title: Differences in Sense of Belonging, Pride, and Mental Health in the Daegu Metropolitan Region due to COVID-19: Comparison between the Presence and Absence of National Disaster Relief Fund

text: Korea's Daegu Metropolitan City once had the second highest rate of COVID-19 infection after Wuhan in China. Following the outbreak, the government provided the first national disaster relief fund to citizens as financial aid. This study investigated whether the sense of regional belonging, pride, and mental health among 550 citizens of Daegu differed between the times before and after COVID-19, based on the presence or absence of the disaster relief fund. Frequency analysis, descriptive statistical analysis, and t-tests were conducted using the SPSS 25.0 program. Results showed that the sense of belonging was higher after COVID-19 than before, while pride was lower. Individuals who received the disaster relief fund showed higher levels of regional belonging and pride with statistical significance. The prevalence of melancholy and depression increased after COVID-19, but the presence or absence of the fund did not lead to a significant difference. Thus, in case of a future national disaster level, provision of the disaster relief fund can raise the sense of regional belonging and pride, in order to elicit communication among local residents toward overcoming difficulties. Furthermore, during challenging disaster situations, central and local governments should provide diverse programs for the citizens' mental health care.


title: Prevention and therapy of COVID-19 via exogenous estrogen treatment for both male and female patients

text: The presented work summarizes the results of studies underlining the crucial role of estrogen receptor (ER) signaling in both innate and adaptive immune responses as well as in tissue repairing processes during respiratory virus infection. Experimental studies justify that among respiratory virus infected mice, a weaker ER signaling leads to increased morbidity and mortality in both males and females. In animal experiments, estrogen treatment silences the inflammatory reactions and decreases virus titers leading to improved survival rate; it seems to be an ideal prevention and therapy against COVID-19. We should overcome the widespread reluctance to estrogen therapy as we have a unique estrogen formula; conjugated estrogens, or conjugated equine estrogens available under the brand name of Premarin deriving from natural sources. Premarin can exert similar ER upregulative and gene repairing power like endogenous estrogen without any risk for adverse reactions. Premarin is capable of stopping the COVID-19 pandemic.


title: Disease and age-related inequalities in paediatric research, funding and communication: lessons from the COVID-19 pandemic

text: COVID-19 has already caused millions of infections, thousands of deaths and countless indirect and poorly estimated consequences on other diseases and the global economy. All ages are potentially susceptible, but the virus has had a lower direct impact on children, with fewer severe cases and low mortality rates. However, the reasons for this are still unclear and we cannot rule out children's role in transmitting the disease. The serious impact that restrictive measures have had on children's lives have not been fully considered. Because children are less affected by COVID-19, the scientific community, health agencies and governments have not focused much attention on them during this pandemic.


COVID-19 and Renin Angiotensin Blockers: Current Evidence and Recommendations


title: Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis

text: BACKGROUND & AIMS: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which has been characterized by fever, respiratory, and gastrointestinal symptoms as well as shedding of virus RNA into feces. We performed a systematic review and meta-analysis of published gastrointestinal symptoms and detection of virus in stool and also summarized data from a cohort of patients with COVID-19 in Hong Kong. METHODS: We collected data from the cohort of patients with COVID-19 in Hong Kong (N = 59; diagnosis from February 2 through February 29, 2020),and searched PubMed, Embase, Cochrane, and 3 Chinese databases through March 11, 2020, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We analyzed pooled data on the prevalence of overall and individual gastrointestinal symptoms (loss of appetite, nausea, vomiting, diarrhea, and abdominal pain or discomfort) using a random effects model. RESULTS: Among the 59 patients with COVID-19 in Hong Kong, 15 patients (25.4%) had gastrointestinal symptoms, and 9 patients (15.3%) had stool that tested positive for virus RNA. Stool viral RNA was detected in 38.5% and 8.7% among those with and without diarrhea, respectively (P = .02). The median fecal viral load was 5.1 log10 copies per milliliter in patients with diarrhea vs 3.9 log10 copies per milliliter in patients without diarrhea (P = .06). In a meta-analysis of 60 studies comprising 4243 patients, the pooled prevalence of all gastrointestinal symptoms was 17.6% (95% confidence interval [CI], 12.3-24.5); 11.8% of patients with nonsevere COVID-19 had gastrointestinal symptoms (95% CI, 4.1-29.1), and 17.1% of patients with severe COVID-19 had gastrointestinal symptoms (95% CI, 6.9-36.7). In the meta-analysis, the pooled prevalence of stool samples that were positive for virus RNA was 48.1% (95% CI, 38.3-57.9); of these samples, 70.3% of those collected after loss of virus from respiratory specimens tested positive for the virus (95% CI, 49.6-85.1). CONCLUSIONS: In an analysis of data from the Hong Kong cohort of patients with COVID-19 and a meta-analysis of findings from publications, we found that 17.6% of patients with COVID-19 had gastrointestinal symptoms. Virus RNA was detected in stool samples from 48.1% patients, even in stool collected after respiratory samples had negative test results. Health care workers should therefore exercise caution in collecting fecal samples or performing endoscopic procedures in patients with COVID-19, even during patient recovery.


title: A Tale of Two Communities: Characterizing Reddit Response to COVID-19 through /r/China_Flu and /r/Coronavirus

text: The COVID-19 pandemic has deeply impacted people's lives around the globe. During the extended lockdowns caused by the pandemic, online communities are crucial for people to access information and share experiences. In particular, two"new"communities have emerged on Reddit: /r/China_flu and /r/Coronavirus. By studying activities and users in these two communities, we provide a characterization of people's responses to COVID-19 on Reddit. First, we find that user activity peaks around March 17, when the World Health Organization (WHO) announced COVID-19 as a pandemic. Shortly after that, the activity levels of both communities have been declining week by week. We further illustrate the central role of these two communities in the emergence of COVID-related communities. Second, we study the differences between these two communities. /r/Coronavirus is recommended as the official community for COVID-19 on Reddit, while /r/China_flu adopts a loose moderation practice. As a result, we observe that these two communities are gradually growing apart and more extremism is being found in /r/China_flu. Finally, we examine the spillover effect of the COVID-19 pandemic on user activity across the entire Reddit platform. Our results show significant changes in user activities outside COVID-related communities. In subreddits related to finance, food, and countries/cities, user activity is recovering to the pre-pandemic level in late April and May as countries reopen, but subreddits related to travel and sports remain highly impacted and show lower activity levels than the pre-pandemic period. Our work highlights the strength of Reddit as a source for understanding public reactions to COVID-19 and the importance of content moderation on the Internet during a pandemic.


title: Is disruption of sleep quality a consequence of severe Covid-19 infection? A case-series examination

text: The Covid-19 outbreak put enormous stress on the health system worldwide, and objective data to handle the emergency are still needed. We aimed to objectively assess the consequence of severe symptoms of Covid-19 infection on sleep quality through wrist actigraphy monitoring of four patients during the sub-acute recovery stage of the disease. The sleep of those patients who had experienced the most severe respiratory symptoms and who had needed prolonged intensive care unit (ICU) stay showed lower Sleep Efficiency and Immobility Time and higher Fragmentation Index compared to those patients who had experienced only mild respiratory symptoms and not requiring ICU stay. Wrist actigraphy assessment provided important clinical information about the sleep and activity levels of Covid-19 patients during the post-acute rehabilitation management.


title: The clinical study on the relationship between serum albumin concentration and lymphocyte levels in patients with 2019-novel coronavirus pneumonia/ 中华急诊医学杂志

text: Objective@#To explore the relationship between different serum albumin and lymphocyte levels in patients with 2019-novel coronavirus (2019-nCoV) pneumonia (COVID-19).@*Methods@#A retrospective study was performed to identify the characteristics of the clinical data of 205 COVID-19 patients who were hospitalized in the Happy Street of Hanchuan People's Hospital, Xiaogan, Hubei Province from January 24 to February 12, 2020, including their general information, serum albumin (ALB) levels, lymphocyte counts (LYM), percentage of lymphocytes (LYM%) and other laboratory parameter levels. Low ALB group and normal ALB group were demarcated by the concentration of 35g/L, further to identify the differences of LYM and LYM% levels and the incidence of LYM and LYM% decline at different ALB levels between groups,as well as the correlation between ALB and LYM, LYM% levels in hypoalbuminemia conditions .@*Results@#17.5% of COVID-19 patients were associated with hypoalbuminemia. The levels of LYM and LYM% in the low ALB group were significantly lower than those in the normal ALB group (P <0.001). The incidence of LYM and LYM% decline in the low ALB group was significantly higher than those in the normal ALB group (P <0.001). The levels of LYM and LYM% in the low ALB group were significantly positively correlated with serum ALB concentrations (P <0.05).@*Conclusions@#The decrease of lymphocyte levels in COVID-19 patients may be correlated to hypoalbuminemia. COVID-19 patients complicated by hypoalbuminemia should be actively intervened to maintain serum albumin in the normal range.


title: Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy

text: A hyperinflammatory syndrome (HIS) may cause a life-threatening acute respiratory distress syndrome (ARDS) in patients with COVID-19 pneumonia. A prospective series of 100 consecutive patients admitted to the Spedali Civili University Hospital in Brescia (Italy) between March 9th and March 20th with confirmed COVID-19 pneumonia and ARDS requiring ventilatory support was analyzed to determine whether intravenous administration of tocilizumab (TCZ), a monoclonal antibody that targets the interleukin 6 (IL-6) receptor, was associated with improved outcome. Tocilizumab was administered at a dosage of 8 mg/kg by two consecutive intravenous infusions 12 h apart. A third infusion was optional based on clinical response. The outcome measure was an improvement in acute respiratory failure assessed by means of the Brescia COVID Respiratory Severity Score (BCRSS 0 to 8, with higher scores indicating higher severity) at 24-72 h and 10 days after tocilizumab administration. Out of 100 treated patients (88 M, 12 F; median age: 62 years), 43 received TCZ in the intensive care unit (ICU), while 57 in the general ward as no ICU beds were available. Of these 57 patients, 37 (65%) improved and suspended noninvasive ventilation (NIV) (median BCRSS: 1 [IQR 0-2]), 7 (12%) patients remained stable in NIV, and 13 (23%) patients worsened (10 died, 3 were admitted to ICU). Of the 43 patients treated in the ICU, 32 (74%) improved (17 of them were taken off the ventilator and were discharged to the ward), 1 (2%) remained stable (BCRSS: 5) and 10 (24%) died (all of them had BCRSS≥7 before TCZ). Overall at 10 days, the respiratory condition was improved or stabilized in 77 (77%) patients, of whom 61 showed a significant clearing of diffuse bilateral opacities on chest x-ray and 15 were discharged from the hospital. Respiratory condition worsened in 23 (23%) patients, of whom 20 (20%) died. All the patients presented with lymphopenia and high levels of C-reactive protein (CRP), fibrinogen, ferritin and IL-6 indicating a HIS. During the 10-day follow-up, three cases of severe adverse events were recorded: two patients developed septic shock and died, one had gastrointestinal perforation requiring urgent surgery and was alive at day 10. In conclusion, our series showed that COVID-19 pneumonia with ARDS was characterized by HIS. The response to TCZ was rapid, sustained, and associated with significant clinical improvement.


The delights and perils of publishing, knowledge-sharing and critique during a pandemic: Observations from COVID-19 coagulopathies


title: Preliminary information on prevention of infections caused by SARS-COV-2 virus in endoscopic laboratories

text: INTRODUCTION: On 11 March 2020, the Director-General of the World Health Organization (WHO) announced COVID-19 (Coronavirus Disease 2019) as a global pandemic Currently, no vaccines are available and there is little evidence of the efficacy of potential therapeutic agents. Furthermore, there is presumably no pre-existing immunity in the population to the new coronavirus, and it is as-sumed that everyone in the population is susceptible. OBJECTIVE: The aim of the procedures described in the article is to minimize the risk of human-to-human transmission of the SARS-CoV-2 (Severe acute respiratory syndrome - coronavirus 2) virus during procedures carried out in endoscopic laboratories. BRIEF DESCRIPTION OF THE STATE OF THE ART: SARS-CoV-2 infection can be asymptomatic, cause severe pneumonia, or lead to death. Symptoms of COVID-19 range from none (asymptomatic) to severe pneumonia and it can be fatal. Case studies to-date indicate that this infection causes a mild illness (i.e. pneumonia or mild pneumonia) in approximately 80% of cases, and most cases recove; 14% have a more severe illness, 6% experience a critical illness. The vast majority of the most serious illnesses and deaths have occurred among the elderly and people with other chronic underlying diseases. Average progression times include: â¢ in mild cases: from the onset of symptoms to recovery in almost 2 weeks; â¢ in severe cases: from the onset of symptoms to recovery in 3-6 weeks, and from symptoms to death in 2-8 weeks. CONCLUSIONS: Special precautions should be taken and procedures followed when performing invasive medical procedures in endoscopic laboratories in patients with specific or clinically probable SARS-CoV-2 infection. This article contains up-to-date information as at 04/04/2020.


title: Safety and services for survivors of intimate partner violence: A researcher-practitioner dialogue on the impact of COVID-19

text: This commentary offers a dialogue between a researcher and practitioner on the potential benefits of collaborative research to benefit survivors of intimate partner violence (IPV), a population exposed to high levels of violence and trauma. The dialogue occurred in a written, back-and-forth exchange, with the researcher and practitioner taking turns asking and responding to questions. The questions posed and answered in this commentary include: How are clients at an emergency domestic violence shelter experiencing the pandemic? How do you think a researcher or community member can help during a time like this? What should a researcher consider when engaging in collaborative research partnerships with service providers during this time? The answers offer insights into the importance of developing strong researcher-practitioner partnerships to improve services for trauma survivors during a global crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Evolving epidemiology and transmission dynamics of coronavirus disease 2019 outside Hubei province, China: a descriptive and modelling study

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) epidemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in Wuhan city, Hubei province, in December, 2019, and has spread throughout China. Understanding the evolving epidemiology and transmission dynamics of the outbreak beyond Hubei would provide timely information to guide intervention policy. METHODS: We collected individual information from official public sources on laboratory-confirmed cases reported outside Hubei in mainland China for the period of Jan 19 to Feb 17, 2020. We used the date of the fourth revision of the case definition (Jan 27) to divide the epidemic into two time periods (Dec 24 to Jan 27, and Jan 28 to Feb 17) as the date of symptom onset. We estimated trends in the demographic characteristics of cases and key time-to-event intervals. We used a Bayesian approach to estimate the dynamics of the net reproduction number (Rt) at the provincial level. FINDINGS: We collected data on 8579 cases from 30 provinces. The median age of cases was 44 years (33-56), with an increasing proportion of cases in younger age groups and in elderly people (ie, aged >64 years) as the epidemic progressed. The mean time from symptom onset to hospital admission decreased from 4·4 days (95% CI 0·0-14·0) for the period of Dec 24 to Jan 27, to 2·6 days (0·0-9·0) for the period of Jan 28 to Feb 17. The mean incubation period for the entire period was estimated at 5·2 days (1·8-12·4) and the mean serial interval at 5·1 days (1·3-11·6). The epidemic dynamics in provinces outside Hubei were highly variable but consistently included a mixture of case importations and local transmission. We estimated that the epidemic was self-sustained for less than 3 weeks, with mean Rt reaching peaks between 1·08 (95% CI 0·74-1·54) in Shenzhen city of Guangdong province and 1·71 (1·32-2·17) in Shandong province. In all the locations for which we had sufficient data coverage of Rt, Rt was estimated to be below the epidemic threshold (ie, <1) after Jan 30. INTERPRETATION: Our estimates of the incubation period and serial interval were similar, suggesting an early peak of infectiousness, with possible transmission before the onset of symptoms. Our results also indicate that, as the epidemic progressed, infectious individuals were isolated more quickly, thus shortening the window of transmission in the community. Overall, our findings indicate that strict containment measures, movement restrictions, and increased awareness of the population might have contributed to interrupt local transmission of SARS-CoV-2 outside Hubei province. FUNDING: National Science Fund for Distinguished Young Scholars, National Institute of General Medical Sciences, and European Commission Horizon 2020.


Emergency Physician Mental Health during the Subacute Phase of the COVID-19 Pandemic


COVID 19 could trigger global diabetes burden - A hypothesis


title: Laboratory management for SARS-CoV-2 detection: a user-friendly combination of the heat treatment approach and rt-Real-time PCR testing

text: The RNA purification is the gold standard for the detection of SARS-CoV-2 in swab samples, but it is dependent on the availability of chemical reagents. In this study, we evaluated the heat treatment method without RNA extraction as a reliable option to nucleic acid purification.


title: Early chest computed tomography to diagnose COVID-19 from suspected patients: A multicenter retrospective study

text: OBJECTIVE: The purpose of this study was to distinguish the imaging features of COVID-19 from those of other infectious pulmonary diseases and evaluate the diagnostic value of chest CT for suspected COVID-19 patients. METHODS: Adult patients suspected of COVID-19 aged >18 years who underwent chest CT scans and reverse-transcription polymerase chain reaction (RT-PCR) tests within 14 days of symptom onset were enrolled. The enrolled patients were confirmed and grouped according to the results of the RT-PCR tests. The basic demographics, single chest CT features, and combined chest CT features were analyzed for the confirmed and nonconfirmed groups. RESULTS: A total of 130 patients were enrolled, with 54 testing positive and 76 testing negative. The typical CT imaging features of the positive group were ground glass opacities (GGOs), the crazy-paving pattern and air bronchogram. The lesions were mostly distributed bilaterally and close to the lower lungs or the pleura. When features were combined, GGOs with bilateral pulmonary distribution and GGOs with pleural distribution were more common among the positive patients, found in 31 (57.4%) and 30 patients (55.6%), respectively. The combinations were almost all statistically significant (P < .05), except for the combination of GGOs with consolidation. Most combinations presented relatively low sensitivity but extremely high specificity. The average specificity of these combinations was approximately 90%. CONCLUSIONS: The combinations with GGOs could be useful in the identification and differential diagnosis of COVID-19, alerting clinicians to isolate patients for prompt treatment and repeat RT-PCR tests until the end of incubation.


title: Trading Privacy for the Greater Social Good: How Did America React During COVID-19?

text: Digital contact tracing and analysis of social distancing from smartphone location data are two prime examples of non-therapeutic interventions used in many countries to mitigate the impact of the COVID-19 pandemic. While many understand the importance of trading personal privacy for the public good, others have been alarmed at the potential for surveillance via measures enabled through location tracking on smartphones. In our research, we analyzed massive yet atomic individual-level location data containing over 22 billion records from ten Blue (Democratic) and ten Red (Republican) cities in the U.S., based on which we present, herein, some of the first evidence of how Americans responded to the increasing concerns that government authorities, the private sector, and public health experts might use individual-level location data to track the COVID-19 spread. First, we found a significant decreasing trend of mobile-app location-sharing opt-out. Whereas areas with more Democrats were more privacy-concerned than areas with more Republicans before the advent of the COVID-19 pandemic, there was a significant decrease in the overall opt-out rates after COVID-19, and this effect was more salient among Democratic than Republican cities. Second, people who practiced social distancing (i.e., those who traveled less and interacted with fewer close contacts during the pandemic) were also less likely to opt-out, whereas the converse was true for people who practiced less social-distancing. This relationship also was more salient among Democratic than Republican cities. Third, high-income populations and males, compared with low-income populations and females, were more privacy-conscientious and more likely to opt-out of location tracking.


[Diagnosis and treatment of disease 2019 novel coronavirus infection suitable for Military support Hubei medical team]


title: [What are the highlights of "Diagnosis and treatment of disease 2019 novel coronavirus infection suitable for Military support Hubei medical team"]

text: Thousands of medical workers in the Military support Hubei medical team are exerting themselves in many hospitals in Hubei Province. They are diligent in treating patients, at the same time, they constantly summarize experience and combine the characteristics of military hospitals. According to "the Diagnosis and Treatment of New Coronavirus Pneumonia "(6th edition) of the National Health Commission of the People's Republic of China, a new guideline for the diagnosis and treatment of 2019 novel coronavirus infection suitable for the military (first trial version) was established. Some unique opinions and suggestions are put forward in terms of disease name, diagnosis criteria, antiviral treatment, glucocorticoid application, etc. This article will make a proper interpretation in order to understand the guideline better and help guide the diagnosis and treatment of diseases.


title: Delayed specific IgM antibody responses observed among COVID-19 patients with severe progression

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide since it was confirmed as the causative agent of COVID-19. Molecular diagnosis of the disease is typically performed via nucleic acid-based detection of the virus from swabs, sputum or bronchoalveolar lavage fluid (BALF). However, the positive rate from the commonly used specimens (swabs or sputum) was less than 75%. Immunological assays for SARS-CoV-2 are needed to accurately diagnose COVID-19. Sera were collected from patients or healthy people in a local hospital in Xiangyang, Hubei Province, China. The SARS-CoV-2 specific IgM antibodies were then detected using a SARS-CoV-2 IgM colloidal gold immunochromatographic assay (GICA). Results were analysed in combination with sera collection date and clinical information. The GICA was found to be positive with the detected 82.2% (37/45) of RT-qPCR confirmed COVID-19 cases, as well as 32.0% (8/25) of clinically confirmed, RT-qPCR negative patients (4-14 days after symptom onset). Investigation of IgM-negative, RT-qPCR-positive COVID-19 patients showed that half of them developed severe disease. The GICA was found to be a useful test to complement existing PCR-based assays for confirmation of COVID-19, and a delayed specific IgM antibody response was observed among COVID-19 patients with severe progression.


Here we are: Agriculture and Human Values in the Coronavirus (COVID-19) pandemic


Issues on Coronavirus Disease 2019 (COVID-19) Pathogenesis


title: Inflamm-aging: Why older men are the most susceptible to SARS-CoV-2 complicated outcomes

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by a high mortality of elderly men with age-related comorbidities. In most of these patients, uncontrolled local and systemic hyperinflammation induces severe and often lethal outcomes. The aging process is characterized by the gradual development of a chronic subclinical systemic inflammation (inflamm-aging) and by acquired immune system impairment (immune senescence). Here, we advance the hypothesis that four well-recognized features of aging contribute to the disproportionate SARS-CoV-2 mortality suffered by elderly men: i. the presence of subclinical systemic inflammation without overt disease, ii. a blunted acquired immune system and type I interferon response due to the chronic inflammation; iii. the downregulation of ACE2 (i.e. the SARS-CoV-2 receptor); and iv. accelerated biological aging. The high mortality rate of SARS-CoV-2 infection suggests that clarification of the mechanisms of inflamm-aging and immune senescence can help combat not only age-related disorders but also SARS-CoV-2 infection.


title: Inpatient Transition to Virtual Care During COVID-19 Pandemic

text: Introduction: During the coronavirus disease 2019 (COVID-19) outbreak, novel approaches to diabetes care have been employed. Care in both the inpatient and outpatient setting has transformed considerably. Driven by the need to reduce the use of personal protective equipment and exposure for patients and providers alike, we transitioned inpatient diabetes management services to largely "virtual" or remotely provided care at our hospital. Methods: Implementation of a diabetes co-management service under the direction of the University of North Carolina division of endocrinology was initiated in July 2019. In response to the COVID-19 pandemic, the diabetes service was largely transitioned to a virtual care model in March 2020. Automatic consults for COVID-19 patients were implemented. Glycemic outcomes from before and after transition to virtual care were evaluated. Results: Data over a 15-week period suggest that using virtual care for diabetes management in the hospital is feasible and can provide similar outcomes to traditional face-to-face care. Conclusion: Automatic consults for COVID-19 patients ensure that patients with serious illness receive specialized diabetes care. Transitioning to virtual care models does not limit the glycemic outcomes of inpatient diabetes care and should be employed to reduce patient and provider exposure in the setting of COVID-19. These findings may have implications for reducing nosocomial infection in less challenging times and might address shortage of health care providers, especially in the remote areas.


PCCM at the Battlefront Against COVID-19 in Wuhan, China


title: Bedside veno-venous ECMO cannulation: A pertinent strategy during the COVID-19 pandemic

text: BACKGROUND: Patient selection and cannulation arguably represent the key steps for the successful implementation of extracorporeal membrane oxygenation (ECMO) support. Cannulation is traditionally performed in the operating room or the catheterization laboratory for a number of reasons, including physician preference and access to real-time imaging, with the goal of minimizing complications and ensuring appropriate cannula positioning. Nonetheless, the patients' critical and unstable conditions often require emergent initiation of ECMO and preclude the safe transport of the patient to a procedural suite. AIMS: Therefore, with the objective of avoiding delay with the initiation of therapy and reducing the hazard of transport, we implemented a protocol for bedside ECMO cannulation. MATHERIAL AND METHODS: A total of 89 patients required ECMO support at Hennepin County Medical Center between March 2015 and December 2019. Twenty-eight (31%) required veno-venous support and were all cannulated at the bedside. Overall survival was 71% with no morbidity or mortality related to the cannulation procedure. CONCLUSION: In the current pandemic, the strategy of veno-venous bedside cannulation may have additional benefits for the care of patients with refractory acute respiratory distress syndrome due to coronavirus-disease-2019, decreasing the risk of exposure of health care worker or other patients to the novel severe acute respiratory syndrome coronavirus-2 occurring during patient transport, preparation, or during disinfection of the procedural suite and the transportation pathway after ECMO cannulation.


Management of acute aortic dissection during the COVID-19 pandemic: Experience from an epicenter in Wuhan, China


Middle East respiratory syndrome coronavirus (MERS-CoV) neutralising antibodies in a high-risk human population, Morocco, November 2017 to January 2018


title: Coronaviruses pandemics: Can neutralizing antibodies help?

text: For the first time in Homo sapiens history, possibly, most of human activities is stopped by coronavirus disease 2019 (COVID-19). Nearly eight billion people of this world are facing a great challenge, maybe not "to be or not to be" yet, but unpredictable. What happens to other major pandemics in the past, and how human beings went through these hurdles? The human body is equipped with the immune system that can recognize, respond and fight against pathogens such as viruses. Following the innate response, immune system processes the adaptive response by which each pathogen is encoded and recorded in memory system. The humoral reaction containing cytokines and antibodies is expected to activate when the pathogens come back. Exploiting this nature of body protection, neutralizing antibodies have been investigated. Learning from past, in parallel to SARS-CoV-2, other coronaviruses SARS-CoV and MERS-CoV who caused previous pandemics, are recalled in this review. We here propose insights of origin and characteristics and perspective for the future of antibodies development.


title: Genetic structure of SARS-CoV-2 reflects clonal superspreading and multiple independent introduction events, North-Rhine Westphalia, Germany, February and March 2020

text: We whole-genome sequenced 55 SARS-CoV-2 isolates from Germany to investigate SARS-CoV-2 outbreaks in 2020 in the Heinsberg district and Düsseldorf. While the genetic structure of the Heinsberg outbreak indicates a clonal origin, reflecting superspreading dynamics from mid-February during the carnival season, distinct viral strains were circulating in Düsseldorf in March, reflecting the city's international links. Limited detection of Heinsberg strains in the Düsseldorf area despite geographical proximity may reflect efficient containment and contact-tracing efforts.


Distinct features of SARS-CoV-2-specific IgA response in COVID-19 patients


title: 21-Day Lockdown in India Dramatically Reduced Air Pollution Indices in Lucknow and New Delhi, India

text: In December 2019, the outbreak of viral disease labeled as Novel Coronavirus started in Wuhan, China, which later came to be known as Covid-19. The disease has spread in almost every part of the world and has been declared a global pandemic in March 2020 by World Health Organization (WHO). The corona virus outbreak has emerged as one of the deadliest pandemics of all time in human history. The ongoing pandemic of COVID-19 has forced several countries of the world to observe complete lockdown forcing people to live in their homes. India also faced the phase of total lockdown for 21 days (in first phase) to avoid the spread of coronavirus to the maximum possible extent. This lockdown impacted the pollution levels of environment and improved air and water quality in the short span owing to very less human activities. The present work scientifically analyzed the available data for primary air pollutants (PM2.5, NO2, SO2 and CO) from two major Indian cities, Lucknow and New Delhi. The analysis was based on air quality data for before lockdown and after lockdown (first phase of 21 days) periods of 21 days each. The results showed significant decline in the studied air pollution indices and demonstrated improvement of air quality in both the cities. The major impact was seen in the levels of PM2.5, NO2 and CO. The levels of SO2 showed less significant decline during the lockdown period. The results are presented with future perspectives to mitigate air pollution in near future by adopting the short and periodical lockdown as a tool.


title: Variation of positiveness to enhance testing of specimens during an epidemic

text: Rapid testing of appropriate specimens from patients suspected for a disease during an epidemic, such as the current Coronavirus outbreak, is of a great importance for the disease management and control. We propose a method to enhance processing large amounts of collected samples. The method is based on mixing samples in testing tubes in a specific configuration, as opposed to testing single samples in each tube, and accounting for natural virus amounts in infected patients from variation of positiveness in test tubes. To illustrate the efficiency of the suggested method we carry out numerical tests for actual scenarios under various tests. Applying the proposed method enhances the number of tests by order of magnitudes, where all positives are identified with no false negatives, and the effective testing time can be reduced drastically even when the uncertainty in the test is relatively high.


title: SARS-CoV-2 RNA polymerase as target for antiviral therapy

text: A new human coronavirus named SARS-CoV-2 was identified in several cases of acute respiratory syndrome in Wuhan, China in December 2019. On March 11 2020, WHO declared the SARS-CoV-2 infection to be a pandemic, based on the involvement of 169 nations. Specific drugs for SARS-CoV-2 are obviously not available. Currently, drugs originally developed for other viruses or parasites are currently in clinical trials based on empiric data. In the quest of an effective antiviral drug, the most specific target for an RNA virus is the RNA-dependent RNA-polymerase (RdRp) which shows significant differences between positive-sense and negative-sense RNA viruses. An accurate evaluation of RdRps from different viruses may guide the development of new drugs or the repositioning of already approved antiviral drugs as treatment of SARS-CoV-2. This can accelerate the containment of the SARS-CoV-2 pandemic and, hopefully, of future pandemics due to other emerging zoonotic RNA viruses.


title: Un-Muting Medical Student Education: Utilizing Telemedicine During the COVID-19 Pandemic and Beyond

text: UNSTRUCTURED: Due to the COVID-19 pandemic, medical schools have paused traditional clerkships, eliminating direct patient encounters from medical student education for the immediate future. Telemedicine offers opportunities in a variety of specialties that can augment student education during this time. The projected growth of telemedicine necessitates that students learn new skills to be effective providers. In this Viewpoint, we delineate specific telehealth opportunities that teach core competencies for patient care, while also teaching telemedicine specific skills. Schools can further augment student education through a variety of telemedicine initiatives across multiple medical fields. The explosion of telemedicine programs due to the pandemic can be a catalyst for schools to integrate telemedicine into their current curricula. The depth and variety of telemedicine opportunities allows schools to continue providing high quality medical education while maintaining social distancing policies.


Impact of the outbreak of SARS-CoV-2 infection on urgent gynecological care


Molecular chronicles of cytokine burst in patients with coronavirus disease 2019 (COVID-19) with cardiovascular diseases


Rechtsfragen der Ressourcenzuteilung in der COVID-19-Pandemie./ [Legal Issues of Resource Allocation in the COVID-19 Pandemic - Between Utilitarianism and Life Value Indifference]


title: Efficacy of chloroquine versus lopinavir/ritonavir in mild/general COVID-19 infection: a prospective, open-label, multicenter, randomized controlled clinical study

text: BACKGROUND: The outbreak of COVID-19 (caused by SARS-Cov-2) is very serious, and no effective antiviral treatment has yet been confirmed. The adage "old drug, new trick" in this context may suggest the important therapeutic potential of existing drugs. We found that the lopinavir/ritonavir treatment recommended in the fifth edition of the Treatment Plan of China can only help to improve a minority of throat-swab nucleic-acid results (3/15) in hospitals. Our previous use of chloroquine to treat patients with COVID-19 infection showed an improvement in more throat-swab nucleic-acid results (5/10) than the use of lopinavir/ritonavir. METHODS/DESIGN: This is a prospective, open-label, randomized controlled, multicenter clinical study. The study consists of three phases: a screening period, a treatment period of no more than 10 days, and a follow-up period for each participant. Participants with COVID-19 infection who are eligible for selection for the study will be randomly allocated to the trial group or the control group. The control group will be given lopinavir/ritonavir treatment for no more than 10 days. The trial group will be given chloroquine phosphate treatment for no more than 10 days. The primary outcome is the clinical recovery time at no more than 28 days after the completion of therapy and follow-up. The secondary outcomes include the rate of treatment success after the completion of therapy and follow-up, the time of treatment success after no more than 28 days, the rate of serious adverse events during the completion of therapy and follow-up, and the time to return to normal temperature (calculated from the onset of illness) during the completion of therapy and follow-up. Comparisons will be performed using two-sided tests with a statistical significance level of 5%. DISCUSSION: This experiment should reveal the efficacy and safety of using chloroquine versus lopinavir/ritonavir for patients with mild/general COVID-19 infection. If the new treatment including chloroquine shows a higher rate of throat-swab SARS-CoV-2 real-time fluorescent reverse transcription polymerase chain reaction (RT-PCR) negativity and is safe, it could be tested as a future COVID-19 treatment. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ID: ChiCTR2000029741 . Registered on 11 February 2020.


Doing the right thing for the right reason when treating ruptured abdominal aortic aneurysms in the COVID-19 era


The proximal origin of SARS-CoV-2


title: Current situation in Urology practice in Spain during the COVID-19 pandemic./ Situacion actual de la urologia en Espana durante la pandemia Covid-19

text: INTRODUCTION: On 11th March 2020the WHO declared COVID19 a global pandemic, a challenge previously unseen for sanitary systems, including the activity in Urology departments MATERIAL AND METHODS: Web and PubMed searchusing the keywords "SARS-CoV-2", "COVID19", "COVID Urology", "COVID surgery", "consensus methods","nominal group", "Delphi method" A narrative revision of the literature until the 20th May 2020, including articles and documents in English and Spanish ;RESULTS: Medical practice in Spain has been forced to rapidly adapt to the pandemic, dedicating most ofits material and human resources to the care of patients infected by SARS-CoV-2 This has meant a significant reduction of the routine practice in Urology, as in other medical specialities, limiting the medical attention tourgent and emergent cases Programmed activity has been reserved for selected cases in which a delayed attention could compromise survival Different scientific associations have made a significant effort to adapt their recommendations to the pandemic, prioritizing high-risk oncologic cases, and reducing the use of ventilators and hospital stays to the minimum These restrictions must be dynamic, adapting to the de-escalating phases as the pandemic is more controlled, widening the range of services available In this de-escalate there is an additional challenge, being the difficulty in generating quality scientific evidence In order to obtain such evidence, consensus methods have been used, such as the nominal group technique or the Delphi method CONCLUSIONS: The COVID19 pandemic has meant a complete disruption in the routine activity in Urologyin Spain, with a need for prioritizing the attention of urgent and high-risk oncologic pathology These restrictions must be progressively modified according to the de-escalating process in the general population INTRODUCCION: El 11 de marzo de2020 la OMS declara el estado de pandemia por COVID19, un reto sin precedentes para los sistemas sanitarios, incluyendo la actividad en el ambito de la Urologia MATERIAL Y METODOS: Busqueda web y PubMed empleando las palabras clave SARS-CoV-2, COVID19,COVID Urology, COVID surgery, consensus methods, nominal group, Delphi method Revision narrativa de la literatura hasta el 20 de mayo 2020 incluyendo articulos y documentos escritos en espanolo ingles RESULTADOS: La actividad asistencial en Espana ha debido adaptarse rapidamente a la pandemia, volcandola mayoria de sus recursos materiales y humanos para atender pacientes infectados por SARS-CoV-2 Esto hasupuesto una disminucion drastica de la actividad habitual en Urologia, al igual que en el resto de especialidades, limitando la atencion a casos urgentes y emergentes La actividad programada ha debido restringirse a sujetos muy seleccionados en los que demorar la atencion podria comprometer la supervivencia Diferentes asociaciones cientificas han realizado un esfuerzo importante para adaptar sus recomendaciones a la pandemia, priorizando patologia oncologica de mayor riesgo, y reduciendo el uso de respiradores y las estancias hospitalarias al maximo Esta restriccion debe ser dinamica, adaptandose a las fases de desescalada a medida que se vaya controlandola pandemia, ampliando los servicios ofrecidos Para esta desescalada nos enfrentamos a un reto adicional,que es la dificultad para generar evidencia cientifica decalidad que guie las actuaciones de los sanitarios Para obtener evidencia en este contexto se ha de recurrir a metodos de consenso CONCLUSIONES: La pandemia por COVID19 ha supuesto una disrupcion completa de la actividad habitual en Urologia en Espana, debiendo priorizar la atencion de patologia urgente y oncologica de riesgo Estas restricciones deben modificarse progresivamente acorde a la desescalada en la poblacion


title: [Current situation in Urology practice in Spain during the COVID-19 pandemic.]

text: INTRODUCTION: On 11th March 2020the WHO declared COVID19 a global pandemic, a challenge previously unseen for sanitary systems, including the activity in Urology departments MATERIAL AND METHODS: Web and PubMed searchusing the keywords "SARS-CoV-2", "COVID19", "COVID Urology", "COVID surgery", "consensus methods","nominal group", "Delphi method" A narrative revision of the literature until the 20th May 2020, including articles and documents in English and Spanish ;RESULTS: Medical practice in Spain has been forced to rapidly adapt to the pandemic, dedicating most ofits material and human resources to the care of patients infected by SARS-CoV-2 This has meant a significant reduction of the routine practice in Urology, as in other medical specialities, limiting the medical attention tourgent and emergent cases Programmed activity has been reserved for selected cases in which a delayed attention could compromise survival Different scientific associations have made a significant effort to adapt their recommendations to the pandemic, prioritizing high-risk oncologic cases, and reducing the use of ventilators and hospital stays to the minimum These restrictions must be dynamic, adapting to the de-escalating phases as the pandemic is more controlled, widening the range of services available In this de-escalate there is an additional challenge, being the difficulty in generating quality scientific evidence In order to obtain such evidence, consensus methods have been used, such as the nominal group technique or the Delphi method CONCLUSIONS: The COVID19 pandemic has meant a complete disruption in the routine activity in Urologyin Spain, with a need for prioritizing the attention of urgent and high-risk oncologic pathology These restrictions must be progressively modified according to the de-escalating process in the general population


Performing dermoscopy in the COVID-19 pandemic


title: What Does the COVID-19 Pandemic Mean for Rheumatology Patients?

text: Purpose of review: The COVID-19 outbreak has resulted in uncertainty for patients with autoimmune rheumatic diseases for several reasons. They are concerned about their risk of developing COVID-19 as many are immune suppressed from their disease and/or treatment, whether they should stop their advanced therapies, if they will have a worse outcome if/when infected due to their underlying medication condition(s) and if they will have drug availability, especially with press (without much data) coverage suggesting hydroxychloroquine may be used in COVID-19 infection causing diversion of medication supply. This article discusses how the pandemic affects people with systemic autoimmune rheumatic diseases. Recent findings: Preliminarily, articles seem to suggest that patients with rheumatic diseases may not have more infections from SARS-CoV-2 and similar outcomes to age and gender matched patients, but fear of rheumatic medications increasing their risk, drug shortages, and work exposure all are concerns for patients. Recent findings: The long term effects of the pandemic in patients with rheumatic diseases will not be known until much later and likely include stressors flaring disease (fear, illness, job loss, social isolation), post-traumatic stress, flaring due to stopping medications, less physician visits with subsequent under-treatment, and increases in chronic concomitant fatigue, pain, fibromyalgia.


title: Sustainable soil use and management: An interdisciplinary and systematic approach

text: Soil is a key component of Earth's critical zone. It provides essential services for agricultural production, plant growth, animal habitation, biodiversity, carbon sequestration and environmental quality, which are crucial for achieving the United Nations' Sustainable Development Goals (SDGs). However, soil degradation has occurred in many places throughout the world due to factors such as soil pollution, erosion, salinization, and acidification. In order to achieve the SDGs by the target date of 2030, soils may need to be used and managed in a manner that is more sustainable than is currently practiced. Here we show that research in the field of sustainable soil use and management should prioritize the multifunctional value of soil health and address interdisciplinary linkages with major issues such as biodiversity and climate change. As soil is the largest terrestrial carbon pool, as well as a significant contributor of greenhouse gases, much progress can be made toward curtailing the climate crisis by sustainable soil management practices. One identified option is to increase soil organic carbon levels, especially with recalcitrant forms of carbon (e.g., biochar application). In general, soil health is primarily determined by the actions of the farming community. Therefore, information management and knowledge sharing are necessary to improve the sustainable behavior of practitioners and end-users. Scientists and policy makers are important actors in this social learning process, not only to disseminate evidence-based scientific knowledge, but also in generating new knowledge in close collaboration with farmers. While governmental funding for soil data collection has been generally decreasing, newly available 5G telecommunications, big data and machine learning based data collection and analytical tools are maturing. Interdisciplinary studies that incorporate such advances may lead to the formation of innovative sustainable soil use and management strategies that are aimed toward optimizing soil health and achieving the SDGs.


title: Atención farmacéutica al paciente externo durante la pandemia COVID-19. Telefarmacia./ Pharmaceutical care to hospital outpatients during the COVID-19 pandemic. Telepharmacy

text: Hospital Pharmacy Service (HPS) in Spain have been impacted by the health crisis caused by the COVID-19 pandemic. Thus, the outbreak has forced HPSs to adapt their outpatient consultation services to Telepharmacy to optimize clinical outcomes and reduce the risk of contagion. The purpose of this article is to describe and analyze the experience of HPSs with outpatient Telepharmacy during the COVID-19 pandemic and expose the lessons learned. Measures have been adopted in on-site outpatient pharmacy clinics to prevent exposure of patients and professionals to the virus. These measures are based on national and international recommendations on social distancing and hygiene. With regard to remote outpatient pharmacy services, teleconsultation with drug dispensing has been promoted based on five basic procedures, each with its advantages and limitations: home drug delivery from HPSs, with the advantage of universal access and the limitation of entailing a substantial investment in resources; HPS coordination with primary care pharmacists, which requires no investments but with limited access to some geographic areas; HPS coordination with community pharmacists based on a large network of pharmacies, which requires the patient to go to the pharmacy, without confidentiality being guaranteed for any patient; geolocation and hospital-based medication dispensing, which provides universal access and direct traceability, but entails investment in human resources; and HPS coordination with associations of patients, which does not entail any additional cost but limits the information available on the diseases of society members. Three main lessons have been learned during the pandemic: the satisfactory capacity of HPS to provide outpatient pharmacy consultation services in the setting of a public health crisis; the usefulness of Telepharmacy for the clinical follow-up, healthcare coordination, outpatient counseling, and informed dispensing and delivery of medication (with a high level of satisfaction among patients); and the need to foster Telepharmacy as a complementary tool through a mixed model of outpatient pharmacy consultation service that incorporates the advantages of each procedure and adapts to the individual needs of each patient in a context of humanized healthcare.


title: SEIRD Model for Qatar Covid-19 Outbreak: A Case Study

text: The Covid-19 outbreak of 2020 has required many governments to develop mathematical-statistical models of the outbreak for policy and planning purposes. This work provides a tutorial on building a compartmental model using Susceptibles, Exposed, Infected, Recovered and Deaths status through time. A Bayesian Framework is utilized to perform both parameter estimation and predictions. This model uses interventions to quantify the impact of various government attempts to slow the spread of the virus. Predictions are also made to determine when the peak Active Infections will occur.


Clozapine Toxicity in the Setting of COVID-19


title: Identification of potential inhibitors of SARS-COV-2 endoribonuclease (EndoU) from FDA approved drugs: a drug repurposing approach to find therapeutics for COVID-19

text: SARS-CoV-2 is causative agent of COVID-19, which is responsible for severe social and economic disruption globally. Lack of vaccine or antiviral drug with clinical efficacy suggested that drug repurposing approach may provide a quick therapeutic solution to COVID-19. Nonstructural protein-15 (NSP15) encodes for an uridylate-specific endoribonuclease (EndoU) enzyme, essential for virus life cycle and an attractive target for drug development. We have performed in silico based virtual screening of FDA approved compounds targeting EndoU in search of COVID-19 drugs from commercially available approved molecules. Two drugs Glisoxepide and Idarubicin used for treatment for diabetes and leukemia, respectively, were selected as stronger binder of EndoU. Both the drugs bound to the active site of the viral endonuclease by forming attractive intermolecular interactions with catalytically essential amino acid residues, His235, His250, and Lys290. Molecular dynamics simulation studies showed stable conformation dynamics upon drugs binding to endoU. The binding free energies for Glisoxepide and Idarubicin were calculated to be -141 ± 11 and -136 ± 16 kJ/mol, respectively. The IC50 were predicted to be 9.2 µM and 30 µM for Glisoxepide and Idarubicin, respectively. Comparative structural analysis showed the stronger binding of EndoU to Glisoxepide and Idarubicin than to uridine monophosphate (UMP). Surface area calculations showed buried are of 361.8Å2 by Glisoxepide which is almost double of the area occupied by UMP suggesting stronger binding of the drug than the ribonucleotide. However, further studies on these drugs for evaluation of their clinical efficacy and dose formulations may be required, which may provide a quick therapeutic option to treat COVID-19. Communicated by Ramaswamy H. Sarma.


title: Impact studies of nationwide measures COVID-19 anti-pandemic: compartmental model and machine learning

text: In this paper, we deal with the study of the impact of worldwide nation measures for COVID-19 anti-pandemic. We drive two processes to analyze COVID-19 data considering measures, and then forecasting is done for Senegal. We show a comparison between deterministic and two machine learning technics for forecasting.


title: Rapid Emergence of SARS-CoV-2 in the Greater New York Metropolitan Area: Geolocation, Demographics, Positivity Rates, and Hospitalization for 46,793 Persons Tested by Northwell Health

text: BACKGROUND: In March 2020, the greater New York metropolitan area became an epicenter for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The initial evolution of case incidence has not been well characterized. METHODS: Northwell Health Laboratories tested 46,793 persons for SARS-CoV-2 from March 4 through April 10. The primary outcome measure was a positive reverse-transcription-polymerase-chain-reaction (RT-PCR) test for SARS-CoV-2. The secondary outcomes included patient age, sex, and race if stated; dates the specimen was obtained and the test result; clinical practice site sources; geo-location of patient residence; and hospitalization. RESULTS: From March 8 through April 10, a total of 26,735 of 46,793 persons (57.1%) tested positive for SARS-CoV-2. Males of each race were disproportionally more affected than females above age 25, with a progressive male predominance as age increased. Of the positive persons, 7,292 were hospitalized directly upon presentation; an additional 882 persons tested positive in an ambulatory setting before subsequent hospitalization, a median of 4.8 days later. Total hospitalization rate was thus 8,174 persons (30.6% of positive persons). There was a broad range (greater than 10-fold) in the cumulative number of positive cases across individual zip codes following documented first case incidents. Test positivity was greater for persons living in zip codes with lower annual household income. CONCLUSIONS: Our data reveal that SARS-CoV-2 incidence emerged rapidly and almost simultaneously across a broad demographic population in the region. These findings support the hypothesis that SARS-CoV-2 infection was widely distributed prior to virus testing availability.


title: Wealth distribution under the spread of infectious diseases

text: We develop a mathematical framework to study the economic impact of infectious diseases by integrating epidemiological dynamics with a kinetic model of wealth exchange. The multi-agent description leads to study the evolution over time of a system of kinetic equations for the wealth densities of susceptible, infectious and recovered individuals, whose proportions are driven by a classical compartmental model in epidemiology. Explicit calculations show that the spread of the disease seriously affects the distribution of wealth, which, unlike the situation in the absence of epidemics, can converge towards a stationary state with a bimodal form. Furthermore, simulations confirm the ability of the model to describe different phenomena characteristics of economic trends in situations compromised by the rapid spread of an epidemic, such as the unequal impact on the various wealth classes and the risk of a shrinking middle class.


The impact of the SARS-CoV-2 outbreak on the safety and availability of blood transfusions in Italy


Covid-19: la troublante decouverte des possibles vertus de la nicotine


COVID-19 vaccines start moving into advanced trials


title: Support Estimation with Sampling Artifacts and Errors

text: The problem of estimating the support of a distribution is of great importance in many areas of machine learning, computer science, physics and biology. Most of the existing work in this domain has focused on settings that assume perfectly accurate sampling approaches, which is seldom true in practical data science. Here we introduce the first known approach to support estimation in the presence of sampling artifacts and errors where each sample is assumed to arise from a Poisson repeat channel which simultaneously captures repetitions and deletions of samples. The proposed estimator is based on regularized weighted Chebyshev approximations, with weights governed by evaluations of so-called Touchard (Bell) polynomials. The supports in the presence of sampling artifacts are calculated using discretized semi-infite programming methods. The estimation approach is tested on synthetic and textual data, as well as on GISAID data collected to address a new problem in computational biology: mutational support estimation in genes of the SARS-Cov-2 virus. In the later setting, the Poisson channel captures the fact that many individuals are tested multiple times for the presence of viral RNA, thereby leading to repeated samples, while other individual's results are not recorded due to test errors. For all experiments performed, we observed significant improvements of our integrated methods compared to those obtained through adequate modifications of state-of-the-art noiseless support estimation methods.


title: COVID-19 response needs to broaden financial inclusion to curb the rise in poverty

text: The ongoing COVID-19 pandemic risks wiping out years of progress made in reducing global poverty. In this paper, we explore to what extent financial inclusion could help mitigate the increase in poverty using cross-country data across 78 low- and lower-middle-income countries. Unlike other recent cross-country studies, we show that financial inclusion is a key driver of poverty reduction in these countries. This effect is not direct, but indirect, by mitigating the detrimental effect that inequality has on poverty. Our findings are consistent across all the different measures of poverty used. Our forecasts suggest that the world's population living on less than $1.90 per day could increase from 8% to 14% by 2021, pushing nearly 400 million people into poverty. However, urgent improvements in financial inclusion could substantially reduce the impact on poverty.


title: Laser Spectroscopic Technique for Direct Identification of a Single Virus I: FASTER CARS

text: From the famous 1918 H1N1 influenza to the present COVID-19 pandemic, the need for improved virial detection techniques is all too apparent. The aim of the present paper is to show that identification of individual virus particles in clinical sample materials quickly and reliably is near at hand. First of all, our team has developed techniques for identification of virions based on a modular atomic force microscopy (AFM). Furthermore, Femtosecond Adaptive Spectroscopic Techniques with Enhanced Resolution via Coherent Anti-Stokes Raman Scattering (FASTER CARS) [1] using tip-enhanced techniques markedly improves the sensitivity.


[COVID-19 and the Invisible Damage]


Testing for Novel Coronavirus Antibodies: A Necessary Adjunct


E-learning during Covid-19


title: Exposure to novel coronavirus in patients on renal replacement therapy during the exponential phase of COVID-19 pandemic: survey of the Italian Society of Nephrology

text: BACKGROUND: Between February and April 2020, Italy experienced an overwhelming growth of the COVID-19 pandemic. Little is known, at the country level, where and how patients on renal replacement therapy (RRT) have been mostly affected. METHODS: Survey of the network of Nephrology centers using a simplified 17 items electronic questionnaire designed by Italian Society of Nephrology COVID-19 Research Group. We used spatial epidemiology and geographical information systems to map SARS-CoV-2 spread among RRT patients in Italy. RESULTS: On April 9th 2020, all nephrology centers (n = 454) listed in the DialMap database were invited to complete the electronic questionnaire. Within 11 days on average, 365 centers responded (80.4% response rate; 2.3% margin of error) totaling 60,441 RRT patients. The surveyed RRT population included 30,821 hemodialysis (HD), 4139 peritoneal dialysis (PD), and 25,481 transplanted (Tx) patients respectively. The proportion of SARS-CoV-2 positive RRT patients in Italy was 2.26% (95% CI 2.14-2.39) with significant differences according to treatment modality (p < 0.001). The proportion of patients positive for SARS-CoV-2 was significantly higher in HD (3.55% [95% CI 3.34-3.76]) than PD (1.38% [95% CI 1.04-1.78] and Tx (0.86% [95% CI 0.75-0.98]) (p < 0.001), with substantial heterogeneity across regions and along the latitude gradient (p < 0.001). In RRT patients the highest rate was in the north-west (4.39% [95% CI 4.11-4.68], followed by the north-east (IR 2.06% [1.79-2.36]), the center (0.91% [0.75-1.09]), the main islands (0.67% [0.47-0.93]), and the south (0.59% [0.45-0.75]. During the COVID-19 pandemic, among SARS-Cov-2 positive RRT patients the fatality rate was 32.8%, as compared to 13.3% observed in the Italian population as of April 23rd. CONCLUSIONS: A substantial proportion of the 60,441 surveyed RRT patients in Italy were SARS-Cov-2 positive and subsequently died during the exponential phase of COVID-19 pandemic. Infection risk and rates seems to differ substantially across regions, along geographical latitude, and by treatment modality.


title: Modifications of emergency dental clinic protocols to combat COVID-19 transmission

text: During the COVID-19 pandemic, incidence rates for dental diseases will continue unabated. However, the intent to prevent the spread of this lethal respiratory disease will likely lead to reduced treatment access due to restrictions on population movements. These changes have the potential to increase dental-related emergency department visits and subsequently contribute to greater viral transmission. Moreover, dentists experience unique challenges with preventing transmission due to frequent aerosol-producing procedures. This paper presents reviews and protocols implemented by directors and residents at the Dental College of Georgia to manage a dental emergency clinic during the COVID-19 pandemic. The methods presented include committee-based prioritization of dental patients, a multilayered screening process, team rotations with social and temporal spacing, and modified treatment room protocols. These efforts aid in the reduction of viral transmission, conservation of personal protective equipment, and expand provider availability. These protocols transcend a university and hospital-based models and are applicable to private and corporate models.


title: Niveles de estrés, ansiedad y depresión en la primera fase del brote del COVID-19 en una muestra recogida en el norte de España./ Niveles de estrés, ansiedad y depresión en la primera fase del brote del COVID-19 en una muestra recogida en el norte de España./ Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain

text: The SARS-CoV-2 virus reached Spain in March 2020, and a nationwide state of alert was declared on March 14th, leading to the confinement of the entire population. The current study was conducted in the Basque Autonomous Community in northern Spain. The authors analyzed stress, anxiety, and depression with the arrival of the virus and the levels of symptoms according to age, comorbidity, and confinement. Levels of anxiety, stress, and depression were measured in a sample of 976 adults, using the DASS scale (Depression Anxiety, and Stress Scale). Although levels of symptoms were generally low at the start of the alert, younger individuals with chronic diseases reported more symptoms than the rest of the population. The study also detected higher levels of symptoms after the stay-at-home order was issued. Such symptoms are predicted to increase as the confinement continues. The authors propose psychological interventions for prevention and treatment in order to mitigate the pandemic's psychological impacts.


title: Uncovering socioeconomic gaps in mobility reduction during the COVID-19 pandemic using location data

text: Using smartphone location data from Colombia, Mexico, and Indonesia, we investigate how non-pharmaceutical policy interventions intended to mitigate the spread of the COVID-19 pandemic impact human mobility. In all three countries, we find that following the implementation of mobility restriction measures, human movement decreased substantially. Importantly, we also uncover large and persistent differences in mobility reduction between wealth groups: on average, users in the top decile of wealth reduced their mobility up to twice as much as users in the bottom decile. For decision-makers seeking to efficiently allocate resources to response efforts, these findings highlight that smartphone location data can be leveraged to tailor policies to the needs of specific socioeconomic groups, especially the most vulnerable.


title: The History of Investigation and Modern Classification of Coronaviruses (nidovirales: Coronaviridae) ;история Изучения И Современная Классификация Коронавирусов (nidovirales: Coronaviridae)

text: An epidemic of COVID-19 (Coronavirus disease 2019) etiologically associated with the SARS-CoV-2 (Severe acute respiratory syndrome-related coronavirus 2) that occurred at the turn of 2019-2020 firstly in Wuhan (Hubei province of China) and then spread to many countries around the world has generated a new wave of interest in coronaviruses The first coronaviruses â€“ representatives of the family Coronaviridae from the order Nidovirales â€“ were discovered in the first half of the last century The first human coronavirus, HCoV-B814, was isolated in 1965 and to date it has not been preserved in virological collections Over the past time, there has been a repeated layering of obsolete names By the beginning of the XXI century coronaviruses were a serious veterinary problem but it was believed that epidemic coronaviruses were not especially dangerous The scientific community had to revise these views for the very first time in 2002, when SARS-CoV (Severe acute respiratory syndrome-related coronavirus) virus entered the human population from the bats in Southeast Asia, and then in 2012 â€“ when natural foci of the MERS-CoV (Middle East respiratory syndrome-related coronavirus) were discovered on the territory of the Arabian Peninsula As a result of increased interest in coronaviruses a large number of new members of the Coronaviridae were discovered in the first two decades of the XXI century, which required several revisions of the taxonomic structure of this family This review is devoted to the history of studying coronaviruses and the system of their modern classification, which has developed at the beginning of 2020 in accordance with the latest recommendations of the International Committee on Taxonomy of Viruses ;Ð’Ð¾Ð·Ð½Ð¸ÐºÑˆÐ°Ñ Ð½Ð° Ñ€ÑƒÐ±ÐµÐ¶Ðµ 2019-2020 Ð³Ð³ ÑÐ½Ð°Ñ‡Ð°Ð»Ð° Ð² Ð³ Ð£Ñ…Ð°Ð½ÑŒ (ÐºÐ¸Ñ‚Ð°Ð¹ÑÐºÐ¾Ð¹ Ð¿Ñ€Ð¾Ð²Ð¸Ð½Ñ†Ð¸Ð¸ Ð¥ÑƒÐ±ÑÐ¹) Ð¸ Ñ€Ð°ÑÐ¿Ñ€Ð¾ÑÑ‚Ñ€Ð°Ð½Ð¸Ð²ÑˆÐ°ÑÑÑ Ð·Ð°Ñ‚ÐµÐ¼ Ð²Ð¾ Ð¼Ð½Ð¾Ð³Ð¸Ðµ ÑÑ‚Ñ€Ð°Ð½Ñ‹ Ð¼Ð¸Ñ€Ð° ÑÐ¿Ð¸Ð´ÐµÐ¼Ð¸Ñ COVID-19 (Coronavirus disease 2019), ÑÑ‚Ð¸Ð¾Ð»Ð¾Ð³Ð¸Ñ‡ÐµÑÐºÐ¸ ÑÐ²ÑÐ·Ð°Ð½Ð½Ð°Ñ Ñ Ð²Ð¸Ñ€ÑƒÑÐ¾Ð¼ Ñ‚ÑÐ¶Ñ‘Ð»Ð¾Ð³Ð¾ Ð¾ÑÑ‚Ñ€Ð¾Ð³Ð¾ Ñ€ÐµÑÐ¿Ð¸Ñ€Ð°Ñ‚Ð¾Ñ€Ð½Ð¾Ð³Ð¾ ÑÐ¸Ð½Ð´Ñ€Ð¾Ð¼Ð° 2â€‘Ð³Ð¾ Ñ‚Ð¸Ð¿Ð° (SARS-CoV-2 â€“ Severe acute respiratory syndrome 2), Ð¿Ð¾Ñ€Ð¾Ð´Ð¸Ð»Ð° Ð½Ð¾Ð²ÑƒÑŽ Ð²Ð¾Ð»Ð½Ñƒ Ð¸Ð½Ñ‚ÐµÑ€ÐµÑÐ° Ðº ÐºÐ¾Ñ€Ð¾Ð½Ð°Ð²Ð¸Ñ€ÑƒÑÐ°Ð¼ ÐŸÐµÑ€Ð²Ñ‹Ðµ ÐºÐ¾Ñ€Ð¾Ð½Ð°Ð²Ð¸Ñ€ÑƒÑÑ‹ â€“ Ð¿Ñ€ÐµÐ´ÑÑ‚Ð°Ð²Ð¸Ñ‚ÐµÐ»Ð¸ ÑÐµÐ¼ÐµÐ¹ÑÑ‚Ð²Ð° Coronaviridae Ð¸Ð· Ð¾Ñ‚Ñ€ÑÐ´Ð° Nidovirales â€“ Ð±Ñ‹Ð»Ð¸ Ð¾Ñ‚ÐºÑ€Ñ‹Ñ‚Ñ‹ ÐµÑ‰Ñ‘ Ð² Ð¿ÐµÑ€Ð²Ð¾Ð¹ Ð¿Ð¾Ð»Ð¾Ð²Ð¸Ð½Ðµ Ð¿Ñ€Ð¾ÑˆÐ»Ð¾Ð³Ð¾ Ð²ÐµÐºÐ° ÐŸÐµÑ€Ð²Ñ‹Ð¹ ÐºÐ¾Ñ€Ð¾Ð½Ð°Ð²Ð¸Ñ€ÑƒÑ Ñ‡ÐµÐ»Ð¾Ð²ÐµÐºÐ°, HCoV-B814, Ð±Ñ‹Ð» Ð¸Ð·Ð¾Ð»Ð¸Ñ€Ð¾Ð²Ð°Ð½ Ð² 1965 Ð³ Ð¸ Ðº Ð½Ð°ÑÑ‚Ð¾ÑÑ‰ÐµÐ¼Ñƒ Ð²Ñ€ÐµÐ¼ÐµÐ½ Ð½Ðµ ÑÐ¾Ñ…Ñ€Ð°Ð½Ð¸Ð»ÑÑ Ð² Ð²Ð¸Ñ€ÑƒÑÐ¾Ð»Ð¾Ð³Ð¸Ñ‡ÐµÑÐºÐ¸Ñ… ÐºÐ¾Ð»Ð»ÐµÐºÑ†Ð¸ÑÑ… Ð—Ð° Ð¿Ñ€Ð¾ÑˆÐµÐ´ÑˆÐµÐµ Ð²Ñ€ÐµÐ¼Ñ Ð¿Ñ€Ð¾Ð¸Ð·Ð¾ÑˆÐ»Ð¾ Ð¼Ð½Ð¾Ð³Ð¾ÐºÑ€Ð°Ñ‚Ð½Ð¾Ðµ Ð½Ð°ÑÐ»Ð¾ÐµÐ½Ð¸Ðµ ÑƒÑÑ‚Ð°Ñ€ÐµÐ²ÑˆÐ¸Ñ… Ð½Ð°Ð·Ð²Ð°Ð½Ð¸Ð¹ Ðš Ð½Ð°Ñ‡Ð°Ð»Ñƒ XXI Ð²ÐµÐºÐ° ÐºÐ¾Ñ€Ð¾Ð½Ð°Ð²Ð¸Ñ€ÑƒÑÑ‹ Ð¿Ñ€ÐµÐ´ÑÑ‚Ð°Ð²Ð»ÑÐ»Ð¸ ÑÐµÑ€ÑŒÑ‘Ð·Ð½ÑƒÑŽ Ð²ÐµÑ‚ÐµÑ€Ð¸Ð½Ð°Ñ€Ð½ÑƒÑŽ Ð¿Ñ€Ð¾Ð±Ð»ÐµÐ¼Ñƒ, Ð¾Ð´Ð½Ð°ÐºÐ¾ ÑÑ‡Ð¸Ñ‚Ð°Ð»Ð¾ÑÑŒ, Ñ‡Ñ‚Ð¾ ÑÐ¿Ð¸Ð´ÐµÐ¼Ð¸Ñ‡ÐµÑÐºÐ¸Ðµ ÐºÐ¾Ñ€Ð¾Ð½Ð°Ð²Ð¸Ñ€ÑƒÑÑ‹ Ð½Ðµ Ð¾Ñ‚Ð½Ð¾ÑÑÑ‚ÑÑ Ðº Ñ‡Ð¸ÑÐ»Ñƒ Ð¾ÑÐ¾Ð±Ð¾ Ð¾Ð¿Ð°ÑÐ½Ñ‹Ñ… ÐÐ°ÑƒÑ‡Ð½Ð¾Ð¼Ñƒ ÑÐ¾Ð¾Ð±Ñ‰ÐµÑÑ‚Ð²Ñƒ Ð¿Ñ€Ð¸ÑˆÐ»Ð¾ÑÑŒ Ð¿ÐµÑ€ÐµÑÐ¼Ð°Ñ‚Ñ€Ð¸Ð²Ð°Ñ‚ÑŒ ÑÑ‚Ð¸ Ð¿Ñ€ÐµÐ´ÑÑ‚Ð°Ð²Ð»ÐµÐ½Ð¸Ñ ÑÐ½Ð°Ñ‡Ð°Ð»Ð° Ð² 2002 Ð³ , ÐºÐ¾Ð³Ð´Ð° Ð²Ð¸Ñ€ÑƒÑ Ñ‚ÑÐ¶Ñ‘Ð»Ð¾Ð³Ð¾ Ð¾ÑÑ‚Ñ€Ð¾Ð³Ð¾ Ñ€ÐµÑÐ¿Ð¸Ñ€Ð°Ñ‚Ð¾Ñ€Ð½Ð¾Ð³Ð¾ ÑÐ¸Ð½Ð´Ñ€Ð¾Ð¼Ð° (SARS-CoV â€“ Severe acute respiratory syndrome-related coronavirus) Ð¿Ñ€Ð¾Ð½Ð¸Ðº Ð² Ð¿Ð¾Ð¿ÑƒÐ»ÑÑ†Ð¸ÑŽ Ð»ÑŽÐ´ÐµÐ¹ Ð¸Ð· Ð¿Ð¾Ð¿ÑƒÐ»ÑÑ†Ð¸Ð¸ Ð»ÐµÑ‚ÑƒÑ‡Ð¸Ñ… Ð¼Ñ‹ÑˆÐµÐ¹ Ð² Ð®Ð³Ð¾-Ð’Ð¾ÑÑ‚Ð¾Ñ‡Ð½Ð¾Ð¹ ÐÐ·Ð¸Ð¸, Ð° Ð¿Ð¾Ñ‚Ð¾Ð¼ Ð² 2012 Ð³ â€“ ÐºÐ¾Ð³Ð´Ð° Ð±Ñ‹Ð»Ð¸ Ð¾Ñ‚ÐºÑ€Ñ‹Ñ‚Ñ‹ Ð¿Ñ€Ð¸Ñ€Ð¾Ð´Ð½Ñ‹Ðµ Ð¾Ñ‡Ð°Ð³Ð¸ Ð²Ð¸Ñ€ÑƒÑÐ° Ð‘Ð»Ð¸Ð¶Ð½ÐµÐ²Ð¾ÑÑ‚Ð¾Ñ‡Ð½Ð¾Ð³Ð¾ Ñ€ÐµÑÐ¿Ð¸Ñ€Ð°Ñ‚Ð¾Ñ€Ð½Ð¾Ð³Ð¾ ÑÐ¸Ð½Ð´Ñ€Ð¾Ð¼Ð° (MERS-CoV â€“ Middle East respiratory syndrome-related coronavirus) Ð½Ð° Ñ‚ÐµÑ€Ñ€Ð¸Ñ‚Ð¾Ñ€Ð¸Ð¸ ÐÑ€Ð°Ð²Ð¸Ð¹ÑÐºÐ¾Ð³Ð¾ Ð¿Ð¾Ð»ÑƒÐ¾ÑÑ‚Ñ€Ð¾Ð²Ð° Ð’ Ñ€ÐµÐ·ÑƒÐ»ÑŒÑ‚Ð°Ñ‚Ðµ Ð°ÐºÑ‚Ð¸Ð²Ð¸Ð·Ð°Ñ†Ð¸Ð¸ Ð¸Ð½Ñ‚ÐµÑ€ÐµÑÐ° Ðº ÐºÐ¾Ñ€Ð¾Ð½Ð°Ð²Ð¸Ñ€ÑƒÑ Ð°Ð¼, Ð² Ð¿ÐµÑ€Ð²Ñ‹Ðµ Ð´Ð²Ð° Ð´ÐµÑÑÑ‚Ð¸Ð»ÐµÑ‚Ð¸Ñ XXI Ð²ÐµÐºÐ° Ð±Ñ‹Ð»Ð¾ Ð¾Ñ‚ÐºÑ€Ñ‹Ñ‚Ð¾ Ð±Ð¾Ð»ÑŒÑˆÐ¾Ðµ ÐºÐ¾Ð»Ð¸Ñ‡ÐµÑÑ‚Ð²Ð¾ Ð½Ð¾Ð²Ñ‹Ñ… Ð¿Ñ€ÐµÐ´ÑÑ‚Ð°Ð²Ð¸Ñ‚ÐµÐ»ÐµÐ¹ Coronaviridae, Ñ‡Ñ‚Ð¾ Ð¿Ð¾Ñ‚Ñ€ÐµÐ±Ð¾Ð²Ð°Ð»Ð¾ Ð½ÐµÑÐºÐ¾Ð»ÑŒÐºÐ¸Ñ… Ñ€ÐµÐ²Ð¸Ð·Ð¸Ð¹ Ñ‚Ð°ÐºÑÐ¾Ð½Ð¾Ð¼Ð¸Ñ‡ÐµÑÐºÐ¾Ð¹ ÑÑ‚Ñ€ÑƒÐºÑ‚ÑƒÑ€Ñ‹ ÑÑ‚Ð¾Ð³Ð¾ ÑÐµÐ¼ÐµÐ¹ÑÑ‚Ð²Ð° ÐÐ°ÑÑ‚Ð¾ÑÑ‰Ð¸Ð¹ Ð¾Ð±Ð·Ð¾Ñ€ Ð¿Ð¾ÑÐ²ÑÑ‰Ñ‘Ð½ Ð¸ÑÑ‚Ð¾Ñ€Ð¸Ð¸ Ð¸Ð·ÑƒÑ‡ÐµÐ½Ð¸Ñ ÐºÐ¾Ñ€Ð¾Ð½Ð°Ð²Ð¸Ñ€ÑƒÑÐ¾Ð² Ð¸ ÑÐ¸ÑÑ‚ÐµÐ¼Ðµ Ð¸Ñ… ÑÐ¾Ð²Ñ€ÐµÐ¼ÐµÐ½Ð½Ð¾Ð¹ ÐºÐ»Ð°ÑÑÐ¸Ñ„Ð¸ÐºÐ°Ñ†Ð¸Ð¸, ÐºÐ¾Ñ‚Ð¾Ñ€Ð°Ñ ÑÐ»Ð¾Ð¶Ð¸Ð»Ð°ÑÑŒ Ð½Ð° Ð½Ð°Ñ‡Ð°Ð»Ð¾ 2020 Ð³ Ð² ÑÐ¾Ð¾Ñ‚Ð²ÐµÑ‚ÑÑ‚Ð²Ð¸Ðµ Ñ Ð¿Ð¾ÑÐ»ÐµÐ´Ð½Ð¸Ð¼Ð¸ Ñ€ÐµÐºÐ¾Ð¼ÐµÐ½Ð´Ð°Ñ†Ð¸ÑÐ¼Ð¸ ÐœÐµÐ¶Ð´ÑƒÐ½Ð°Ñ€Ð¾Ð´Ð½Ð¾Ð³Ð¾ ÐšÐ¾Ð¼Ð¸Ñ‚ÐµÑ‚Ð° Ð¿Ð¾ Ñ‚Ð°ÐºÑÐ¾Ð½Ð¾Ð¼Ð¸Ð¸ Ð²Ð¸Ñ€ÑƒÑÐ¾Ð²


Enhanced Recovery After Cesarean (ERAC) - beyond the pain scores


title: Necessity of ventilation for mitigating virus transmission quantified simply

text: To mitigate the SARS-CoV-2 pandemic, officials have employed social distancing and stay-at-home measures. Less attention has focused on ventilation. Effective distancing practices for open spaces may be ineffective for poorly ventilated spaces, both of which are commonly filled with turbulent air. While turbulence initially reduces the risk of infection near a virion-source, it eventually increases the exposure risk for all occupants in a space without ventilation. Here we estimate the time-scale for virions injected into a room of turbulent air to infect an occupant, distinguishing cases of low vs. high initial virion mass loads and virion-destroying vs. virion-reflecting walls. An open window typifies ventilation and we show that its minimum area needed to ensure safety depends only on the ratio of total viral load to threshold load for infection. Our minimalist estimates complement more detailed approaches and present opportunities for generalization.


title: SARS-CoV-2-related paediatric inflammatory multisystem syndrome, an epidemiological study, France, 1 March to 17 May 2020

text: End of April 2020, French clinicians observed an increase in cases presenting with paediatric inflammatory multisystem syndrome (PIMS). Nationwide surveillance was set up and demonstrated temporospatial association with the coronavirus disease (COVID-19) epidemic for 156 reported cases as at 17 May: 108 were classified as confirmed (nâ¯=â¯79), probable (nâ¯=â¯16) or possible (nâ¯=â¯13) post-COVID-19 PIMS cases. A continuum of clinical features from Kawasaki-like disease to myocarditis was observed, requiring intensive care in 67% of cases.


The liaison between respiratory failure and high blood pressure: evidence from COVID-19 patients


Society for Vascular Medicine (SVM) Leaders Respond to the COVID-19 Crisis


title: Elevated interleukin-6 is associated with severity of COVID-19: a meta-analysis

text: Coronavirus disease 2019 (COVID-19) has spread rapidly around the world since its emergence in humans last December. Previous studies suggested that numerous markers of inflammation were elevated in patients in with severe disease relative to patients with milder conditions, and an elevated level of interleukin-6 (IL-6) was associated with a high case fatality of COVID-19 infection. This article is protected by copyright. All rights reserved.


Familial cluster of SARS-CoV-2 infection associated with a railway journey


Molecular mimicry between SARS-CoV-2 and respiratory pacemaker neurons


title: Évolution de l'activité d'électro-convulsivo-thérapie en France depuis le début de la pandémie COVID-19./ [Evolution of electro-convulsive therapy activity in France since the beginning of the COVID-19 pandemic]

text: The recent COVID-19 pandemic has led to major organisational changes in health care settings, especially in psychiatric hospitals. We conducted a national online survey to assess the evolution of electroconvulsive therapy (ECT) in the different centres practicing this treatment. 65 responses from all over France were analysed. More than 90 % of the centres practising ECT experienced a decrease in their activity. Half of the centres experienced a total cessation of activity and 25 % of the centres experienced a decrease of more than half of their usual activity. Post-pandemic COVID-19 psychiatric care is expected to be difficult. It is essential not to add to this difficulty the complications, often serious, that will be associated with delaying or stopping the practice of ECT. It will also be necessary to remain vigilant with regard to the specific neuropsychiatric consequences that will follow the pandemic.


Medical education during pandemics: a UK perspective


Letter to the Editor: Case of the Index Patient Who Caused Tertiary Transmission of Coronavirus Disease 2019 in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Pneumonia Monitored by Quantitative RT-PCR


Symptomatic Infants have Higher Nasopharyngeal SARS-CoV-2 Viral Loads but Less Severe Disease than Older Children


title: Neutrophil extracellular traps in COVID-19

text: In severe cases of coronavirus disease 2019 (COVID-19), viral pneumonia progresses to respiratory failure. Neutrophil extracellular traps (NETs) are extracellular webs of chromatin, microbicidal proteins, and oxidant enzymes that are released by neutrophils to contain infections. However, when not properly regulated, NETs have the potential to propagate inflammation and microvascular thrombosis - including in the lungs of patients with acute respiratory distress syndrome. We now report that sera from patients with COVID-19 have elevated levels of cell-free DNA, myeloperoxidase-DNA (MPO-DNA), and citrullinated histone H3 (Cit-H3); the latter 2 are specific markers of NETs. Highlighting the potential clinical relevance of these findings, cell-free DNA strongly correlated with acute-phase reactants, including C-reactive protein, D-dimer, and lactate dehydrogenase, as well as absolute neutrophil count. MPO-DNA associated with both cell-free DNA and absolute neutrophil count, while Cit-H3 correlated with platelet levels. Importantly, both cell-free DNA and MPO-DNA were higher in hospitalized patients receiving mechanical ventilation as compared with hospitalized patients breathing room air. Finally, sera from individuals with COVID-19 triggered NET release from control neutrophils in vitro. Future studies should investigate the predictive power of circulating NETs in longitudinal cohorts and determine the extent to which NETs may be novel therapeutic targets in severe COVID-19.


ACMQ Student, Resident, and Fellow Section (SRF) COVID-19 Resident and Fellow Survey


title: Corona Virus International Public Health Emergencies: Implications for Radiology Management

text: The outbreak of 2019 novel coronavirus (2019-nCoV) pneumonia was reported in Wuhan, Hubei Province, China in December 2019 and has spread internationally. This article discusses how radiology departments can most effectively respond to this public health emergency.


title: COVID-19 Pandemic Spurs Policy Changes Benefiting Older Adults

text: This article reviews recent federal and state policy changes in response to the COVID-19 pandemic that affect health care and quality of life for older adults. Specific regulations and guidelines issued at the state and federal level have increased access and provided additional funding for essential services and supports. Many of these changes are temporary and have the potential to improve care beyond the immediate crisis. This period of greater flexibility offers the opportunity to accrue evidence on quality and access to influence sustained change. [Journal of Gerontological Nursing, 46(6), 19-23.].


ASPHER statement on the novel coronavirus disease (COVID-19) outbreak emergency


Annals On Call - Clinical Reasoning and COVID-19 Part 2


COVID-19 online surveys need to follow standards and guidelines: Comment on "Does COVID-19 pandemic affect sexual behaviour? A cross-sectional, cross-national online survey" and "Binge watching behavior during COVID 19 pandemic: A cross-sectional, cross-national online survey"


Covid-19: Doctors feel shut out of plans for dealing with backlog of missed care


Covid-19: healthcare and politics are inexorably intertwined


Reply: Triage Considerations for Patients Referred for Structural Heart Disease Intervention During the Coronavirus Disease 2019 (COVID-19) Pandemic: An ACC/SCAI Consensus Statement


title: Digitalization of COVID-19 pandemic management and cyber risk from connected systems

text: What makes cyber risks arising from connected systems challenging during the management of a pandemic? Assuming that a variety of cyber-physical systems are already operational-collecting, analyzing, and acting on data autonomously-what risks might arise in their application to pandemic management? We already have these systems operational, collecting, and analyzing data autonomously, so how would a pandemic monitoring app be different or riskier? In this review article, we discuss the digitalization of COVID-19 pandemic management and cyber risk from connected systems.


title: Mathematical model of infection kinetics and its analysis for COVID-19, SARS and MERS

text: The purpose of this paper is to reveal the spread rules of the three pneumonia: COVID-19, SARS and MERS. We compare the new spread characteristics of COVID-19 with those of SARS and MERS. By considering the growth rate and inhibition constant of infectious diseases, their propagation growth model is established. The parameters of the three coronavirus transmission growth models are obtained by nonlinear fitting. Parametric analysis shows that the growth rate of COVID-19 is about twice that of the SARS and MERS, and the COVID-19 doubling cycle is two to three days, suggesting that the number of COVID-19 patients would double in two to three days without human intervention. The infection inhibition constant in Hubei is two orders of magnitude lower than in other regions, which reasonably explains the situation of the COVID-19 outbreak in Hubei.


title: Assessing the Burden of Nondeferrable Major Uro-oncologic Surgery to Guide Prioritisation Strategies During the COVID-19 Pandemic: Insights from Three Italian High-volume Referral Centres

text: The coronavirus 2019 (COVID-19) pandemic has led to an unprecedented emergency scenario for all aspects of health care, including urology. At the time of writing, Italy was the country with the highest rates of both infection and mortality. A panel of experts recently released recommendations for prioritising urologic surgeries in a low-resource setting. Of note, major cancer surgery represents a compelling challenge. However, the burden of these procedures and the impact of such recommendations on urologic practice are currently unknown. To fill this gap, we assessed the yearly proportion of high-priority major uro-oncologic surgeries at three Italian high-volume academic centres. Of 2387 major cancer surgeries, 32.3% were classified as high priority (12.6% of radical nephroureterectomy, 17.3% of nephrectomy, 33.9% of radical prostatectomy, and 36.2% of radical cystectomy cases). Moreover, 26.4% of high-priority major cancer surgeries were performed in patients at higher perioperative risk (American Society of Anesthesiologists score ≥3), with radical cystectomy contributing the most to this cohort (50%). Our real-life data contextualise ongoing recommendations on prioritisation strategies during the current COVID-19 pandemic, highlighting the need for better patient selection for surgery. We found that approximately two-thirds of elective major uro-oncologic surgeries can be safely postponed or changed to another treatment modality when the availability of health care resources is reduced. PATIENT SUMMARY: We used data from three high-volume Italian academic urology centres to evaluate how many surgeries performed for prostate, bladder, kidney, and upper tract urothelial cancer can be postponed in times of emergency. We found that approximately two-thirds of patients with these cancers do not require high-priority surgery. Conversely, of patients requiring high-priority surgery, approximately one in four is considered at high perioperative risk. These patients may pose challenges in allocation of resources in critical scenarios such as the current COVID-19 pandemic.


Coronavirus disease-2019: An update on third coronavirus outbreak of 21st century


title: Severe refractory thrombocytopenia in a woman positive for coronavirus disease 2019 with lupus and antiphospholipid syndrome

text: The coronavirus disease 2019 (COVID-19) pandemic has created new challenges that necessitate prompt responses in unexpected clinical situations. Multiple extrapulmonary manifestations and complications of COVID-19 have already been described, but only scattered data are present on immunologic manifestations. We present a case of severe refractory thrombocytopenia in a 51-year-old woman with a history of long-standing systemic lupus erythematosus and antiphospholipid syndrome who presented with hemoptysis in the setting of COVID-19 infection. The patient failed to respond to initial treatment with intravenous immunoglobulin, high-dose steroids, and platelet transfusion, but responded to eltrombopag, with prompt improvement of a platelet count. The current case report provides clinical data of relevance to the largely unexplored question of the immunologic complications of COVID-19 in patients with a pre-existing inflammatory state.


title: T-Cell Subset Counts in Peripheral Blood Can Be Used as Discriminatory Biomarkers for Diagnosis and Severity Prediction of Coronavirus Disease 2019

text: This study evaluated the significance of lymphocyte subset detection in peripheral blood in the diagnosis and prognosis of coronavirus disease 2019 (COVID-19). Our results revealed that CD3+ T cells, CD4+ T cells, CD8+ T cells, and natural killer cells were significantly decreased in patients with COVID-19. These patients had a relatively slight decrease in CD4+ T cells but a severe decrease in CD8+ T cells. The significantly elevated CD4/CD8 ratio was observed in COVID-19 patients. T-cell subset counts were related to the severity and prognosis of COVID-19, suggesting that the counts of CD8+ T and CD4+ T cells can be used as diagnostic markers of COVID-19 and predictors of disease severity.


Cardiopulmonary Resuscitation in the prone position: a good option for patients with COVID-19


How the coronavirus pandemic slashed carbon emissions - in five graphs


Possible method for the production of a Covid-19 vaccine


Outbreak of chilblain-like acral lesions in children in the metropolitan area of Milan, Italy, during the COVID-19 pandemic


title: Colon capsule endoscopy: an innovative method for detecting colorectal pathology during the COVID-19 pandemic?

text: AIM: The coronavirus pandemic has led to significant challenges for healthcare delivery across the globe. Non-emergency endoscopic activity in the UK has been postponed, raising concerns of increased delays in the diagnosis of colorectal cancer and a surge in demand once services resume. Measures to mitigate this risk must be considered. METHOD: This paper reviews various investigative modalities for colorectal disease which could be deployed during cessation of colonoscopy services. We focus on colon capsule endoscopy (CCE) due to its relevance during the COVID-19 pandemic and its ability to triage patients effectively to further endoscopic investigations. RESULTS: CT of the abdomen and pelvis has been suggested as a triage tool while access to colonoscopy is limited. However, CT may lead to the spread of COVID-19 as patients attend the hospital, and it exposes them to the risks of radiation. Faecal immunochemistry tests have been demonstrated as a good predictor of colonic pathology and could be safely used to risk stratify patients when prioritizing colonoscopy. CCE is a safe and innovative technology for investigating the colon. Procedures can be carried out in the community and can be conducted safely during the coronavirus pandemic. It has been shown to be an accurate detector of colonic neoplasia and can reduce demand for colonoscopy. CONCLUSION: As colonoscopy services resume, they will probably experience high demand leading to further delays for patients. CCE could be used to reduce the number of patients requiring colonoscopy and triage those requiring further endoscopic investigations appropriately.


Funders Support Mental Health Care: COVID-19 And Before


Adaptation to the Plastic Barrier Sheet to Facilitate Intubation during the COVID-19 Pandemic


title: Characteristics and Outcomes of Recipients of Heart Transplant With Coronavirus Disease 2019

text: Importance: Recipients of heart transplant (HT) may be at increased risk of adverse outcomes attributable to infection with coronavirus disease 2019 (COVID-19) because of multiple comorbidities and clinically significant immunosuppression. Objective: To describe the characteristics, treatment, and outcomes of recipients of HT with COVID-19. Design, Setting, and Participants: This case series from a single large academic heart transplant program in New York, New York, incorporates data from between March 1, 2020, and April 24, 2020. All recipients of HT followed up by this center who were infected with COVID-19 were included. Interventions: Heart transplant and a confirmed diagnosis of COVID-19. Main Outcomes and Measures: The primary measure was vital status at end of study follow-up. Secondary measures included patient characteristics, laboratory analyses, changes to immunosuppression, and treatment administered for COVID-19. Results: Twenty-eight patients with HT received a confirmed diagnosis of COVID-19. The median age was 64.0 (interquartile range [IQR], 53.5-70.5) years, 22 (79%) were men, and the median time from HT was 8.6 (IQR, 4.2-14.5) years. Comorbid conditions included hypertension in 20 patients (71%), diabetes in 17 patients (61%), and cardiac allograft vasculopathy in 16 patients (57%). Twenty-two participants (79%) were admitted for treatment, and 7 (25%) required mechanical ventilation. Most (13 of 17 [76%]) had evidence of myocardial injury (median high-sensitivity troponin T, 0.055 [IQR, 0.0205-0.1345] ng/mL) and elevated inflammatory biomarkers (median peak high-sensitivity C-reactive protein, 11.83 [IQR, 7.44-19.26] mg/dL; median peak interleukin 6, 105 [IQR, 38-296] pg/mL). Among patients managed at the study institution, mycophenolate mofetil was discontinued in 16 patients (70%), and 6 (26%) had a reduction in the dose of their calcineurin inhibitor. Treatment of COVID-19 included hydroxychloroquine (18 patients [78%]), high-dose corticosteroids (8 patients [47%]), and interleukin 6 receptor antagonists (6 patients [26%]). Overall, 7 patients (25%) died. Among 22 patients (79%) who were admitted, 11 (50%) were discharged home, 4 (18%) remain hospitalized at the end of the study, and 7 (32%) died during hospitalization. Conclusions and Relevance: In this single-center case series, COVID-19 infection was associated with a case fatality rate of 25% in recipients of HT. Immunosuppression was reduced in most of this group of patients. Further study is required to evaluate the optimal approach to management of COVID-19 infection in the HT population.


Mental wellness system for COVID-19


title: Coronavirus disease-2019 epidemic response in Uganda: The need to strengthen and engage primary healthcare

text: In Uganda, the numbers of new coronavirus disease cases have continued to increase slowly since the first case was confirmed. Given that the disease is likely to be holoendemic, the role of primary care (PC) with its features of comprehensiveness, accessibility, coordination and continuity, functioning at the heart of a primary healthcare (PHC) approach, will be important. The elements of PC are applicable in the epidemic preparation, case finding and management, follow-up and post-epidemic phases of responding to this pandemic. This also presents opportunities and lessons for strengthening PHC as well as for reflections on missed opportunities. The effective use of available resources in response to the epidemic should mainly focus on community mobilisation and PHC teams for the prevention, screening, testing and treatment of mild and moderate cases.


title: COVID-19 and maternal and child food and nutrition insecurity: a complex syndemic

text: Globally, the COVID-19 pandemic has already led to major increases in unemployment and is expected to lead to unprecedented increases in poverty and food and nutrition insecurity, as well as poor health outcomes. Families where young children, youth, pregnant and lactating women live need to be protected against the ongoing protracted pandemic and the aftershocks that are very likely to follow for years to come. The future wellbeing of the vast majority of the world now depends on reconfiguring the current ineffective food, nutrition, health, and social protection systems to ensure food and nutrition security for all. Because food, nutrition, health, and socio-economic outcomes are intimately inter-linked, it is essential that we find out how to effectively address the need to reconfigure and to provide better intersecoral coordination among global and local food, health care, and social protection systems taking equity and sutainability principles into account. Implementation science research informed by complex adaptive sytems frameworks will be needed to fill in the major knowledge gaps. Not doing so will not only put the development of individuals at further risk, but also negatively impact on the development potential of entire nations and ultimately our planet.


title: A mathematical model for the coronavirus COVID-19 outbreak

text: A mathematical model is proposed for quantitative description of the outbreak of novel coronavirus COVID-19 in China. Although the model is relatively simple, the comparison with the public data shows that an exact solution solution of the model (with the correctly-specified parameters) leads to the results, which are in good agreement with the measured data. Prediction of the total number of the COVID-19 cases is discussed and an example is presented using the measured data in Austria.


title: How to Build the Plane While Flying: VTE/PE Thromboprophylaxis Clinical Guidelines for COVID-19 Patients

text: Over the years, the practice of medicine has evolved from authority-based to experience-based to evidence-based with the introduction of the scientific process, clinical trials, and outcomes-based data analysis (Tebala GD. Int J Med Sci. 2018;15(12):1397-1405). The time required to perform the necessary randomized controlled trials, a systematic literature review, and meta-analysis of these trials to then create, accept, promulgate, and educate the practicing clinicians to use the evidence-based clinical guidelines is typically measured in years. When the severe acute respiratory syndrome novel coronavirus-2 (SARS-nCoV-2) pandemic commenced in Wuhan, China at the end of 2019, there were few available clinical guidelines to deploy, let alone adapt and adopt to treat the surge of coronavirus disease 2019 (COVID-19) patients. The aim of this study is to first explain how clinical guidelines, on which bedside clinicians have grown accustomed, can be created in the midst of a pandemic, with an evolving scientific understanding of the pathophysiology of the hypercoagulable state. The second is to adapt and adopt current venous thromboembolism diagnostic and treatment guidelines, while relying on the limited available observational reporting of COVID-19 patients to create a comprehensive clinical guideline to treat COVID-19 patients.


title: Conservative two-stage group testing

text: Inspired by applications in testing for COVID-19, we consider a variant of two-stage group testing we call"conservative"two-stage testing, where every item declared to be defective must be definitively confirmed by being tested by itself in the second stage. We study this in the linear regime where the prevalence is fixed while the number of items is large. We study various nonadaptive test designs for the first stage, and derive a new lower bound for the total number of tests required. We find that a first-stage design with constant tests per item and constant items per test due to Broder and Kumar (arXiv:2004.01684) is extremely close to optimal. Simulations back up the theoretical results.


title: Laboratory diagnostics within a modular hospital at the time of Coronavirus disease 2019 (COVID-19) in Wuhan

text: An outbreak of the so-called Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), has been spreading rapidly nationwide in China since December 2019. Wuhan, Hubei Province, is the hardest-hit region, with a rise in confirmed cases and its hospitals overwhelmed. On 2nd February, 2020, Wuhan began to build a modular hospital to treat patients caught with mild illness. The mobile modular hospital is mainly composed of medical modules, technical support modules, ward units, living support units and transportation capacity under field conditions, and there are complete equipment and specialized personnel to treat patients. Due to the severity and particularity of SARS-CoV-2, taking granted from lessons learnt from mobile modular hospitals, we use the existing large venues to construct a new fixed modular hospital. As patients need to be treated and tested, it is important to develop a clinical laboratory in the modular hospital and ensure biosafety. The construction of a clinical laboratory in the modular hospital is faced with problems such as time pressure, limited site selection, high level of biosafety, lack of experience and so forth. This paper mainly discusses how to construct the clinical laboratory in the modular hospital quickly and safely and put it into use to provide testing service for patients under various limited conditions.