title: Experimental aerosol survival of SARS-CoV-2 in artificial saliva and tissue culture media at medium and high humidity

text: SARS-CoV-2, the causative agent of the COVID-19 pandemic, may be transmitted via airborne droplets or contact with surfaces onto which droplets have deposited. In this study, the ability of SARS-CoV-2 to survive in the dark, at two different relative humidity values and within artificial saliva, a clinically relevant matrix, was investigated. SARS-CoV-2 was found to be stable, in the dark, in a dynamic small particle aerosol under the four experimental conditions we tested and viable virus could still be detected after 90 minutes. The decay rate and half-life was determined and decay rates ranged from 0.4 to 2.27 % per minute and the half lives ranged from 30 to 177 minutes for the different conditions. This information can be used for advice and modelling and potential mitigation strategies.


title: Aerosol Box 2.0: Adjustments and Improvements Made in Mexico for Intubating Patients During the Coronavirus Disease 2019 Pandemic

text: In January 2020, a global pandemic was declared by the World Health Organization authorities for coronavirus disease 2019 (COVID-19). Since then, we have looked for ways to avoid transmission with mitigation measures and social distancing. However, areas with a high incidence of COVID-19 have struggled to maintain adequate supplies of personal protective equipment (PPE) essential for health workers. Many innovations have been proposed to assist providers including barriers to use during airway management. We present adaptations to previously described intubation or "aerosol" boxes.


title: Coronavirus-19 disease (COVID-19): A case series of early suspected cases reported and the implications towards the response to the pandemic in Zimbabwe

text: Zimbabwe is among the countries that have been identified to be at risk of the COVID-19 pandemic. As of the 15th of March 2020, there was no confirmed case of the virus. Official reports of suspected cases were used to appraise the general screening, case management, and the emergency preparedness and response of the country towards the COVID-19 pandemic. In terms of the surveillance and capacity to screen at the ports of entry, the country seems to be faring well. The country might not be screening optimally, considering the number of COVID-19 tests conducted to date and the suspected cases who missed testing. Three of the suspected cases faced mental, social, and psychological consequences due to them being suspected cases of COVID-19. There is a need to enhance the screening process and infrastructure at all the ports of entry. More COVID-19 diagnostic tests should be procured to increase the testing capacity. Training and awareness on mental, social, and psychological consequences of COVID-19 should be offered to the health care workers and the general public. More financial resources should be sourced to enable the country control the pandemic.


title: Risk and Management of Patients with Mastocytosis and MCAS in the SARS-CoV-2 (COVID-19) Pandemic: Expert Opinions

text: The COVID-19 (SARS-CoV-2) pandemic has massively distorted our health care systems and caused catastrophic consequences in our affected communities. The number of victims continues to increase and patients at risk can only be protected to a degree, since the virulent state may be asymptomatic. Risk factors concerning COVID-19-induced morbidity and mortality include advanced age, an impaired immune system, cardiovascular or pulmonary diseases, obesity, diabetes mellitus, and cancer treated with chemotherapy. Here within, we discuss the risk and impact of COVID-19 in patients with mastocytosis and mast cell activation syndromes. As no published data are yet available, expert opinions are, by necessity, based on case experience and reports from patients. Whereas the overall risk to acquire the SARS-CoV-2 virus may not be elevated in mast cell disease, certain conditions may increase the risk of infected patients to develop severe COVID-19. These factors include certain co-morbidities, mast cell activation-related events affecting the cardiovascular or bronchopulmonary system and chemotherapy or immunosuppressive drugs. Therefore, such treatments should be carefully evaluated on a case-by-case basis during a COVID-19 infection. By contrast, other therapies, such as anti-mediator-type drugs, venom immunotherapy, or vitamin D, should be continued. Overall, patients with mast cell disorders should follow the general and local guidelines in the COVID-19 pandemic and advice from their medical provider.


title: Epidemiological characteristics of respiratory viruses in patients with acute respiratory infections during 2009-2018 in southern China

text: BACKGROUND: Acute respiratory infections (ARIs) remain a major public threat with high morbidity and mortality all over the world, and viruses are important pathogens that cause ARIs. This work is conducted to better understand the epidemiological characteristics of respiratory viruses circulating in southern China. METHODS: Totally 22,680 respiratory samples were collected from ARI patients from 18 hospitals in southern China during 2009-2018, and seven common respiratory viruses including Flu, RSV, PIV, hMPV, ADV, HCoV and HBoV were screened using in-house real-time PCR. RESULTS: Totally 9,760 ARI cases (9760/22680, 43.03%) were detected as positive for the 7 common respiratory viruses. The most detected virus was Flu (14.15%), followed by RSV (10.33%) and PIV (5.43%). Flu-A, PIV3 and HCoV-OC43 were the predominant subtypes. Although most of the viruses were more easily detected in inpatients and males, Flu was more likely detected in outpatient and females. Flu infection was more likely to cause URTI (upper respiratory tract infection), whereas RSV infection was more likely to cause pneumonia and bronchitis. The prevalence of Flu was particularly high in 2009. The epidemic level was found notably high in 2014-2018 for RSV, in 2016-2018 for PIV, in the summer of 2018 for ADV, in the summer of 2016 and winter of 2018 for HCoV, and in the summer of 2011 and autumn of 2018 for HBoV. The co-detection rate of 7 viruses was 4.70% and RSV, PIV and Flu were the most commonly co-detected viruses. CONCLUSIONS: This work demonstrates the epidemiological characteristics of 7 common respiratory viruses in ARI patients in southern China.


Anormal pulmonary function and residual CT abnormalities in rehabilitating COVID-19 patients after discharge


Editorial. Pediatric neurosurgery along with Children's Hospitals' innovations are rapid and uniform in response to the COVID-19 pandemic


Economic Recession from the Covid-19 Pandemic Signals Recruiting Difficulty Ahead for Radiology Residency Programs


Letter: Implementation of a Neurosurgery Telehealth Program Amid the COVID-19 Crisis-Challenges, Lessons Learned, and a Way Forward


title: Monash University, UEA, UCR Time Series Regression Archive

text: Time series research has gathered lots of interests in the last decade, especially for Time Series Classification (TSC) and Time Series Forecasting (TSF). Research in TSC has greatly benefited from the University of California Riverside and University of East Anglia (UCR/UEA) Time Series Archives. On the other hand, the advancement in Time Series Forecasting relies on time series forecasting competitions such as the Makridakis competitions, NN3 and NN5 Neural Network competitions, and a few Kaggle competitions. Each year, thousands of papers proposing new algorithms for TSC and TSF have utilized these benchmarking archives. These algorithms are designed for these specific problems, but may not be useful for tasks such as predicting the heart rate of a person using photoplethysmogram (PPG) and accelerometer data. We refer to this problem as Time Series Regression (TSR), where we are interested in a more general methodology of predicting a single continuous value, from univariate or multivariate time series. This prediction can be from the same time series or not directly related to the predictor time series and does not necessarily need to be a future value or depend heavily on recent values. To the best of our knowledge, research into TSR has received much less attention in the time series research community and there are no models developed for general time series regression problems. Most models are developed for a specific problem. Therefore, we aim to motivate and support the research into TSR by introducing the first TSR benchmarking archive. This archive contains 19 datasets from different domains, with varying number of dimensions, unequal length dimensions, and missing values. In this paper, we introduce the datasets in this archive and did an initial benchmark on existing models.


title: Interpretation of CT signs of 2019 novel coronavirus (COVID-19) pneumonia

text: OBJECTIVES: To characterize and interpret the CT imaging signs of the 2019 novel coronavirus (COVID-19) pneumonia in China. MATERIALS AND METHODS: The CT images of 130 patients diagnosed as COVID-19 pneumonia from several hospitals in China were collected and their imaging features were analyzed and interpreted in detail. RESULTS: Among the 130 patients, we can see (1) distribution: 14 cases with unilateral lung disease and 116 cases with bilateral disease, the distribution was mainly lobular core (99 cases) and subpleural (102 cases); (2) number: 9 cases with single lesion, 113 cases with multiple lesions, and 8 cases with diffuse distribution; (3) density: 70 cases of pure ground glass opacity (GGO), and 60 cases of GGO with consolidation; (4) accompanying signs: vascular thickening (100 cases), "parallel pleura sign" (98 cases), "paving stone sign" (100 cases), "halo sign" (18 cases), "reversed halo sign" (6 cases), pleural effusion (2 cases), and pneumonocele (2 cases). After follow-up CT examination on 35 patients, 21 cases turned better and 14 became worse. There were signs of consolidation with marginal contraction, bronchiectasis, subpleural line, or fibrous streak. CONCLUSION: GGO and consolidation are the most common CT signs of COVID-19 pneumonia, mainly with lobular distribution and subpleural distribution. The main manifestations were tissue organization and fibrosis at late stage. The most valuable features are the parallel pleura sign and the paving stone sign. KEY POINTS: â¢ The CT signs of the COVID-19 pneumonia are mainly distributed in the lobular core, subpleural and diffused bilaterally. â¢ The CT signs include the "parallel pleura sign," "paving stone sign," "halo sign," and "reversed halo sign." â¢ During the follow-up, the distribution of lobular core, the fusion of lesions, and the organization changes at late stage will appear.


title: The APPCN multisite didactic initiative: Development, benefits, and challenges

text: Objective: The Covid-19 pandemic disrupted instructional activity in neuropsychology training programs. In response, the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) launched a multisite didactic initiative (MDI). This manuscript describes the development and implementation of the MDI and presents findings from a recently conducted online survey concerning MDI participation.Methods: Faculty and trainees at APPCN member programs were recruited to complete the MDI survey, administered using the Qualtrics platform, through email announcements and via website link and on-screen quick response code shared at online didactic sessions. The MDI survey instrument was designed to capture basic demographics and professional role; information regarding level of site participation, benefits of participation, barriers to participation, online conference platform(s) used, and interest in continued participation; as well as anxiety and work engagement ratings.Results: The response rate was estimated to be 21-29%. Transition to videoconferencing for didactics was noted by 80% due to Covid-19, with 17% of respondents experiencing cancellation or reduction in didactic activities. About 79% endorsed that participation in MDI activities was always or nearly always beneficial. Barriers to participation included not having time, difficulty accessing didactic information, and not knowing about the MDI. Interestingly, trainees at nonparticipating sites reported greater anxiety than trainees at participating sites.Conclusion: It is hoped that these findings will inform future efforts to develop and implement online training activities. The benefits reported by respondents suggest that this work is warranted, while reported barriers to participation identify areas for improvement.


Fellowship Training in Adult Cardiothoracic Anesthesiology: Navigating the New Educational Landscape as a Result of the Coronavirus Crisis


title: Understanding SARS-CoV-2: Genetic Diversity, Transmission and Cure in Human

text: As the SARS-CoV-2 virus race around the world across the different population, there needs to be a consolidated effort to understand the divergence of demographically distributed strains. The emerging trends in SARS-CoV-2 genome data show specific mutation and genetic diversity, which could provide the basis to develop a cocktail of vaccine and may also be used to develop the region-specific diagnostic tool, thus decreasing the chances of testing failures in fields. Since the transmission of SARS-CoV-2 is subject to the extent of human interaction, the insights from the correlation of genetic diversity with epidemiological parameter would give paramount information to tackle this transmission. Previously, studies have also correlated the epidemiological data with gut microbiome and its role in immunomodulation for maintaining health status, and such information could be generated from recovered individuals from different demographic regions. It will help in designing a probiotic-based diet for modulation of the gut microbiome, and that could be another plausible prophylactic treatment option. The genomics data suggest that a specific variant of SARS-CoV-2 gets enriched with the specific demographic region. Overall, demographic data suggests that host influences mutation and expression of the virus. Hence, the experiences from the clinical intervention for that region should be considered in control and treatment strategies.


title: SARS-CoV-2 infection virological diagnosis

text: SARS-CoV-2 infection has to be confirmed by virological diagnosis. Multiple diagnostic tests are available without enough perspective on their reliability. Therefore, it is important to choose the most suitable test according to its sensitivity and specificity but also to the stage of the disease. Currently, the RT-PCR detection of the viral genome in respiratory samples is the most reliable test to confirm the diagnosis of an acute SARS-CoV-2 infection. It has to be done in Class II biological safety laboratory. However, it may lack sensitivity, particularly in the advanced phase of infection, and depends closely on the samples' quality. Rapid PCR by cartridge system reduces response times but is not suitable for laboratories with high throughput of requests. Detection of virus antigens on respiratory samples is a quick and easy to use technique; however it has not good specificity and sensitivity and cannot be used for diagnosis and patient management. The detection of specific antibodies against SARS-CoV-2 is better used for epidemiological analyses. Research should be encouraged to overcome the limits of the currently available diagnostic tests.


title: Renal complications in COVID-19: a systematic review and meta-analysis

text: PURPOSE: Emerging data suggest that coronavirus disease 2019 (COVID-19) has extrapulmonary manifestations but its renal manifestations are not clearly defined. We aimed to evaluate renal complications of COVID-19 and their incidence using a systematic meta-analysis. DESIGN: Observational studies reporting renal complications in COVID-19 patients were sought from MEDLINE, Embase and the Cochrane Library from 2019 to June 2020. The nine-star Newcastle-Ottawa Scale was used to evaluate methodological quality. Incidence with 95% confidence intervals (CIs) were pooled using random-effects models. RESULTS: We included 22 observational cohort studies comprising of 17,391 COVID-19 patients. Quality scores of studies ranged from 4 to 6. The pooled prevalence of pre-existing chronic kidney disease (CKD) and end-stage kidney disease was 5.2% (2.8-8.1) and 2.3% (1.8-2.8), respectively. The pooled incidence over follow-up of 2-28 days was 12.5% (10.1-15.0) for electrolyte disturbance (e.g. hyperkalaemia), 11.0% (7.4-15.1) for acute kidney injury (AKI) and 6.8% (1.0-17.0) for renal replacement therapy (RRT). In subgroup analyses, there was a higher incidence of AKI in US populations and groups with higher prevalence of pre-existing CKD. CONCLUSIONS: Frequent renal complications reported among hospitalized COVID-19 patients are electrolyte disturbance, AKI and RRT. Aggressive monitoring and management of these renal complications may help in the prediction of favourable outcomes. Systematic review registration: PROSPERO 2020: CRD42020186873 KEY MESSAGES COVID-19 affects multiple organs apart from the respiratory system; however, its renal manifestations are not clearly defined. In this systematic meta-analysis of 22 observational cohort studies, the prevalence of pre-existing chronic kidney disease (CKD) in COVID-19 patients was 5.2%. The most frequent renal complication was electrolyte disturbance (particularly hyperkalaemia) with an incidence of 12.5% followed by acute kidney injury (AKI) with an incidence of 11.0%; US populations and groups with higher prevalence of CKD had higher incidence of AKI.


title: Most chilblains observed during the COVID-19 outbreak occur in patients who are negative for COVID-19 on PCR and serology testing

text: INTRODUCTION: Acral lesions, mainly chilblains, are the most frequently reported cutaneous lesions associated with COVID-19. In more than 80% of tested patients, nasopharyngeal swabs were negative on RT-PCR for SARS-CoV-2 when performed, and serology was generally not performed. MATERIALS AND METHODS: A national survey was launched on March 30, 2020 by the French society of dermatology asking physicians to report cases of skin manifestations in patients with suspected or confirmed COVID-19 by using a standardized questionnaire. We report the results for acral manifestations. RESULTS: We collected 311 cases of acral manifestations (58.5% females, median age 25.7 years [range 18-39]). The most frequent clinical presentation (65%) was typical chilblains. In total, 93 cases (30%) showed clinical suspicion of COVID-19, 67 (22%) had only less specific infectious symptoms, and 151 (49%) had no clinical signs preceding or during the course of acral lesions. Histology of skin biopsies was consistent with chilblains (n= 26/29). Twelve patients showed significant immunological abnormalities. Ten patients were positive among the 150 (48%) who were tested (RT-PCR and/or serology). Seven of 121 RT-PCR-tested patients were positive and 5 of 75 serology-tested patients were positive (IgG) among them RT-PCR and serology were both positive for two patients. Seven of 121 RT-PCR-tested patients were positive for SARS-CoV-2 (6%), and 5 of 75 serology-tested patients had IgG anti- SARS-CoV-2 (7 %). Tested and untested patients or those with and without confirmed COVID-19 did not differ in age, sex, history or acral-lesion clinical characteristics. CONCLUSION: The results of this survey do not rule out that SARS-CoV-2 could be directly responsible for some cases of chilblains but found no evidence of SARS-CoV-2 infection in large majority of patients with acral lesions during the COVID-19 lockdown period in France.


title: Clinical characteristics and therapeutic procedure for a critical case of novel coronavirus pneumonia treated with glucocorticoids and non-invasive ventilator treatment

text: The novel coronavirus pneumonia (NCP) outbreak occurred in Wuhan, China at the end of 2019. Here, we report the clinical characteristics and therapeutic procedure for a case of severe NCP. The patient was started on glucocorticoids and non-invasive ventilator treatment. After treatment, the patient's symptoms improved, and the status was confirmed as NCP negative. Our results may provide clues for the treatment of NCP.


title: Dynamics of an imprecise stochastic Lotka Volterra food chain chemostat model with Levy jumps

text: Population dynamics are often affected by sudden environmental perturbations. Parameters of stochastic models are often imprecise due to various uncertainties. In this paper, we formulate a stochastic Lotka Volterra food chain chemostat model that includes Levy jumps and interval parameters. Firstly, we prove the existence and uniqueness of the positive solution. Moreover, the threshold between extinction and persistence in the mean of the microorganism is obtained. Finally, some simulations are carried out to demonstrate our theoretical results.


title: Impact of social distancing during COVID-19 pandemic on crime in Los Angeles and Indianapolis

text: Governments have implemented social distancing measures to address the ongoing COVID-19 pandemic. The measures include instructions that individuals maintain social distance when in public, school closures, limitations on gatherings and business operations, and instructions to remain at home. Social distancing may have an impact on the volume and distribution of crime. Crimes such as residential burglary may decrease as a byproduct of increased guardianship over personal space and property. Crimes such as domestic violence may increase because of extended periods of contact between potential offenders and victims. Understanding the impact of social distancing on crime is critical for ensuring the safety of police and government capacity to deal with the evolving crisis. Understanding how social distancing policies impact crime may also provide insights into whether people are complying with public health measures. Examination of the most recently available data from both Los Angeles, CA, and Indianapolis, IN, shows that social distancing has had a statistically significant impact on a few specific crime types. However, the overall effect is notably less than might be expected given the scale of the disruption to social and economic life.


title: Bilateral transient olfactory bulbs edema during COVID-19-related anosmia

text: An asymptomatic 27-year-old physician is diagnosed SARS-CoV-2 by occupational medicine after contagion (RT-PCR).


title: Comparative genomic signature representations of the emerging COVID-19 coronavirus and other coronaviruses: High identity and possible recombination between Bat and Pangolin coronaviruses

text: Coronaviruses are responsible on respiratory diseases in animal and human. The combination of numerical encoding techniques and digital signal processing methods are becoming increasingly important in handling large genomic data. In this paper, we propose to analyze the SARS-CoV-2 genomic signature using the combination of different nucleotide representations and signal processing tools in the aim to identify its genetic origin. The sequence of SARS-CoV-2 was compared with 21 relevant sequences including bat, yak and pangolin coronavirus sequences. In addition, we developed a new algorithm to locate the nucleotide modifications. The results show that the Bat and Pangolin coronaviruses were the most related to SARS-CoV-2 with 96% and 86% of identity all along the genome. Within the S gene sequence, the Pangolin sequence presents local highest nucleotide identity. Those findings suggest genesis of SARS-Cov-2 through evolution from bat and pangolin strains. This study offers new ways to automatically characterize viruses.


title: Covid-19: Eine Ad hoc Public-Health-Ethikberatung./ [Covid-19: An ad hoc public health ethics consultation]

text: In this paper we describe the process and content of our ad hoc public health ethics consultation for a Bavarian health authority in relation to Covid-19.


Covid-19: Doctors sound alarm over hospital transmissions


China coronavirus: partial border closures into Hong Kong are not enough, say doctors


Urgent Issues Facing Immigrant Physicians in the United States in the COVID-19 Era


title: Coronavirus disease 2019 in pregnancy

text: OBJECTIVES: This study aimed to compare clinical courses and outcomes between pregnant and reproductive-aged non-pregnant women with COVID-19, and to assess the vertical transmission potential of COVID-19 in pregnancy. METHODS: Medical records of pregnant and reproductive-aged non-pregnant women hospitalized with COVID-19 from January 15 to March 15, 2020 were retrospectively reviewed. The severity of disease, virus clearance time, and length of hospital stay were measured as the primary objective, while the vertical transmission potential of COVID-19 was also assessed. RESULTS: Eighty-two patients (28 pregnant women, 54 reproductive-aged non-pregnant women) with laboratory-confirmed COVID-19 were enrolled in this study. Univariate regression indicated no association between pregnancy and severity of disease (OR 0.73, 95% CI 0.08-5.15; p=0.76), virus clearance time (HR 1.16, 95% CI 0.65-2.01; p=0.62), and length of hospital stay (HR 1.10, 95% CI 0.66-1.84; p=0.71). Of the pregnant women, 22 delivered 23 live births, either by cesarean section (17, 60.7%) or vaginal delivery (5, 17.9%), and no neonate was infected with SARS-CoV-2. CONCLUSIONS: Pregnant women have comparable clinical courses and outcomes with reproductive-aged non-pregnant women when infected with SARS-CoV-2. No evidence supported vertical transmission of COVID-19 in the late stage of pregnancy, including vaginal delivery.


Effect of favipiravir and an anti-inflammatory strategy for COVID-19


Interpretation of the 7th edition of the "diagnosis and treatment guidelines of coronavirus disease 2019 in China": Progress and challenges


title: The Sample Complexity of Best-$k$ Items Selection from Pairwise Comparisons

text: This paper studies the sample complexity (aka number of comparisons) bounds for the active best-$k$ items selection from pairwise comparisons. From a given set of items, the learner can make pairwise comparisons on every pair of items, and each comparison returns an independent noisy result about the preferred item. At any time, the learner can adaptively choose a pair of items to compare according to past observations (i.e., active learning). The learner's goal is to find the (approximately) best-$k$ items with a given confidence, while trying to use as few comparisons as possible. In this paper, we study two problems: (i) finding the probably approximately correct (PAC) best-$k$ items and (ii) finding the exact best-$k$ items, both under strong stochastic transitivity and stochastic triangle inequality. For PAC best-$k$ items selection, we first show a lower bound and then propose an algorithm whose sample complexity upper bound matches the lower bound up to a constant factor. For the exact best-$k$ items selection, we first prove a worst-instance lower bound. We then propose two algorithms based on our PAC best items selection algorithms: one works for $k=1$ and is sample complexity optimal up to a loglog factor, and the other works for all values of $k$ and is sample complexity optimal up to a log factor.


Antihypertensive treatment with ACEI/ARB of patients with COVID-19 complicated by hypertension


On the Front Lines of Primary Care during the Coronavirus Pandemic Shifting from office visits to telephone triage, telemedicine


title: Decentralized Blockchain for Privacy-Preserving Large-Scale Contact Tracing

text: Activity-tracking applications and location-based services using short-range communication (SRC) techniques have been abruptly demanded in the COVID-19 pandemic, especially for automated contact tracing. The attention from both public and policy keeps raising on related practical problems, including \textit{1) how to protect data security and location privacy? 2) how to efficiently and dynamically deploy SRC Internet of Thing (IoT) witnesses to monitor large areas?} To answer these questions, in this paper, we propose a decentralized and permissionless blockchain protocol, named \textit{Bychain}. Specifically, 1) a privacy-preserving SRC protocol for activity-tracking and corresponding generalized block structure is developed, by connecting an interactive zero-knowledge proof protocol and the key escrow mechanism. As a result, connections between personal identity and the ownership of on-chain location information are decoupled. Meanwhile, the owner of the on-chain location data can still claim its ownership without revealing the private key to anyone else. 2) An artificial potential field-based incentive allocation mechanism is proposed to incentivize IoT witnesses to pursue the maximum monitoring coverage deployment. We implemented and evaluated the proposed blockchain protocol in the real-world using the Bluetooth 5.0. The storage, CPU utilization, power consumption, time delay, and security of each procedure and performance of activities are analyzed. The experiment and security analysis is shown to provide a real-world performance evaluation.


title: Isolation, Sequence, Infectivity, and Replication Kinetics of Severe Acute Respiratory Syndrome Coronavirus 2

text: Since its emergence in Wuhan, China, in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected ≈6 million persons worldwide. As SARS-CoV-2 spreads across the planet, we explored the range of human cells that can be infected by this virus. We isolated SARS-CoV-2 from 2 infected patients in Toronto, Canada; determined the genomic sequences; and identified single-nucleotide changes in representative populations of our virus stocks. We also tested a wide range of human immune cells for productive infection with SARS-CoV-2. We confirm that human primary peripheral blood mononuclear cells are not permissive for SARS-CoV-2. As SARS-CoV-2 continues to spread globally, it is essential to monitor single-nucleotide polymorphisms in the virus and to continue to isolate circulating viruses to determine viral genotype and phenotype by using in vitro and in vivo infection models.


title: Psychological interventions during COVID-19: Challenges for low and middle income countries

text: At the start of 2020, the 2019 coronavirus disease (COVID-19), originating from China has spread to the world. There have been increasing numbers of confirmed cases and deaths around the globe. The COVID-19 pandemic has paved the way for considerable psychological and psychosocial morbidity among the general public and health care providers. An array of guidelines has been put forward by multiple agencies for combating mental health challenges. This paper addresses some of the mental health challenges faced by low and middle income countries (LMIC). It is worthwhile to note that these are challenges at the current stage of the pandemic and may change with the course of the pandemic itself.


Pour un dépistage systématique du SARS-CoV-2 avant une chirurgie./ The case for routine screening for SARS-CoV-2 before surgery


The COVID-19 pandemic: reflections for the field of sleep medicine


title: A low-cost, helmet-based, non-invasive ventilator for COVID-19

text: Coronavirus disease 2019 (COVID-19) has created an unprecedented need for breathing assistance devices. Since the demand for commercial, full-featured ventilators is far higher than the supply capacity, many rapid-response ventilators are being developed for invasive mechanical ventilation of patients. Most of these emergency ventilators utilize mechanical squeezing of bag-valve-masks or Ambu-bags. These"bag squeezer"designs are bulky and heavy, depends on many moving parts, and difficulty to assemble and use. Also, invasive ventilation requires intensive care unit support, which may be unavailable to a vast majority of patients, especially in developing countries. In this work, we present a low-cost ($<$\$200), portable (fits in an 8"x8"x4"box), non-invasive ventilator (NIV), designed to provide relief to early-stage COVID-19 patients in low-resource settings. We used a high-pressure blower fan for providing noninvasive positive-pressure ventilation. Our design supports continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) modes. A common concern of using CPAP or BiPAP for treating COVID-19 patients is the aerosolization of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used a helmet-based solution that contains the spread of the virus. Our end-to-end solution is compact, low-cost ($<$\$400 including the helmet, viral filters, and a valve), and easy-to-use. Our NIV provides 0-20 cmH$_{2}$O pressure with flow rates of 60-180 Lmin$^{-1}$. We hope that our report will encourage implementations and further studies on helmet-based NIV for treating COVID-19 patients in low-resource settings.


Commercial influence and covid-19


title: Evaluation of the relationship between slow-waves of intracranial pressure, mean arterial pressure and brain tissue oxygen in TBI: a CENTER-TBI exploratory analysis

text: Brain tissue oxygen (PbtO2) monitoring in traumatic brain injury (TBI) has demonstrated strong associations with global outcome. Additionally, PbtO2 signals have been used to derive indices thought to be associated with cerebrovascular reactivity in TBI. However, their true relationship to slow-wave vasogenic fluctuations associated with cerebral autoregulation remains unclear. The goal of this study was to investigate the relationship between slow-wave fluctuations of intracranial pressure (ICP), mean arterial pressure (MAP) and PbtO2 over time. Using the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) high resolution ICU sub-study cohort, we evaluated those patients with recorded high-frequency digital intra-parenchymal ICP and PbtO2 monitoring data of a minimum of 6 h in duration. Digital physiologic signals were processed for ICP, MAP, and PbtO2 slow-waves using a moving average filter to decimate the high-frequency signal. The first 5 days of recording were analyzed. The relationship between ICP, MAP and PbtO2 slow-waves over time were assessed using autoregressive integrative moving average (ARIMA) and vector autoregressive integrative moving average (VARIMA) modelling, as well as Granger causality testing. A total of 47 patients were included. The ARIMA structure of ICP and MAP were similar in time, where PbtO2 displayed different optimal structure. VARIMA modelling and IRF plots confirmed the strong directional relationship between MAP and ICP, demonstrating an ICP response to MAP impulse. PbtO2 slow-waves, however, failed to demonstrate a definite response to ICP and MAP slow-wave impulses. These results raise questions as to the utility of PbtO2 in the derivation of cerebrovascular reactivity measures in TBI. There is a reproducible relationship between slow-wave fluctuations of ICP and MAP, as demonstrated across various time-series analytic techniques. PbtO2 does not appear to reliably respond in time to slow-wave fluctuations in MAP, as demonstrated on various VARIMA models across all patients. These findings suggest that PbtO2 should not be utilized in the derivation of cerebrovascular reactivity metrics in TBI, as it does not appear to be responsive to changes in MAP in the slow-waves. These findings corroborate previous results regarding PbtO2 based cerebrovascular reactivity indices.


title: Reporting of D-dimer data in COVID-19: some confusion and potential for misinformation

text: Coronavirus disease 2019 (COVID-19) represents a new pandemic caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2). A previous pooled analysis clearly identified elevated D-dimer levels as being associated with severity of COVID-19. Since then, several other studies have provided clearer support for this initial evidence. However, potentially under-recognized by those reporting on D-dimer is the considerable variation in reporting units for D-dimer, and thus also the potential for misreporting of D-dimer data based on poor or incomplete reporting. A PubMed search was used to identify recent papers reporting on D-dimers in COVID-19-based studies. We report that: (1) most publications did not identify either the manufacturer or D-dimer product used; (2) most did not identify whether D-dimer values were reported as D-dimer units (DDU) or fibrinogen equivalent units (FEU) (~2 × differences); (3) nearly half did not identify normal cut-off values; (4) some did not report numerical findings or units for D-dimer; (5) where reported, most identified units as either mg/L or µg/mL; (6) we identified at least four errors in reporting from 21 papers. It may not be possible to truly standardize D-dimer assays, but it should be feasible to harmonize D-dimer assays to a single unit of measurement.


Could severe COVID-19 be considered a complementopathy?


Psychological Impact of the COVID-19 Pandemic Among the Elderly: A Case Series From India


title: [Investigation on a cluster epidemic of COVID-19 in a supermarket in Liaocheng, Shandong province]

text: Objective: To explore clustered epidemic of COVID-19 in Liaocheng city and analyze infection status and chain of transmission of the cases. Methods: A joint investigation team of emergency response for COVID-19 epidemic by CDC professional workers of Liaocheng city and district at two levels on January 30, 2020. According to a indicator case from ZH supermarkets, close contacts and related subjects were tracked and screened on February 1, including ZH supermarket employees, family members having contact history with related cases during January 13-26, supermarket clients during January 16-30 and family members of related cases. an epidemiological investigation was carried on and their swab of nose /throat were collected and were sent to Liaocheng CDC laboratory, real-time fluorescence quantitative RT-PCR was used to detect nucleic acids of SARS-CoV-2. Results: a total of 8 437 people were screened during January 30 to February 9, 2020 (120 employees of supermarket, 93 family members, and 8224 clients of supermarket). The epidemic was caused by ZH cases and brought clustered cases in four families. A total 25 cases of SARS-CoV-2 infection, the total infection rate of subjects was 0.30% (25/8 437) with 22 confirmed cases (0.26%, 22/8 437) and 3 asymptomatic patients (0.04%, 3/8 437), asymptomatic patients accounted for 12.00% (3/25) of all infection cases. The infection rates of supermarket employees, family members of confirmed cases and supermarket clients were 9.17% (11/120), 12.90% (12/93) and 0.02% (2/8 224). Conclusions: This was a cluster epidemic caused by one imported case of COVID-19 in a supermarket of Liaocheng city. Prevention and control of cluster epidemic should be focused on chain of community transmission and family cluster cases. It must also be an attention for transmission risk of asymptomatic patients.


title: The psychological effects of the COVID-19 pandemic and coping with them in Saudi Arabia

text: This commentary summarizes the psychological effects of the COVID-19 pandemic and the people's response to the steps taken by the Saudi government to decrease the impact of this psychological trauma and stress. It is concluded that people are responding well to the threat of psychological trauma imposed by this disease and are following the instructions of their government and health regulatory body. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Trend and forecasting of the COVID-19 outbreak in China


Let Africa into the market for COVID-19 diagnostics


Peripheral lymphocyte subset alterations in COVID-19 patients


title: Transmission risk of SARS-CoV-2 to healthcare workers -observational results of a primary care hospital contact tracing

text: BACKGROUND: The coronavirus disease (COVID)-19 epidemic is evolving rapidly. Healthcare workers are at increased risk for infection, and specific requirements for their protection are advisable to ensure the functioning of the basic healthcare system, including the availability of general practitioners (GPs). Understanding the transmission risk is particularly important for guiding evidence-based protective measures in the primary healthcare setting. METHODS: Healthcare worker contacts of an initially undiagnosed COVID-19 case, who were without personal protective equipment, in particular not wearing facemasks, were screened with nasopharyngeal swabs and polymerase chain reaction tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), irrespective of respiratory symptoms or fever seven days after initial contact. The details of exposure to the index case were obtained during routine contact investigation after unintentional pathogen exposure. RESULTS: Twenty-one healthcare workers reported contacts with the index case. Three healthcare workers reported respiratory symptoms (cough) or low-grade fever within 4 days. None of them tested positive for SARS-CoV-2 at the time of symptom onset. All 21 healthcare workers tested SARS-CoV-2 negative 7 days after initial index case contact, including the three healthcare workers with previous symptoms. Ten of the 21 healthcare workers reported a cumulative exposure time of >15 minutes. Longer cumulative contact times were associated with more individual contacts, reduced contact time per contact and activities with physical patient contact. The closest relative of the index patient tested SARS-CoV-2 positive 2 days after the index case presented at the hospital emergency department. CONCLUSION: We found a low risk of SARS-CoV-2 transmission in a primary care setting. These findings are compatible with previous reports of the highest transmission probability in household settings with prolonged close contacts. The current protective measures for healthcare workers, including strict adherence to basic standard hygiene and facemasks, offer considerable protection during short periods of contact with symptomatic COVID-19 cases by diminishing the risk of direct and indirect transmission.


Commentary: Performing cardiac surgery in the coronavirus disease 2019 (COVID-19) era: What is the new normal?


title: Cuba's Pedro Kourí Tropical Medicine Institute:Battling COVID-19 One Study, One Test, One Patient at a Time

text: This MEDICC Review roundtable brings you specialists from Havana's Pedro Kourí Tropical Medicine Institute (IPK), who are working directly with testing, research and patient care during the COVID-19 pandemic Founded in 1937 by its namesake, the Institute has gained considerable worldwide prestige Today, it is a PAHO-WHO Collaborating Center for the Study of Dengue and Its Vector, and for the Elimination of Tuberculosis Its main role within Cuba's health system is as the national reference center for prevention, control, management and elimination of infectious diseases, including epidemics Its 479 workers staff 32 departments, including laboratories, research and teach-ing facilities, a hospital and isolation center The IPK's hospital treats later-stage AIDS patients, while the Institute is the nation-al reference center for attention to all HIV-positive patients and maintains the national HIV/AIDS registry, as well as registries for other infectious diseases The institution was responsible for training the Cuban doctors who served in West Africa during the 2014-2016 Ebola outbreaks and for those going abroad to assist in the COVID-19 response today, and its professionals offer an internationally-recognized biennial course on dengue


text: This MEDICC Review roundtable brings you specialists from Havana's Pedro Kourí Tropical Medicine Institute (IPK), who are working directly with testing, research and patient care during the COVID-19 pandemic. Founded in 1937 by its namesake, the Institute has gained considerable worldwide prestige. Today, it is a PAHO-WHO Collaborating Center for the Study of Dengue and Its Vector, and for the Elimination of Tuberculosis. Its main role within Cuba's health system is as the national reference center for prevention, control, management and elimination of infectious diseases, including epidemics. Its 479 workers staff 32 departments, including laboratories, research and teach-ing facilities, a hospital and isolation center. The IPK's hospital treats later-stage AIDS patients, while the Institute is the nation-al reference center for attention to all HIV-positive patients and maintains the national HIV/AIDS registry, as well as registries for other infectious diseases. The institution was responsible for training the Cuban doctors who served in West Africa during the 2014-2016 Ebola outbreaks and for those going abroad to assist in the COVID-19 response today, and its professionals offer an internationally-recognized biennial course on dengue.


COVID-19: We All Have a Role


title: AGA Institute Rapid Review of the Gastrointestinal and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19

text: BACKGROUND & AIMS: Multiple gastrointestinal (GI) symptoms, including diarrhea, nausea/vomiting, and abdominal pain, as well as liver enzyme abnormalities, have been variably reported in patients with coronavirus disease 2019 (COVID-19). The American Gastroenterological Association Institute Clinical Guideline Committee and Clinical Practice Updates Committee performed a systematic review and meta-analysis of international data on GI and liver manifestations of COVID-19. METHODS: We performed a systematic literature search to identify published and unpublished studies using OVID Medline and preprint servers (medRxiv, LitCovid, and SSRN [Social Science Research] up until April 5, 2020; major journal sites were monitored for US publications until April 19, 2020. We analyzed the prevalence of diarrhea, nausea, vomiting, and abdominal pain, as well as liver function tests abnormalities, using a fixed-effect model and assessed the certainty of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. RESULTS: We identified 118 studies and used a hierarchal study selection process to identify unique cohorts. We performed a meta-analysis of 47 studies including 10,890 unique patients. Pooled prevalence estimates of GI symptoms were as follows: diarrhea 7.7% (95% confidence interval [CI], 7.2%-8.2%), nausea/vomiting 7.8% (95% CI, 7.1%-8.5%), and abdominal pain 2.7% (95% CI, 2.0%-3.4%). Most studies reported on hospitalized patients. The pooled prevalence estimates of elevated liver abnormalities were as follows: aspartate transaminase 15.0% (95% CI, 13.6%-16.5%) and alanine transaminase 15.0% (95% CI, 13.6%-16.4%). When analyzed comparing data from China to studies from countries other than China, diarrhea, nausea/vomiting, and liver abnormalities were more prevalent outside of China, with diarrhea reported in 18.3% (95% CI, 16.6%-20.1%). Isolated GI symptoms were reported rarely. We also summarized the Gl and liver adverse effects of the most commonly utilized medications for COVID-19. CONCLUSIONS: GI symptoms are associated with COVID-19 in <10% of patients. In studies outside of China, estimates are higher. Further studies are needed with standardized GI symptoms questionnaires and liver function test checks on admission to better quantify and qualify the association of these symptoms with COVID-19. Based on findings from our meta-analysis, we provide several Best Practice Statements for the consultative management of COVID-19.


title: Quantifying the improvement in confirmation efficiency of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the early phase of the outbreak in Hong Kong in 2020

text: BACKGROUNDS: The emerging virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused a large outbreak of coronavirus disease, COVID-19, in Wuhan, China, since December 2019. COVID-19 soon spread to other regions of China and overseas. In Hong Kong, local mitigation measures were implemented since the first imported case was confirmed on January 23, 2020. Here we evaluated the temporal variation of detection delay from symptoms onset to laboratory confirmation of SARS-CoV-2 in Hong Kong. METHODS: A regression model is adopted to quantify the association between the SARS-CoV-2 detection delay and calendar time. The association is tested and further validated by a Cox proportional hazard model. FINDINGS: The estimated median detection delay was 9.5 days (95%CI: 6.5-11.5) in the second half of January, reduced to 6.0 days (95%CI: 5.5-9.5) in the first half of February 2020. We estimate that SARS-CoV-2 detection efficiency improved at a daily rate of 5.40% (95%CI: 2.54-8.33) in Hong Kong. CONCLUSIONS: The detection efficiency of SARS-CoV-2 was likely being improved substantially in Hong Kong since the first imported case was detected. Sustaining enforcement in timely detection and other effective control measures are recommended to prevent the SARS-CoV-2 infection.


Home PAP devices in COVID-19 infected patients


title: Triage of critical care resources in COVID-19: a stronger role for justice

text: Some ethicists assert that there is a consensus that maximising medical outcomes takes precedence as a principle of resource allocation in emergency triage of absolutely scarce resources. But the nature of the current severe acute respiratory syndrome-related coronavirus 2 pandemic and the history of debate about balancing equity and efficiency in resource allocation do not support this assertion. I distinguish a number of concerns with justice and balancing considerations that should play a role in critical care triage policy, focusing on discrimination and on fundamental egalitarian and social justice concerns.


title: Pandemic preparedness of community pharmacies for COVID-19

text: BACKGROUND: Community pharmacies provide an important healthcare service, which is broadly established, and constitutes the preferred and initial contact for members of the community. The significant value of community pharmacies was further highlighted during the COVID-19 pandemic crisis. OBJECTIVE: The assessment of community pharmacies preparedness for the COVID-19 pandemic. METHODS: A cross-sectional interview survey of 1018 community pharmacies working in four regions of Egypt (South, East, Centre, and North). Data collection was conducted from 8-19 April 2020. RESULTS: Availability of personal protective equipment (PPE) and medication was better than alcohol (70% conc.). Home delivery services were available in 49.1% of pharmacies. Infection control measures covering interactions between staff were in place in up to 99.5% of pharmacies. Conversely, there was less frequent availability of contactless payment (29.1%), hand sanitizers (62.1%) or masks (86.5%) for customer use, or a separate area for patients with suspected COVID-19 (64%). Verbal customer education (90.4%) was used preferably to written (81.3%). Despite high clinical knowledge and awareness (97.6%-99.2%), only 8.8% of pharmacists had reported suspected COVID-19 cases, however this varied significantly with pharmacist demographics (geographic region P < 0.001; pandemic training p < 0.001; position p = 0.019; age p = 0.046). CONCLUSIONS: Government and policymakers strive to mitigate the shortage of PPE and medication. More attention should be given to infection control measures around interactions between staff and customers to ensure community pharmacists are fit and able to provide continuity in their important role. Educating customers using regularly-updated posters, banners or signs will contribute to decreasing contact with patients, and reducing the number and duration of visits to the pharmacy. Pandemic preparedness of community pharmacists must also extend to reporting procedures. By avoiding under-reporting or over-reporting, community pharmacists will contribute to accurate monitoring of the national spread of infection.


title: Prolonged Infectivity of SARS-CoV-2 in Fomites

text: We spotted severe acute respiratory syndrome coronavirus 2 on polystyrene plastic, aluminum, and glass for 96 hours with and without bovine serum albumin (3 g/L). We observed a steady infectivity (<1 log10 drop) on plastic, a 3.5 log10 decrease on glass, and a 6 log10 drop on aluminum. The presence of proteins noticeably prolonged infectivity.


First case of student suicide in India due to the COVID-19 education crisis: A brief report and preventive measures


Students Supporting Critical Care - A contention plan to prevent the decompensation of ICUs in the COVID-19 pandemic:Translating Bjorn Ibsens' polio-lessons to modern times


title: Co-infection of Coronavirus Disease 2019 and Influenza A: A Report from Iran

text: BACKGROUND: In late December 2019, a viral pneumonia known as coronavirus disease 2019 (COVID-19) originated from China and spread very rapidly in the world. Since then, COVID-19 has become a global concern and health problem. METHODS: We present four patients in this study, selected from among patients who presented with pneumonia symptoms and were suspicious for COVID-19. They were referred to the intended centers for COVID-19 diagnosis and management of Shiraz University of Medical Sciences in southern Iran. Two nasopharyngeal and oropharyngeal throat swab samples were collected from each patient and tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using real-time reverse-transcriptase- polymerase-chain-reaction (RT-PCR). The samples were also tested for influenza viruses and the complete respiratory panel. RESULTS: In the present report, four patients were diagnosed in the starting days of COVID-19 disease in our center in southern Iran with co-infection of SARS-CoV-2 and influenza A virus. CONCLUSION: This co-infection of COVID-19 and influenza A highlights the importance of considering SARS-CoV-2 PCR assay regardless of other positive findings for other pathogens in the primary test during the epidemic.


title: Encountering COVID-19 as Endocrinologists

text: The world is entering an era of disaster and chaos due to coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2. Since its first emergence in December 2019 in Wuhan, China, COVID-19 has swept through Asia and propagated throughout the world to Europe and North America. As of April 13, 1,773,084 people were infected and 111,652 people had died from COVID-19 globally, and new record levels of infection are being reported every day. Based on the data that have been amassed so far, the primary risk factors for a severe disease course or even mortality from COVID-19 are underlying diseases such as diabetes and hypertension. As the global prevalence of diabetes continues to increase, patients with endocrine diseases such as diabetes mellitus and those who are on long-term corticosteroid therapy due to adrenal insufficiency or hypopituitarism are at risk for a poor prognosis of COVID-19. As endocrinologists, we would like to briefly review the current knowledge about the relationship between COVID-19 and endocrine diseases and to discuss what we can do for the safety and health of our patients with endocrine diseases in this globally threatening situation.


title: Managing Patients with Multiple Myeloma during the COVID-19 Pandemic: Recommendations from an Expert Panel - ABHH Monoclonal Gammopathies Committe

text: Since the World has been facing the COVID-19 pandemic, special attention has been taken concerning cancer patients; related to their immunosuppression status, adding risk for more aggressive COVID-19 and mortality, but also concerns about the access and the quality of care in cancer therapy. The COVID-19 pandemic impacts the number of infected, its related mortality, as well as the care of cancer patients. Multiple myeloma patients are a particular group with several important aspects to be considered during pandemic times. In essence, they are immunosuppressed in different intensities during their treatment. Most of them are elderly and all of them require long-term therapy, with prolonged contact with the health care system, possibly including a stem cell transplant during the treatment. A panel of experts in multiple myeloma and infectious diseases discusses pieces of evidence and the lack of the same in the scenario of COVID-19 in myeloma patients, while also exposing what is expected for the next phases of the COVID-19 pandemic.


title: Low-Cost and High-Throughput Testing of COVID-19 Viruses and Antibodies via Compressed Sensing: System Concepts and Computational Experiments

text: Coronavirus disease 2019 (COVID-19) is an ongoing pandemic infectious disease outbreak that has significantly harmed and threatened the health and lives of millions or even billions of people. COVID-19 has also negatively impacted the social and economic activities of many countries significantly. With no approved vaccine available at this moment, extensive testing of COVID-19 viruses in people are essential for disease diagnosis, virus spread confinement, contact tracing, and determining right conditions for people to return to normal economic activities. Identifying people who have antibodies for COVID-19 can also help select persons who are suitable for undertaking certain essential activities or returning to workforce. However, the throughputs of current testing technologies for COVID-19 viruses and antibodies are often quite limited, which are not sufficient for dealing with COVID-19 viruses' anticipated fast oscillating waves of spread affecting a significant portion of the earth's population. In this paper, we propose to use compressed sensing (group testing can be seen as a special case of compressed sensing when it is applied to COVID-19 detection) to achieve high-throughput rapid testing of COVID-19 viruses and antibodies, which can potentially provide tens or even more folds of speedup compared with current testing technologies. The proposed compressed sensing system for high-throughput testing can utilize expander graph based compressed sensing matrices developed by us \cite{Weiyuexpander2007}.


title: Consensus on standardized diagnosis and treatment for osteoporotic vertebral compression fracture patients during epidemic of corona virus disease 2019/ 中华创伤杂志

text: Since December 2019, the corona virus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (2019-nCoV) has been reported in Wuhan, Hubei Province. Almost 70% of patients susceptible to 2019-nCoV are over age of 50 years, with extremely large proportion of critical illness and death of the elderly patients. Meanwhile, the elderly patients are at high risk of osteoporotic fractures especially osteoporotic vertebral compression fractures (OVCF). During the prevention and control of COVID-19 epidemic, orthopedists are confronted with the following difficulties including how to screen and protect OVCF patients, how to accurately diagnose and assess the condition of OVCF patients with suspected or confirmed COVID-19, and how to develop reasonable treatment plans and comprehensive protective measures in emergency and outpatient clinics. In order to standardize the diagnosis and treatment of patients with OVCF diagnosed with COVID-19, the authors jointly develop this expert consensus. The consensus systematically recommends the standardized emergency and outpatient screening and confirmation procedures for OVCF patients with suspected or confirmed COVID-19 and protective measures for emergency and outpatient clinics. Moreover, the consensus describes the grading and classification of OVCF patients diagnosed with COVID-19 according to the severity of illness and recommends different treatment plans and corresponding protective measures based on the different types and epidemic prevention and control requirements.


title: Care of Patients With a Laryngectomy During the COVID-19 Pandemic

text: Patients with a laryngectomy are at increased risk for droplet-transmitted diseases and, therefore, COVID-19, which has now caused a worldwide pandemic. Adaptive measures to protect patients with a laryngectomy and their families were designed and implemented in the Hong Kong SAR (HK). Driven by the fear of severe acute respiratory syndrome in 2003, hospitals in HK have since modified infection control routines to prevent a repeat public health nightmare. To face COVID-19, caused by SARS-CoV-2, we have adapted guidelines for our patients with a laryngectomy. Contact precautions, droplet precautions with physical barriers, and hand and equipment hygiene are our mainstays of prevention against COVID-19, and sharing these routines is the aim of this article. The COVID-19 pandemic is still roaring ahead. Awareness and precautions for patients with a laryngectomy who may be at higher risk are outlined here and should be maintained during the current pandemic.


Covid-19: Increased demand for steroid inhalers causes "distressing" shortages


Let us not forget the mask in our attempts to stall the spread of COVID-19


Enteric involvement in hospitalised patients with COVID-19 outside Wuhan


title: Continuing medical education during a pandemic: an academic institution's experience

text: The COVID-19 pandemic has affected healthcare systems worldwide. The disruption to hospital routines has affected continuing medical education (CME) for specialty trainees (STs). We share our academic institution's experience in mitigating the disruption on the CME programme amidst the pandemic. Most specialty training programmes had switched to videoconferencing to maintain teaching. Some programmes also utilized small group teachings with precautions and e-learning modules. Surgical residencies were disproportionately affected due to reductions in elective procedures but some ways to provide continued surgical exposure include going through archived surgical videos with technical pointers from experienced faculty and usage of surgical simulators . We should adapt CME sessions to keep trainees up to date with core clinical competencies as they will continue to manage both COVID-19 and non-COVID-19 cases and this pandemic may last until year's end.


Initiating adjunct low-dose hydroxyurea therapy for stroke prevention in children with SCA during the COVID-19 pandemic


Covid-19: healthcare staff in hotspot areas are prioritised as testing expands


title: COVID-19, an opportunity to reevaluate the correlation between long-term effects of anthropogenic pollutants on viral epidemic/pandemic events and prevalence

text: Occupational, residential, dietary and environmental exposures to mixtures of synthetic anthropogenic chemicals after World War II have a strong relationship with the increase of chronic diseases, health cost and environmental pollution. The link between environment and immunity is particularly intriguing as it is known that chemicals and drugs can cause immunotoxicity (e.g., allergies and autoimmune diseases). In this review, we emphasize the relationship between long-term exposure to xenobiotic mixtures and immune deficiency inherent to chronic diseases and epidemics/pandemics. We also address the immunotoxicologic risk of vulnerable groups, taking into account biochemical and biophysical properties of SARS-CoV-2 and its immunopathological implications. We particularly underline the common mechanisms by which xenobiotics and SARS-CoV-2 act at the cellular and molecular level. We discuss how long-term exposure to thousand chemicals in mixtures, mostly fossil fuel derivatives, exposure toparticle matters, metals, ultraviolet (UV)-B radiation, ionizing radiation and lifestyle contribute to immunodeficiency observed in the contemporary pandemic, such as COVID-19, and thus threaten global public health, human prosperity and achievements, and global economy. Finally, we propose metrics which are needed to address the diverse health effects of anthropogenic COVID-19 crisis at present and those required to prevent similar future pandemics.


title: Surgical management strategies for orthopedic trauma patients under epidemic of novel coronavirus pneumonia/ 中华创伤杂志

text: With the outbreak of novel coronavirus pneumonia (NCP) induced by 2019 novel coronavirus (2019-nCoV) in Wuhan, Hubei Province in December 2019, more and more suspected or confirmed cases have been found in various regions of China. Although China has adopted unprecedented strict quarantine and closed management measures to prevent the spreading of the disease, Department of Traumatic Orthopedics may still have to manage NCP patients with open fractures or severe trauma that require emergency surgery. Therefore, the identification and management of 2019-nCoV infection as soon as possible as well as the protection of all medical staff involved in the emergency treatment of patients are the severe challenges faced by orthopedic traumatologists during the prevention and control of NCP. Based on the characteristics of such patients and related diagnosis and treatment experiences during the epidemic of NCP, the authors formulate the surgical management strategies for orthopedic trauma patients.


title: Guidelines on the Prevention and Control of Disease in Dental Practice during the Coronavirus Outbreak

text: Coronavirus disease 2019 has become a worldwide pandemic that is seriously jeopardising people's health. The National Health Commission and regional health administrations have issued regulations on the prevention and control of coronavirus disease 2019. Dentistry involves many invasive treatments, which differentiates it from other forms of medical practice. The following guidelines were produced by experts from the Stomatological Healthcare Service branch of the Chinese Stomatological Association to prevent the spread of coronavirus disease 2019 in dental clinics. The guidelines are in accordance with the relevant laws and documents from the health administration and range from technical guidelines to advice on how dental treatment should be conducted. Dental institutions can take these suggestions as a reference, based on the current local epidemic situation. It is anticipated that the guidelines will help dental institutions of different sizes to prevent the spread of the epidemic.


Prevention of COVID-19 by drug repurposing: rationale from drugs prescribed for mental disorders


title: "The storm has arrived": the impact of SARS-CoV-2 on medical students

text: In a few weeks, the global community has witnessed, and for some of us experienced first-hand, the human costs of the COVID-19 pandemic. There is incredible variability in how countries are choosing to thwart the disease's outbreak, sparking intense discussions around what it means to teach and learn in the era of COVID-19, and more specifically, the role medical students play in the midst of the pandemic. A multi-national and multi-institutional group made up of a dedicated medical student from Austria, passionate clinicians and educators from Switzerland, and a PhD scientist involved in Medical Education from Canada, have assembled to summarize the ingenious ways medical students around the world are contributing to emergency efforts. They argue that such efforts change COVID-19 from a "disruption" to medical students learning to something more tangible, more important, allowing students to become stakeholders in the expansion and delivery of healthcare.


Specific pathways to prevent SARS-CoV-2 infection in case of repeated hospital admissions for radiotherapy


COVID-19 in Pakistan: Impact on global polio eradication initiative


Homeless mentally ill people and COVID-19 pandemic: The two-way sword for LMICs


title: Scientific Collaboration During the COVID-19 Pandemic: N95DECON.org

text: Many academics and researchers have responded to the COVID-19 pandemic by forming on-line national and international collaborative groups to rapidly investigate issues of prevention and treatment. This commentary describes the spontaneous formation of an international team of 115 researchers who summarized the literature on safe methods for decontaminating N95 filtering facepiece respirators in response to the supply crisis. The summary reports and fact sheets on the (www.n95decon.org) website have had more than 200 000 unique visits and the organization's webinars have reached health care professionals from more than 50 countries. The team is extending its mission to cover other personal protective equipment. The success of these collaborations may alter how scientific questions are tackled in the future.


title: Inflammation resolution: a dual-pronged approach to averting cytokine storms in COVID-19?

text: Severe coronavirus disease (COVID-19) is characterized by pulmonary hyper-inflammation and potentially life-threatening "cytokine storms". Controlling the local and systemic inflammatory response in COVID-19 may be as important as anti-viral therapies. Endogenous lipid autacoid mediators, referred to as eicosanoids, play a critical role in the induction of inflammation and pro-inflammatory cytokine production. SARS-CoV-2 may trigger a cell death ("debris")-induced "eicosanoid storm", including prostaglandins and leukotrienes, which in turn initiates a robust inflammatory response. A paradigm shift is emerging in our understanding of the resolution of inflammation as an active biochemical process with the discovery of novel endogenous specialized pro-resolving lipid autacoid mediators (SPMs), such as resolvins. Resolvins and other SPMs stimulate macrophage-mediated clearance of debris and counter pro-inflammatory cytokine production, a process called inflammation resolution. SPMs and their lipid precursors exhibit anti-viral activity at nanogram doses in the setting of influenza without being immunosuppressive. SPMs also promote anti-viral B cell antibodies and lymphocyte activity, highlighting their potential use in the treatment of COVID-19. Soluble epoxide hydrolase (sEH) inhibitors stabilize arachidonic acid-derived epoxyeicosatrienoic acids (EETs), which also stimulate inflammation resolution by promoting the production of pro-resolution mediators, activating anti-inflammatory processes, and preventing the cytokine storm. Both resolvins and EETs also attenuate pathological thrombosis and promote clot removal, which is emerging as a key pathology of COVID-19 infection. Thus, both SPMs and sEH inhibitors may promote the resolution of inflammation in COVID-19, thereby reducing acute respiratory distress syndrome (ARDS) and other life-threatening complications associated with robust viral-induced inflammation. While most COVID-19 clinical trials focus on "anti-viral" and "anti-inflammatory" strategies, stimulating inflammation resolution is a novel host-centric therapeutic avenue. Importantly, SPMs and sEH inhibitors are currently in clinical trials for other inflammatory diseases and could be rapidly translated for the management of COVID-19 via debris clearance and inflammatory cytokine suppression. Here, we discuss using pro-resolution mediators as a potential complement to current anti-viral strategies for COVID-19.


title: Citokinellenes terápia az új típusú koronavírus okozta megbetegedés (COVID-19) kezelésében - tocilizumab elsoként való alkalmazása egy hazai infektológiai osztályon./ Anti-cytokine therapy in novel coronavirus disease (COVID-19)  the first administration of tocilizumab in Hungary at a department of infectology

text: During the past few months, a pandemic originating from China named new coronavirus disease (COVID-19) has shown how vulnerable the world is. To date, no medication supported by randomized clinical trials has been approved for the treatment of COVID-19. At the time of writing of this paper, severe acute respiratory syndrome caused by coronavirus-2 (SARS-CoV-2) has been responsible - according to modest estimations - for around 4 million of infections and 300 000 deaths. Unveiling details of patomechanism, in fatal cases the role of immune dysregulation, namely cytokine release syndrome (CRS) has been discovered. Based on the current knowledge, interleukin-6 (IL6) plays a pivotal role in COVID-19 associated CRS. Case reports and result of small case series suggest efficacy of an IL6 inhibitor monoclonal antibody (tocilizumab) in treating CRS. Authors describe a case and review recent knowledge on the treatment of COVID-19. To our knowledge, the first case of severe COVID-19-associated cytokine storm syndrome - treated succesfully with IL6 monoclocal antibody at a Hungarian department of infectology - is presented here. Orv Hetil. 2020; 161(26): 1070-1077.


title: Coronavirus membrane fusion mechanism offers a potential target for antiviral development

text: The coronavirus disease 2019 (COVID-19) pandemic has focused attention on the need to develop effective therapies against the causative agent, SARS-CoV-2, and also against other pathogenic coronaviruses (CoV) that have emerged in the past or might appear in future. Researchers are therefore focusing on steps in the CoV replication cycle that may be vulnerable to inhibition by broad-spectrum or specific antiviral agents. The conserved nature of the fusion domain and mechanism across the CoV family make it a valuable target to elucidate and develop pan-CoV therapeutics. In this article, we review the role of the CoV spike protein in mediating fusion of the viral and host cell membranes, summarizing the results of research on SARS-CoV, MERS-CoV, and recent peer-reviewed studies of SARS-CoV-2, and suggest that the fusion mechanism be investigated as a potential antiviral target. We also provide a supplemental file containing background information on the biology, epidemiology, and clinical features of all human-infecting coronaviruses, along with a phylogenetic tree of these coronaviruses.


title: Energetics and IC50 based epitope screening in SARS CoV-2 (COVID 19) spike protein by immunoinformatic analysis implicating for a suitable vaccine development

text: BACKGROUND: The recent outbreak by SARS-CoV-2 has generated a chaos in global health and economy and claimed/infected a large number of lives. Closely resembling with SARS CoV, the present strain has manifested exceptionally higher degree of spreadability, virulence and stability possibly due to some unidentified mutations. The viral spike glycoprotein is very likely to interact with host Angiotensin-Converting Enzyme 2 (ACE2) and transmits its genetic materials and hijacks host machinery with extreme fidelity for self propagation. Few attempts have been made to develop a suitable vaccine or ACE2 blocker or virus-receptor inhibitor within this short period of time. METHODS: Here, attempt was taken to develop some therapeutic and vaccination strategies with a comparison of spike glycoproteins among SARS-CoV, MERS-CoV and the SARS-CoV-2. We verified their structure quality (SWISS-MODEL, Phyre2, and Pymol) topology (ProFunc), motifs (MEME Suite, GLAM2Scan), gene ontology based conserved domain (InterPro database) and screened several epitopes (SVMTrip) of SARS CoV-2 based on their energetics, IC50 and antigenicity with regard to their possible glycosylation and MHC/paratope binding (Vaxigen v2.0, HawkDock, ZDOCK Server) effects. RESULTS: We screened here few pairs of spike protein epitopic regions and selected their energetic, Inhibitory Concentration50 (IC50), MHC II reactivity and found some of those to be very good target for vaccination. A possible role of glycosylation on epitopic region showed profound effects on epitopic recognition. CONCLUSION: The present work might be helpful for the urgent development of a suitable vaccination regimen against SARS CoV-2.


Public health might be endangered by possible prolonged discharge of SARS-CoV-2 in stool


title: Characteristics of and Public Health Emergency Responses to COVID-19 and H1N1 Outbreaks: A Case-Comparison Study

text: BACKGROUND: Recently, the novel coronavirus disease (COVID-19) has already spread rapidly as a global pandemic, just like the H1N1 swine influenza in 2009. Evidences have indicated that the efficiency of emergency response was considered crucial to curb the spread of the emerging infectious disease. However, studies of COVID-19 on this topic are relatively few. METHODS: A qualitative comparative study was conducted to compare the timeline of emergency responses to H1N1 (2009) and COVID-19, by using a set of six key time nodes selected from international literature. Besides, we also explored the spread speed and peak time of COVID-19 and H1N1 swine influenza by comparing the confirmed cases in the same time interval. RESULTS: The government's entire emergency responses to the epidemic, H1N1 swine influenza (2009) completed in 28 days, and COVID-19 (2019) completed in 46 days. Emergency responses speed for H1N1 was 18 days faster. As for the epidemic spread speed, the peak time of H1N1 came about 4 weeks later than that of COVID-19, and the H1N1 curve in America was flatter than COVID-19 in China within the first four months after the disease emerged. CONCLUSIONS: The speed of the emergency responses to H1N1 was faster than COVID-19, which might be an important influential factor for slowing down the arrival of the peak time at the beginning of the epidemic. Although COVID-19 in China is coming to an end, the government should improve the public health emergency system, in order to control the spread of the epidemic and lessen the adverse social effects in possible future outbreaks.


title: Suggestions on the prevention of COVID-19 for health care workers in department of otorhinolaryngology head and neck surgery

text: The epidemic of the Coronavirus Disease 2019 (COVID-19) has presented as a grim and complex situation recently. More than 77,000 cases of COVID-19 has been confirmed in China until February 25th, 2020, which are causing great impact on economy and society, as well as seriously interfering with ordinary medical practice in the department of otorhinolaryngology head and neck surgery. This article discussed medical precautions required in the clinic, inpatient ward and operation room of otorhinolaryngology head and neck department, which aims to protect health care workers from COVID-19.


Guillain-Barré Syndrome Associated with SARS-CoV-2


Initial Observations of COVID-19 in US Children


Who Needs a Corona?


Covid-19: FDA approves use of convalescent plasma to treat critically ill patients


Four cases from a family cluster were diagnosed as COVID-19 after 14-day of quarantine period


title: Influences of cyclosporin A and non-immunosuppressive derivatives on cellular cyclophilins and viral nucleocapsid protein during human coronavirus 229E replication

text: The well-known immunosuppressive drug cyclosporin A inhibits replication of various viruses including coronaviruses by binding to cellular cyclophilins thus inactivating their cis-trans peptidyl-prolyl isomerase function Viral nucleocapsid proteins are inevitable for genome encapsidation and replication Here we demonstrate the interaction between the N protein of HCoV-229E and cyclophilin A, not cyclophilin B Cyclophilin inhibitors abolish this interaction Upon infection, cyclophilin A stays evenly distributed throughout the cell, whereas cyclophilin B concentrates at ER-bleb-like structures We further show the inhibitory potential of non-immunosuppressive CsA derivatives Alisporivir, NIM811, compound 3 on HCoV-229E-GFP and -Luciferase replication in human Huh-7 5 hepatoma cells at 18 and 48 h time points post infection with EC50 s at low micromolar ranges Thus, non-immunosuppressive CsA derivatives effectively inhibit HCoV-229E replication suggesting them as possible candidates for the treatment of HCoV infection The interruption of interaction between CypA and N protein by CsA and its derivatives suggest a mechanism how CypA inhibitors suppress viral replication , Highlights:, * HCoV-229E replication is inhibited by Alisporivir, NIM811 and other non-immunosuppressive Cyclosporin A derivatives , * HCoV-229E N protein interacts with cyclophilin A , * Cyclophilin A is required for coronavirus replication , * Cyclophilin B concentrates in bleb-like structures of the ER in HCoV-infected Huh7 cells , (C) 2020Elsevier, Inc


title: Infection rate and clinical management of cancer patients during the COVID-19 pandemic: experience from a tertiary care hospital in northern Italy

text: BACKGROUND: Optimal management of patients with cancer during COVID-19 pandemic is still pending. METHODS: Our patients were advised to maintain their scheduled appointments, and planned cancer treatment was continued without unnecessary delays in an outpatient setting. Additional strict preventive infection measures were rapidly implemented at our outpatient department. When COVID-19 test became widely available, universal testing of healthcare workers and vigorous screening of all patients coming to our facility for COVID-19 infection were performed by SARS-CoV-2 real-time reverse transcription PCR on rhinopharyngeal swab. RESULTS: As of the data cut-off on 9 April 2020, a total of 156 oncology patients with a median age of 67 (range 26-86) years and 63 haematology patients (median age 69 years, range 23-89) were screened for COVID-19 during active cancer treatment. Prevalence (1.8%; 4/219) of COVID-19 in patients with cancer was significantly higher compared with a respective control group of asymptomatic counterparts (p=0.018). Outcomes of COVID-19 positive patients were good, with only one observed death due to progression of advanced metastatic disease. CONCLUSION: Our data indicate that continuation of anticancer treatment in epidemic areas during the COVID-19 pandemic seems to be safe and feasible, if adequate and strict preventive measures are vigorously and successfully carried out.


title: RelDenClu:A Relative Density based Biclustering Method for identifying non-linear feature relations with an Application to identify factors effecting spread of COVID-19

text: The existing biclustering algorithms for finding feature relation based biclusters often depend on assumptions like monotonicity or linearity. Though a few algorithms overcome this problem by using density-based methods, they tend to miss out many biclusters because they use global criteria for identifying dense regions. The proposed method, RelDenClu uses the local variations in marginal and joint densities for each pair of features to find the subset of observations, which forms the bases of the relation between them. It then finds the set of features connected by a common set of observations, resulting in a bicluster. To show the effectiveness of the proposed methodology, experimentation has been carried out on fifteen types of simulated data. It has been used for unsupervised learning using three real-life datasets. Applicability of the algorithm is also explored on three real-life datasets to see its utility as an aid to supervised learning. For all the cases the performance of the proposed method is compared with that of seven different state-of-the-art algorithms. The proposed algorithm produces better results. The efficacy of the algorithm is shown on COVID-19 dataset and found out that some features (genetic, demographics and others) are likely to affect the spread of COVID-19.


title: Dispersion of speech aerosols in the context of physical distancing recommendations

text: High-speed particle image velocimetry (PIV) was used to quantify the dispersion of aerosol-laden gas clouds generated during phonetic vocalization by a human subject at different sound intensity levels. The measured PIV data was used to quantify the initial penetration depth. Using classical pulsed jet scaling laws propagation distances were computed for time periods beyond the measured duration. Our results indicate that the penetration distance was comparable between loud intensity speech (for example during singing, classroom lectures, parties etc.) and moderate intensity cough. Based on theoretical aerosol propagation distance and time, the 6 feet physical distancing recommendations are likely sufficient to avoid incidental exposure by the initial penetration of the aerosol cloud, but insufficient for prolonged exposure to slow propagating aerosol clouds.


COVID-19 and ethical considerations: Valuable decision-making tools from the leading medical societies in France


Scalable and robust SARS-CoV-2 testing in an academic center


Evidence of short-range aerosol transmission of SARS-CoV-2 and call for universal airborne precautions for anesthesiologists during the COVID-19 pandemic


title: [Health protection guideline of schools and other educational institutions during COVID-19 outbreak]

text: This guideline stipulates the management requirements, on-site hygiene operation, personal protection and comprehensive security of schools and other educational institutions. It is applicable to the unified standard prevention and control of schools and other educational institutions during COVID-19 outbreak.


title: Quantifying the Risk of SARS-CoV-2 Transmission in the United States

text: In the United States, the rate of symptomatic transmission of SARS-CoV-2 to contacts was only 0 45%, but was 10 5% in household contacts;there were tertiary symptomatic transmissions However, since only symptomatic individuals underwent testing, the actual overall rate of transmission with or without resultant symptomatic illness is likely to be higher , (C) 2020 AHC Media LLC


Patients with advanced basal cell carcinomas in treatment with sonic hedgehog inhibitors during the coronavirus disease 2019 (COVID-19) period: Management and adherence to treatment


Patient care during the COVID-19 pandemic: do not leave delirium behind


Novel Coronavirus (COVID-19): A Global Pandemic


Letter to the Editor: "Medical Student Concerns Relating to Neurosurgery Education During COVID-19"


title: Study of lockdown/testing mitigation strategies on stochastic SIR model and its comparison with South Korea, Germany and New York data

text: We are currently facing a highly critical case of a world-wide pandemic. The novel coronavirus (SARS-CoV-2, a.k.a. COVID-19) has proved to be extremely contagious and the original outbreak from Asia has now spread to all continents. This situation will fruitfully profit from the study in regards of the spread of the virus, assessing effective countermeasures to weight the impact of the adopted strategies. The standard Susceptible-Infectious-Recovered (SIR) model is a very successful and widely used mathematical model for predicting the spread of an epidemic. We adopt the SIR model on a random network and extend the model to include control strategies {\em lockdown} and {\em testing} -- two often employed mitigation strategies. The ability of these strategies in controlling the pandemic spread is investigated by varying the effectiveness with which they are implemented. The possibility of a second outbreak is evaluated in detail after the mitigation strategies are withdrawn. We notice that, in any case, a sudden interruption of such mitigation strategies will likely induce a resurgence of a second outbreak, whose peak will be correlated to the number of susceptible individuals. In fact, we find that a population will remain vulnerable to the infection until the herd immunity is achieved. We also test our model with real statistics and information on the epidemic spread in South Korea, Germany, and New York and find a remarkable agreement with the simulation data.


Health Care Policy After the COVID-19 Pandemic


COVID-19 and the American Board of Ophthalmology: When the Best-Laid Plans Go Awry


Strengthening early testing and surveillance of COVID-19 to enhance identification of asymptomatic patients


Skin manifestations in COVID-19: A case series of five patients from Elazig, Turkey


Glucocorticoid therapy delays the clearance of SARS-CoV-2 RNA in an asymptomatic COVID-19 patient


Immunotherapies for COVID-19: lessons learned from sepsis


Neuroradiologists and the Novel Coronavirus


title: A short review on antibody therapy for COVID-19

text: The beginning of the novel SARS-CoV-2 human coronavirus in Wuhan, China, has triggered a worldwide respiratory disease outbreak (COVID-19). By April 07, 2020, SARS-CoV-2 has affected more than 1.36 million people worldwide and caused more than 75,900 deaths. To date, the anti-malaria drug hydroxychloroquine found to be a treatment option for SARS-CoV-2. In addition to supportive treatment, such as oxygen supply in moderate cases and extracorporeal membrane oxygenation in critically ill patients, unique medications for this condition are also under investigation. Here we reviewed the antibody therapy might be an immediate strategy for emergency prophylaxis and SARS-CoV-2 therapy.


title: Effect of hydroxychloroquine on prevention of COVID-19 virus infection among healthcare professionals: a structured summary of a study protocol for a randomised controlled trial

text: OBJECTIVES: Comparison of the effect of hydroxychloroquine with placebo to prevent infection from the COVID -19 virus among healthcare professionals TRIAL DESIGN: Single centre, 2-arm, double-blind randomised (ratio 1:1) placebo-controlled trial PARTICIPANTS: Treatment staff who are in contact with patients and have at least 3 shifts a week in Arash hospital affiliated with Tehran University of Medical Sciences, in Iran and who consent to participate in the study. Exclusion criteria include: History of COVID -19 virus infection, clinical symptoms such as fever, nausea, dyspnea and myalgia in the past two months, history of underlying diseases hypersensitivity to hydroxychloroquine and G6PD enzyme deficiency. INTERVENTION AND COMPARATOR: Intervention group: Hydroxychloroquine 200 mg tablet of Amin Pharmaceutical. CONTROL GROUP: placebo which is completely similar in form and taste to 200 mg hydroxychloroquine tablet and is manufactured by the same factory (Amin Pharmacy). The dosage is two tablets daily, once a week for one to three months (based on the duration of the Coronavirus epidemic in Tehran). MAIN OUTCOMES: Confirmed COVID-19 virus infection using Polymerase chain reaction (PCR) test is the primary outcome. The time period for measuring the primary outcome is any infection within the trial period up to one month after taking the last dose. RANDOMISATION: The randomized block allocation method was developed using Stata version 15 software by an independent researcher, using a block size of six. Allocation to the two treatment groups will be conducted by this researcher using paper labels (random 10-digit codes) in a 1:1 ratio t The labels will be attached to the drug packages in order of randomization. Drug packages will be arranged in a box according to the randomization list. BLINDING (MASKING): Participants and caregivers are blinded to group assignment and the data will be analyzed by an independent statistical expert who is unaware of the treatment allocation. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): A total of 282 participants will be randomised with 141 participants the Hydroxychloroquineeach intervention group and 141 participants to the placebo control group TRIAL STATUS: The protocol version number is 99-1-101-47091 and the approval ID is IR.TUMS.VCR.REC.1399.001 and recruitment began April 7, 2020, and is anticipated to be complete by August 7, 2020. TRIAL REGISTRATION: The name of the trial register is Iranian registry of clinical trial (IRCT), registration number is IRCT20120826010664N6, date of trial registration is April 7, 2020, FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Surgical chief resident, a resilient figure during the COVID-19 pandemic


Rapid Detection of COVID-19 Coronavirus Using a Reverse Transcriptional Loop-Mediated Isothermal Amplification (RT-LAMP) Diagnostic Platform


Spontaneous reporting of onset of disturbing dreams and nightmares related to early life traumatic experiences during the COVID-19 pandemic by patients with posttraumatic stress disorder in remission


Covid-19: Woman whose father died in care home launches legal review over government's "litany of failures"


title: Anti-SARS-CoV-2 hyperimmune plasma workflow

text: Coronavirus disease 2019 (COVID-19) caused by the novel coronavirus has become a Public Health Emergency of International Concern. Among the various treatment proposals for COVID-19 infection, passive immunotherapy using plasma from recovering patients - "convalescent plasma" (CP)- could be a promising option in the treatment of SARS-CoV-2 infections. Immune (i.e. "convalescent") plasma refers to plasma that is collected from individuals, following resolution of infection and development of antibodies. Passive antibody administration through transfusion of convalescent plasma may offer the only short-term strategy to confer immediate immunity to susceptible individuals. According to the World Health Organization (WHO), the use of plasma therapy is permitted when faced with «serious diseases for which there are no effective pharmacological treatments¼. Several clinical trials are underway to test the effectiveness of hyperimmune plasma at various stages of SARS-CoV2.The Food and Drug Administration (FDA), the U.S. regulatory authority, has approved the use of CP for compassionate use in the treatment of patients with a critical COVID-19 infection. Below are the general indications for drawing up clinical protocols for the integral management of "COVID-19-convalescent plasma" for which the validation and approval of the Ethics Committees is still necessary.


title: Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north India

text: BACKGROUND AND AIMS: During the current pandemic of COVID-19, India is under lockdown which could cause disruption in diet and lifestyle in patients with type 2 diabetes (T2DM). We aimed to study lifestyle changes and other common issues related to treatment in our previously seen and treated patients with T2DM. METHODS: Patients (n, 150) who were regularly following up before lockdown were interviewed telephonically (after 45 days of start of lockdown) regarding lifestyle changes, stress and other diabetes-related questions. RESULT: Carbohydrate consumption and frequency of snacking increased in 21% and 23% patients, respectively. Interestingly, 27% patients reported an increase in consumption of fruits. Exercise duration was reduced in 42% and weight gain occurred in 19% patients. Frequency of doing self-monitoring of blood glucose (SMBG) was decreased in 23% patients. 'Mental stress' of any kind was reported in 87% patients. Availability of medicines and insulin was uninterrupted in 91% patients. Knowledge about telemedicine was present in 69% and majority (92%) of these patients preferred video consultation. CONCLUSION: During 45 days of lockdown increase in carbohydrate intake, decrease in exercise, decreased SMBG and widespread mental stress in patients with T2DM was recorded, factors which may destabilize or exacerbate hyperglycemia and hypertension. Some positive changes (e.g. increased intake of fruits) were also observed.


title: Is the mental health of young students and their family members affected during the quarantine period? Evidence from the COVID-19 pandemic in Albania

text: INTRODUCTION: The use of quarantine method has a significant impact on mental health status. AIM: This study aimed to assess the levels of depression among bachelor and master university students (nurses/midwives) and their family members' during the quarantine period of COVID-19 pandemic. METHOD: A cross-sectional study was conducted in Vlora University, Albania. Patient Health Questionnaire (PHQ-9) was used. Institutional e-mails of all active students were used for their recruitment. RESULTS: In total, 863 students and 249 family members participated in the study. The mean PHQ-9 score was 6.220 (SD=5.803) and 6.280 (SD=5.857) for students and family members, respectively. Being unsatisfied with COVID-19 prevention measures, beliefs that COVID-19 infection and quarantine process can cause problems on their health status were the key factors for students to be screened positive for mental problems in multiple regression analysis. For parents, the last two factors were found to contribute significantly. DISCUSSION: Our findings indicate that quarantine measures have a significant impact on the levels of depression among both university students and their family members. Broader population studies are necessary to safeguard these results. IMPLICATIONS FOR PRACTICE: Provision of mental health services during the quarantine period is of paramount significance. Mental health first aid trainingand support could benefit both students and their parents significantly. Additionally, follow up services after the end of quarantine are recommended.


COVID-19 and SIC (!)


title: The Efficacy of Lockdown Against COVID-19: A Cross-Country Panel Analysis

text: BACKGROUND: There has been much debate about the effectiveness of lockdown measures in containing COVID-19, and their appropriateness given the economic and social cost they entail. To the best of our knowledge, no existing contribution to the literature has attempted to gauge the effectiveness of lockdown measures over time in a longitudinal cross-country perspective. OBJECTIVES: This paper aims to fill the gap in the literature by assessing, at an international level, the effect of lockdown measures (or the lack of such measures) on the numbers of new infections. Given this policy's expected change in effectiveness over time, we also measure the effect of having a lockdown implemented over a given number of days (from 7 to 20 days). METHODS: We pursue our objectives by means of a quantitative panel analysis, building a longitudinal dataset with observations from countries all over the world, and estimating the impact of lockdown via feasible generalized least squares fixed effect, random effects, generalized estimating equation, and hierarchical linear models. RESULTS: Our results show that lockdown is effective in reducing the number of new cases in the countries that implement it, compared with those countries that do not. This is especially true around 10 days after the implementation of the policy. Its efficacy continues to grow up to 20 days after implementation. CONCLUSION: Results suggest that lockdown is effective in reducing the R0, i.e. the number of people infected by each infected person, and that, unlike what has been suggested in previous analyses, its efficacy continues to hold 20 days after the introduction of the policy.


Treating Insomnia during the COVID-19 Pandemic: Observations and Perspectives from a Behavioral Sleep Medicine Clinic