title: Personal protective equipment during the coronavirus disease (COVID) 2019 pandemic - a narrative review

text: Personal protective equipment has become an important and emotive subject during the current coronavirus disease 2019 epidemic. Coronavirus disease 2019 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately 1 metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from coronavirus disease 2019 cross-infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care - contact, droplet or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment.


title: 2019 Novel Coronavirus Outbreak: a Quiz or Final Exam?

text: The 2019 novel coronavirus (2019-nCoV) is an emerging pathogen and is threatening the global health. Strikingly, more than 28 000 cases and 550 deaths have been reported within two months from disease emergence. Armed with experience from previous epidemics in the last two decades, clinicians, scientists, officials, and citizens in China are all contributing to the prevention of further 2019-nCoV transmission. Efficient preliminary work has enabled us to understand the basic characteristics of 2019-nCoV, but there are still many unanswered questions. It is too early now to judge our performance in this outbreak. Continuous and strengthened efforts should be made not only during the epidemic, but also afterwards in order to prepare for any incoming challenges.


title: Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization

text: OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has created a need for data regarding the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women. After implementing universal screening for COVID-19 in women admitted for delivery, we sought to describe the characteristics of COVID-19 in this large cohort of women. STUDY DESIGN: An observational study of women admitted to labor and delivery units in Kaiser Permanente Southern California (KPSC) hospitals between April 6 and May 11, 2020 who were universally offered testing for SARS-CoV-2 infection (n = 3,963). Hospital inpatient and outpatient physician encounter, and laboratory records were used to ascertain universal testing levels, test results, and medical and obstetrical histories. The prevalence of SARS-CoV-2 infection was estimated from the number of women who tested positive during labor per 100 women delivered. RESULTS: Of women delivered during the study period, 3,923 (99.0%) underwent SARS-CoV-2 testing. A total of 17 (0.43%; 95% confidence interval: 0.23-0.63%) women tested positive, and none of them were symptomatic on admission. There was no difference in terms of characteristics between SARS-CoV-2 positive and negative tested women. One woman developed a headache attributed to COVID-19 3 days postpartum. No neonates had a positive test at 24 hours of life. CONCLUSION: The findings suggest that in pregnant women admitted for delivery between April 6 and May 11, 2020 in this large integrated health care system in Southern California, prevalence of SARS-CoV-2 test positive was very low and all patients were asymptomatic on admission. KEY POINTS: · The prevalence of SARS-CoV-2 infection in a large diverse cohort of term pregnant women was 0.43%.. · 99% of women accepted SARS-CoV-2 screening on admission to labor and delivery.. · All women with positive test results were asymptomatic at the time of testing..


Management of Patients With Crohn's Disease and Ulcerative Colitis During the Coronavirus Disease-2019 Pandemic: Results of an International Meeting


Early percutaneous tracheostomy for patients with COVID-19


Spotlight: COVID-19 PPE and Endoscopy


Universal Masking is an Effective Strategy to Flatten the SARS-2-CoV Healthcare Worker Epidemiologic Curve


title: Variable pool testing for infection spread estimation

text: We present a method for efficient estimation of the prevalence of infection in a population with high accuracy using only a small number of tests. The presented approach uses pool testing with a mix of pool sizes of various sizes. The test results are then combined to generate an accurate estimation over a wide range of infection probabilities. This method does not require an initial guess on the infection probability. We show that, using the suggested method, even a set of only $50$ tests with a total of only $1000$ samples can produce reasonable estimation over a wide range of probabilities. A measurement set with only $100$ tests is shown to achieve $25\%$ accuracy over infection probabilities from $0.001$ to $0.5$. The presented method is applicable to COVID-19 testing.


title: Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion

text: PURPOSE: Invasive pulmonary aspergillosis is increasingly reported in patients with influenza admitted to the intensive care unit (ICU). Classification of patients with influenza-associated pulmonary aspergillosis (IAPA) using the current definitions for invasive fungal diseases has proven difficult, and our aim was to develop case definitions for IAPA that can facilitate clinical studies. METHODS: A group of 29 international experts reviewed current insights into the epidemiology, diagnosis and management of IAPA and proposed a case definition of IAPA through a process of informal consensus. RESULTS: Since IAPA may develop in a wide range of hosts, an entry criterion was proposed and not host factors. The entry criterion was defined as a patient requiring ICU admission for respiratory distress with a positive influenza test temporally related to ICU admission. In addition, proven IAPA required histological evidence of invasive septate hyphae and mycological evidence for Aspergillus. Probable IAPA required the detection of galactomannan or positive Aspergillus culture in bronchoalveolar lavage (BAL) or serum with pulmonary infiltrates or a positive culture in upper respiratory samples with bronchoscopic evidence for tracheobronchitis or cavitating pulmonary infiltrates of recent onset. The IAPA case definitions may be useful to classify patients with COVID-19-associated pulmonary aspergillosis (CAPA), while awaiting further studies that provide more insight into the interaction between Aspergillus and the SARS-CoV-2-infected lung. CONCLUSION: A consensus case definition of IAPA is proposed, which will facilitate research into the epidemiology, diagnosis and management of this emerging acute and severe Aspergillus disease, and may be of use to study CAPA.


title: Non-Central Limit Theorem Statistical Analysis for the"Long-tailed"Internet Society

text: This article presents a statistical analysis method and introduces the corresponding software package"tailstat,"which is believed to be widely applicable to today's internet society. The proposed method facilitates statistical analyses with small sample sets from given populations, which render the central limit theorem inapplicable. A large-scale case study demonstrates the effectiveness of the method and provides implications for applying similar analyses to other cases.


title: Endourology (Lithiasis). Management, surgical considerations and follow-up of patients in the COVID-19 era

text: PURPOSE: To provide recommendations on the endourological management of lithiasis in the scenario of the COVID-19 pandemic. MATERIALS AND METHODS: A non-systematic review in PubMed and the grey literature, as well as recommendations by a panel of stakeholders was made, regarding management, surgical considerations and follow-up of patients affected by lithiasis in the COVID-19 era. RESULTS: Under the current outbreak and COVID-19 pandemic scenario, patients affected by lithiasis should be prioritized into low, intermediate and high risk categories, to decide their delay and save resources, healthcare personnel, beds and ventilators. However, patients with potentially serious septic complications need emergency interventions. The possibility of performing or restarting elective activity depends on local conditions, the availability of beds and ventilators, and the implementation of screening protocols in the context of the COVID-19 pandemic. Delaying lithiasis surgery and increasing waiting lists will have consequences and will require considerable additional effort. Teleconsultation may be useful in guiding these patients, reducing visits and unnecessary exposure. CONCLUSIONS: categorization and prioritization of patients affected by lithiasis is crucial for management, surgical selection and follow-up. Protocols, measures and additional efforts should be carried out in the current situation of the COVID-19 pandemic.


title: Using a diagnostic model based on routine laboratory tests to distinguish patients infected with SARS-CoV-2 from those infected with influenza virus

text: BACKGROUND: The differential diagnosis between novel coronavirus pneumonia patients (NCPP) and influenza patients (IP) remains a challenge in clinical practice. METHODS: Between January 2018 and March 2020, 1,027 NCPP and 1,140 IP were recruited from Tongji hospital. Routine blood examination, biochemical indicators and coagulation function analysis were simultaneously performed in all participants. RESULTS: There was no sex predominance in NCPP. The NCPP were frequently encountered in the sixth and seventh decades of life. The mean age of NCPP (56±16 years) was higher than IP (47±17 years), but without statistical difference. Although most results of routine laboratory tests between NCPP and IP had no significant differences, some laboratory tests showed an obvious change in NCPP. It was observed that NCPP had significantly decreased white blood cells, alkaline phosphatase and d-dimer compared with IP. However, the results of lactate dehydrogenase, erythrocyte sedimentation rate and fibrinogen were significantly increased in NCPP compared with IP. The diagnostic model based on a combination of 18 routine laboratory indicators showed an area under the curve of 0.796 (95% CI, 0.777-0.814), with a sensitivity of 46.93% and specificity of 90.09% when using a cut-off value of 0.598. CONCLUSIONS: Some routine laboratory results had statistical difference between NCPP and IP. A diagnostic model based on a combination of routine laboratory results provided an adjunct approach in the differential diagnosis between NCPP and IP.


title: Coronavirus Disease Health Care Delivery Impact on African Americans

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 1.5 million individuals and led to over 91, 000 deaths in the United States (US) alone as of May 20th, 2020. Minority populations, however, continue to be a high-risk population to contract the SARS-CoV-2 infection. While socioeconomic inequality may help to explain why minority ethnic populations are contracting the SARS-CoV-2 in larger proportions, the reason for elevated mortality rates in African Americans is still unknown. African Americans are less likely than whites to utilize high-quality hospitals, ambulatory care services, and regular primary care providers; this is most likely a result of barriers to accessing high quality treatment, as African Americans have substantially higher uninsured rates. However, previous reports have shown that regardless of insurance status, African Americans are more likely to be directed toward lower quality treatment plans compared to their white counterparts, and that physicians carry implicit biases that negatively impact treatment regimens for these minority populations. While income, education, and access to healthcare should be revised in due time, in the short term physicians should do everything possible to learn about implicit biases that may exist in healthcare, as the first step to minimize implicit biases is to recognize that they exist.


La crisis del coronavirus y su impacto en las residencias de personas mayores en España./ La crisis del coronavirus y su impacto en las residencias de personas mayores en España./ The coronavirus crisis and its impact on residential care homes for the elderly in Spain


COVID-19 and Immigrants' Access to Sexual and Reproductive Health Services in the United States


Antiphospholipid antibodies in patient with acute lower member ischemia and pulmonary thromboembolism as a result of infection by SARS-CoV2


Concomitant brain arterial and venous thrombosis in a COVID-19 patient


text: COVID-19 infection can cause a severe pneumonia which, in some cases, can lead to admission in intensive care unit for respiratory support.1 In severe cases, systemic thrombotic complication has been described, including cerebrovascular disease (5.7-23% of cases).2,3.


Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people


title: Knowledge and Behaviors Toward COVID-19 Among US Residents During the Early Days of the Pandemic: Cross-Sectional Online Questionnaire

text: BACKGROUND: The early days of the coronavirus disease (COVID-19) pandemic in the United States brought uncertainty in the knowledge about COVID-19 and what to do about it. It is necessary to understand public knowledge and behaviors if we are to effectively address the pandemic. OBJECTIVE: The aim of this study is to test the hypothesis that knowledge about COVID-19 influences participation in different behaviors including self-reports of purchasing more goods than usual, attending large gatherings, and using medical masks. METHODS: This study was funded and approved by the Institutional Review Board on March 17, 2020. The cross-sectional online survey of 1034 US residents aged 18 years or older was conducted on March 17, 2020. RESULTS: For every point increase in knowledge, the odds of participation in purchasing more goods (odds ratio [OR] 0.88, 95% CI 0.81-0.95), attending large gatherings (OR 0.87, 95% CI 0.81-0.93), and using medical masks (OR 0.56, 95% CI 0.50-0.62) decreased by 12%, 13%, and 44%, respectively. Gen X and millennial participants had 56% and 76% higher odds, respectively, of increased purchasing behavior compared to baby boomers. The results suggest that there is a politicization of response recommendations. Democrats had 30% lower odds of attending large gatherings (OR 0.70, 95% CI 0.50-0.97) and 48% lower odds of using medical masks (OR 0.52, 95% CI 0.34-0.78) compared to Republicans. CONCLUSIONS: This survey is one of the first attempts to study determinants of knowledge and behaviors in response to the COVID-19 pandemic in the United States. A national, coordinated effort toward a pandemic response may ensure better compliance with behavioral recommendations to address this public health emergency.


Pseudoscience and COVID-19 - we've had enough already


title: Care Robots with Sexual Assistance Functions

text: Residents in retirement and nursing homes have sexual needs just like other people. However, the semi-public situation makes it difficult for them to satisfy these existential concerns. In addition, they may not be able to meet a suitable partner or find it difficult to have a relationship for mental or physical reasons. People who live or are cared for at home can also be affected by this problem. Perhaps they can host someone more easily and discreetly than the residents of a health facility, but some elderly and disabled people may be restricted in some ways. This article examines the opportunities and risks that arise with regard to care robots with sexual assistance functions. First of all, it deals with sexual well-being. Then it presents robotic systems ranging from sex robots to care robots. Finally, the focus is on care robots, with the author exploring technical and design issues. A brief ethical discussion completes the article. The result is that care robots with sexual assistance functions could be an enrichment of the everyday life of people in need of care, but that we also have to consider some technical, design and moral aspects.


Management of COVID-19 in hemodialysis patients: The Genoa experience


Emergency Radiology in 2020: Moving Forward Together


title: Proactive Identification of Palliative Care Needs Among Patients With COVID-19 in the ICU

text: In the setting of the coronavirus disease 2019 (COVID-19) pandemic, new strategies are needed to address the unique and significant palliative care (PC) needs of patients with COVID-19 and their families, particularly when health systems are stressed by patient surges. Many PC teams rely on referral-based consultation methods that can result in needs going unidentified and/or unmet. Here, we describe a novel system to proactively identify and meet the PC needs of all patients with COVID-19 being cared for in our hospital's intensive care units. Patients were screened through a combination of chart review and brief provider interview, and PC consultations were provided via telemedicine for those with unmet needs identified. In the first six weeks of operation, our pilot program of proactive screening and outreach resulted in PC consultation for 12 of the 29 (41%) adult patients admitted to the intensive care unit with COVID-19 at our institution. Consultations were most commonly for patient and family support as well as for goals of care and advance care planning, consistent with identified PC needs within this unique patient population.


Letter to the Editor: Awake Craniotomy for Intracranial Gliomas During Coronavirus Disease 2019 Pandemic


The pandemic's first major research scandal erupts


Potential inhibition of COVID-19-driven pneumonia by immunosuppressive therapy and anti-TNFα antibodies: a case report


Sex and Gender Differences in Health: What the COVID-19 Pandemic Can Teach Us


title: Clinician Wellness During the COVID-19 Pandemic: Extraordinary Times and Unusual Challenges for the Allergist/Immunologist

text: The global spread of coronavirus disease 2019 (COVID-19) has caused sudden and dramatic societal changes. The allergy/immunology community has quickly responded by mobilizing practice adjustments and embracing new paradigms of care to protect patients and staff from severe acute respiratory syndrome coronavirus 2 exposure. Social distancing is key to slowing contagion but adds to complexity of care and increases isolation and anxiety. Uncertainty exists across a new COVID-19 reality, and clinician well-being may be an underappreciated priority. Wellness incorporates mental, physical, and spiritual health to protect against burnout, which impairs both coping and caregiving abilities. Understanding the stressors that COVID-19 is placing on clinicians can assist in recognizing what is needed to return to a point of wellness. Clinicians can leverage easily accessible tools, including the Strength-Focused and Meaning-Oriented Approach to Resilience and Transformation approach, wellness apps, mindfulness, and gratitude. Realizing early warning signs of anxiety, depression, substance abuse, and posttraumatic stress disorder is important to access safe and confidential resources. Implementing wellness strategies can improve flexibility, resilience, and outlook. Historical parallels demonstrate that perseverance is as inevitable as pandemics and that we need not navigate this unprecedented time alone.


title: The Unexpected Risks of COVID-19 on Asthma Control in Children

text: Much is being learned about clinical outcomes for adult COVID-19 patients with underlying chronic conditions; however, there is less coverage on how the COVID-19 pandemic impacts the management of chronic medical conditions, such as asthma, in children and youth. Asthma is a common chronic medical condition in children that is uniquely susceptible to changes brought on by COVID-19. Sudden dramatic changes in the environment, medical practice, and medication use have altered the asthma management landscape with potential impacts on asthma outcomes. In this paper, we review how changes in transportation and travel patterns, school attendance, physical activity, and time spent indoors, along with changes in health care delivery since the start of the pandemic, all play a contributing role in asthma control in children. We review potentially important influences of asthma control in children during the COVID-19 pandemic worthy of further study.


Intensivist-led care in the COVID-19 pandemic


SARS-CoV-2 containment in complex surgical units during the COVID-19 pandemic


title: [Dynamic changes of chest CT imaging in patients with corona virus disease-19 (COVID-19)]

text: OBJECTIVE: To analyze the dynamic changes of chest CT images of patients with corona virus disease-19 (COVID-19). METHODS: Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed. RESULTS: The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare, the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%). CONCLUSIONS: The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.


title: Ethical decision-making for children with neuromuscular disorders in the COVID-19 crisis

text: The sudden appearance and proliferation of COVID-19 has forced societies and governmental authorities across the world to confront the possibility of resource constraints when critical care facilities are overwhelmed by the sheer numbers of grievously ill patients. As governments and health care systems develop and update policies and guidelines regarding the allocation of resources, patients and families affected by chronic disabilities, including many neuromuscular disorders that affect children and young adults, have become alarmed at the possibility that they may be determined to have less favorable prognoses due to their underlying diagnoses and thus be assigned to lower priority groups. It is important for health care workers, policymakers, and government officials to be aware that the long term prognoses for children and young adults with neuromuscular disorders are often more promising than previously believed, due to a better understanding of the natural history of these diseases, benefits of multidisciplinary supportive care, and novel molecular therapies that can dramatically improve the disease course. Although the realities of a global pandemic have the potential to require a shift from our usual, highly individualistic standards of care to crisis standards of care, shifting priorities should nonetheless be informed by good facts. Resource allocation guidelines with the potential to affect children and young adults with neuromuscular disorders should take into account the known trajectory of acute respiratory illness in this population, and rely primarily on contemporary long-term outcome data.


title: Development of clinical care guidelines for faculty and residents in the era of COVID-19

text: BACKGROUND: The global COVID-19 pandemic brings new challenges to otolaryngology resident education. Surgical volume and clinic visits are curtailed, personal protective equipment for operating room participation is restricted, and the risk of COVID-19 disease transmission during heretofore routine patient care is the new norm. METHODS: We describe a small-team "cohorting" protocol including guidelines for faculty and resident in common clinical scenarios with attention paid to the risk of common otolaryngologic procedures. RESULTS: A rotating small-team approach was implemented at each clinical site, limiting interaction between department members but providing comprehensive coverage. Faculty were involved at the earliest phase of clinical interactions. Guidelines delineated faculty and resident roles based on risk stratification by patient COVID status and anticipated procedures. Special consideration was given to high-risk procedures such as endoscopy and tracheotomy. CONCLUSIONS: A small-team-based approach with guidelines for faculty/resident roles may mitigate risk while optimizing patient care and maximizing education.


title: The Class of COVID-19: Texas Medical Students Struggle with Uncertainty

text: Texas medical students struggle to fight the pandemic in their own way while adjusting to a lot of uncertainty


title: Infection Control Precautions and Care Delivery in Hemodialysis Unit during Coronavirus Disease 2019 Outbreak: A Case Series

text: BACKGROUND: With an estimated basic reproductive number of 3.77, the Coronavirus Disease 2019 (COVID-19) continues to spread. It is urgent to exert adequate efforts for the management of dialysis patients, caregivers, and healthcare personnel (HCP). This study aimed at reporting practical workflow, identification of high-risk or suspected cases of CO-VID-19, and subsequent response measures. METHODS: At the time of the COVID-19 outbreak, precautions and practice protocols were applied in our dialysis units (DUs). This single-center study retrospectively reviewed all high-risk/suspected cases from January 23, 2020, to February 10, 2020. Epidemiological, clinical feature, and detailed data on all cases were recorded. RESULTS: Practical workflow for the clinical management of dialysis patients, caregivers, and HCP was initiated. A total of 6 high-risk/suspected cases were identified. Female gender, older age, presence of cardiovascular disease, diabetes, anuresis, immunocompromised status, hypoalbuminemia, and underweight were noticeable features in these cases. Direct evidence of infection or epidemiological risk was detected in five cases. Close monitoring for temperature and oxygen saturation during hemodialysis sessions may be reasonable. No confirmed COVID-19 cases were reported in our DU, but certain cases showed rapid deterioration due to other critically severe condition needing hospitalization. Portable dialysis machines are of great need to ensure dialysis care provision. CONCLUSIONS: Our study described a practical workflow for patient-centered management during COVID-19 outbreak. Potential risk factors and underlying clinical patterns were reported. Further studies regarding the efficacy of infection control precautions and practice protocols tailored for dialysis settings are warranted.


title: PPE Portraits-a Way to Humanize Personal Protective Equipment

text: The use of personal protective equipment (PPE) has skyrocketed, as providers don masks, glasses, and gowns to protect their eyes, noses, and mouths from COVID-19. Yet these same facial features express human individuality, and are crucial to nonverbal communication. Isolated ICU patients may develop "post intensive-care syndrome," which mimics PTSD with sometimes debilitating consequences. While far from a complete solution, PPE Portraits (disposable portrait picture stickers - 4" × 5") have the potential to humanize care. Preparing for a larger effectiveness evaluation on patient and provider experience, we collected initial qualitative implementation insights during Spring 2020's chaotic surge preparation. Front-line providers reported more comfort with patient interactions while wearing PPE Portraits: "It makes it feel less like a disaster zone [for the patient]." A brief pilot showed signs of significant adoption: a participating physician requested PPE Portraits at their clinic, shift nurses had taken PPE Portraits with them to inpatient services, and masked medical assistant team-members requested PPE Portraits to wear over scrubs. We believe PPE Portraits may support patient care and health, and even potentially healthcare team function and provider wellness. While we await data on these effects, we hope hospitals can use our findings to speed their own implementation testing.


Twin epidemics of covid-19 and non-communicable disease


title: The Iranian Society of Echocardiography (ISE) Statement on Performing Echocardiography During the COVID-19 Pandemic

text: Corona virus disease 2019(COVID-19) pandemic has caused a significant burden on the global health system. Considerable cardiovascular involvement has been reported among COVID-19 patients with higher ICU admission and mortality rates among patients with cardiovascular comorbidities. Consequently, diagnostic cardiovascular evaluations such as echocardiography are a crucial part of the disease management. On the other hand, providing safety for the patients and the healthcare personnel is a matter of great concern in the pandemic state. In this document, we have provided recommendations on performing echocardiography in hospital echocardiography labs and outpatient echocardiography clinics during the current COVID-19 (Coronavirus disease of 2019) outbreak.


title: La pandemia de Coronavirus SARS-CoV-2 (COVID-19): Situación actual e implicaciones para México./ The SARS-CoV-2 (COVID-19) coronavirus pandemic: current situation and implications for Mexico

text: The Coronavirus pandemic (COVID-19) is one of the most devastating in this century. It originated in China in December 2019 caused by the SARS-Cov-2 virus, and in less than a month it had been classified as an "International Public Health Emergency". To date there are nearly 3 million people infected and more than 250,000 deaths caused by the disease worldwide. Initially it affects the respiratory tract with atypical pneumonia and in severe cases it produces systemic inflammation with cytokine storm that can cause rapid deterioration with circulatory and respiratory failure, coagulopathy and a lethality rate of approximately 7%. In Mexico, the first case was detected in February 2020, and to date there are 26,616 confirmed cases and 2,961 deaths throughout the country. The low number of diagnostic tests conducted in our country clearly underestimates the real incidence and impact of the disease. The most affected groups are those with risk factors such as age over 60, presence of hypertension, diabetes or cardiovascular disease. Of the confirmed cases, 15% are healthcare workers. There is no specific treatment or vaccine yet, so it is important to have hygiene, social isolation and personal protection measures. Health, social and economic consequences could have great impact in the near future.


title: SARS-CoV-2 infection-induced immune responses: Friends or foes?

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging coronavirus that belongs to the ß-genus, causing the outbreak of coronavirus disease 19 (COVID-19). SARS-CoV-2 infection can stimulate a pronounced immune response in the host, which embodies in the decrease of lymphocytes and aberrant increase of cytokines in COVID-19 patients. SARS-CoV-2 RNA and proteins interact with various pattern recognition receptors that switch on antiviral immune responses to regulate viral replication and spreading within the host in vivo. However, overactive and impaired immune responses also cause immune damage and subsequent tissue inflammation. This article focuses on the dual roles of immune system during SARS-CoV-2 infection, providing a theoretical basic for identifying therapeutic targets in a situation with an unfavourable immune reaction.


Business Unusual: COVID-19 Ramifications for Arthroplasty


How should we implement radiotherapy for cancer patients in China during the endemic period of COVID-19?


title: A Note on Cryptographic Algorithms for Private Data Analysis in Contact Tracing Applications

text: Contact tracing is an important measure to counter the COVID-19 pandemic. In the early phase, many countries employed manual contact tracing to contain the rate of disease spread, however it has many issues. The manual approach is cumbersome, time consuming and also requires active participation of a large number of people to realize it. In order to overcome these drawbacks, digital contact tracing has been proposed that typically involves deploying a contact tracing application on people's mobile devices which can track their movements and close social interactions. While studies suggest that digital contact tracing is more effective than manual contact tracing, it has been observed that higher adoption rates of the contact tracing app may result in a better controlled epidemic. This also increases the confidence in the accuracy of the collected data and the subsequent analytics. One key reason for low adoption rate of contact tracing applications is the concern about individual privacy. In fact, several studies report that contact tracing applications deployed in multiple countries are not privacy friendly and have potential to be used for mass surveillance by the concerned governments. Hence, privacy respecting contact tracing application is the need of the hour that can lead to highly effective, efficient contact tracing. As part of this study, we focus on various cryptographic techniques that can help in addressing the Private Set Intersection problem which lies at the heart of privacy respecting contact tracing. We analyze the computation and communication complexities of these techniques under the typical client-server architecture utilized by contact tracing applications. Further we evaluate those computation and communication complexity expressions for India scenario and thus identify cryptographic techniques that can be more suitably deployed there.


Both/and problem in an either/or world


title: Lipid-Protein and Protein-Protein Interactions in the Pulmonary Surfactant System and Their Role in Lung Homeostasis

text: Pulmonary surfactant is a lipid/protein complex synthesized by the alveolar epithelium and secreted into the airspaces, where it coats and protects the large respiratory air-liquid interface. Surfactant, assembled as a complex network of membranous structures, integrates elements in charge of reducing surface tension to a minimum along the breathing cycle, thus maintaining a large surface open to gas exchange and also protecting the lung and the body from the entrance of a myriad of potentially pathogenic entities. Different molecules in the surfactant establish a multivalent crosstalk with the epithelium, the immune system and the lung microbiota, constituting a crucial platform to sustain homeostasis, under health and disease. This review summarizes some of the most important molecules and interactions within lung surfactant and how multiple lipid-protein and protein-protein interactions contribute to the proper maintenance of an operative respiratory surface.


title: Precaution of SARS-CoV-2 infection in ophthalmology medical staff/ 国际眼科杂志(Guoji Yanke Zazhi)

text: @#The epidemic of the SARS-CoV-2 infection has presented as a critical period. Until February 14th 2020, more than 55 000 cases of SARS-CoV-2 infection has been confirmed in China, which has a great impact on economy and society, and also seriously interfering with ordinary medical practice of ophthalmology. In order to protect ophthalmology medical staff from SARS-CoV-2 infection during the outbreak period, this paper suggests the necessary medical protective measures for ophthalmology outpatient and ward.


title: Comprehensive Named Entity Recognition on CORD-19 with Distant or Weak Supervision

text: We created this CORD-NER dataset with comprehensive named entity recognition (NER) on the COVID-19 Open Research Dataset Challenge (CORD-19) corpus (2020-03-13). This CORD-NER dataset covers 75 fine-grained entity types: In addition to the common biomedical entity types (e.g., genes, chemicals and diseases), it covers many new entity types related explicitly to the COVID-19 studies (e.g., coronaviruses, viral proteins, evolution, materials, substrates and immune responses), which may benefit research on COVID-19 related virus, spreading mechanisms, and potential vaccines. CORD-NER annotation is a combination of four sources with different NER methods. The quality of CORD-NER annotation surpasses SciSpacy (over 10% higher on the F1 score based on a sample set of documents), a fully supervised BioNER tool. Moreover, CORD-NER supports incrementally adding new documents as well as adding new entity types when needed by adding dozens of seeds as the input examples. We will constantly update CORD-NER based on the incremental updates of the CORD-19 corpus and the improvement of our system.


Pulmonary thrombosis in 2019-nCoV pneumonia?


title: [Emergency plan for inter-hospital transfer of newborns with SARS-CoV-2 infection]

text: Since December 2019, the outbreak of coronavirus disease (COVID-19) has become the most serious public health issue. As the special population with immature immune function, newborns with COVID-19 have been reported. Newborns with suspected or confirmed COVID-19 should be transferred to designated hospitals for isolation treatment. An emergency transfer response plan for newborns with COVID-19 has been worked out. This plan puts forward the indications for neonatal COVID-19 transfer, organization management, protection strategies for medical staff, work procedures, and disinfection methods for transfer equipment, in order to provide guidance and suggestions for the inter-hospital transfer of suspected or confirmed neonatal COVID-19.


title: Conspiracy vs Science: A Large-scale Analysis of Online Discussion Cascades

text: With the emergence and rapid proliferation of social media platforms and social networking sites, recent years have witnessed a surge of misinformation spreading in our daily life. Drawing on a large-scale dataset which covers more than 1.4M posts and 18M comments, we investigate the propagation of two distinct narratives--(i) conspiracy information, whose claims are generally unsubstantiated and thus referred as misinformation to some extent, and (ii) scientific information, whose origins are generally readily identifiable and verifiable--in an online social media platform. We find that conspiracy cascades tend to propagate in a multigenerational branching process while science cascades are more likely to grow in a breadth-first manner. Specifically, conspiracy information triggers larger cascades, involves more users and generations, persists longer, is more viral and bursty than science information. Content analysis reveals that conspiracy cascades contain more negative words and emotional words which convey anger, fear, disgust, surprise and trust. We also find that conspiracy cascades are more concerned with political and controversial topics. After applying machine learning models, we achieve an AUC score of nearly 90% in discriminating conspiracy from science narratives using the constructed features. We also find that conspiracy cascades are more likely to be controlled by a broader set of users than science cascades. Although political affinity is thought to affect the consumption of misinformation, there is very few evidence that political orientation of the information source plays a role during the propagation of conspiracy information. Our study provides complementing evidence to current misinformation research and has practical policy implications to stem the propagation and mitigate the influence of misinformation online.


Coronavirus Disease-2019: Modified Underwater Seal Chest Drain System


title: Some pathological observations on the naturally infected dromedary camels (Camelus dromedarius) with the Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia 2018-2019

text: Background: The natural MERS-CoV infection in dromedary camels is understudied. Recent experimental studies showed no obvious clinical signs in the infected dromedary camels.Aim: To study the pathological changes associated with natural MERS-CoV infection in dromedary camels.Methods: Tissues from three MERS-CoV positive animals as well as two negative animals were collected and examined for the presence of pathological changes. The screening of the animals was carried out first by the rapid agglutination test and then confirmed by the RT-PCR. The selected animals ranged from six to twelve months in age. The sensitivity of the latter technique was much higher in the detection of MERS-CoV than the Rapid test (14 out of 75 animals positive or 18% versus 31 out of 75 positive or 41%).Results: MERS-CoV induced marked desquamation of the respiratory epithelium accompanied by lamina propria and submucosal mononuclear cells infiltration, epithelial hyperplasia in the respiratory tract, and interstitial pneumonia. Ciliary cell loss was seen in the trachea and turbinate. In addition, degeneration of glomerular capillaries with the complete destruction of glomerular tufts that were replaced with fibrinous exudate in renal corpuscles in the renal cortex were noticed. Expression of the MERS-CoV-S1 and MERS-CoV-N proteins was revealed in respiratory tract, and kidneys.Conclusion: To our knowledge, this is the first study describing the pathological changes of MERS-CoV infection in dromedary camels under natural conditions. In contrast to experimental infection in case of spontaneous infection interstitial pneumonea is evident at least in some affected animals.


title: Diabetes and COVID-19

text: According to previous reports, diabetes seems to be a risk factor which worsens the serious clinical events caused by COVID-19. But is diabetes per se a risk factor that increases the probability of getting the virus? This paper will discuss this point. There are not many research data on antidiabetic drugs in this context. The potential influence of glucose-lowering agents on the severity of COVID-19 has not been described yet. Dipeptidylpeptidase-4 (DPP-4) is a cell surface protein ubiquitously expressed in many tissues and it is also a soluble molecule found in serum/plasma fluids. DPP-4 is involved in infection of cells by some viruses. This paper reviews data about the use of DPP-4 inhibitors and others diabetes drugs on COVID-19 patients. As such, no available evidence has yet suggested that glucose-lowering drugs - including those targeting DPP4-related pathways - produce any significant harm or benefit in the context of human infections. However, insulin must remain the first-choice agent in the management of critically ill-hospitalized patients, while it is recommended to suspend other agents in unstable patients. This paper provides related French and international recommendations for people with diabetes who got infected by COVID-19 and upholds that infections may alter glucose control and may require additional vigilance.


Viability of SARS-CoV-2 in faecal bio-aerosols


title: Application of Artificial Intelligence in COVID-19 drug repurposing

text: BACKGROUND AND AIM: COVID-19 outbreak has created havoc and a quick cure for the disease will be a therapeutic medicine that has usage history in patients to resolve the current pandemic. With technological advancements in Artificial Intelligence (AI) coupled with increased computational power, the AI-empowered drug repurposing can prove beneficial in the COVID-19 scenario. METHODS: The recent literature is studied and analyzed from various sources such as Scopus, Google Scholar, PubMed, and IEEE Xplore databases. The search terms used are 'COVID-19', ' AI ', and 'Drug Repurposing'. RESULTS: AI is implemented in the field design through the generation of the learning-prediction model and performs a quick virtual screening to accurately display the output. With a drug-repositioning strategy, AI can quickly detect drugs that can fight against emerging diseases such as COVID-19. This technology has the potential to improve the drug discovery, planning, treatment, and reported outcomes of the COVID-19 patient, being an evidence-based medical tool. CONCLUSIONS: Thus, there are chances that the application of the AI approach in drug discovery is feasible. With prior usage experiences in patients, few of the old drugs, if shown active against SARS-CoV-2, can be readily applied to treat the COVID-19 patients. With the collaboration of AI with pharmacology, the efficiency of drug repurposing can improve significantly.


Implementing telemedicine in inflammatory bowel disease: Is COVID-19 the definitive trigger?


title: Feasibility of Known RNA Polymerase Inhibitors as Anti-SARS-CoV-2 Drugs

text: Coronaviruses (CoVs) are positive-stranded RNA viruses that infect humans and animals. Infection by CoVs such as HCoV-229E, -NL63, -OC43 and -HKU1 leads to the common cold, short lasting rhinitis, cough, sore throat and fever. However, CoVs such as Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and the newest SARS-CoV-2 (the causative agent of COVID-19) lead to severe and deadly diseases with mortality rates ranging between ~1 to 35% depending on factors such as age and pre-existing conditions. Despite continuous global health threats to humans, there are no approved vaccines or drugs targeting human CoVs, and the recent outbreak of COVID-19 emphasizes an urgent need for therapeutic interventions. Using computational and bioinformatics tools, here we present the feasibility of reported broad-spectrum RNA polymerase inhibitors as anti- SARS-CoV-2 drugs targeting its main RNA polymerase, suggesting that investigational and approved nucleoside RNA polymerase inhibitors have potential as anti-SARS-CoV-2 drugs. However, we note that it is also possible for SARS-CoV-2 to evolve and acquire drug resistance mutations against these nucleoside inhibitors.


title: Studying the pathophysiology of coronavirus disease 2019: a protocol for the Berlin prospective COVID-19 patient cohort (Pa-COVID-19)

text: PURPOSE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide causing a global health emergency. Pa-COVID-19 aims to provide comprehensive data on clinical course, pathophysiology, immunology and outcome of COVID-19, to identify prognostic biomarkers, clinical scores, and therapeutic targets for improved clinical management and preventive interventions. METHODS: Pa-COVID-19 is a prospective observational cohort study of patients with confirmed SARS-CoV-2 infection treated at Charité - Universitätsmedizin Berlin. We collect data on epidemiology, demography, medical history, symptoms, clinical course, and pathogen testing and treatment. Systematic, serial blood sampling will allow deep molecular and immunological phenotyping, transcriptomic profiling, and comprehensive biobanking. Longitudinal data and sample collection during hospitalization will be supplemented by long-term follow-up. RESULTS: Outcome measures include the WHO clinical ordinal scale on day 15 and clinical, functional, and health-related quality-of-life assessments at discharge and during follow-up. We developed a scalable dataset to (i) suit national standards of care, (ii) facilitate comprehensive data collection in medical care facilities with varying resources, and (iii) allow for rapid implementation of interventional trials based on the standardized study design and data collection. We propose this scalable protocol as blueprint for harmonized data collection and deep phenotyping in COVID-19 in Germany. CONCLUSION: We established a basic platform for harmonized, scalable data collection, pathophysiological analysis, and deep phenotyping of COVID-19, which enables rapid generation of evidence for improved medical care and identification of candidate therapeutic and preventive strategies. The electronic database accredited for interventional trials allows fast trial implementation for candidate therapeutic agents. TRIAL REGISTRATION: Registered at the German registry for clinical studies (DRKS00021688).


title: QT prolongation in a diverse, urban population of COVID-19 patients treated with hydroxychloroquine, chloroquine, or azithromycin

text: PURPOSE: Hydroxychloroquine, chloroquine, and azithromycin have been used for treatment of COVID-19, but may cause QT prolongation. Minority populations are disproportionately impacted by COVID-19. This study evaluates the risk of QT prolongation and subsequent outcomes after administration of these medications in largely underrepresented minority COVID-19 patients. METHODS: We conducted an observational study on hospitalized COVID-19 patients in the Montefiore Health System (Bronx, NY). We examined electrocardiograms (ECG) pre/post-medication initiation to evaluate QTc, HR, QRS duration, and presence of other arrhythmias. RESULTS: One hundred five patients (mean age 67 years; 44.8% F) were analyzed. The median time from the first dose of any treatment to post-medication ECG was 2 days (IQR: 1-3). QTc in men increased from baseline (440 vs 455 ms, p < 0.001), as well as in women (438 vs 463 ms, p < 0.001). The proportion of patients with QT prolongation increased significantly (14.3% vs 34.3%, p < 0.001) even when adjusted for electrolyte abnormalities. The number of patients whose QTc > 500 ms was significantly increased after treatment (16.2% vs. 4.8%, p < 0.01). Patients with either QTc > 500 ms or an increase of 60 ms had a higher frequency of death (47.6% vs. 22.6%, p = 0.02) with an odds ratio of 3.1 (95% CI: 1.1-8.7). Adjusting for race/ethnicity yielded no significant associations. CONCLUSIONS: Hydroxychloroquine, chloroquine, and/or azithromycin were associated with QTc prolongation but did not result in fatal arrhythmias. Our findings suggest that any harm is unlikely to outweigh potential benefits of treatment. Careful risk-benefit analyses for individual patients should guide the use of these medications. Randomized control trials are necessary to evaluate their efficacies.


Reply to Nepomuceno et al.: A renewed call for detailed social and demographic COVID-19 data from all countries


Monitoring Returning Travelers During the Early Weeks of the COVID-19 Pandemic: One US County's Experience


Thoughts on home exercise during COVID-19


title: Bat-borne viruses in Africa: a critical review

text: In Africa, bat-borne zoonoses emerged in the past few decades resulting in large outbreaks or just sporadic spillovers. In addition, hundreds of more viruses are described without any information on zoonotic potential. We discuss important characteristics of bats including bat biology, evolution, distribution and ecology that not only make them unique among most mammals but also contribute to their potential as viral reservoirs. The detection of a virus in bats does not imply that spillover will occur and several biological, ecological and anthropogenic factors play a role in such an event. We summarize and critically analyse the current knowledge on African bats as reservoirs for corona-, filo-, paramyxo- and lyssaviruses. We highlight that important information on epidemiology, bat biology and ecology is often not available to make informed decisions on zoonotic spillover potential. Even if knowledge gaps exist, it is still important to recognize the role of bats in zoonotic disease outbreaks and implement mitigation strategies to prevent exposure to infectious agents including working safely with bats. Equally important is the crucial role of bats in various ecosystem services. This necessitates a multidisciplinary One Health approach to close knowledge gaps and ensure the development of responsible mitigation strategies to not only minimize risk of infection but also ensure conservation of the species.


Virtual health care in the era of COVID-19


The French response to COVID-19: intrinsic difficulties at the interface of science, public health, and policy


The COVID-19 epidemic of manuscripts


No evidence so far on the protective effect of hydroxychloroquine to prevent COVID-19: response to the comment by Joob and Wiwanitkit


Improving Universal Protocol Performance in Radiology through Implementation of a Standardized Time-out


title: An update on novel COVID-19 pandemic: a battle between humans and virus

text: In the 21st century, human civilization has witnessed three major epidemics caused by Coronaviruses namely severe acute respiratory syndrome coronavirus (SARS CoV) in 2003, Middle East respiratory syndrome coronavirus (MERS CoV) in 2012 and 2019 novel coronavirus (2019 nCoV) or coronavirus disease (COVID 19) in 2019. Among these, COVID-19 has greater transmission and mortality rate. 2019 nCoV belongs to a large family of positive sense single-stranded RNA viruses (+ssRNA) that can be isolated in different animal species. The most communal symptoms of COVID-19 include fever, cough, and shortness of breath during the incubation period (2-14 days) of infection. COVID-19 transmission is occurring from infected humans to close contact with one another through respiratory droplets, coughs, and sneezes of infected person. Moreover, the virus containing surfaces may also transmit the infection. Diagnosis is being carried out by collecting a nasopharyngeal swab or sputum specimen for detection of SARS-CoV-2 RNA by reverse-transcription polymerase chain reaction (RT-PCR). Rapid diagnosing methods are also under development which can diagnose COVID 19 in few minutes to hours. Currently, there is no specific cure or preventive therapeutics available. Hence, based upon limited in-vitro and anecdotal data, Chloroquine, or Hydroxychloroquine, Remdesivir, Lopinavir and Ritonavir are being employed in the management. Search for new specific anti-viral drugs from natural/synthetic origins is under full swing and many of them are currently used as chemotherapeutic drugs under clinical investigation. Yet, there is a strong need for development of vaccine, which may take several months to few years for the development.


title: Efficacy and safety of convalescent plasma for severe COVID-19 based on evidence in other severe respiratory viral infections: a systematic review and meta-analysis

text: BACKGROUND: The safety and efficacy of convalescent plasma in severe coronavirus disease 2019 (COVID-19) remain uncertain. To support a guideline on COVID-19 management, we conducted a systematic review and meta-analysis of convalescent plasma in COVID-19 and other severe respiratory viral infections. METHODS: In March 2020, we searched international and Chinese biomedical literature databases, clinical trial registries and prepublication sources for randomized controlled trials (RCTs) and nonrandomized studies comparing patients receiving and not receiving convalescent plasma. We included patients with acute coronavirus, influenza and Ebola virus infections. We conducted a meta-analysis using random-effects models and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Of 1099 unique records, 6 studies were eligible, and none of these included patients with COVID-19. One nonrandomized study (n = 40) on convalescent plasma in severe acute respiratory syndrome coronavirus (SARS-CoV) provided uninformative results regarding mortality (relative risk [RR] 0.10, 95% confidence interval [CI] CI 0.01 to 1.70). Pooled estimates from 4 RCTs on influenza (n = 572) showed no convincing effects on deaths (4 RCTs, RR 0.94, 95% CI 0.49 to 1.81), complete recovery (2 RCTs, odds ratio 1.04, 95% CI 0.69 to 1.64) or length of stay (3 RCTs, mean difference -1.62, 95% CI -3.82 to 0.58, d). The quality of evidence was very low for all efficacy outcomes. Convalescent plasma caused few or no serious adverse events in influenza RCTs (RR 0.85, 95% CI 0.56 to 1.29, low-quality evidence). INTERPRETATION: Studies of non-COVID-19 severe respiratory viral infections provide indirect, very low-quality evidence that raises the possibility that convalescent plasma has minimal or no benefit in the treatment of COVID-19 and low-quality evidence that it does not cause serious adverse events.


title: Comparison of SARS-CoV-2 detection from nasopharyngeal swab samples by the Roche cobas 6800 SARS-CoV-2 test and a laboratory-developed real-time RT-PCR test

text: The urgent need to implement and rapidly expand testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has led to the development of multiple assays. How these tests perform relative to one another is poorly understood. We evaluated the concordance between the Roche Diagnostics cobas 6800 SARS-CoV-2 test and a laboratory-developed test (LDT) real-time reverse transcription-polymerase chain reaction based on a modified Centers for Disease Control and Prevention protocol, for the detection of SARS-CoV-2 in samples submitted to the Clinical Laboratories of the Mount Sinai Health System. A total of 1006 nasopharyngeal swabs in universal transport medium from persons under investigation were tested for SARS-CoV-2 as part of routine clinical care using the cobas SARS-CoV-2 test with subsequent evaluation by the LDT. Cycle threshold values were analyzed and interpreted as either positive ("detected" or "presumptive positive"), negative (not detected), inconclusive, or invalid. Statistical analysis was performed using GraphPad Prism 8. The cobas SARS-CoV-2 test reported 706 positive and 300 negative results. The LDT reported 640 positive, 323 negative, 34 inconclusive, and 9 invalid results. When excluding inconclusive and invalid results, the overall percent agreement between the two platforms was 95.8%. Cohen's κ coefficient was 0.904 (95% confidence interval, 0.875-0.933), suggesting almost perfect agreement between both platforms. An overall discordance rate of 4.2% between the two systems may reflect differences in primer sequences, assay limit of detection, or other factors, highlighting the importance of comparing the performance of different testing platforms.


Impact, Strategies, and Opportunities for Early and Midcareer Cardiovascular Researchers During the COVID-19 Pandemic


Legal aspects of COVID-19 pandemic management for community nurses


The Biology of Pulmonary Coronavirus Infection Underscores Host-Directed Therapies as an Option


title: Cutaneous manifestations and considerations in COVID-19 pandemic: A systematic review

text: BACKGROUND: COVID-19 had a great impact on medical approaches among dermatologist OBJECTIVE: This systematic review focuses on all skin problems related to COVID-19, including primary and secondary COVID-related cutaneous presentations and the experts recommendations about dermatological managements especially immunomodulators usage issues METHOD: Search was performed on PubMed, Scopus, Embase and ScienceDirect. Other additional resources were searched included Cochrane, WHO, Medscape and coronavirus dermatology resource of Nottingham university. The search completed on May/03/2020. 377 articles assigned to the inclusion and exclusion groups RESULT: Eighty-nine articles entered the review. Primary mucocutaneous and appendageal presentations could be the initial or evolving signs of COVID-19. It could be manifest most commonly as a maculopapular exanthamatous or morbiliform eruption, generalized urticaria or pseudo chilblains recognized as "COVID toes" (pernio-like acral lesions or vasculopathic rashes). CONCLUSION: During pandemic, Non-infected non-at risk patients with immune-medicated dermatologic disorders under treatment with immunosuppressive immunomodulators are not needed to alter their regimen or discontinue the therapies. At-risk and infection-suspected patients needed to dose reduction, interval increase or temporary drug discontinuation (at least 2 weeks). Patients with an active COVID-19 infection should hold the biologic or non-biologic immunosuppressives until the complete recovery occur (at least 4 weeks). This article is protected by copyright. All rights reserved.


title: Recomendaciones para la ejecución de anestesia regional no obstétrica en perioperatorio de pacientes COVID-19

text: En diciembre de 2019, surgió una serie de casos de neumonía causada por un nuevo coronavirus, denominado 2019-nCoV o SARS-CoV2 La propagación del virus ha sido extremadamente rápida y la organización mundial de la salud declaró a la enfermedad COVID-19, causada por 2019-nCoV, como una pandemia En este contexto la Sociedad de Anestesiología de Chile (SACH) ha elaborado recomendaciones generales para el manejo perioperatorio de los pacientes sospechosos y/o portadores de la enfermedad Sin embargo, dado que durante el levantamiento de evidencia para la confección de dicha guía se objetivó la ausencia de sugerencias específicas para la ejecución de técnicas de anestesia regional fuera del ambiente obstétrico, se solicitó desde el Comité Científico de SACH al Comité de Anestesia Regional de SACH (CARSACH), representante LASRA (LatinAmerican Society of Regional Anesthesia) en Chile, a través de un grupo de expertos, confeccionar recomendaciones locales en esta materia


title: Diarrhea Is Associated With Prolonged Symptoms and Viral Carriage in Corona Virus Disease 2019

text: BACKGROUND & AIMS: We compared clinical, laboratory, radiological, and outcome features of patients with SARS-CoV-2 infection (COVID-19) with pneumonia, with vs without diarrhea. METHODS: We performed a retrospective, single-center analysis of 84 patients with SARS-CoV-2 pneumonia in Wuhan Union Hospital, China, from January 19 through February 7, 2020. Cases were confirmed by real-time reverse-transcriptase PCR of nasal and pharyngeal swab specimens for SARS-CoV-2 RNA. Blood samples were analyzed for white blood cell count, lymphocyte count, alanine aminotransferase, creatine kinase, lactate dehydrogenase, D-dimer, C-reactive protein, and in some cases, immunoglobulins, complement, lymphocyte subsets, and cytokines. Virus RNA was detected in stool samples by real-time PCR. RESULTS: Of the 84 patients with SARS-CoV-2 pneumonia, 26 (31%) had diarrhea. The duration of fever and dyspnea in patients with diarrhea was significantly longer than those without diarrhea (all P < .05). Stool samples from a higher proportion of patients with diarrhea tested positive for virus RNA (69%) than from patients without diarrhea (17%) (P < .001). As of February 19, a lower proportion of patients with diarrhea had a negative result from the latest throat swab for SARS-CoV-2 (77%) than patients without diarrhea (97%) (P = .010), during these patients' hospitalization. Of 76 patients with a negative result from their latest throat swab test during hospitalization, a significantly higher proportion of patients with diarrhea had a positive result from the retest for SARS-CoV-2 in stool (45%) than patients without diarrhea (20%) (P = .039). CONCLUSIONS: At a single center in Wuhan, China, 31% of patients with SARS-CoV-2 pneumonia had diarrhea. A significantly higher proportion of patients with diarrhea have virus RNA in stool than patients without diarrhea. Elimination of SARS-CoV-2 from stool takes longer than elimination from the nose and throat.


Covid-19, a graphic account


title: Reply to "Potential challenges in managing obstetric patients with COVID-19" H2S as a potential defence against COVID-19?

text: The outbreak of COVID-19 pneumonia caused by a new coronavirus (SARS-CoV-2) is posing a global health emergency and has led to more than 380,000 deaths worldwide The cell entry of SARS-CoV-2 depends on two host proteins angiotensin-converting enzyme 2 (ACE2) and TMPRSS2 There is currently no vaccine available and also no effective drug for the treatment of COVID-19 Hydrogen sulfide (H2S) as a novel gasotransmitter has been shown to protect against lung damage via its anti-inflammation, anti-oxidative stress, anti-viral, pro-survival, and anti-aging effects In light of the research advances on H2S signalling in biology and medicine, this review proposed H2S as a potential defence against COVID-19 It is suggested that H2S may block SARS-CoV-2 entry into host cells by interfering with ACE2 and TMPRSS2, inhibit SARS-CoV-2 replication by attenuating virus assembly/release, and protect SARS-CoV-2-induced lung damage by suppressing immune response and inflammation development Preclinical studies and clinical trials with slow-releasing H2S donor(s) or the activators of endogenous H2S-generating enzymes should be considered as a preventative treatment or therapy for COVID-19


COVID-19 will further exacerbate global antimicrobial resistance


Covid-19 and alcohol: parental drinking influences the next generation


title: The impact of COVID-19 pandemics on dermatologic surgery: real-life data from the Italian Red-Zone

text: BACKGROUND: The COVID-19 pandemic is challenging healthcare systems worldwide. Dermatology had to re-prioritize visits, guarantee urgent care, and ensure continuity for chronic patients. OBJECTIVES: To evaluate the COVID-19 impact on dermatologic surgery outpatient management. MATERIAL AND METHODS: In this real-life retrospective observational study, we evaluated both major and minor outpatient surgeries (MaOS and MiOS) performance in 2020, before and during the first month of lockdown declaration, in a primary referral center in Northern Italy. During the lockdown, all lifesaving and cancer surgery, (approximately 80% of our usual activities), were continued. Data from 2020 were compared with the 2019 corresponding periods to assess the real-life impact of COVID-19 in dermatologic surgical activities. RESULTS: From January 1st to April 3rd, 2020 we performed 769 interventions, compared to 908 over the corresponding 2019 period. After the lockdown, scheduled surgeries were reduced by 14.8%; overall performed ones displayed a reduction of 46.5% (51.6% MaOS, 44.2% MiOS). 52.9% and 12.5% procedures were canceled due to patients' renunciation and due to confirmed/suspected COVID-19, respectively. CONCLUSIONS: While reduced in number, dermatologic surgeries, similarly to other surgical specialties, remained operative to provide oncological and/or life-saving procedures.


Tracheostomy techniques in COVID-19 patients. No flow through an open door is protector


title: An international survey in Latin America on the practice of interventional cardiology during the COVID-19 pandemic, with a particular focus on myocardial infarction

text: INTRODUCTION: A reduction in the number of interventional cardiology procedures has emerged as a result of the COVID-19 pandemic. A survey was performed to quantify this decrease and the impact on the management of myocardial infarction in Latin America. METHODS: A telematic survey was conducted for all countries in Latin America. Diagnostic catheterisations, coronary and structural interventions, as well as the incidence and delay to reperfusion therapy of myocardial infarction (STEMI), were recorded. Two periods were compared: from 24 February to 8 March 2020 (pre-COVID-19) and another 2week period that varied according to country (COVID-19). RESULTS: Responses were obtained from 79 centres in 20 countries. There was a significant decrease in the number of diagnostic procedures (-65.2%), coronary interventions (-59.4%), structural therapeutics (-86.1%) and STEMI care (-51.2%). A decrease was noted in the incidence of STEMI, but also a delay in the time to STEMI reperfusion. While there was a variation in activity in interventional cardiology between countries, patient behaviour was rather homogeneous. CONCLUSIONS: A significant reduction in healthcare activity has been noted during the COVID-19 pandemic, including STEMI care, with the risk of increased mortality and/or morbidity following STEMI. Healthcare providers should encourage patients with suspected symptoms of STEMI to call for emergency care to ensure rapid diagnosis and timely reperfusion treatment.


Can COVID-19 cause myalgia with a completely different mechanism? A hypothesis


title: When time falls apart: The public health implications of distorted time perception in the age of COVID-19

text: Collective trauma, like the COVID-19 pandemic, can dramatically alter how we perceive time and view our futures. Indeed, the pandemic has challenged us to cope with an ambiguous, invisible threat that has changed our way of life and made our futures, both near and far, less certain. In this commentary, we review existing literature on time perception in the context of stress and trauma and discuss its implications for mental health and well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Cross-infection of Adenovirus among Medical Staff: A Warning from Intensive Care Unit in a Tertiary Care Teaching Hospital in China

text: RATIONALE: In 2019, a small HAdV55-associated outbreak of adenovirus infection occurred among the intensive care unit (ICU) staff in Xiangya Hospital of Central South University in Hunan Province, China during the treatment of a patient. OBJECTIVE: To investigate the characteristics of a nosocomial adenovirus outbreak in the ICU. METHODS: We evaluated all the patients treated and the medical staff working in the ICU from August 1 to September 4, 2019. We further performed an epidemiological and molecular analysis for this outbreak from patient to healthcare workers and between healthcare workers. After the outbreak, we adopted exposure prevention and droplet prevention measures based on standard precautions. MEASUREMENTS AND MAIN RESULTS: Between August 1 and August 27, 2019, 27 cases of human adenovirus cross-infection were reported in our institution. Among the cases, 11 were doctors (41%), 11 were nurses (41%), three were respiratory therapists (11%), and two were caregivers (7%). The attack rate was 28.4% and the fatality rate was 0. The results showed that contact with the index case, lack of hand hygiene or gloving adherence was a risk factor for infection after adenovirus exposure. After taking specific precautions, no new cases of infection have appeared since August 27. CONCLUSIONS: Our results show that HAdV55 in a single patient had strong transmission potential in an intensive care unit with adequate facilities and standardized operation. We provide convincing evidence indicating that attention could be highlighted the role of standard and specific precautions in controlling the spread of adenovirus in ICUs.


title: The pulmonary sequalae in discharged patients with COVID-19: a short-term observational study

text: BACKGROUND: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia were discharged from hospitals in Wuhan, China. We aimed to determine the cumulative percentage of complete radiological resolution at each time point, to explore the relevant affecting factors, and to describe the chest CT findings at different time points after hospital discharge. METHODS: Patients with COVID-19 pneumonia confirmed by RT-PCR who were discharged consecutively from the hospital between 5 February 2020 and 10 March 2020 and who underwent serial chest CT scans on schedule were enrolled. The radiological characteristics of all patients were collected and analysed. The total CT score was the sum of non-GGO involvement determined at discharge. Afterwards, all patients underwent chest CT scans during the 1st, 2nd, and 3rd weeks after discharge. Imaging features and distributions were analysed across different time points. RESULTS: A total of 149 patients who completed all CT scans were evaluated; there were 67 (45.0%) men and 82 (55.0%) women, with a median age of 43 years old (IQR 36-56). The cumulative percentage of complete radiological resolution was 8.1% (12 patients), 41.6% (62), 50.3% (75), and 53.0% (79) at discharge and during the 1st, 2nd, and 3rd weeks after discharge, respectively. Patients ≤44 years old showed a significantly higher cumulative percentage of complete radiological resolution than patients > 44 years old at the 3-week follow-up. The predominant patterns of abnormalities observed at discharge were ground-glass opacity (GGO) (125 [83.9%]), fibrous stripe (81 [54.4%]), and thickening of the adjacent pleura (33 [22.1%]). The positive count of GGO, fibrous stripe and thickening of the adjacent pleura gradually decreased, while GGO and fibrous stripe showed obvious resolution during the first week and the third week after discharge, respectively. "Tinted" sign and bronchovascular bundle distortion as two special features were discovered during the evolution. CONCLUSION: Lung lesions in COVID-19 pneumonia patients can be absorbed completely during short-term follow-up with no sequelae. Two weeks after discharge might be the optimal time point for early radiological estimation.


title: Development of pediatric surgical decision-making guidelines for COVID-19 in a New York City children's hospital

text: OBJECTIVE: During the COVID-19 pandemic, experience-based guidelines are needed in the pediatric population in order to deliver high quality care in a new way that keeps patients and healthcare workers safe and maximizes hospital resource utilization. BACKGROUND: The COVID-19 pandemic has created an unprecedented strain on national health care resources, particularly in New York City, the epicenter of the outbreak in the United States. Prudent allocation of surgical resources during the pandemic quickly became essential, and there is an unprecedented need to weigh the risks of operating versus delaying intervention in our pediatric patients. METHODS: Here we describe our experience in surgical decision-making in the pediatric surgical population at Morgan Stanley Children's Hospital of New York-Presbyterian (MSCHONY), which has served as a major urban catchment area for COVID-19 positive pediatric patients. We describe how we have adjusted our current treatment of multiple facets of pediatric surgery including oncology, trauma, minimally invasive procedures, and extracorporeal membrane oxygenation (ECMO). CONCLUSIONS: Our pediatric surgery department had to creatively and expeditiously adjust our protocols, guidelines, and workforce to not only serve our pediatric population but merge ourselves with our adult hospital system during the COVID pandemic. TYPE OF STUDY: Clinical research paper LEVEL OF EVIDENCE: Level V.


Privileges and Immunity Certification During the COVID-19 Pandemic


title: A framework for the computational prediction and analysis of non-coding RNAs in microbial environmental populations and their experimental validation

text: Small regulatory RNAs and antisense RNAs play important roles in the regulation of gene expression in bacteria but are underexplored, especially in natural populations. While environmentally relevant microbes often are not amenable to genetic manipulation or cannot be cultivated in the laboratory, extensive metagenomic and metatranscriptomic datasets for these organisms might be available. Hence, dedicated workflows for specific analyses are needed to fully benefit from this information. Here, we identified abundant sRNAs from oceanic environmental populations of the ecologically important primary producer Prochlorococcus starting from a metatranscriptomic differential RNA-Seq (mdRNA-Seq) dataset. We tracked their homologs in laboratory isolates, and we provide a framework for their further detailed characterization. Several of the experimentally validated sRNAs responded to ecologically relevant changes in cultivation conditions. The expression of the here newly discovered sRNA Yfr28 was highly stimulated in low-nitrogen conditions. Its predicted top targets include mRNAs encoding cell division proteins, a sigma factor, and several enzymes and transporters, suggesting a pivotal role of Yfr28 in the coordination of primary metabolism and cell division. A cis-encoded antisense RNA was identified as a possible positive regulator of atpF encoding subunit b' of the ATP synthase complex. The presented workflow will also be useful for other environmentally relevant microorganisms for which experimental validation abilities are frequently limiting although there is wealth of sequence information available.


Atypical erythema nodosum in a patient with COVID-19 pneumonia


title: The paediatric weight management office visit via telemedicine: pre- to post-COVID-19 pandemic

text: Telemedicine is a powerful tool that erases many logistical barriers to care and may increase access. Due to the need for social distancing, the COVID-19 pandemic has temporarily reduced in-person visits for clinical care. Providers, clinical staff and patients are pressed to acutely learn new skills and adapt clinical care through the use of telemedicine whilst administrators, policy makers and regulatory organizations make changes to existing policies to meet this national emergency. Our tertiary care, interdisciplinary paediatric weight management clinic began the use of telemedicine 5 years ago to bring access to an underserved, rural population at their primary care office, which has allowed our clinic to pivot seamlessly to in-home telemedicine visits during the pandemic. Telemedicine rules and regulations are rapidly changing to meet the COVID-19 national emergency, but many supports for new telemedicine providers are already in place. In this article, we provide an overview of telemedicine components, policies and regulations. We review the operationalization of our clinic's telemedicine visit prior to the pandemic. We discuss how telemedicine services are impacted by COVID-19 and key resources are provided. Finally, we reimagine telemedicine services post-pandemic to expand effective, coordinated health care, particularly for patients with chronic needs such as obesity.


How 3D Printing Can Prevent Spread of COVID-19 Among Healthcare Professionals During Times of Critical Shortage of Protective Personal Equipment


title: Characteristics of the COVID-19 Outbreak in Korea From the Mass Infection Perspective

text: On December 31, 2019, the Chinese government officially announced that the country had some cases of pneumonia with an unknown cause. By February 8, 2020, there were 24 confirmed cases in Korea, and the number of cases has steadily increased since then. On March 9, 2020, the cumulative number of confirmed cases in Korea was 7382, with 51 deaths. This study examines the characteristics of the coronavirus disease 2019 (COVID-19) outbreak from the perspective of the large-scale number of confirmed COVID-19 cases and deaths. This study is significant in that it emphasizes the precautionary principle in preventing and managing infectious diseases, and makes suggestions for urgently needed public health policies.


An unequal blow


title: Communicating Adverse Drug Reaction Insights Through Patient Organizations: Experiences from a Pilot Study in the Netherlands

text: INTRODUCTION: To improve therapeutic decision making, it is crucial that information regarding adverse drug reactions reaches patients. It is not enough to disseminate such findings through regulatory and scientific channels; targeted efforts to reach patients are necessary. One possible avenue is to collaborate with patient organizations. OBJECTIVES: The aim of this pilot study was to explore how adverse drug reactions can be communicated through patient organizations. METHODS: A text describing a signal of levothyroxine and panic attacks was tailored to patients' needs, in terms of language, style and content, with emphasis placed on what to do when experiencing the symptoms described. The signal was communicated via the Dutch thyroid organization's digital newsletter, social media channels, website and print magazine. RESULTS: The digital newsletter was distributed to around 5000 subscribers. On Facebook, 13,820 people viewed the message, with 2346 clicks in the message, indicating an intention to read the whole post. The interactions on social media were positive, and the tone was respectful. CONCLUSION: Patient organizations can help enable effective communication of adverse drug reactions to a relevant audience. The social media post generated more engagement than other communications from the patient organization, indicating a strong interest in this information. The additional patient experiences that were shared in the comments on social media further strengthened the original signal and its relevance to patients, creating an interesting feedback loop. The favourable experiences in this study support further consideration and exploration of this approach to communicate adverse drug reactions to patients.


title: [Clinical analysis of suspected COVID-19 patients with anxiety and depression]

text: OBJECTIVE: To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis. METHODS: Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients. RESULTS: Female patients are more likely to have anxiety (OR=3.206, 95%CI: 1.073-9.583, P<0.05) and depression (OR=9.111, 95%CI: 2.143-38.729, P<0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (OR=3.267, 95%CI: 1.082-9.597, P<0.05). CONCLUSIONS: During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.


title: Coronavirus disease 2019 (COVID-19) in neurology and neurosurgery: A scoping review of the early literature

text: Coronavirus disease 2019 (COVID-19) is a devastating respiratory illness that has dramatically changed the medical landscape around the world. In parallel with a rise in the number of cases globally, the COVID-19 literature has rapidly expanded with experts around the world disseminating knowledge and collaborating on best practices. To date, the literature has predominantly consisted of case reports, case series, and systemic protocols for dealing with this deadly disease from a plethora of specialties with larger observational and randomized studies only now starting to emerge. This scoping review of MEDLINE, EMBASE, SCOPUS, and the Cochrane Library aims to evaluate and summarize the current status of the COVID-19 literature at it applies to neurology and neurosurgery. Neurological symptomatology, neurological risk factors for poor prognosis, pathophysiology for neuroinvasion, and actions taken by neurological or neurosurgical services to manage the current COVID-19 crisis are reviewed.


title: Sécurité et efficacité de différents modes d'anesthésie pour des parturientes infectées par la COVID-19 accouchant par césarienne : une série de 17 cas./ Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients

text: PURPOSE: To assess the management and safety of epidural or general anesthesia for Cesarean delivery in parturients with coronavirus disease (COVID-19) and their newborns, and to evaluate the standardized procedures for protecting medical staff. METHODS: We retrospectively reviewed the cases of parturients diagnosed with severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection disease (COVID-19). Their epidemiologic history, chest computed tomography scans, laboratory measurements, and SARS-CoV-2 nucleic acid positivity were evaluated. We also recorded the patients' demographic and clinical characteristics, anesthesia and surgery-related data, maternal and neonatal complications, as well as the health status of the involved medical staff. RESULTS: The clinical characteristics of 17 pregnant women infected with SARS-CoV-2 were similar to those previously reported in non-pregnant adult patients. All of the 17 patients underwent Cesarean delivery with anesthesia performed according to standardized anesthesia/surgery procedures. Fourteen of the patients underwent continuous epidural anesthesia with 12 experiencing significant intraoperative hypotension. Three patients received general anesthesia with tracheal intubation because emergency surgery was needed. Three of the parturients are still recovering from their Cesarean delivery and are receiving in-hospital treatment for COVID-19. Three neonates were born prematurely. There were no deaths or serious neonatal asphyxia events. All neonatal SARS-CoV-2 nucleic acid tests were negative. No medical staff were infected throughout the patient care period. CONCLUSIONS: Both epidural and general anesthesia were safely used for Cesarean delivery in the parturients with COVID-19. Nevertheless, the incidence of hypotension during epidural anesthesia appeared excessive. Proper patient transfer, medical staff access procedures, and effective biosafety precautions are important to protect medical staff from COVID-19.


title: Stability of Variables Derived From Measures of Multisensory Function in Children With Autism Spectrum Disorder

text: Children with autism spectrum disorder (ASD) display differences in multisensory function as quantified by several different measures. This study estimated the stability of variables derived from commonly used measures of multisensory function in school-aged children with ASD. Participants completed: a simultaneity judgment task for audiovisual speech, tasks designed to elicit the McGurk effect, listening-in-noise tasks, electroencephalographic recordings, and eye-tracking tasks. Results indicate the stability of indices derived from tasks tapping multisensory processing is variable. These findings have important implications for measurement in future research. Averaging scores across repeated observations will often be required to obtain acceptably stable estimates and, thus, to increase the likelihood of detecting effects of interest, as it relates to multisensory processing in children with ASD.


REPLY TO: Interleukin-17: a potential therapeutic target in COVID-19


COVID-19 spurs wave of innovative diagnostics


title: The need for a coordinated international pandemic response

text: The COVID-19 pandemic has drawn attention to the international agreement governing responses to public health emergencies, with some experts calling for its revision. Lynn Eaton and Gary Humphreys report.


Re: Hanbing Song, Bobak Seddighzadeh, Matthew R. Cooperberg, Franklin W. Huang. Expression of ACE2 and TMPRSS2, the SARS-CoV-2 Receptor and Co-Receptor, in Prostate Epithelial Cells. Eur Urol. In press DOI: 10.1016/j.eururo.2020.04.065


title: Depression, anxiety, and stress and socio-demographic correlates among general Indian public during COVID-19

text: BACKGROUND: The severe outbreak of COVID-19 has affected the mental health of Indians. AIM: The objective of this article was to find the prevalence rates of depression, anxiety and stress and their socio-demographic correlates among Indian population during the lockdown to contain the spread of COVID-19. METHODS: A cross-sectional survey was conducted using an electronic questionnaire. A total of 354 participants were recruited through convenience sampling. Depression, anxiety and stress were measured using Depression Anxiety Stress Scale (DASS-21), a 21-item self-reported questionnaire. RESULTS: In total, 25%, 28% and 11.6% of the participants were moderate to extremely severely depressed, anxious and stressed, respectively. Binary logistic regressions indicated employment status (odds ratio (OR) = 1.91; 95% confidence interval (CI): 1.072-3.418) and binge drinking (OR = 2.03; 95% CI: 1.045-3.945) were significantly associated with depressive symptoms; gender (OR = 2.17; 95% CI: 1.317-3.589), employment status (OR = 1.77; 95% CI: 1.002-3.141) and binge drinking (OR = 2.62; 95% CI: 1.361-5.048) were significantly associated with anxiety symptoms; and binge drinking (OR = 3.42; 95% CI: 1.544-7.583) was significantly associated with stress symptoms. CONCLUSION: Depression, anxiety and stress among Indian population during the lockdown were prevalent. Along with other measures to contain the spread of COVID-19, mental health of citizens needs the urgent attention of the Indian government and mental health experts. Further large-scale studies should be conducted on different professions and communities such as health care professionals and migrant workers and incorporate other mental health indicators.


title: What makes a foodborne virus: comparison between coronaviruses with human noroviruses

text: In order to answer the question whether coronaviruses (CoVs) can be transmitted via foods, this review made a comparison between CoVs with the most recognized foodborne virus, human noroviruses (NoVs). As a result, although CoVs indeed have shown the possibilities to remain infectious on foods and/or food packaging materials long enough (from several days to several weeks) to potentially cause transmission, they seem to be less persistent than NoVs towards common disinfection practices with alcohols, chlorine and ultraviolet (UV). More importantly, the chance of foodborne transmission of CoVs is considered low as CoVs mainly spread through the respiratory tract and there is no clear evidence showing CoVs can follow fecal-oral routes like human NoVs and other foodborne viruses.


Clinical features of covid-19


title: CompRes: A Dataset for Narrative Structure in News

text: This paper addresses the task of automatically detecting narrative structures in raw texts. Previous works have utilized the oral narrative theory by Labov and Waletzky to identify various narrative elements in personal stories texts. Instead, we direct our focus to news articles, motivated by their growing social impact as well as their role in creating and shaping public opinion. We introduce CompRes -- the first dataset for narrative structure in news media. We describe the process in which the dataset was constructed: first, we designed a new narrative annotation scheme, better suited for news media, by adapting elements from the narrative theory of Labov and Waletzky (Complication and Resolution) and adding a new narrative element of our own (Success); then, we used that scheme to annotate a set of 29 English news articles (containing 1,099 sentences) collected from news and partisan websites. We use the annotated dataset to train several supervised models to identify the different narrative elements, achieving an $F_1$ score of up to 0.7. We conclude by suggesting several promising directions for future work.


title: COVID-19: Lessons for the climate change emergency

text: The ongoing COVID-19 outbreak pandemic is now a global crisis. It has caused 9+ million confirmed cases and 400,000+ deaths at the time of writing and triggered unprecedented preventative measures that have confined a substantial portion of the global population and established 'social distancing' as a new global behavioral norm. The COVID-19 crisis has affected all aspects of everyday life and work, and heavily impacted the global economy. This crisis also offers unprecedented insights into how the global climate crisis may be managed, as there are many parallels between the COVID-19 crisis and what we expect from the imminent global climate emergency. Reflecting upon the challenges of today's crisis may help us better prepare for the future. Here we compile a list, by no means comprehensive, of the similarities and differences between the two crises, and the lessons we can learn from them: (i) High momentum trends, (ii) Irreversible changes, (iii) Social and spatial inequality, (iv) Weakening of international solidarity, and (v) Less costly to prevent than to cure.


Emerging phenotype of SARS-CoV2 associated pancreatitis


title: Evaluation of Ultra Low Dose chest CT imaging for Covid 19 diagnosis and follow up

text: Objective: Computed Tomography (CT) has an important role to detect lung lesion related to Covide 19. The purpose of this work is to obtain diagnostic findings of Ultra-Low Dose (ULD) chest CT image and compare with routine dose chest CT. Material and Methods: Patients, suspected of Covid 19 infection, were scanned successively with routine dose, and ULD, with 98% or 94% dose reduction, protocols. Axial images of routine and ULD chest CT were evaluated objectively by two expert radiologists and quantitatively by Signal to Noise Ratio (SNR) and pixel by pixel noise measurement. Results: It was observed that the ULD and routine dose chest CT images could detect Covid 19 related lung lesions in patients with PCR positive test. Also, SNR and pixel noise values were comparable in these protocols. Conclusion: ULD chest CT with 98% dose reduction can be used in non-pandemic situation as a substitute for chest radiograph for screening and follow up. Routine chest CT protocol can be replaced by ULD, with 94% dose reduction, to detect patients suspected with Covid 19 at an early stage and for its follow up.


title: [Treatment strategies of Budd-Chiari syndrome during the epidemic period of 2019 coronavirus disease]

text: Prevention and control about the situation of 2019 coronavirus disease (COVID-19) are grim at present. In addition to supporting the frontline actively, medical workers in general surgery spare no efforts in making good diagnosis and treatment of specialized diseases by optimizing treatment process, providing medical advice online, mastering indications of delayed operation and emergency operation reasonably, etc. Budd-Chiari syndrome is a complex disorder, and severity of the disease varies, serious cases can be life threatening. While fighting the epidemic, medical workers should also ensure the medical needs of patients. However, instead of continuing the traditional treatment, a new management system should be developed. Based on the characteristics of Budd-Chiari syndrome patients in China and our experience, patients are divided into ordinary cases and critical cases, and treatment strategies suitable for the epidemic period of COVID-19 are put forward for reference and discussion by physicians.


title: Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) Infection Before Scheduled Deliveries

text: OBJECTIVE: To evaluate the rate of coronavirus disease 2019 (COVID-19) infection with the use of universal testing in our obstetric population presenting for scheduled deliveries, as well as the concordance or discordance rate among their support persons during the initial 2-week period of testing. Additionally, we assessed the utility of a screening tool in predicting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing results in our cohort. METHODS: This was an observational study in which all women who were scheduled for a planned delivery within the Mount Sinai Health system from April 4 to April 15, 2020, were contacted and provided with an appointment for themselves as well as their support persons to undergo COVID-19 testing 1 day before their scheduled delivery. Both the patients and the support persons were administered a standardized screen specific for COVID-19 infection by telephone interview. Those support persons who screened positive were not permitted to attend the birth. All patients and screen-negative support persons underwent SARS-CoV-2 testing. RESULTS: During the study period, 155 patients and 146 support persons underwent SARS-CoV-2 testing. The prevalence of asymptomatic COVID-19 infection was 15.5% (CI 9.8-21.2%) and 9.6% (CI 4.8-14.4%) among patients and support persons, respectively. The rate of discordance among tested pairs was 7.5%. Among patients with COVID-19 infection, 58% of their support persons also had infection; in patients without infection, fewer than 3.0% of their support persons had infection. CONCLUSION: We found that more than 15% of asymptomatic maternity patients tested positive for SARS-CoV-2 infection despite having screened negative with the use of a telephone screening tool. Additionally, 58% of their asymptomatic, screen-negative support persons also tested positive for SARS-CoV-2 infection. Alternatively, testing of the support persons of women who had tested negative for COVID-19 infection had a low yield for positive results. This has important implications for obstetric and newborn care practices as well as for health care professionals.


title: Inference for a test-negative case-control study with added controls

text: Test-negative designs with added controls have recently been proposed to study COVID-19. An individual is test-positive or test-negative accordingly if they took a test for a disease but tested positive or tested negative. Adding a control group to a comparison of test-positives vs test-negatives is useful since additional comparison of test-positives vs controls can have potential biases different from the first comparison. Bonferroni correction ensures necessary type-I error control for these two comparisons done simultaneously. We propose two new methods for inference which have better interpretability and higher statistical power for these designs. These methods add a third comparison that is essentially independent of the first comparison, but our proposed second method often pays much less for these three comparisons than what a Bonferroni correction would pay for the two comparisons.