title: Clinical characteristics of COVID-19 in Saudi Arabia: A national retrospective study

text: BACKGROUND: The global battle to contain the novel coronavirus disease 2019 (COVID-19) pandemic rages on. Previous studies described the clinical characteristics of COVID-19, but knowledge gaps remain in the Middle East region. Identifying these features will help in mapping the disease and guiding pandemic management. A multi-center, retrospective cross-sectional study was initiated to describe the demographic data, clinical characteristics, and outcomes of COVID-19 cases across all the regions of Saudi Arabia. METHODS: The analysis included all laboratory-confirmed positive COVID-19 patients from the 1st of March 2020 to 31st of March 2020 across all regions of Saudi Arabia. Demographic data, clinical characteristics, incubation periods, laboratory findings, and patient outcomes data were retrieved from 1519 cases in the Health Electronic Surveillance Network Database. RESULTS: The median age was 36 years and 54.3% (n = 825) of the patients were men. Patients working in health care facilities represented 12.5% of the cases (n = 190) and 9.3% of cases were asymptomatic. The median incubation period was 6 days. The most common symptoms were cough (89.4%), fever (85.6%), and sore throat (81.6%); 20.1% of the patients had underlying comorbidities. Hypertension was seen in 8.8% and diabetes in 7.6% of all the cases. The percentage of cases with temperatures >38Ö¯C was 20.3% (n = 129), and 1.6% of patients had heart rates ≥125 beats/min and 4.7% of them had respiratory rates of >24 breaths/min. Lymphocytopenia occurred in 37.5% of cases. Overall, 71.6% of patients were admitted to hospitals and 4.7% required ICU treatment. We could not completely assess the clinical courses or final outcomes of COVID-19 patients. CONCLUSION: In this multi-center retrospective study, fever and cough were common symptoms. Special attention should be addressed toward asymptomatic carriers and workers in health care facilities as they play a key role in disease transmission.


Transmission of SARS-CoV-2 in Domestic Cats


title: Impact of COVID 19 lockdown on orthopaedic surgeons in India: A survey

text: Background: In the fight against COVID 19, the government of India announced a 3 weeks lockdown of the entire country of 1.3 billion people on 24th March 2020. Methods: One week after the lockdown was announced, we conducted an anonymous online survey of the orthopaedic surgeons in India through social media platforms to assess the impact of the lockdown during COVID 19. The survey had a total of 13 questions with (3-5) options and was designed with an aim to understand the perception and the state of mind of the Orthopaedic surgeons in the lockdown situation. Results: The survey was completed by 611 orthopaedic surgeons from 140 cities in India. There were 22.5% orthopaedic surgeons who said that they were definitely stressed out, and 40.5% who said they were mildly stressed out. As the age decreased, the percentage of orthopaedic surgeons feeling "definitely stressed out" increased. Disruption of life-work balance and uncertainties regarding return to work were other strongly associated factors with the "definitely stressed out" group. Conclusion: The psychological impact of the lockdown during COVID 19 on orthopaedic surgeons may become a potential concern that will require addressal through open discussion. Level of evidence: diagnostic level 4.


title: Melanoma Screening Days During the Coronavirus Disease 2019 (COVID-19) Pandemic: Strategies to Adopt

text: Melanoma is one of the most common cancers, with an increasing incidence worldwide. Disease stage represents the most important prognosis factor; therefore, early diagnosis is essential for melanoma patients' survival rates. Following the outbreak in China, the coronavirus disease 2019 (COVID-19) pandemic has spread all over the world and the majority of dermatological visits have been postponed. These measures could cause a delay in melanoma diagnosis and management leading to an increase of morbidity, mortality and healthcare costs. Herein we propose an alternative model of skin cancer screening and the organization of screening campaigns in order to detect malignant lesions early during this emergency period.


SARS-CoV-2 Infection in Patients with Down Syndrome, Congenital Heart Disease, and Pulmonary Hypertension: Is Down Syndrome a Risk Factor?


title: Reconfiguring and ramping-up ventilator production in the face of COVID-19: Can robots help?

text: As the COVID-19 pandemic expands, the shortening of medical equipment is swelling. A key piece of equipment getting far-out attention has been ventilators. The difference between supply and demand is substantial to be handled with normal production techniques, especially under social distancing measures in place. The study explores the rationale of human-robot teams to ramp up production using advantages of both the ease of integration and maintaining social distancing. The paper presents a model for faster integration of collaborative robots and design guidelines for workstation. The scenarios are evaluated for an open source ventilator through continuous human-robot simulation and amplification of results in a discrete event simulation.


title: Febuxostat therapy in outpatients with suspected COVID-19: A clinical trial

text: BACKGROUND: The aim of this clinical trial was to evaluate the effects of febuxostat (FBX) in comparison with hydroxychloroquine (HCQ) on clinical symptoms, laboratory tests and chest CT findings in outpatients with moderate symptoms of COVID-19 infection. METHODS: We conducted a clinical trial involving adult outpatients with the moderate respiratory illness following COVID-19 infection. Patients were randomly assigned to receive either FBX or HCQ for 5 days. The measured variables were needs to hospitalization, clinical and laboratory data including fever, cough, breathing rate, C-Reactive Protein level, lymphocytes count at onset of admission and was well as at 5 days of treatments. In addition, CT findings were evaluated on admission and 14 days after initiation of treatment. RESULTS: Sixty subjects were enrolled in the study with a 1 to 1 ratio in FBX and HCQ groups. On admission, fever (66.7%), cough (87%), tachypnea (44.4%), dyspnea (35%), elevated CRP value (94.4%) and lung involvement according to chest CT (100%) were documented in enrolled patients with insignificant difference between FBX and HCQ groups. Fever, cough and tachypnea were significantly mitigated in both groups after five days of treatments without any significant differences between groups. The mean percentages of lung involvement were significantly reduced to 7.3% and 8% after 14 days of treatment with FBX and HCQ, respectively. In adult outpatients with moderate COVID-19 infection, the effectiveness of FBX and HCQ was not different in terms of resolution of clinical manifestations, laboratory tests and lung CT findings. CONCLUSION: This trial suggests that FBX is as an alternative treatment to HCQ for COVID-19 infection and may be considered in patients with a contraindication or precaution to HCQ.


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

text: OBJECTIVES: To investigate the incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases receiving targeted biologic and synthetic disease modifying anti-rheumatic drugs (tDMARDs) and to explore the possible effect of these treatments in the clinical expression of COVID-19. METHODS: A cross-sectional study comprising of a telephone survey and electronic health records review was performed including all adult and paediatric patients with rheumatic diseases treated with tDMARDs in a large rheumatology tertiary centre in Barcelona, Spain. Demographics, disease activity, COVID-19 related symptoms and contact history data were obtained from the start of the 2020 pandemic. Cumulative incidence of confirmed cases (SARS-CoV-2 positive PCR test) was compared to the population estimates for the same city districts from a governmental COVID-19 health database. Suspected cases were defined following WHO criteria and compared to those without compatible symptoms. RESULTS: 959 patients with rheumatic diseases treated with tDMARDs were included. We identified 11 confirmed SARS-CoV-2 positive cases in the adult cohort and no confirmed positive cases in the paediatric cohort. COVID-19 incidence rates of the rheumatic patient cohort were very similar to that of the general population [(0.48% (95% CI 0.09 to 0.87%)] and [0.58% (95% CI 0.56 to 0.60%)], respectively. We found significant differences in tDMARDs proportions between the suspected and non-suspected cases (p=0.002). CONCLUSION: Adult and paediatric patients with rheumatic diseases on tDMARDs do not seem to present a higher risk of COVID-19 or a more severe disease outcome when compared to general population.


title: COVID-19 critical illness pathophysiology driven by diffuse pulmonary thrombi and pulmonary endothelial dysfunction responsive to thrombolysis

text: Patients with severe COVID-19 disease have been characterized as having the acute respiratory distress syndrome (ARDS). Critically ill COVID-19 patients have relatively well-preserved lung mechanics despite severe gas exchange abnormalities, a feature not consistent with classical ARDS but more consistent with pulmonary vascular disease. Many patients with severe COVID-19 also demonstrate markedly abnormal coagulation, with elevated d-dimers and higher rates of venous thromboembolism. We present four cases of patients with severe COVID-19 pneumonia with severe respiratory failure and shock, with evidence of markedly elevated dead-space ventilation who received tPA. All showed post treatment immediate improvements in gas exchange and/or hemodynamics. We suspect that severe COVID-19 pneumonia causes respiratory failure via pulmonary microthrombi and endothelial dysfunction. Treatment for COVID-19 pneumonia may warrant anticoagulation for milder cases and thrombolysis for more severe disease.


title: Monitoring Depression Trend on Twitter during the COVID-19 Pandemic

text: The COVID-19 pandemic has severely affected people's daily lives and caused tremendous economic loss worldwide. However, its influence on people's mental health conditions has not received as much attention. To study this subject, we choose social media as our main data resource and create by far the largest English Twitter depression dataset containing 2,575 distinct identified depression users with their past tweets. To examine the effect of depression on people's Twitter language, we train three transformer-based depression classification models on the dataset, evaluate their performance with progressively increased training sizes, and compare the model's"tweet chunk"-level and user-level performances. Furthermore, inspired by psychological studies, we create a fusion classifier that combines deep learning model scores with psychological text features and users' demographic information and investigate these features' relations to depression signals. Finally, we demonstrate our model's capability of monitoring both group-level and population-level depression trends by presenting two of its applications during the COVID-19 pandemic. We hope this study can raise awareness among researchers and the general public of COVID-19's impact on people's mental health.


title: [Expert recommendations on the management of patients with advanced non-small cell lung cancer during epidemic of coronavirus disease 2019 (Trial version)]

text: The outbreak of coronavirus disease 2019 (COVID-19) has become a public health emergency of major international concern. Given the systemic immunosuppressive state caused by malignancy and anticancer treatments, patients with advanced lung cancer may be at a higher risk of COVID-19 infection. During epidemic of COVID-19, a guideline for the optimal management of patients with advanced lung cancer urgently needs to be proposed to distinguish the symptoms of COVID-19 and the side effects of antitumor drugs. This network questionnaire survey was conducted on the lung cancer group of the Chinese Thoracic Society, Chinese Medical Association; the lung cancer group of the Chinese Society of Clinical Oncology Youth Committee; and the Chinese Respiratory Oncology Collaboration. 321 valid questionnaires were received. Based on the guidelines on lung cancer and the results of the questionnaires, a consensus was reached. During the epidemic of COVID-19, We recommended that patients with advanced NSCLC should be treated as outpatients as possible at the nearest medical center; Patients who need to be hospitalized for antitumor treatment should be excluded from COVID-19 infection; More intensive attention should be paid to identification of COVID-19-related symptoms and adverse reactions caused by the malignancy or antitumor treatments. Stronger personal protection should be made for advanced NSCLC patients; An intentional postponing of antitumor treatment should be considered according to patient performance status. Treatment strategies should be made according to different types of advanced NSCLC patients and efficacy and toxicity of drugs.


title: Successful management of the first reported case in Austria of COVID-19 with ARDS

text: We report the successful management of a patient with severe respiratory failure due to COVID-19 admitted to an intensive care unit complicated by secondary catheter-related infection of Candida glabrata. We are discussing some of the clinical challenges and the pitfalls in molecular diagnosis of SARS-CoV-2, including the fact that a positive PCR result may not always reflect infectiousness.


Prioritizing Frontline Workers during the COVID-19 Pandemic


title: Rapid urban health security assessment tool: a new resource for evaluating local-level public health preparedness

text: Urbanisation will be one of the defining demographic trends of the 21st century-creating unique opportunities for sustainable capacity development, as well as substantial risks and challenges for managing public health and health emergencies. Plans and policies for responding to public health emergencies are generally framed at higher levels of governance, but developing, improving and sustaining the capacities necessary for implementing these policies is a direct function of local-level authorities. Evaluating local-level public health capacities is an important process for identifying strengths and weaknesses that can impact the preparedness for, detection of and response to health security threats. However, while various evaluations and assessments exist for evaluating capacities at other levels, currently, there are no readily available health security assessments for the local-level. In this paper, we describe a tool-the Rapid Urban Health Security Assessment (RUHSA) Tool-that is based on a variety of other relevant assessments and guidance documents. Assessing capacities allow for local-level authorities to identify the strengths and weaknesses of their local health security systems, create multiyear action plans and prioritise opportunities for improving capacities, effectively engage with development partners to target resources effectively and develop compelling narratives and a legacy of leadership. While the RUHSA Tool was not designed to be used in the midst of a public health emergency, such as the ongoing COVID-19 pandemic, it may also be adapted to inform a checklist for prioritising what capacities and activities a city needs to rapidly develop or to help focus requests for assistance.


title: Alcohol Use in Australia during the Early Days of the COVID-19 Pandemic: Initial results from the COLLATE project

text: AIMS: The effect of social isolation measures used to control the spread of COVID-19 are negatively impacting the mental health of many. One of the consequences of exposure to disasters/pandemics is an increase in alcohol use. The current study aimed to examine what predisposing (distal) and pandemic-related (proximal) factors were associated with increased drinking in the wake of the COVID-19 pandemic. METHODS: On the 1st of April 2020, 5,158 Australians completed a survey from the COvid-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project, a nationwide study aimed at tracking key mental health concerns. Using logistic regression, distal (demographics and previous drinking behaviours) and proximal factors (employment, lifestyle factors and mood) were assessed for their association with increased drinking since the onset of the COVID-19 pandemic. RESULTS: Distal factors including heavier drinking pre-pandemic, middle age, average or higher income; and proximal factors including job loss, eating more, changes to sleep as well as stress and depression, were all associated with increased drinking in the COVID-19 pandemic environment. Female sex and self-reported history of mental illness became non-significant after proximal measures were added to the model. Living alone, exercise, anxiety or status as an essential or health care worker were not associated with increased drinking. CONCLUSIONS: These results provide guidance as to who might be targeted to receive support based on predisposing demographic factors and pre-pandemic drinking behaviour. Second, they indicate what behaviours/factors accompany increased alcohol use and provide targets for psychosocial and psychoeducational supports to address these proximal factors. This article is protected by copyright. All rights reserved.


title: Immunopathology and immunotherapeutic strategies in severe acute respiratory syndrome coronavirus 2 infection

text: The outbreak of coronavirus disease 2019 (COVID-19) and pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a major concern globally. As of 14 April 2020, more than 1.9 million COVID-19 cases have been reported in 185 countries. Some patients with COVID-19 develop severe clinical manifestations, while others show mild symptoms, suggesting that dysregulation of the host immune response contributes to disease progression and severity. In this review, we have summarized and discussed recent immunological studies focusing on the response of the host immune system and the immunopathology of SARS-CoV-2 infection as well as immunotherapeutic strategies for COVID-19. Immune evasion by SARS-CoV-2, functional exhaustion of lymphocytes, and cytokine storm have been discussed as part of immunopathology mechanisms in SARS-CoV-2 infection. Some potential immunotherapeutic strategies to control the progression of COVID-19, such as passive antibody therapy and use of interferon αß and IL-6 receptor (IL-6R) inhibitor, have also been discussed. This may help us to understand the immune status of patients with COVID-19, particularly those with severe clinical presentation, and form a basis for further immunotherapeutic investigations.


title: ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of calcium metabolic disorders and osteoporosis

text: Endocrinologists have had to make rapid changes to services so that resources can be focused on the COVID-19 response to help prevent spread of the virus. Herein we provide pragmatic advice on the management of commonly encountered calcium metabolic problems and osteoporosis. Non-urgent elective appointments should be postponed, and remote consultations and digital health solutions promoted. Patients should be empowered to self-manage their conditions safely. Patients, their caregivers and healthcare providers should be directed to assured national or international online resources and specific patient groups. For patients in acute hospital settings, existing emergency guidance on the management of hyper- and hypo-calcaemia should be followed. An approach to osteoporosis management is outlined. IV zoledronic acid infusions can be delayed for 6-9 months during the pandemic. Patients established on denosumab, teriparatide and abaloparatide should continue planned therapy. In the event of supply issues with teriparatide or abaloparatide, pausing this treatment in the short term is likely to be relatively harmless, whereas delaying denosumab may cause an immediate increased risk of fracture. The challenge of this pandemic will act as a catalyst to innovate within our management of metabolic bone and mineral disorders to ensure best use of resources and resilience of healthcare systems in its aftermath.


title: The mental health of those whose rights have been taken away: An essay on the mental health of indigenous peoples in the face of the 2019 Coronavirus (2019-nCoV) outbreak

text: BACKGROUND: In Latin America there are about 45 million indigenous people in 826 communities that represent 8.3% of the population. An estimated 798,365 Aboriginal and Torres Strait Islander were in Australia, 5,2 million indigenous people living in America and 2,13 million in Canada. Racial/ethnic disparities in mental health service use have increased especially in the context of the new coronavirus pandemic. Thus, we aimed to describe the mental health situation of the indigenous population in the context of the COVID-19 pandemic METHOD: : The studies were identified in well-known international journals found in three electronic databases: PubMed, Scopus, and MEDLINE. The data were cross-checked with information from the main international newspapers. RESULTS: According to the literature, due to the COVID-19 pandemic there is a lack of specialized mental health services and professionals, a restricted access to quality information and a lack of access to inputs, causing negative feelings and it can exacerbate pre-existing mental problems (eg: depression, suicidal ideation, smoking and binge drink). The cultural differences are a risk factor to worsen the mental health of this already vulnerable population. CONCLUSION: providing psychological first aid is an essential care component for indigenous populations that have been victims COVID-19 pandemic.


title: (Indoor) isolation, stress and physical inactivity: vicious circles accelerated by Covid-19?

text: The Covid-19 epidemic necessitates the application of strict isolation strategies to curb virus spreading. Isolation of individuals in combination with fear of contagion, quarantine and stigma, as well as with potential (mis)information overload ("infodemic")1 , however, causes chronic stress and is associated with a burden on mental health, posing risk factors for anxiety and depression. It is well understood that chronic stress is a major modulator of immunity2 and thus directly influences probability of infection.


Estimating the risk of COVID-19 in multiple sclerosis patients in Buenos Aires, Argentina


title: Clinical features of COVID-19 convalescent patients with re-positive nucleic acid detection

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a pandemic that has rapidly spread worldwide. Increasingly, confirmed patients being discharged according to the current diagnosis and treatment protocols, follow-up of convalescent patients is important to knowing about the outcome. METHODS: A retrospective study was performed among 98 convalescent patients with COVID-19 in a single medical center. The clinical features of patients during their hospitalization and 2-week postdischarge quarantine were collected. RESULTS: Among the 98 COVID-19 convalescent patients, 17 (17.3%) were detected positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid during 2-week postdischarge quarantine. The median time from discharge to SARS-CoV-2 nucleic acid re-positive was 4 days (IQR, 3-8.5).The median time from symptoms onset to final respiratory SARS-CoV-2 detection of negative result was significantly longer in re-positive group (34 days [IQR, 29.5-42.5]) than in non-re-positive group (19 days [IQR, 16-26]). On the other hand, the levels of CD3-CD56 + NK cells during hospitalization and 2-week postdischarge were higher in re-positive group than in non-re-positive group (repeated measures ANOVA, P = .018). However, only one case in re-positive group showed exudative lesion recurrence in pulmonary computed tomography (CT) with recurred symptoms. CONCLUSION: It is still possible for convalescent patients to show positive for SARS-CoV-2 nucleic acid detection, but most of the re-positive patients showed no deterioration in pulmonary CT findings. Continuous quarantine and close follow-up for convalescent patients are necessary to prevent possible relapse and spread of the disease to some extent.


Intervenções não farmacológicas para o enfrentamento à epidemia da COVID-19 no Brasil./ Intervenções não farmacológicas para o enfrentamento à epidemia da COVID-19 no Brasil./ Nonpharmaceutical interventions for tackling the COVID-19 epidemic in Brazil


title: Blood lactate increases with the progression of mitral valve disease in dogs/ Aumento de lactato sanguíneo com progressão de valvopatia mitral em cães

text: In dogs with congestive heart failure, the upregulated sympathetic tone causes vasoconstriction that impairs peripheral blood supply, therefore causing the accumulation of lactate. In this prospective cross-sectional study with a longitudinal component, blood lactate was quantified in 10 healthy and 34 myxomatous mitral valve disease (MMVD) dogs to investigate its potential use as a diagnostic and prognostic biomarker. While there were no differences in lactate concentration between control animals and stages B1 (3.31±0.62mmol/L) and B2 (3.32±0.46mmol/L) dogs, significant differences were found between healthy (2.50±0.69mmol/L) and both C (3.99±0.47mmol/L) and D (6.97±1.23mmol/L) animals. When a cut-off of 3.35mmol/L was used, lactate was able to distinguish dogs with normal and remodeled hearts with a sensitivity of 78.2% and specificity of 63.6%. Also, significant correlations existed between lactate and indicators of cardiac remodeling. Finally, animals with blood lactate <3.5mmol/L carried a better prognosis when compared with dogs in which lactate was >5.0mmol/L. Our results suggest that the progression of MMVD results in accumulation of lactate within the bloodstream, which is likely attributable to the impaired peripheral tissue perfusion. In MMVD dogs, blood lactate may be used as a surrogate for cardiac remodeling, and an increased concentration is associated with a worse prognosis regarding the time to evolve into congestive heart failure.(AU)


Oculoplastic, Orbital, and Lacrimal Care in the Coronavirus Disease 2019 Pandemic: A Shared Experience From Melbourne


Bipolar disorder, COVID-19, and the risk of relapse


title: Improving performance of CNN to predict likelihood of COVID-19 using chest X-ray images with preprocessing algorithms

text: As the rapid spread of coronavirus disease (COVID-19) worldwide, chest X-ray radiography has also been used to detect COVID-19 infected pneumonia and assess its severity or monitor its prognosis in the hospitals due to its low cost, low radiation dose, and wide accessibility. However, how to more accurately and efficiently detect COVID-19 infected pneumonia and distinguish it from other community-acquired pneumonia remains a challenge. In order to address this challenge, we in this study develop and test a new computer-aided diagnosis (CAD) scheme. It includes several image pre-processing algorithms to remove diaphragms, normalize image contrast-to-noise ratio, and generate three input images, then links to a transfer learning based convolutional neural network (a VGG16 based CNN model) to classify chest X-ray images into three classes of COVID-19 infected pneumonia, other community-acquired pneumonia and normal (non-pneumonia) cases. To this purpose, a publicly available dataset of 8,474 chest X-ray images is used, which includes 415 confirmed COVID-19 infected pneumonia, 5,179 community-acquired pneumonia, and 2,880 non-pneumonia cases. The dataset is divided into two subsets with 90% and 10% of images in each subset to train and test the CNN-based CAD scheme. The testing results achieve 94.0% of overall accuracy in classifying three classes and 98.6% accuracy in detecting Covid-19 infected cases. Thus, the study demonstrates the feasibility of developing a CAD scheme of chest X-ray images and providing radiologists useful decision-making supporting tools in detecting and diagnosis of COVID-19 infected pneumonia.


Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners: Information for healthcare professionals


title: Exploratory Analysis of Covid-19 Tweets using Topic Modeling, UMAP, and DiGraphs

text: This paper illustrates five different techniques to assess the distinctiveness of topics, key terms and features, speed of information dissemination, and network behaviors for Covid19 tweets. First, we use pattern matching and second, topic modeling through Latent Dirichlet Allocation (LDA) to generate twenty different topics that discuss case spread, healthcare workers, and personal protective equipment (PPE). One topic specific to U.S. cases would start to uptick immediately after live White House Coronavirus Task Force briefings, implying that many Twitter users are paying attention to government announcements. We contribute machine learning methods not previously reported in the Covid19 Twitter literature. This includes our third method, Uniform Manifold Approximation and Projection (UMAP), that identifies unique clustering-behavior of distinct topics to improve our understanding of important themes in the corpus and help assess the quality of generated topics. Fourth, we calculated retweeting times to understand how fast information about Covid19 propagates on Twitter. Our analysis indicates that the median retweeting time of Covid19 for a sample corpus in March 2020 was 2.87 hours, approximately 50 minutes faster than repostings from Chinese social media about H7N9 in March 2013. Lastly, we sought to understand retweet cascades, by visualizing the connections of users over time from fast to slow retweeting. As the time to retweet increases, the density of connections also increase where in our sample, we found distinct users dominating the attention of Covid19 retweeters. One of the simplest highlights of this analysis is that early-stage descriptive methods like regular expressions can successfully identify high-level themes which were consistently verified as important through every subsequent analysis.


title: The impact of the risk of COVID-19 on Black, Asian and Minority Ethnic (BAME) members of the UK dental profession

text: There is growing evidence that Black, Asian and Minority Ethnic (BAME) groups in the UK are at increased risk of death from coronavirus (COVID-19), with Black Afro-Caribbean, Indian, Pakistani and Bangladeshi populations being particularly at risk. Although the reasons are unclear, it is likely to be a combination of cultural and socioeconomic, as well as the higher prevalence of co-morbidities such as high blood pressure, cardiovascular disease, raised body mass index (BMI) and type 2 diabetes in these populations. The NHS is advising that frontline staff of BAME origin should be risk-assessed regarding their safety in working in clinical areas which are at risk of COVID-19. There is, however, little evidence on the risks posed to the BAME community within the dental profession. This paper outlines some of the challenges faced, and advocates that urgent action needs to be taken to mitigate the risks of COVID-19 and ensure BAME staff safety upon returning to work.


Status and Suggestions on Postmortem Examination during the Outbreak of COVID-19


title: Preparing an obstetric unit in the heart of the epidemic strike of COVID-19: quick reorganization tips

text: COVID-19 is placing considerable strain on healthcare systems. Disaster and military medicine specialists were involved in the outbreak in Italy, after many units were overwhelmed. Health providers were caught off guard and personnel was unprepared to face this unprecedented threat. Local decisions accelerated the rate of the spread. Many countries declared a state of emergency and lockdown to contain the exponential transmission of the disease. The purpose of this review is to suggest quick key points of strategies to implement in obstetric units without delay to respond to the oncoming wave, based on experience and feedback from the field. It is essential in an emergency situation to understand what is at stake and prepare maternity wards in the best possible way.


title: Loud and silent epidemics in the third millennium: tuning-up the volume

text: The media play a key role in promoting public health and influencing debate regarding health issues; however, some topics seem to generate a stronger response in the public, and this may be related to how the media construct and deliver their messages. Mass media coverage of COVID-19 epidemic has been exceptional with more than 180,000 articles published each day in 70 languages from March 8 to April 8, 2020. One may well wonder if this massive media attention ever happened in the past and if it has been finally proven to be beneficial or even just appropriate. Surgical site and implant-related infections represent a substantial part of health care-associated infections; with an estimated overall incidence of 6% post-surgical infection, approximately 18 million new surgical site infections are expected each year globally, with 5 to 10% mortality rate and an astounding economic and social cost. In the current mediatic era, orthopaedic surgeons need to refocus some of their time and energies from surgery to communication and constructive research. Only raising mediatic awareness on surgical site and implant-related infections may tune up the volume of silent epidemics to a level that can become audible by governing institutions.


Role of von Willebrand Factor and ADAMTS-13 in the Pathogenesis of Thrombi in SARS-CoV-2 Infection: Time to Rethink


title: Free DNA, a reason for severe COVID-19 infection?

text: The fast-growing outbreak of 2019 novel coronaviruses (SARS-CoV-2) reached all continents except the Antarctica in merely three months. Severe SARS-CoV-2 infection (COVID-19) has a bad clinical outcome, and some reports emphasized the role of cytokine storm and dysfunctions of multiple organs. However, the etiology of severe COVID-19 has been largely unknown. Similar as SARS-CoV and MERS-CoV, SARS-CoV-2 is also thought derived from bat coronaviruses. However, it is not pathogenic for bat at all, because free DNA in cytoplasm or blood cannot bring up violent immune response in bat; but it can produce severe inflammations in human. I hypothesized that the damage induced by free DNA is a reason for severe COVID-19, which can explain many symptoms of this disease, such as cytokine storm, acute respiratory distress syndrome (ARDS) and muscus plug, acute injuries of heart, liver and kidney, and some special symptoms of COVID-19. My hypothesis will be helpful for better understand the etiology of severe COVID-19.


Innovation in Cancer Care Delivery in the Era of COVID-19


title: Author Correction: Management of IBD during the COVID-19 outbreak: resetting clinical priorities

text: An amendment to this paper has been published and can be accessed via a link at the top of the paper.


title: Chest CT imaging features and clinical outcome of coronavirus disease 2019 (COVID-19): A single-center case study in Ningbo, China

text: OBJECTIVE: The purpose of this study was to investigate the chest CT imaging features and clinical outcome of coronavirus disease 2019 (COVID-19) in Ningbo, China. METHODS: In this retrospective study, twenty-eight confirmed and seven highly suspected cases of COVID-19 were enrolled in Ningbo first hospital from January 26, 2020 to March 5, 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). The initial and follow-up chest CT imaging features, epidemiological history, and outcome were analyzed. RESULTS: The average age of the patients was 57.3 ± 15.3 years (range: 27-96 years), including 25 females and 10 males. On CT images, 89.3% (25/28) confirmed and 100% (7/7) suspected patients had ground-glass opacities (GGOs), and GGOs with mixed consolidations were observed in 35.7% (10/28) confirmed and 42.9% (3/7) suspected cases, most of these lesions were distributed under the peripheral of both lungs. 17 confirmed and 4 suspected cases had a history of participating in Ningbo Tian-tong Temple rituals and all had GGOs in their lungs during the initial CT scan. As of March 25, 2020, the lung lesions of our cases were significantly resolved and all patients have been discharged from the hospital. CONCLUSION: The most common chest CT features are multiple bilateral and peripheral GGOs with mixed consolidations or not in the lungs of patients with COVID-19. Chest CT plays an important role in the diagnosis and monitoring treatment response of this disease. There was no reported death in our cases.


title: Emergency Powers in Response to COVID-19: Policy diffusion, Democracy, and Preparedness

text: We examine COVID-19-related states of emergency (SOEs) using data on 180 countries in the period January 1 through June 12, 2020. The results suggest that states' declaration of SOEs is driven by both external and internal factors. A permissive regional environment, characterized by many and simultaneously declared SOEs, may have diminished reputational and political costs, making employment of emergency powers more palatable for a wider range of governments. At the same time, internal characteristics, specifically democratic institutions and pandemic preparedness, shaped governments' decisions. Weak democracies with poor pandemic preparedness were considerably more likely to opt for SOEs than dictatorships and robust democracies with higher preparedness. We find no significant association between pandemic impact, measured as national COVID-19-related deaths, and SOEs, suggesting that many states adopted SOEs proactively before the disease spread locally.


The Coronavirus Pandemic in Israel: Implications for Radiation Oncology Departments


COPD patients in a COVID-19 society: depression and anxiety


Lung function testing in the COVID-19 endemic


Double trouble: methanol outbreak in the wake of the COVID-19 pandemic in Iran-a cross-sectional assessment


title: COVID-19 societal response captured by seismic noise in China and Italy

text: Seismic noise with frequencies above 1 Hz is often called cultural noise and is generally correlated quite well with human activities. Recently, cities in mainland China and Italy imposed lockdown restrictions in response to COVID-19, which gave us an unprecedented opportunity to study the relationship between seismic noise above 1 Hz and human activities. Using seismic records from stations in China and Italy, we show that seismic noise above 1 Hz was primarily generated by the local transportation systems. The lockdown of the cities and the imposition of travel restrictions led to a ~4-12 dB energy decrease in seismic noise in mainland China. Data also show that different Chinese cities experienced distinct periods of diminished cultural noise, related to differences in local response to the epidemic. In contrast, there was only ~1-6 dB energy decrease of seismic noise in Italy, after the country was put under a lockdown. The noise data indicate that traffic flow did not decrease as much in Italy, but show how different cities reacted distinctly to the lockdown conditions.


title: Co-expression of SARS-CoV-2 entry genes in the superficial adult human conjunctival, limbal and corneal epithelium suggests an additional route of entry via the ocular surface

text: PURPOSE: The high infection rate of SARS-CoV-2 necessitates the need for multiple studies identifying the molecular mechanisms that facilitate the viral entry and propagation. Currently the potential extra-respiratory transmission routes of SARS-CoV-2 remain unclear. METHODS: Using single-cell RNA Seq and ATAC-Seq datasets and immunohistochemical analysis, we investigated SARS-CoV-2 tropism in the embryonic, fetal and adult human ocular surface. RESULTS: The co-expression of ACE2 receptor and entry protease TMPRSS2 was detected in the human adult conjunctival, limbal and corneal epithelium, but not in the embryonic and fetal ocular surface up to 21 post conception weeks. These expression patterns were corroborated by the single cell ATAC-Seq data, which revealed a permissive chromatin in ACE2 and TMPRSS2 loci in the adult conjunctival, limbal and corneal epithelium. Co-expression of ACE2 and TMPRSS2 was strongly detected in the superficial limbal, corneal and conjunctival epithelium, implicating these as target entry cells for SARS-CoV-2 in the ocular surface. Strikingly, we also identified the key pro-inflammatory signals TNF, NFKß and IFNG as upstream regulators of the transcriptional profile of ACE2+TMPRSS2+ cells in the superficial conjunctival epithelium, suggesting that SARS-CoV-2 may utilise inflammatory driven upregulation of ACE2 and TMPRSS2 expression to enhance infection in ocular surface. CONCLUSIONS: Together our data indicate that the human ocular surface epithelium provides an additional entry portal for SARS-CoV-2, which may exploit inflammatory driven upregulation of ACE2 and TMPRSS2 entry factors to enhance infection.


title: Rapidly fatal outcome of Covid-19 after successful emergency surgery during pandemic outbreak in Northern Italy

text: INTRODUCTION: A pandemic outbreak of novel coronavirus, named SARS-CoV-2 and responsible of Coronavirus Disease 2019 (COVID-19), has rapidly spread from China to Europe, being Northern Italy the first focus outside Asia. Little is known about the evolution of SARS-CoV-2 infection in patients undergoing surgery. PRESENTATION OF CASE: Here we report the first confirmed case of early postoperative SARS-CoV-2 infection in a patient recovering after Hartmann's procedure for acute diverticulitis. After an otherwise unevenful postoperative course, on post-operative day 8, the patient suddenly presented hyperpyrexia and cough, rapidly evolving to respiratory failure and death 36 h after symptoms onset. CT-scan identified bilateral, diffuse, interstitial pneumonitis and oropharyngeal swab test confirmed the presence of SARS-CoV-2. A previous contact with the partner, developing the same symptoms, remained unrecognized until ICU admission. DISCUSSION: During a pandemic outbreak, the early identification of SARS-CoV-2 infection of an inside patient initially considered to be infection-free has a pivotal importance not only for the prompt patient's management, but also to avoid infection spreading to other patients and hospital personnel.In the reported case, a more precise information to the patient regarding the imperative necessity to inform the medical personnel of any person of his entourage presenting, at any time, any tell-tale sign, symptom or examination which may be attributed to COVID-19, may have had allowed to anticipate patient's isolation and examinations and procedures aimed at identifying such an infection. CONCLUSION: Persistent hyperleucocytosis and increased CRP serum level in spite of uneventful postoperative course were the only, aspecific markers of an ongoing SARS-CoV-2 infection before symptoms' onset, and should be considered in future clinical practice in order to adopt the prompt and appropriate patient management and limit COVID-19 contagion in surgical units.


Paradox of success and public perspective: COVID-19 and the perennial problem of prevention


The paradox of success and public perspective: COVID-19 and the perennial problem of prevention


COVID-19 and asthma: To have or not to have T2 inflammation makes a difference?


Anatomy: Beyond the COVID-19 Pandemic


title: Glecaprevir and Maraviroc are high-affinity inhibitors of SARS-CoV-2 main protease: possible implication in COVID-19 therapy

text: Due to the lack of efficient therapeutic options and clinical trial limitations, the FDA-approved drugs can be a good choice to handle Coronavirus disease (COVID-19). Many reports have enough evidence for the use of FDA-approved drugs which have inhibitory potential against target proteins of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Here, we utilized a structure-based drug design approach to find possible drug candidates from the existing pool of FDA-approved drugs and checked their effectiveness against the SARS-CoV-2. We performed virtual screening of the FDA-approved drugs against the main protease (Mpro) of SARS-CoV-2, an essential enzyme, and a potential drug target. Using well-defined computational methods, we identified Glecaprevir and Maraviroc (MVC) as the best inhibitors of SARS-CoV-2 Mpro. Both drugs bind to the substrate-binding pocket of SARS-CoV-2 Mpro and form a significant number of non-covalent interactions. Glecaprevir and MVC bind to the conserved residues of substrate-binding pocket of SARS-CoV-2 Mpro. This work provides sufficient evidence for the use of Glecaprevir and MVC for the therapeutic management of COVID-19 after experimental validation and clinical manifestations.


More on COVID-19 coagulopathy in Caucasian patients


title: Household secondary attack rate of COVID-19 and associated determinants in Guangzhou, China: a retrospective cohort study

text: BACKGROUND: As of June 8, 2020, the global reported number of COVID-19 cases had reached more than 7 million with over 400â000 deaths. The household transmissibility of the causative pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains unclear. We aimed to estimate the secondary attack rate of SARS-CoV-2 among household and non-household close contacts in Guangzhou, China, using a statistical transmission model. METHODS: In this retrospective cohort study, we used a comprehensive contact tracing dataset from the Guangzhou Center for Disease Control and Prevention to estimate the secondary attack rate of COVID-19 (defined as the probability that an infected individual will transmit the disease to a susceptible individual) among household and non-household contacts, using a statistical transmission model. We considered two alternative definitions of household contacts in the analysis: individuals who were either family members or close relatives, such as parents and parents-in-law, regardless of residential address, and individuals living at the same address regardless of relationship. We assessed the demographic determinants of transmissibility and the infectivity of COVID-19 cases during their incubation period. FINDINGS: Between Jan 7, 2020, and Feb 18, 2020, we traced 195 unrelated close contact groups (215 primary cases, 134 secondary or tertiary cases, and 1964 uninfected close contacts). By identifying households from these groups, assuming a mean incubation period of 5 days, a maximum infectious period of 13 days, and no case isolation, the estimated secondary attack rate among household contacts was 12·4% (95% CI 9·8-15·4) when household contacts were defined on the basis of close relatives and 17·1% (13·3-21·8) when household contacts were defined on the basis of residential address. Compared with the oldest age group (≥60 years), the risk of household infection was lower in the youngest age group (<20 years; odds ratio [OR] 0·23 [95% CI 0·11-0·46]) and among adults aged 20-59 years (OR 0·64 [95% CI 0·43-0·97]). Our results suggest greater infectivity during the incubation period than during the symptomatic period, although differences were not statistically significant (OR 0·61 [95% CI 0·27-1·38]). The estimated local reproductive number (R) based on observed contact frequencies of primary cases was 0·5 (95% CI 0·41-0·62) in Guangzhou. The projected local R, had there been no isolation of cases or quarantine of their contacts, was 0·6 (95% CI 0·49-0·74) when household was defined on the basis of close relatives. INTERPRETATION: SARS-CoV-2 is more transmissible in households than SARS-CoV and Middle East respiratory syndrome coronavirus. Older individuals (aged ≥60 years) are the most susceptible to household transmission of SARS-CoV-2. In addition to case finding and isolation, timely tracing and quarantine of close contacts should be implemented to prevent onward transmission during the viral incubation period. FUNDING: US National Institutes of Health, Science and Technology Plan Project of Guangzhou, Project for Key Medicine Discipline Construction of Guangzhou Municipality, Key Research and Development Program of China.


title: Spatial-temporal distribution of COVID-19 in China and its prediction: A data-driven modeling analysis

text: Currently, the outbreak of COVID-19 is rapidly spreading especially in Wuhan city, and threatens 14 million people in central China. In the present study we applied the Moran index, a strong statistical tool, to the spatial panel to show that COVID-19 infection is spatially dependent and mainly spread from Hubei Province in Central China to neighbouring areas. Logistic model was employed according to the trend of available data, which shows the difference between Hubei Province and outside of it. We also calculated the reproduction number R0 for the range of [2.23, 2.51] via SEIR model. The measures to reduce or prevent the virus spread should be implemented, and we expect our data-driven modeling analysis providing some insights to identify and prepare for the future virus control.


Attention should be paid to venous thromboembolism prophylaxis in the management of COVID-19


title: Clinical course of coronavirus disease 2019 in 11 patients after thoracic surgery and challenges in diagnosis

text: OBJECTIVES: To illustrate the clinical course and difficulties in early diagnosis of coronavirus disease 2019 (COVID-19) in patients after thoracic surgery. METHODS: We retrospectively analyzed the clinical course of the first 11 patients diagnosed with COVID-19 after thoracic surgery in early January 2020. Postoperative clinical, laboratory, and radiologic records and the time line of clinical course were summarized. Potential prognostic factors were evaluated. RESULTS: In the 11 confirmed cases (3 female, 8 male), median days from symptom onset to case detection was 8. Insidious symptom onset and misinterpreted postoperative changes on chest computed tomography (CT) resulted in delay in diagnosis. There were 3 fatalities due to respiratory failure, whereas 4 severe and 4 mild cases recovered and were discharged. All patients had once experienced leukocytosis and eosinopenia. Remittent fever and resected lung segments ≥5 were associated with fatality. CONCLUSIONS: The case fatality rate of postsurgical patients subsequently diagnosed with COVID-19 was 27.3%. Insidious symptom onset, postoperative leukocytosis with lymphopenia, and postsurgical CT changes overshadowed the early signs of viral pneumonia. Dynamic symptom monitoring, serial chest CTs, and tests for viral RNA and serum antibody improve the chance for prompt detection of COVID-19. Consideration should be given to preadmission and preoperative screening and strict contact isolation during the postoperative period.


Cerebrovascular disease is associated with the risk of mortality in coronavirus disease 2019


SARS-CoV-2 shedding and infectivity


The risk of hand eczema in healthcare workers during the COVID-19 pandemic: Do we need specific attention or prevention strategies?


title: [Epidemiological investigation on a cluster epidemic of COVID-19 in a collective workplace in Tianjin]

text: Objective: To investigate and analysis the epidemiological characteristics of a cluster epidemic of COIVD-19 in a collective workplace in Tianjin, evduate the prevention and control measures based on limited evidence and experience in early period of COVID-19 epidemic. Methods: Descriptive research method was used to describe the distribution and other epidemiological characteristics of the cluster cases of COVID-19. Results: Since the onset of the first index case on January 15, ten confirmed COVID-19 cases had occurred in the workplace, and the epidemic had spread from the workplace to 4 families, infecting 7 family members. The median age of 17 cases was 55 (19-79) years. All the 10 employee cases were males, and in the family cases, 3 were males and 4 were females. Of the employee cases, 8 worked in CW workshop and 2 worked in administrative office building. The median exposure-onset interval of all the cases was 4 days, and the median exposure-onset interval was 4.5 days in the employee cases and 4 days in the family cases. The median onset-medical care seeking interval was 4 days in the non-isolated cases, 2.5 days in the cases with home isolation after onset, and 0.5 day in the cases with home isolation before onset. Conclusions: The clustering of COVID-19 cases was observed in this workplace in Tianjin, which affected 4 families. In the early stage of the epidemic, accurate and rapid blocking and control measures can completely prevent the large-scale spread of COVID-19.


title: Confidence in the dynamic spread of epidemics under biased sampling conditions

text: The interpretation of sampling data plays a crucial role in policy response to the spread of a disease during an epidemic, such as the COVID-19 epidemic of 2020. However, this is a non-trivial endeavor due to the complexity of real world conditions and limits to the availability of diagnostic tests, which necessitate a bias in testing favoring symptomatic individuals. A thorough understanding of sampling confidence and bias is necessary in order make accurate conclusions. In this manuscript, we provide a stochastic model of sampling for assessing confidence in disease metrics such as trend detection, peak detection, and disease spread estimation. Our model simulates testing for a disease in an epidemic with known dynamics, allowing us to use Monte-Carlo sampling to assess metric confidence. We use this method to show that trends in the disease may be identified using under $10000$ biased samples each day, and an estimate of disease spread can be made with additional $1000-2000$ unbiased samples each day. We also demonstrate that the model can be used to assess more advanced metrics by finding the precision and recall of a strategy for finding peaks in the dynamics.


The COVID-19 outbreak: The issue of face masks


An Acute Respiratory Infection Runs Into the Most Common Noncommunicable Epidemic-COVID-19 and Cardiovascular Diseases


Telemedicine in the Time of the Coronavirus


Participating in telehealth is a complex occupation


title: Expansion of myeloid-derived suppressor cells in patients with severe coronavirus disease (COVID-19)

text: SARS-CoV-2 is associated with a 3.4% mortality rate in patients with severe disease. The pathogenesis of severe cases remains unknown. We performed an in-depth prospective analysis of immune and inflammation markers in two patients with severe COVID-19 disease from presentation to convalescence. Peripheral blood from 18 SARS-CoV-2-infected patients, 9 with severe and 9 with mild COVID-19 disease, was obtained at admission and analyzed for T-cell activation profile, myeloid-derived suppressor cells (MDSCs) and cytokine profiles. MDSC functionality was tested in vitro. In four severe and in four mild patients, a longitudinal analysis was performed daily from the day of admission to the early convalescent phase. Early after admission severe patients showed neutrophilia, lymphopenia, increase in effector T cells, a persisting higher expression of CD95 on T cells, higher serum concentration of IL-6 and TGF-ß, and a cytotoxic profile of NK and T cells compared with mild patients, suggesting a highly engaged immune response. Massive expansion of MDSCs was observed, up to 90% of total circulating mononuclear cells in patients with severe disease, and up to 25% in the patients with mild disease; the frequency decreasing with recovery. MDSCs suppressed T-cell functions, dampening excessive immune response. MDSCs decline at convalescent phase was associated to a reduction in TGF-ß and to an increase of inflammatory cytokines in plasma samples. Substantial expansion of suppressor cells is seen in patients with severe COVID-19. Further studies are required to define their roles in reducing the excessive activation/inflammation, protection, influencing disease progression, potential to serve as biomarkers of disease severity, and new targets for immune and host-directed therapeutic approaches.


Pulmonary embolism in a young pregnant woman with COVID-19


title: COVID-19 and Abdominal Transplant: A Stepwise Approach to Practice During Pandemic Conditions

text: BACKGROUND: The novel severe acute respiratory syndrome Coronavirus (SARS-CoV-2) disease has transformed innumerable aspects of medical practice, particularly in the field of transplantation. MAIN BODY: Here we describe a single-center approach to creating a generalizable, comprehensive, and graduated set of recommendations to respond in stepwise fashion to the challenges posed by these conditions, and the underlying principles guiding such decisions. CONCLUSION: Creation of a stepwise plan will allow transplant centers to respond in a dynamic fashion to the ongoing challenges posed by the COVID-19 pandemic.


Targeting the Adipose Tissue in COVID-19


[A case report of aplastic anemia accompanied with COVID-19]


Blood Glucose Control During Lockdown for COVID-19: CGM Metrics in Italian Adults With Type 1 Diabetes


COVID-19 Pandemic - Nephrology Experiences


Protocolo de atención a pacientes con síndrome coronario agudo en el Hospital de Fuerteventura durante la pandemia de COVID-19


Perioperative Outcomes of Urological Surgery in Patients with SARS-CoV-2 Infection


title: Turning the Crisis Into an Opportunity: Digital Health Strategies Deployed During the COVID-19 Outbreak

text: Digital health technologies offer significant opportunities to reshape current health care systems. From the adoption of electronic medical records to mobile health apps and other disruptive technologies, digital health solutions have promised a better quality of care at a more sustainable cost. However, the widescale adoption of these solutions is lagging behind. The most adverse scenarios often provide an opportunity to develop and test the capacity of digital health technologies to increase the efficiency of health care systems. Catalonia (Northeast Spain) is one of the most advanced regions in terms of digital health adoption across Europe. The region has a long tradition of health information exchange in the public health care sector and is currently implementing an ambitious digital health strategy. In this viewpoint, we discuss the crucial role digital health solutions play during the coronavirus disease (COVID-19) pandemic to support public health policies. We also report on the strategies currently deployed at scale during the outbreak in Catalonia.


title: Recomendaciones para la atención de pacientes con insuficiencia cardiaca y COVID-19

text: The COVID-19 pandemic decreed by the World Health Organization (WHO) since March 12, 2020 is wreaking havoc globally and it is a true economic, social and health challenge Although the clinical manifestations of COVID-19 are respiratory symptoms, some patients also have cardiological symptoms Among patients with cardiological conditions2 they represent a group of higher risk and, in fact, they are a particularly vulnerable group, due to their higher risk of contagion and greater severity in case of acquiring the disease1 those with heart failure (HF), including heart transplant (CT) and ventricular assists, as well as patients with pulmonary arterial hypertension (PAH) HF is the main chronic cardiovascular disease and patients in this group are the most vulnerable for the development of more serious clinical symptoms after suffering the infection, and to a greater extent cases with advanced HF3 In fact, HF is one of the most frequent complications in patients with COVID-194 Likewise, transplant patients who require immunosuppressants to avoid graft rejection, constitute a population especially susceptible to infection and to develop more serious processes This situation has made the National Association of Cardiologists of Mexico (ANCAM) and the Mexican Society of Cardiology (SMC) together with their respective chapters, have prepared the following recommendations for medical personnel, who participate in the care of this special group of patients in the different clinical settings, who suffer or not, of COVID-19


title: COVID-19 amplifies gender disparities in research

text: Early evidence suggests that women, including female researchers, are disproportionately affected by the \mbox{COVID-19} pandemic, with negative consequences to their productivity. Here, we test this hypothesis by analyzing the proportion of male and female researchers that publish scientific papers during the pandemic. We use data from biomedical preprint servers and Springer-Nature journals to show that the fraction of women publishing during the pandemic drops significantly across disciplines and research topics, after controlling for temporal trends. The impact is particularly pronounced for biomedical papers related to COVID-19 research. Further, by geocoding author's affiliations, we show that gender disparities are exacerbated in poorer countries, even though these countries had less of a gender gap in research prior to the pandemic. Our results illustrate how exceptional events like a global pandemic can further amplify gender inequalities in research. Our work could inform fairer scientific evaluation practices, especially for early-career female researchers who may be disproportionately affected by the pandemic.


title: The enclosed ward management strategies in psychiatric hospitals during COVID-19 outbreak

text: During the COVID-19 pandemic, as a large city located in Southwest China, Chengdu was mainly affected by imported cases. For a psychiatric hospital, the enclosed management model, the crowded wards and the uncooperative patients are the risk factors of nosocomial infection. Admitting new patients while preventing the COVID-19 outbreak within the institutions was a crucial challenge. The Mental Health Centre of Chengdu proposed a series of effective management strategies to deal with the rapidly evolving situation during the COVID-19 pandemic which included regulation for the inpatients, their families and staff, and achieved Zero infection in our hospital.


title: Recommandations du Comité Lithiase de l'Association Française d'Urologie pour la prise en charge des calculs urinaires durant la crise sanitaire liée à la pandémie à COVID-19./ [Recommendations of the Urolithiasis Committee of the French Urology Association for the management and the treatment of the stone formers patients during the COVID-19 pandemic crisis]

text: For the first time, faced with a crisis with an exceptional magnitude due to the COVID-19 pandemic responsible for saturation of emergency services and intensive care units, the urolithiasis committee of the French Urology Association designed the recommendations for care and treatment of stone-forming patients and their treatment during crisis.


Fighting on two fronts: drug-drug interactions in people living with HIV infected with SARS-CoV-2


title: Inhalational volatile-based sedation for COVID-19 pneumonia and ARDS

text: Hospitals worldwide are experiencing a shortage in essential intravenous sedative medications. This is attributable to high number and high sedative needs of COVID-19 critical care patients with disruption of drug supply chains. Inhaled volatile anesthetic agents are an abundant resource and readily implementable solution for providing ICU sedation. Inhaled volatile agents may also provide important pulmonary benefits for COVID-19 patients with ARDS that could improve gas exchange and reduce time spent on a ventilator. We review the use of volatile agents, and provide a technical overview and algorithm for administering inhaled volatile-based sedation in ICUs.


Looking beyond the coronavirus: lessons and principles


title: Inpatient Care of Patients with COVID-19: A Guide for Hospitalists

text: Since its emergence in December 2019, the virus known as severe acute respiratory syndrome coronavirus 2 has quickly caused a pandemic. This virus causes a disease now known as coronavirus disease 2019, or COVID-19. As an increasing proportion of the at-risk population becomes infected, and patients with severe illness are hospitalized, it is essential for hospitalists to remain current on how to best care for people with suspected or confirmed disease. Establishing a system for logistical planning, and accurate information sharing is strongly recommended. Infection control remains the ultimate goal. As such, health care workers should be educated on universal and isolation precautions, and the appropriate use of personal protective equipment. Social distancing should be encouraged to prevent the spread of infection, and creative and innovative ways to reduce contact may need to be considered. Moreover, it is imperative to prepare for contingencies as medical staff will inevitably get sick or become unavailable. Hospitalists have the difficult task of caring for patients while also adapting to the many logistical and social elements of a pandemic.


Analyzing the Cost Effectiveness of Policy Responses for COVID-19: The Importance of Capturing Social Consequences


title: Power-law distribution in Burst-suppression on electroencephalogram of dogs

text: Burst-suppression (BS) is a reliable electroencephalogram (EEG) indicator of excessive deep anesthesia common in mammals. Since some intermittent events are known to follow a power-law, we investigated the power-law hypothesis in BS by comparing it with alternative functions focusing on flattish periods and developed a new method for detecting BS as an application of statistical model in dogs. Young-adult 6 beagles and senior 6 beagles were anesthetized with sevoflurane 2.0%-5.0% and three of 64 sec EEG (256 Hz) from Fpz-T4 via scalp electrodes were recorded. Three thresholds for peak-to-peak voltage were set: mean value of peak-to-peak voltage at sevoflurane 2.0% in each dog (AS2%), 3mcrV, and 5mcrV. The subthreshold periods were discriminated as $\tau$ events. We fitted the empirical probability distribution of $\tau$ by a power-law distribution and an exponential distribution. These two distributions were compared by the normalized log-likelihood ratio test to see which distribution was better fit. At sevoflurane 2.0%-3.0%, by any threshold, the exponential distribution became better fit in all dogs. The power-law distribution became better fit only when BS expressed on EEG. No strict threshold was required for detection of onset of BS. We showed a transition from exponential behavior to power-law behavior on the right tail of $\tau$ distributions in response to the appearance of suppression waves with increasing anesthetic. This will be a robust tool for BS detection.


title: The association between treatment with heparin and survival in patients with Covid-19

text: This study investigates the association between the treatment with heparin and mortality in patients admitted with Covid-19. Routinely recorded, clinical data, up to the 24th of April 2020, from the 2075 patients with Covid-19, admitted in 17 hospitals in Spain between the 1st of March and the 20th of April 2020 were used. The following variables were extracted for this study: age, gender, temperature, and saturation of oxygen on admission, treatment with heparin, hydroxychloroquine, azithromycin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, together with data on mortality. Multivariable logistic regression models were used to investigate the associations. At the time of collecting the data, 301 patients had died, 1447 had been discharged home from the hospitals, 201 were still admitted, and 126 had been transferred to hospitals not included in the study. Median follow up time was 8 (IQR 5-12) days. Heparin had been used in 1734 patients. Heparin was associated with lower mortality when the model was adjusted for age and gender, with OR (95% CI) 0.55 (0.37-0.82) p = 0.003. This association remained significant when saturation of oxygen < 90%, and temperature > 37 °C were added to de model with OR 0.54 (0.36-0.82) p = 0.003, and also when all the other drugs were included as covariates OR 0.42 (0.26-0.66) p < 0.001. The association between heparin and lower mortality observed in this study can be acknowledged by clinicians in hospitals and in the community. Randomized controlled trials to assess the causal effects of heparin in different therapeutic regimes are required.


Taking a Closer Look at COVID-19, Health Inequities, and Racism


title: Toxic shock-like syndrome and COVID-19: A case report of multisystem inflammatory syndrome in children (MIS-C)

text: Early reports of COVID-19 in pediatric populations emphasized a mild course of disease with severe cases disproportionately affecting infant and comorbid pediatric patients. After the peak of the epidemic in New York City, in late April to early May, cases of severe illness associated with COVID-19 were reported among mostly previously healthy children ages 5-19. Many of these cases feature a toxic shock-like syndrome or Kawasaki-like syndrome in the setting of SARS-CoV-2 positive diagnostic testing and the CDC has termed this presentation Multisystem Inflammatory Syndrome (MIS-C). It is essential to disseminate information among the medical community regarding severe and atypical presentations of COVID-19 as prior knowledge can help communities with increasing caseloads prepare to quickly identify and treat these patients as they present in the emergency department. We describe a case of MIS-C in a child who presented to our Emergency Department (ED) twice and on the second visit was found to have signs of distributive shock, multi-organ injury and systemic inflammation associated with COVID-19. The case describes two ED visits by an 11- year-old SARS-CoV-2-positive female who initially presented with fever, rash and pharyngitis and returned within 48 hours with evidence of cardiac and renal dysfunction and fluid-refractory hypotension requiring vasopressors and PICU admission.


Covid-19: Health Education England shares advice for trainees


title: Evaluation of a nursing and midwifery exchange between rural and metropolitan hospitals: A mixed methods study

text: INTRODUCTION: This paper reports on the findings of the Nursing and Midwifery Exchange Program, initiated to promote rural and remote nursing and midwifery, and to facilitate clinical skills development and clinical collaboration between health services in Queensland, Australia. The project was undertaken over an 18-month period in one state of Australia, offering structured, temporary exchange of personnel between metropolitan and rural health services. BACKGROUND: Globally, there is an increasing awareness of nursing shortages, and with it, the need to ensure that nurses and midwives are prepared for specialist roles and practice. This is particularly important in rural and remote areas, where there are pre-existing barriers to access to services, and difficulties in attracting suitably qualified, permanent staff. METHODS: A mixed methods approach to the evaluation was undertaken with two cohorts. One cohort was the nurses and midwives who participated in the exchange (n = 24) and the other cohort were managers of the participating health services (n = 10). The nurses and midwives who participated in the exchange were asked to complete a questionnaire that included questions related to embeddedness and job satisfaction. The managers participated in a Delphi series of interviews. RESULTS: Those who participated in exchange reporting a higher score on the reported degree of understanding of rural client, which was accompanied with a moderate-to-large effect size estimate (d = 0.61). Nurses/midwives in the exchange group reported higher scores on their perceptions of aspects of their home community that would be lost if they had to leave, which was accompanied with a large effect size (d = 0.83). Overall, NMEP was reported by the participants to be a positive way to improve professional development opportunities for nurses and midwives. The findings also show the program supported practical collaboration and raised the profile of nursing and midwifery in rural areas. CONCLUSION: Exchange programs support clinical and professional development, raising the awareness of different contexts of practice and related skills requirements, and thereby supporting a greater understanding of different nursing roles. In the light of increasingly complex care required by patients with chronic conditions being managed in community-based services, programs such as NMEP provide the opportunity to build collaborative networks between referring and referral centres as well as contribute to the ongoing skills development.


Lack of SARS-CoV-2 RNA environmental contamination in a tertiary referral hospital for infectious diseases in Northern Italy


title: The effectiveness of full and partial travel bans against COVID-19 spread in Australia for travellers from China during and after the epidemic peak in China

text: BACKGROUND: Australia implemented a travel ban on China on February 1st 2020, while COVID-19 was largely localised to China. We modelled three scenarios to test the impact of travel bans on epidemic control. Scenario one was no ban, scenario two and three were the current ban followed by a full or partial lifting (allow over 100 000 university students to enter Australia, but not tourists) from the 8th of March 2020. METHODS: We used disease incidence data from China and air travel passenger movements between China and Australia during and after the epidemic peak in China, derived from incoming passenger arrival cards. We used the estimated incidence of disease in China, using data on expected proportion of under-ascertainment of cases, and an age specific deterministic model to model the epidemic in each scenario. RESULTS: The modelled epidemic with the full ban fitted the observed incidence of cases well, predicting 57 cases on March 6th in Australia, compared to 66 observed on this date, however we did not account for imported cases from other countries. The modelled impact without a travel ban results in more than 2000 cases and about 400 deaths, if the epidemic remained localised to China and no importations from other countries occurred. The full travel ban reduced cases by about 86%, while the impact of a partial lifting of the ban is minimal, and may be a policy option. CONCLUSIONS: Travel restrictions were highly effective for containing the COVID-19 epidemic in Australia during the epidemic peak in China and averted a much larger epidemic at a time when COVID-19 was largely localised to China. This research demonstrates the effectiveness of travel bans applied to countries with high disease incidence. This research can inform decisions on placing or lifting travel bans as a control measure for the COVID-19 epidemic.


title: New onset severe right ventricular failure associated with COVID-19 in a young infant without previous heart disease

text: We present our recent experience with a 6-month-old infant with a personal history of short bowel syndrome that presented with fever, cyanosis, and cardiogenic shock secondary to severe pulmonary hypertension and right ventricular failure without pulmonary thromboembolism. He did not present signs of toxin-mediated disease or Kawasaki disease. He was finally diagnosed with SARS-CoV-2 infection. If this presentation is confirmed in future research, the severe cardiovascular impairment in children with COVID-19 could be also attributable to the primary pulmonary infection, not only to a multisystem inflammatory syndrome but also in children without heart disease.


Clinical characteristics of 11 asymptomatic patients with COVID-19


Improving the efficacy of the plastic tents and boxes used for airway management of corona virus disease-19 patients: seal and negative suction


ACMT Position Statement: Off-Label Prescribing during COVID-19 Pandemic


Information about the novel coronavirus


COVID-19 and the Editorial Process: Reflections from The Journal of Pediatrics


title: How Much Support Is There for the Recommendations Made to the General Population during Confinement? A Study during the First Three Days of the COVID-19 Quarantine in Spain

text: Background: Recommendations on lifestyles during quarantine have been proposed by researchers and institutions since the COVID-19 crisis emerged. However, most of these have never been tested under real quarantine situations or derive from older investigations conducted mostly in China and Canada in the face of infections other than COVID-19. The present study aimed at exploring the relationship between a comprehensive set of recommended lifestyles, socio-demographic, and personality variables and mood during the first stages of quarantine. Methods: A virtual snow-ball recollection technique was used to disseminate the survey across the general population in Spain starting the first day of mandatory quarantine (15 March 2020) until three days later (17 March). In total, 2683 Spanish adults (mean age = 34.86 years, SD = 13.74 years; 77.7% women) from the general population completed measures on socio-demographic, COVID-related, behavioral, personality/cognitive, and mood characteristics. Results: In the present study, depression and anger were higher than levels reported in a previous investigation before the COVID-19 crisis, while vigor, friendliness, and fatigue were lower. Anxiety levels were comparable. The expected direction of associations was confirmed for the majority of predictors. However, effect sizes were generally small and only a subset of them correlated to most outcomes. Intolerance of unpleasant emotions, neuroticism, and, to a lesser extent, agreeableness, sleep quality, young age, and time spent Internet surfing were the most robust and strongest correlates of mood states. Conclusions: Some recommended lifestyles (i.e., maintaining good quality of sleep and reducing Internet surfing) might be more important than others during the first days of quarantine. Promoting tolerance to unpleasant emotions (e.g., through online, self-managed programs) might also be of upmost importance. So far, recommendations have been made in general, but certain subgroups (e.g., certain personality profiles and young adults) might be especially vulnerable and should receive more attention.


title: Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19)

text: OBJECTIVES: To assess the efficacy of corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19). DESIGN, SETTING: Observational study in the two COVID-19-designated hospitals in Wuhu, Anhui province, China, 24 January - 24 February 2020. PARTICIPANTS: Thirty-one patients infected with the severe acute respiratory coronavirus 2 (SARS-CoV-2) treated at the two designated hospitals. MAIN OUTCOME MEASURES: Virus clearance time, length of hospital stay, and duration of symptoms, by treatment type (including or not including corticosteroid therapy). RESULTS: Eleven of 31 patients with COVID-19 received corticosteroid treatment. Cox proportional hazards regression analysis indicated no association between corticosteroid treatment and virus clearance time (hazard ratio [HR], 1.26; 95% CI, 0.58-2.74), hospital length of stay (HR, 0.77; 95% CI, 0.33-1.78), or duration of symptoms (HR, 0.86; 95% CI, 0.40-1.83). Univariate analysis indicated that virus clearance was slower in two patients with chronic hepatitis B infections (mean difference, 10.6 days; 95% CI, 6.2-15.1 days). CONCLUSIONS: Corticosteroids are widely used when treating patients with COVID-19, but we found no association between therapy and outcomes in patients without acute respiratory distress syndrome. An existing HBV infection may delay SARS-CoV-2 clearance, and this association should be further investigated.


title: The cytokine storm of COVID-19: a spotlight on prevention and protection

text: INTRODUCTION: The cytokine release syndrome (CRS) of COVID-19 is associated with the development of critical illness requiring multi-organ support. Further research is required to halt progression of multi-organ injury induced by hyper-inflammation. AREAS COVERED: PubMed/MEDLINETM databases were accessed between May 9th-June 9th, 2020, to review the latest perspectives on the treatment and pathogenesis of CRS. EXPERT OPINION: Over-activity of chemotaxis triggers a macrophage activation syndrome (MAS) resulting in the release of pro-inflammatory cytokines. IL-6 and TNF- α are at the forefront of hyper-inflammation. The inflammatory cascade induces endothelial activation and capillary leak, leading to circulatory collapse and shock. As endothelial dysfunction persists, there is activation of the clotting cascade and microvascular obstruction. Continued endothelial activation results in multi-organ failure, regardless of pulmonary tissue damage. We propose that targeting the endothelium may interrupt this cycle. Immuno-modulating therapies have been suggested, however, further data is necessary to confirm that they do not jeopardize adaptive immunity. Inhibition of IL-6 and the Janus Kinase, signal transducer and activator of transcription proteins pathway (JAK/STAT), are favorable targets. Remote ischemic conditioning (RIC) reduces the inflammation of sepsis in animal models and should be considered as a low risk intervention, in combination with cardiovascular protection.


title: Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series

text: INTRODUCTION: The world is currently undergoing an extremely stressful scenario due to the COVID-19 pandemic. This unexpected and dramatic situation could increase the incidence of mental health problems, among them, psychotic disorders. The aim of this paper was to describe a case series of brief reactive psychosis due to the psychological distress from the current coronavirus pandemic. MATERIALS AND METHODS: We report on a case series including all the patients with reactive psychoses in the context of the COVID-19 crisis who were admitted to the Virgen del Rocío and Virgen Macarena University Hospitals (Seville, Spain) during the first two weeks of compulsory nationwide quarantine. RESULTS: In that short period, four patients met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a brief reactive psychotic disorder. All of the episodes were directly triggered by stress derived from the COVID-19 pandemic and half of the patients presented severe suicidal behavior at admission. CONCLUSIONS: We may now be witnessing an increasing number of brief reactive psychotic disorders as a result of the COVID-19 pandemic. This type of psychosis has a high risk of suicidal behavior and, although short-lived, has a high rate of psychotic recurrence and low diagnostic stability over time. Therefore, we advocate close monitoring in both the acute phase and long-term follow-up of these patients.


title: COVID-19-associated acute disseminated encephalomyelitis (ADEM)

text: A 51-year-old woman with COVID-19 infection developed coma and an impaired oculocephalic response to one side. MRI of the brain demonstrated acute multifocal demyelinating lesions, and CSF testing did not identify a direct cerebral infection. High-dose steroids followed by a course of IVIG was administered, and the patient regained consciousness over the course of several weeks. As more patients reach the weeks after initial infection with COVID-19, acute disseminated encephalomyelitis should be considered a potentially treatable cause of profound encephalopathy or multifocal neurological deficits.


Can beta-adrenergic blockers be used in the treatment of COVID-19?


A novel coronavirus (2019-nCoV) causing pneumonia-associated respiratory syndrome


title: Down-regulated gene expression spectrum and immune responses changed during the disease progression in COVID-19 patients

text: BACKGROUND: WHO characterizes novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a pandemic. Here, we investigated the clinical, cytokine levels, T cell proportion and related gene expression occurring in COVID-19 patients on admission and after intial treatment. METHODS: 11 patients diagnosed as COVID-19 with similar initial treatment regimen were enrolled in the hospital. Plasma cytokines, CyTOF and microfluidic qPCR for gene expression were conducted. RESULTS: 5 mild and 6 severe patients were included. Cough and fever were the top symptoms in the 11 COVID-2019 cases. The elder age, more neutrophils numbers and higher C-reactive protein level were found in severe cases. IL-10 level was significantly varied with disease progression and treatment. The decreased T cell proportions were observed in COVID-19 patients especially in severe cases, and all elevated to normal in mild patiens after initial treatment but only CD4+T cells return to normal in severe cases. The number of DEGs increased with the disease progress, and decreased after initial treatment. All down-regulated DEGs in severe cases mainly involved in Th17 cell differentiation, cytokine-mediated signaling pathway and T cell activation. After initial treatmen in severe cases, MAP2K7 and SOS1 were upregulated relative to that on admission. CONCLUSIONS: Our findings show a decreased T cell proportion with down-regulated gene expression related to T cell activation and differentiation were occurred in COVID-19 severe patients, which may help to provide effective treatment strategies for COVID-19 .


People with Intellectual Disabilities and the COVID-19 Pandemic


title: Hospital capacity and capacity planning in Washington

text: Hospital capacity in the State of Washington may be unable to satisfy the number of COVID-19 patients The adjusted occupancy rate (adjusted for outpatient equivalent days) places many hospitals near capacity prior to the current pandemic Models of COVID-19 cases and hospital care generate scenarios under which hospital capacity is insufficient Short-run tactics involve re-purposing of hospital units and other facilities Long-run strategies will require organizational commitment and new policies and incentives to address capacity concerns


title: Biochemical Characterization of Middle East Respiratory Syndrome Coronavirus Spike Protein Proteolytic Processing

text: The coronavirus spike envelope glycoprotein is an essential viral component that mediates virus entry events. Biochemical assessment of the spike protein is critical for understanding structure-function relationships and the roles of the protein in the viral life cycle. Coronavirus spike proteins are typically proteolytically processed and activated by host cell enzymes such as trypsin-like proteases, cathepsins, or proprotein-convertases. Analysis of coronavirus spike proteins by western blot allows the visualization and assessment of proteolytic processing by endogenous or exogenous proteases. Here, we present a method based on western blot analysis to investigate spike protein proteolytic cleavage by transient transfection of HEK-293 T cells allowing expression of the spike protein of the highly pathogenic Middle East respiratory syndrome coronavirus in the presence or absence of a cellular trypsin-like transmembrane serine protease, matriptase. Such analysis enables the characterization of cleavage patterns produced by a host protease on a coronavirus spike glycoprotein.


title: Correction: Impact of COVID-19 on ophthalmic specialist training in the United Kingdom-the trainees' perspective

text: An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Pandemia COVID-19./ Pandemia COVID-19./ COVID-19 pandemic


Covid-19: environmental health officers and retired doctors step up to fill contact tracing void


Global mental health and COVID-19


title: COVID-19 and Acute Pulmonary Embolism in Postpartum Patient

text: We report a 36-year-old woman in Iran who sought care for left shoulder pain and cough 5 days after a scheduled cesarean section. Acute pulmonary embolism and coronavirus disease were diagnosed. Physicians should be aware of the potential for these concurrent conditions in postpartum women.


title: Otologic and Audiologic Considerations for COVID-19

text: The COVID-19 pandemic has created a number of considerations for otolaryngology; anosmia and ageusia in particular have gained significant attention. Here we present considerations in regard to treatment with quinine-derived drugs and the influence of masks on communication.


title: Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia

text: OBJECTIVE: To retrospectively analyze the chest computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia. METHODS: From January 9, 2020, to February 26, 2020, totally 56 laboratory-confirmed patients with COVID-19 underwent chest CT. For 40 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and the affected lung lobes. Furthermore, the initial CT scan and the follow-up CT scans were compared. RESULTS: Forty patients (83.6%) had two or more opacities in the lung. Eighteen (32.7%) patients had only ground-glass opacities; twenty-nine patients (52.7%) had ground-glass and consolidative opacities; and eight patients (14.5%) had only consolidation. A total of 43 patients (78.2%) showed two or more lobes involved. The opacities tended to be both in peripheral and central (30/55, 54.5%) or purely peripheral distribution (25/55, 45.5%). Fifty patients (90.9%) had the lower lobe involved. The first follow-up CT scans showed that twelve patients (30%) had improvement, 26 (65%) patients had mild-moderate progression, and two patients (5%) had severe progression with "white lungs." The second follow-up CT showed that 22 patients (71%) showed improvement compared with the first follow-up CT, four patients (12.9%) had aggravated progression, and five patients (16.1%) showed unchanged radiographic appearance. CONCLUSIONS: The common CT features of COVID-19 pneumonia are multiple lung opacities, multiple types of the opacity (ground-glass, ground-glass and consolidation, and consolidation alone), and multiple lobes especially the lower lobe involved. Follow-up CT could demonstrate the rapid progression of COVID-19 pneumonia (either in aggravation or absorption). KEY POINTS: â¢ The predominant CT features of COVID-19 pneumonia are multiple ground-glass opacities with or without consolidation and, with both lungs, multiple lobes and especially the lower lobe affected. â¢ CT plays a crucial role in early diagnosis and assessment of COVID-19 pneumonia progression. â¢ CT findings of COVID-19 pneumonia may not be consistent with the clinical symptoms or the initial RT-PCR test results.


Commentary: Cardiothoracic Surgery and COVID-19: A Surge of Collective Strength


Impact of SARS-CoV-2 on Hospital Acquired Infection Rates in the United States: Predictions and Early Results


title: Prior and novel coronaviruses, Coronavirus Disease 2019 (COVID-19), and human reproduction: what is known?

text: OBJECTIVE: To summarize current understanding of the effects of novel and prior coronaviruses on human reproduction, specifically male and female gametes, and in pregnancy. DESIGN: Review of English publications in PubMed and Embase to April 6, 2020. METHOD(S): Articles were screened for reports including coronavirus, reproduction, pathophysiology, and pregnancy. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Reproductive outcomes, effects on gametes, pregnancy outcomes, and neonatal complications. RESULT(S): Seventy-nine reports formed the basis of the review. Coronavirus binding to cells involves the S1 domain of the spike protein to receptors present in reproductive tissues, including angiotensin-converting enzyme-2 (ACE2), CD26, Ezrin, and cyclophilins. Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-CoV-1) may cause severe orchitis leading to germ cell destruction in males. Reports indicate decreased sperm concentration and motility for 72-90 days following Coronavirus Disease 2019 (COVID-19) infection. Gonadotropin-dependent expression of ACE2 was found in human ovaries, but it is unclear whether SARS-Coronavirus 2 (CoV-2) adversely affects female gametogenesis. Evidence suggests that COVID-19 infection has a lower maternal case fatality rate than SARS or Middle East respiratory syndrome (MERS), but anecdotal reports suggest that infected, asymptomatic women may develop respiratory symptoms postpartum. Coronavirus Disease 2019 infections in pregnancy are associated with preterm delivery. Postpartum neonatal transmission from mother to child has been reported. CONCLUSION(S): Coronavirus Disease 2019 infection may affect adversely some pregnant women and their offspring. Additional studies are needed to assess effects of SARS-CoV-2 infection on male and female fertility.


title: I call BS: Fraud Detection in Crowdfunding Campaigns

text: Donations to charity-based crowdfunding environments have been on the rise in the last few years. Unsurprisingly, deception and fraud in such platforms have also increased, but have not been thoroughly studied to understand what characteristics can expose such behavior and allow its automatic detection and blocking. Indeed, crowdfunding platforms are the only ones typically performing oversight for the campaigns launched in each service. However, they are not properly incentivized to combat fraud among users and the campaigns they launch: on the one hand, a platform's revenue is directly proportional to the number of transactions performed (since the platform charges a fixed amount per donation); on the other hand, if a platform is transparent with respect to how much fraud it has, it may discourage potential donors from participating. In this paper, we take the first step in studying fraud in crowdfunding campaigns. We analyze data collected from different crowdfunding platforms, and annotate 700 campaigns as fraud or not. We compute various textual and image-based features and study their distributions and how they associate with campaign fraud. Using these attributes, we build machine learning classifiers, and show that it is possible to automatically classify such fraudulent behavior with up to 90.14% accuracy and 96.01% AUC, only using features available from the campaign's description at the moment of publication (i.e., with no user or money activity), making our method applicable for real-time operation on a user browser.


title: Interpret with caution: An evaluation of the commercial AusDiagnostics versus in-house developed assays for the detection of SARS-CoV-2 virus

text: INTRODUCTION: There is limited data on the analytical performance of commercial nucleic acid tests (NATs) for laboratory confirmation of COVID-19 infection. METHODS: Nasopharyngeal, combined nose and throat swabs, nasopharyngeal aspirates and sputum was collected from persons with suspected SARS-CoV-2 infection, serial dilutions of SARS-CoV-2 viral cultures and synthetic positive controls (gBlocks, Integrated DNA Technologies) were tested using i) AusDiagnostics assay (AusDiagnostics Pty Ltd); ii) in-house developed assays targeting the E and RdRp genes; iii) multiplex PCR assay targeting endemic respiratory viruses. Discrepant SARS-CoV-2 results were resolved by testing the N, ORF1b, ORF1ab and M genes. RESULTS: Of 52 clinical samples collected from 50 persons tested, respiratory viruses were detected in 22 samples (42 %), including SARS CoV-2 (nâ¯=â¯5), rhinovirus (nâ¯=â¯7), enterovirus (nâ¯=â¯5), influenza B (nâ¯=â¯4), hMPV (nâ¯=â¯5), influenza A (nâ¯=â¯2), PIV-2 (nâ¯=â¯1), RSV (nâ¯=â¯2), CoV-NL63 (nâ¯=â¯1) and CoV-229E (nâ¯=â¯1). SARS-CoV-2 was detected in four additional samples by the AusDiagnostics assay. Using the in-house assays as the "gold standard", the sensitivity, specificity, positive and negative predictive values of the AusDiagnostics assay was 100 %, 92.16 %, 55.56 % and 100 % respectively. The Ct values of the real-time in-house-developed PCR assay targeting the E gene was significantly lower than the corresponding RdRp gene assay when applied to clinical samples, viral culture and positive controls (mean 21.75 vs 28.1, pâ¯=â¯0.0031). CONCLUSIONS: The AusDiagnostics assay is not specific for the detection SARS-CoV-2. Any positive results should be confirmed using another NAT or sequencing. The case definition used to investigate persons with suspected COVID-19 infection is not specific.


title: Vitamin D receptor stimulation to reduce acute respiratory distress syndrome (ARDS) in patients with coronavirus SARS-CoV-2 infections: Revised Ms SBMB 2020_166

text: Coronavirus infection is a serious health problem awaiting an effective vaccine and/or antiviral treatment. The major complication of coronavirus disease 2019 (COVID-19), the Acute Respiratory Distress syndrome (ARDS), is due to a variety of mechanisms including cytokine storm, dysregulation of the renin-angiotensin system, neutrophil activation and increased (micro)coagulation. Based on many preclinical studies and observational data in humans, ARDS may be aggravated by vitamin D deficiency and tapered down by activation of the vitamin D receptor. Several randomized clinical trials using either oral vitamin D or oral Calcifediol (25OHD) are ongoing. Based on a pilot study, oral calcifediol may be the most promising approach. These studies are expected to provide guidelines within a few months.