (i.e. phone in to) a tribunal held by conference call. Psycho-surgery for involuntary patients is banned. While it is clear that revisions are urgent and necessary in light of Covid-19, the proportionality of these changes will depend on how, and the extent to which, they are used in practice. With good communication, efficient team-working and close adherence to professional codes of practice and ethics, it is hoped that these amendments will result in a review system that is as reasonable, robust and reassuring as the current, highly unusual circumstances permit.


Issues relevant to mental health promotion in frontline health care providers managing quarantined/isolated COVID19 patients


First COVID-19 suicide case in Bangladesh due to fear of COVID-19 and xenophobia: Possible suicide prevention strategies


title: Renin-Angiotensin System Blockers and the COVID-19 Pandemic: At Present There Is No Evidence to Abandon Renin-Angiotensin System Blockers

text: During the spread of the severe acute respiratory syndrome coronavirus-2, some reports of data still emerging and in need of full analysis indicate that certain groups of patients are at risk of COVID-19. This includes patients with hypertension, heart disease, diabetes mellitus, and clearly the elderly. Many of those patients are treated with renin-angiotensin system blockers. Because the ACE2 (angiotensin-converting enzyme 2) protein is the receptor that facilitates coronavirus entry into cells, the notion has been popularized that treatment with renin-angiotensin system blockers might increase the risk of developing a severe and fatal severe acute respiratory syndrome coronavirus-2 infection. The present article discusses this concept. ACE2 in its full-length form is a membrane-bound enzyme, whereas its shorter (soluble) form circulates in blood at very low levels. As a mono-carboxypeptidase, ACE2 contributes to the degradation of several substrates including angiotensins I and II. ACE (angiotensin-converting enzyme) inhibitors do not inhibit ACE2 because ACE and ACE2 are different enzymes. Although angiotensin II type 1 receptor blockers have been shown to upregulate ACE2 in experimental animals, the evidence is not always consistent and differs among the diverse angiotensin II type 1 receptor blockers and differing organs. Moreover, there are no data to support the notion that ACE inhibitor or angiotensin II type 1 receptor blocker administration facilitates coronavirus entry by increasing ACE2 expression in either animals or humans. Indeed, animal data support elevated ACE2 expression as conferring potential protective pulmonary and cardiovascular effects. In summary, based on the currently available evidence, treatment with renin-angiotensin system blockers should not be discontinued because of concerns with coronavirus infection.


title: Response-adaptive randomization in clinical trials: from myths to practical considerations

text: Response-adaptive randomization (RAR) is part of a wider class of data-dependent sampling algorithms, for which clinical trials have commonly been used as a motivating application. In that context, patient allocation to treatments is defined using the accrued data on responses to alter randomization probabilities, in order to achieve different experimental goals. RAR has received abundant theoretical attention from the biostatistical literature since the 1930's and has been the subject of heated debates. Recently it has received renewed consideration from the applied community due to successful practical examples and its widespread use in machine learning. Many position papers on the subject present a one-sided view on its use, which is of limited value for the non-expert. This work aims to address this persistent gap by providing a critical, balanced and updated review of methodological and practical issues to consider when debating the use of RAR in clinical trials.


Covid-19: Pandemic exposes inequalities in global food systems


title: What patients "see" doctors in online fever clinics during COVID-19 in Wuhan?

text: OBJECTIVE: In December 2019, coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. Online fever clinics were developed by hospitals, largely relieving the hospital's burden. Online fever clinics could help people stay out of crowded hospitals and prevent the risk of cross infections. The objective of our study was to describe the patient characteristics of an online fever clinic and explore the most important concerns and question of online patients. MATERIALS AND METHODS: Our study extracted data from fever clinic records in medical information systems from January 24 to February 18, 2020 in a tertiary hospital in Wuhan. We described the characteristics of patients in fever clinic, then we extracted and classified questions of patient consultations through the online fever clinic dataset. RESULTS: For the 64 487 patients who attended the online fever clinic, the average age was 30.4 years, and 37 665 (58.4%) were female patients. The current state of patients from online were home without isolation (52 360 [81.2%]), home isolated (11 152 [17.29%]), and outpatient observation (975 [1.51%]). From the 594 patient questions analyzed, confirming diagnosis and seeking medical treatment account for 60.61% and 38.05%, respectively, followed by treating (25.59%), preventing (4.38%), and relieving anxiety (1.68%). DISCUSSION: Online fever clinics can effectively relieve patients' mood of panic, and doctors can guide patients with suspected of COVID-19 to isolate and protect themselves through online fever clinic. Online fever clinics can also help to reduce the pressure of hospital fever clinics and prevent cross infection. CONCLUSIONS: This study indicated the importance of online fever clinics during the COVID-19 outbreak for prevention and control.


title: Canadian Society of Thoracic Radiology/Canadian Association of Radiologists Consensus Statement Regarding Chest Imaging in Suspected and Confirmed COVID-19

text: On March 11, 2020, the World Health Organization declared infection related to a novel coronavirus (SARS-CoV-2) a pandemic. The role and impact of imaging predates this declaration and continues to change rapidly. This article is a consensus statement provided by the Canadian Society of Thoracic Radiology and the Canadian Association of Radiologists outlining the role of imaging in COVID-19 patients. The objectives are to answer key questions related to COVID-19 imaging of the chest and provide guidance for radiologists who are interpreting such studies during this pandemic. The role of chest radiography (CXR), computed tomography (CT), and lung ultrasound is discussed. This document attempts to answer key questions for the imager when dealing with this crisis, such as "When is CXR appropriate in patients with suspected or confirmed COVID-19 infection?" or "How should a radiologist deal with incidental findings of COVID-19 on CT of the chest done for other indications?" This article also provides recommended reporting structure for CXR and CT, breaking diagnostic possibilities for both CXR and CT into 3 categories: typical, nonspecific, and negative based on imaging findings with representative images provided. Proposed reporting language is also outlined based on this structure. As our understanding of this pandemic evolves, our appreciation for how imaging fits into the workup of patients during this unprecedented time evolves as well. Although this consensus statement was written using the most recent literature, it is important to maintain an open mind as new information continues to surface.


title: The prospects of sitting 'end of year' open book exams in the light of COVID-19: A medical student's perspective

text: Medical schools in the UK have been forced to dramatically restructure teaching and assessment amidst the Coronavirus (COVID-19) pandemic. As part of this, some have opted to assess progression through open book examinations (OBE). I aim to share my thoughts as an unsettled 4th year medical student about to embark on my first set of clinical exams conducted in this format. The difficulties associated with preparing for examinations under such unique and challenging circumstances cannot be underestimated. Working from home, during social distancing, surrounds students with the extra family stresses that we are all facing during this pandemic. This combined with a new, unfamiliar examination format will inevitably lead to students feeling daunted. While some would argue that an OBE may reward good problem solvers, students still require a strong foundation of knowledge. The luxury of reference will not be afforded in all clinical settings thus leading to concerns regarding students skimming over essential learning points. Furthermore, we cannot ignore the increased opportunity for academic misconduct resulting from an open book assessment format. Why are medical schools placing undue stress on students who could instead focus their attention on living compassionately for others during this difficult time?


title: Rapid In-Vitro Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Using Povidone-Iodine Oral Antiseptic Rinse

text: PURPOSE: To investigate the optimal contact time and concentration for viricidal activity of oral preparation of povidone-iodine (PVP-I) against SARS-CoV-2 ('corona virus') to mitigate the risk and transmission of the virus in the dental practice. MATERIALS AND METHODS: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) USA-WA1/2020 strain, virus stock was tested against oral antiseptic solutions consisting of aqueous povidone-iodine (PVP-I) as the sole active ingredient. The PVP-I was tested at diluted concentrations of 0.5%, 1%, and 1.5%. Test media without any virus was added to 2 tubes of the compounds to serve as toxicity and neutralization controls. Ethanol (70%) was tested in parallel as a positive control, and water only as a negative control. The test solutions and virus were incubated at room temperature (22 ± 2 °C) for time periods of 15 and 30 seconds. The solution was then neutralized by a 1/10 dilution in minimum essential medium (MEM) 2% fetal bovine serum (FBS), 50 µg/mL gentamicin. Surviving virus from each sample was quantified by standard end-point dilution assay and the log reduction value (LRV) of each compound compared to the negative (water) control was calculated. RESULTS: PVP-I oral antiseptics at all tested concentrations of 0.5%, 1%, and 1.5%, completely inactivated SARS-CoV-2 within 15 seconds of contact. The 70% ethanol control group was unable to completely inactivate SARS-CoV-2 after 15 seconds of contact, but was able to inactivate the virus at 30 seconds of contact. CONCLUSIONS: PVP-I oral antiseptic preparations rapidly inactivated SARS-CoV-2 virus in vitro. The viricidal activity was present at the lowest concentration of 0.5 % PVP-I and at the lowest contact time of 15 seconds. This important finding can justify the use of preprocedural oral rinsing with PVP-I (for patients and health care providers) may be useful as an adjunct to personal protective equipment, for dental and surgical specialties during the COVID-19 pandemic.


Prognosis of patients with sickle cell disease and COVID-19: a French experience


We Know Liver Biochemistries Are Elevated in COVID-19, But Should We Be Concerned?


title: [Diagnosis and clinical management of 2019 novel coronavirus infection: an operational recommendation of Peking Union Medical College Hospital (V2.0)]

text: Since December 2019, China has been experiencing an outbreak of new infectious disease caused by 2019 novel coronavirus (2019-nCoV). The clinical features include fever, coughing, shortness of breath, and inflammatory pulmonary infiltration revealed by X ray. China rapidly identified 2019-nCoV-related pneumonia a statutory infectious disease. To standardize the diagnosis and treatment of this new infectious disease, operational guidelines for the diagnosis and management of 2019-nCoV infection is accomplished by Peking Union Medical College Hospital.


title: COVID-19 and the re-opening of schools: a policy maker's dilemma

text: The epidemic of coronavirus disease 2019 (COVID-19) broke out in Wuhan, China, in December 2019 and rapidly spread across the world. In order to counter this epidemic, several countries put in place different restrictive measures, such as the school's closure and a total lockdown. However, as the knowledge on the disease progresses, clinical evidence showed that children mainly have asymptomatic or mild disease and it has been suggested that they are also less likely to spread the virus. Moreover, the lockdown and the school closure could have negative consequences on children, affecting their social life, their education and their mental health. As many countries have already entered or are planning a phase of gradual lifting of the containment measures of social distancing, it seems plausible that the re-opening of nursery schools and primary schools could be considered a policy to be implemented at an early stage of recovery efforts, putting in place measures to do it safely, such as the maintenance of social distance, the reorganisation of classes into smaller groups, the provision of adequate sanitization of spaces, furniture and toys, the prompt identification of cases in the school environment and their tracing. Therefore, policy makers have the task of balancing pros and cons of the school re-opening strategy, taking into account psychological, educational and social consequences for children and their families. Another issue to be considered is represented by socio-economic disparities and inequalities which could be amplified by school's closure.


C3 polymorphisms represent an important immunological confounder on the spread and outcome of COVID-19


title: Understanding Coronavirus

text: Since the identification of the first cases of the coronavirus in December 2019 in Wuhan, China, there has been a significant amount of confusion regarding the origin and spread of the so-called 'coronavirus', officially named SARS-CoV-2, and the cause of the disease COVID-19 Conflicting messages from the media and officials across different countries and organizations, the abundance of disparate sources of information, unfounded conspiracy theories on the origins of the newly emerging virus and the inconsistent public health measures across different countries, have all served to increase the level of anxiety in the population Where did the virus come from? How is it transmitted? How does it cause disease? Is it like flu? What is a pandemic? What can we do to stop its spread? Written by a leading expert, this concise and accessible introduction provides answers to the most common questions surrounding coronavirus for a general audience


Kidney transplant programmes during the COVID-19 pandemic


Innate T cells in COVID-19: friend or foe?


title: Novel human coronavirus (SARS-CoV-2): A lesson from animal coronaviruses

text: The recent pandemic caused by the novel human coronavirus, referrred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), not only is having a great impact on the health care systems and economies in all continents but it is also causing radical changes of common habits and life styles. The novel coronavirus (CoV) recognises, with high probability, a zoonotic origin but the role of animals in the SARS-CoV-2 epidemiology is still largely unknown. However, CoVs have been known in animals since several decades, so that veterinary coronavirologists have a great expertise on how to face CoV infections in animals, which could represent a model for SARS-CoV-2 infection in humans. In the present paper, we provide an up-to-date review of the literature currently available on animal CoVs, focusing on the molecular mechanisms that are responsible for the emergence of novel CoV strains with different antigenic, biologic and/or pathogenetic features. A full comprehension of the mechanisms driving the evolution of animal CoVs will help better understand the emergence, spreading, and evolution of SARS-CoV-2.


A Call for Rapid Submission of Data for Aggregate Review: Can Daily Radiotherapy Imaging Be Used as a Potential Screen for Coronavirus Disease 2019?


A guide to R - the pandemic's misunderstood metric


title: COVID-19 presenting with diarrhoea and hyponatraemia

text: COVID-19 is a viral disease with a high infectivity rate. The full spectrum of the disease is not yet understood. This understanding may help in limiting potential exposure. We present a young man with diarrhoea, abdominal pain and hyponatraemia who turned out to be positive for COVID-19.


A response to: Determining Urgent/Emergent status of Gastrointestinal (GI) Endoscopic Procedures in an Ambulatory Care Setting during the Coronavirus Disease of 2019 (COVID-19)


title: Systemic evaluation and localization of resistin expression in normal human tissues by a newly developed monoclonal antibody

text: Resistin and resistin-like molecules are pleiotropic cytokines that are involved in inflammatory diseases. Our previous work suggested that resistin has the potential to be used as a biomarker and therapeutic target for human pulmonary arterial hypertension. However, data are limited on the distribution of resistin in healthy human organs. In this study, we used our newly developed anti-human resistin (hResistin) antibody to immunohistochemically detect the expression, localization, and intracellular/extracellular compartmentalization of hResistin in a full human tissue panel from healthy individuals. The potential cross reactivity of this monoclonal anti-hResistin IgG1 with normal human tissues also was verified. Results showed that hResistin is broadly distributed and principally localized in the cytoplasmic granules of macrophages scattered in the interstitium of most human tissues. Bone marrow hematopoietic precursor cells also exhibited hResistin signals in their cytoplasmic granules. Additionally, hResistin labeling was observed in the cytoplasm of nervous system cells. Notably, the cytokine activity of hResistin was illustrated by positively stained extracellular material in most human tissues. These data indicate that our generated antibody binds to the secreted hResistin and support its potential use for immunotherapy to reduce circulating hResistin levels in human disease. Our findings comprehensively document the basal expression patterns of hResistin protein in normal human tissues, suggest a critical role of this cytokine in normal and pathophysiologic inflammatory processes, and offer key insights for using our antibody in future pharmacokinetic studies and immunotherapeutic strategies.


Response to Whitehead et al. re: "Recovery of Elective Facial Plastic Surgery in the Post-Coronavirus Disease 2019 Era: Recommendations from the European Academy of Facial Plastic Surgery Task Force"