title: Is Pakistan prepared for the COVID-19 epidemic? A questionnaire-based survey

text: COVID-19 is a pandemic that began in China in December 2019. World health organization (WHO) has expressed fears that Pakistan might emerge as the next epicenter of this pandemic. We hypothesize that at present the Pakistani masses are not prepared to face any threat of a looming epidemic. The main aim of this study was to evaluate the basic knowledge of educational and health care workers (HCWs) regarding COVID-19, its control, and prevention. Knowledge about origin, symptoms, and spread of viral infection was assessed. In this cross-sectional survey, a self-designed questionnaire was distributed among 302 HCWs including physicians (10.9%), nurses (1.32%), lab staff (1.65%), and academic individuals including faculty and students (86.42%) of different organizations. Results were analyzed using the χ2 test. Obtained results validate our null hypothesis that Pakistani masses are not well aware of the COVID-19 and strategies for the prevention and control of infection. The study concluded that individuals belonging to the front-line workers and high literacy groups are not prepared for the alarming situation in the country. Effectual implementation of infection control programs should be practiced, and it depends on awareness, training, and cooperation of individuals.


title: Immune responses and pathogenesis in persistently PCR-positive patients with SARS-CoV-2 infection

text: Coronavirus disease (COVID-19) caused by SARS-CoV-2 emerged in China in December 2019 and then rapidly spread worldwide. Why COVID-19 patients with the same clinical condition have different outcomes remains unclear. This study aimed to examine the differences in the phenotype and functions of major populations of immune cells between COVID-19 patients with same severity but different outcomes. Four common type adult inpatients with laboratory confirmed COVID-19 from Beijing YouAn Hospital, Capital Medical University were included in this study. The patients were divided into two groups based on whether or not COVID-19 PCR-negative conversion occurred within three weeks. Peripheral blood samples were collected to compare the differences in the phenotype and functions of major populations of immune cells between the two groups of patients. The result shows that the proportions of CD3+ CD8+ CD38+ HLA-DR+ CD27- effector T killer cells generally declined, whereas that of CD3+ CD4+ CD8+ double-positive T cells (DPTs) increased in the persistently PCR-positive patients. In summary, considering the imbalance between effector T killer cells/ CD3+CD4+CD8+ DPTs was a possible key factor for PCR-negative conversion in COVID-19 patients. This article is protected by copyright. All rights reserved.


Differentiating Domains of Involuntary Containment for Persons With Severe Psychiatric Impairment and COVID-19


title: Face coverings for the public: Laying straw men to rest

text: Background This article responds to one by Graham Martin and colleagues, who offered a critique of my previous publications on face coverings for the lay public in the Covid-19 pandemic. Their paper reflects criticisms that have been made of face coverings policies more generally. Method Narrative rebuttal. Results I address charges that my coauthors and I had misapplied the precautionary principle; drawn conclusions that were not supported by empirical research; and failed to take account of potential harms But before that, I remind my critics that the evidence on face coverings goes beyond the contested trials and observational studies they place centre stage. I set out some key findings from basic science, epidemiology, mathematical modelling, case studies, and natural experiments, and use this rich and diverse body of evidence as the backdrop for my rebuttal of their narrowly framed objections. I challenge my critics' apparent assumption that a particular kind of systematic review should be valorised over narrative and real-world evidence, since stories are crucial to both our scientific understanding and our moral imagination. Conclusion I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis. It is time to lay straw men to rest and embrace the full range of evidence in the context of the perilous threat the world is now facing.


A Global Respiratory Perspective on the COVID-19 Pandemic: Commentary and Action Proposals


title: Linking aerosol characteristics of size distributions, core potential pathogens and toxic metal(loid)s to wastewater treatment process

text: Wastewater treatment plants (WWTPs) play important roles in water purification but are also important source of aerosols. However, the relationship between aerosol characteristics and wastewater treatment process remains poorly understood. In this study, aerosols were collected over a 24-month period from a WWTP using a modified anaerobic-anoxic-oxic process. The aerated tank (AerT) was characterized by the highest respiratory fraction (RF) concentrations (861-1525 CFU/m3) and proportions (50.76%-65.96%) of aerosol particles. Fourteen core potential pathogens and 15 toxic metal(loid)s were identified in aerosols. Mycobacterium was the genus that aerosolized most easily in fine grid, pre-anoxic tank, and AerT. High wastewater treatment efficiency may increase the emission of RF and core potential pathogens. The median size of activated sludge, richness of core potential pathogens in wastewater, and total suspended particulates were the most influential factors directly related to the RF proportions, core community of potential pathogens, and composition of toxic metal(loid)s in WWTP aerosols, respectively. Relative humidity, temperature, input and removal of biochemical oxygen demand, dissolved oxygen, and mixed liquor suspended solids could also directly or indirectly affect the aerosol characteristics. This study enhances the mechanistic understanding of linking aerosol characteristics to treatment processes and has important implications for targeted manipulation.


Individuals with covert severe acute respiratory syndrome coronavirus 2 infection: Are they a critical booby-trap?


title: Impact of lockdown following COVID-19 on the gaming behavior of college students

text: Background: The uncertainty about the impact of the lockdown in wake of COVID-19 on their future academic and carrier prospects, besides other concerns; makes college students, particularly vulnerable to stress during the COVID-19 pandemic. Gaming has been recognized as a coping mechanism against stress in the previously published literature. Objectives: The current study aimed to assess the gaming behavior of college students during the lockdown following COVID-19. Methods: Data were collected from a cohort of students that constituted the sampling frame of an ongoing project. A total of 393 college students were enrolled. All the eligible students were subsequently contacted through E-mail and WhatsApp messenger and invited to share the details. Results: About half (50.8%) of the participants reported that their gaming behavior had increased, whereas 14.6% reported a decrease in their gaming during the lockdown period. In binary logistic regression analysis, hours of gaming per day (odds ratio [OR] 1.75 [1.29-2.36]), increase in gaming due to examination related stress (OR 4.96 [1.12-21.98]), and belief that gaming helps managing stress (OR 4.27 [1.65-11.04]), were found to be independently associated with gaming behavior during lockdown period. Conclusion: In the lockdown period following COVID-19 pandemic, the increase in gaming behavior was associated with examination-related stress and the belief that gaming helps combat stress. These observations highlight the need to focus on the coping style of the students to ascertain the likelihood of them engaging in gaming behavior as a coping mechanism against stress.


title: Medical mask or N95 respirator: When and how to use?

text: COVID-19 pandemic is now a global threat to human health reaching up to 2 million infected people all around the world. Since its first recognition in Wuhan, many topics were discussed intensively about COVID-19, both in the public and scientific community. Personal protective equipment, especially masks, has been among the hottest topics during this pandemic. Regardless of which mask is used, performing hand hygiene frequently with an alcohol-based hand rub or with soap and water if hands are dirty is the most effective preventive measure for COVID-19. The type of mask used when caring for COVID-19 patients will vary according to the setting, type of personnel/person, and activity. Although the main transmission route for COVID-19 is droplets, during aerosol generating procedures airborne transmission may occur. Keeping the distancing and medical masks and eye protection during close contact efficiently protects against respiratory diseases transmitted via droplets. Airborne precautions include goggles and respiratory protection with the use of an N95 or an equivalent mask respirator to prevent airborne transmission.


title: The Image of Disease in Religious, Medical-Astrological and Social Discourses: Old Polish Literature as an Example of Early Modern European Mentality

text: Today, the world is struggling with a coronavirus epidemic. People explain differently the causes and sense of this disease. Old Polish literature about diseases is representative for European thought in the modern era. The problem of the disease appears in old Polish literature in various discourses. The three most important are religious, medical-astrological and social discourse. In this article, I discuss basic paradigms of thinking connected with these discourses and the relationship between them. In the religious discourse, it is God who decides about health and illness. The pathological state of the organism can be both a trial and a punishment for the sinner. The medical and astrological discourse is based on ancient medicine, medieval medicine and astrology. It assumes a close dependence of human health on the balance of the fluids in the body and on the planetary system. The social discourse is dominated by epidemics of infectious diseases. It is a collection of advices for organizing a society during a pandemic.


title: Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau

text: As a city famous for tourism, the public healthcare system of Macau SAR has been under great pressure during the outbreak of the Coronavirus Disease 2019 (COVID-19). In this study, we report clinical and microbiological features of ten COVID-19 patients enrolled in the Centro Hospitalar Conde de São Januário (CHCSJ) between January 21 to February 16, 2020. Clinical samples from all patients including nasopharyngeal swab (NPS)/sputum, urine, and feces were collected for serial virus RNA testing by standard qRT-PCR assay. In total, seven were imported cases and three were local cases. The median duration from Macau arrival to admission in imported cases was 3 days. Four patients required oxygen therapy but none of them needed machinal ventilation. No fatal cases were noted. The most common symptoms were fever (80%) and diarrhea (80%). In the "Severe" group, there was significantly more elderly patients (p=0.045), higher lactate dehydrogenase levels (p=0.002), and elevated C-Reactive protein levels compared to the "Mild to Moderate" group (p<0.001). There were positive SARS-CoV-2 RNA signals in all patients' NPS and stool specimens but negative in all urine specimens. Based on our data on SARS-CoV-2 RNA shedding in stool and the possibility of a lag in viral detection in NPS specimens, the assessment of both fecal and respiratory specimen is recommended to enhance diagnostic sensitivity, and also to aid discharge decision before the role of viral RNA shedding in stool is clarified.


title: Recharging improves efficiency of decontaminated N95 masks

text: N95 masks form a critical part of the personal protective equipment used by frontline health-care workers, and are typically meant for one-time usage. However, the recent COVID pandemic has resulted in a serious shortage of these masks leading to a worldwide effort to develop decontamination and re-use procedures. A major factor contributing to the filtration efficiency of N95 masks is the presence of an intermediate layer of charged polypropylene electret fibers that trap particles through electrostatic or electrophoretic effects. This charge degrades quickly when the mask is used. Moreover, simple decontamination procedures (e.g. use of alcohol) immediately degrade any remaining charge from the polypropylene, thus severely impacting the filtration efficiency post decontamination. In this brief report, we summarize preliminary results on the development of a simple laboratory setup allowing measurement of charge and filtration efficiency in N95 masks. We show how the charge on the mask changes due to decontamination treatments, and correlate with reduced filtration efficiency. Additionally, we propose and show that it is possible to recharge the masks post-decontamination treatment and recover filtration efficiency. Importantly, recharging can be performed using readily available equipment and materials, and so can be employed both in urban and rural settings. We emphasize that because of the current worldwide lockdown, the measurements reported in this report are preliminary, performed with hastily constructed home-built equipment on a small variety of masks available to us. Although we are confident in our results, we encourage groups with special-purpose equipment to redo and verify our experiments.


Letter to the Editor: Impact of COVID-19 Outbreak on Acute Low Back Pain


title: Mental health ramifications of the COVID-19 pandemic for Black Americans: Clinical and research recommendations

text: Mental health clinicians and researchers must be prepared to address the unique needs of Black Americans who have been disproportionately affected by the COVID-19 pandemic. Race-conscious and culturally competent interventions that consider factors such as discrimination, distrust of health care providers, and historical and racial trauma as well as protective factors including social support and culturally sanctioned coping strategies are needed. Research to accurately assess and design treatments for the mental health consequences of COVID-19 among Black Americans is warranted. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Improving Stroke Care in Times of the COVID-19 Pandemic Through Simulation: Practice Your Protocols!

text: During the coronavirus disease 2019 (COVID-19) pandemic, infectious disease control is of utmost importance in acute stroke treatment. This is a new situation for most stroke teams that often leads to uncertainty among physicians, nurses, and technicians who are in immediate contact with patients. The situation is made even more complicated by numerous new regulations and protocols that are released in rapid succession. Herein, we are describing our experience with simulation training for COVID-19 stroke treatment protocols. One week of simulation training allowed us to identify numerous latent safety threats and to adjust our institution-specific protocols to mitigate them. It also helped our physicians and nurses to practice relevant tasks and behavioral patterns (eg, proper donning and doffing PPE, where to dispose potentially contaminated equipment) to minimize their infectious exposure and to adapt to the new situation. We therefore strongly encourage other hospitals to adopt simulation training to prepare their medical teams for code strokes during the COVID-19 pandemic.


title: Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19)

text: As coronavirus disease 2019 (COVID-19) pandemic continues, an increasing number of countries and territories are adopting restrictive measures based on physical ("social") distancing, aimed at preventing human-to-human transmission and thereby limiting virus propagation. Nationwide lockdowns, encompassing mass quarantine under stay-at-home ordinances, have already been proven effective to contain the COVID-19 outbreak in some countries. Nevertheless, a prolonged homestay may also be associated with potential side effects, which may jeopardize people's health and thus must be recognized and mitigated in a way without violating local ordinances. Some of the most important undesirable consequences of prolonged homestay such as physical inactivity, weight gain, behavioral addiction disorders, insufficient sunlight exposure and social isolation will be critically addressed in this article, which also aims to provide some tentative recommendations for the alleviation of side effects.


title: In vitro maturation of collared peccary (Pecari tajacu) oocytes after different incubation times/ Maturação in vitro de oócitos de cateto (Pecari tajacu) após diferentes períodos de incubação

text: Oocyte in vitro maturation (IVM) is the first step of the in vitro reproductive technologies that enables mature oocytes to be generated ex vivo and after used for embryo production. In this sense, the establishment of culture environment, as oocyte incubation time, is essential for the success of the IVM. Therefore, the study was carried out to investigate the relationship between the meiotic potential and the IVM times of collared peccary oocytes, wild mammals of great commercial and ecological interest. Thus, ovaries were collected of females derived from captivity and transported to the laboratory within 1 hour of slaughtering. The oocytes derived from follicles (3-6mm in diameter) were recovered by aspirated and sliced. Good quality oocytes (evenly granulated cytoplasm with a least one layer of surrounding cumulus cells) were selected and subjected to culture in TCM 199 supplemented with 10µg/mL FSH, 10% FBS and 100µM cysteamine at 38.5°C, 5% CO2 and maximum humidity for 24 or 48 hours. After the incubation period, the nuclear status, the presence of first polar body and the expansion of cumulus cells of oocytes were assessed. The data obtained were analyzed by Fisher exact test (P<0.05). A total of four sessions (2-3 females per session) were performed, resulting in eighteen aspirated and sliced ovaries with normal morphological characteristics. An oocyte recovery rate of about 83.1% (59/71) was obtained with 3.3 oocytes/ovary and 2.3 viable oocytes/ovary. After different incubation times, differences (P<0.05) were observed in 24 and 48 hours for expansion of the cumulus cells (38.1% vs. 100%), presence of first polar body (52.4% vs. 90.5%) and nuclear status in second metaphase (19.0% vs. 76.2%), respectively. In conclusion, 48 hours is suitable time for the in vitro maturation of oocytes derived from collared peccaries when compared to the time of 24 hours, according to the meiotic potential observed. Additional studies should be conducted to improve the quality of the oocyte culture environment, as medium composition, aiming to obtain viable mature oocytes for other in vitro biotechnologies.(AU)


Faecal shedding of SARS-CoV-2: considerations for hospital settings


title: Use of all cause mortality to quantify the consequences of covid-19 in Nembro, Lombardy: descriptive study

text: OBJECTIVE: To quantify the impact of coronavirus disease 2019 (covid-19) on all cause mortality in Nembro, an Italian city severely affected by the covid-19 pandemic. DESIGN: Descriptive study. SETTING: Nembro, in the Bergamo province of Lombardy, northern Italy. POPULATION: Residents of Nembro. MAIN OUTCOME MEASURES: Monthly all cause mortality between January 2012 and April 2020 (data to 11 April), number of confirmed deaths from covid-19 to 11 April 2020, and weekly absolute number of deaths between 1 January and 4 April across recent years by age group and sex. RESULTS: Nembro had 11 505 residents as of 1 January 2020. Monthly all cause mortality between January 2012 and February 2020 fluctuated around 10 per 1000 person years, with a maximum of 21.5 per 1000 person years. In March 2020, monthly all cause mortality reached a peak of 154.4 per 1000 person years. For the first 11 days in April, this rate decreased to 23.0 per 1000 person years. The observed increase in mortality was driven by the number of deaths among older people (≥65 years), especially men. From the outbreak onset until 11 April 2020, only 85 confirmed deaths from covid-19 in Nembro were recorded, corresponding to about half of the 166 deaths from all causes observed in that period. CONCLUSIONS: The study findings show how covid-19 can have a considerable impact on the health of a small community. Furthermore, the results suggest that the full implications of the covid-19 pandemic can only be completely understood if, in addition to confirmed deaths related to covid-19, consideration is also given to all cause mortality in a given region and time frame.


Challenges and adaptations in training during pandemic COVID-19: observations by an orthopedic resident in Singapore


Crowdsourcing data to mitigate epidemics


Clinical characteristics and outcomes of patients with COVID-19 and rheumatic disease in China 'hot spot' versus in US 'hot spot': similarities and differences


title: New understanding of the damage of SARS-CoV-2 infection outside the respiratory system

text: Since early December 2019, a number of pneumonia cases associated with unknown coronavirus infection were identified in Wuhan, China, and many additional cases were identified in other regions of China and in other countries within 3 months. Currently, more than 80,000 cases have been diagnosed in China, including more than 3000 deaths. The epidemic is spreading to the rest of the world, posing a grave challenge to prevention and control. On February 12, 2020, the International Committee on Taxonomy of Viruses and the World Health Organization officially named the novel coronavirus and associated pneumonia as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19), respectively. According to the recent research on SARS-CoV-2, the virus mainly infects the respiratory system but may cause damage to other systems. In this paper, we will systematically review the pathogenic features, transmission routes, and infection mechanisms of SARS-CoV-2, as well as any adverse effects on the digestive system, urogenital system, central nervous system, and circulatory system, in order to provide a theoretical and clinical basis for the diagnosis, classification, treatment, and prognosis assessment of SARS-CoV-2 infection.


Are high-performing health systems resilient against the COVID-19 epidemic?


Dermatologic surgery training during the COVID-19 era


title: BigO: A public health decision support system for measuring obesogenic behaviors of children in relation to their local environment

text: Obesity is a complex disease and its prevalence depends on multiple factors related to the local socioeconomic, cultural and urban context of individuals. Many obesity prevention strategies and policies, however, are horizontal measures that do not depend on context-specific evidence. In this paper we present an overview of BigO (http://bigoprogram.eu), a system designed to collect objective behavioral data from children and adolescent populations as well as their environment in order to support public health authorities in formulating effective, context-specific policies and interventions addressing childhood obesity. We present an overview of the data acquisition, indicator extraction, data exploration and analysis components of the BigO system, as well as an account of its preliminary pilot application in 33 schools and 2 clinics in four European countries, involving over 4,200 participants.


Les urgences neuro-ophtalmologiques pendant l'infection COVID-19./ [Neuro-ophthalmologic emergencies during this COVID-19 pandemic]


How to fight an infodemic


title: Covid-19: Ethical Challenges for Nurses

text: The Covid-19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses' relationships with patients and families. We urge policy-makers to ensure that nurses' voices and perspectives are integrated into both local and global decision-making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic.


Let's not forget our female front line


COVID-19: The heart of the issue


The Urgent Need to Address Violence Against Health Workers During the COVID-19 Pandemic


title: [Epidemiological investigation of a family clustering of COVID-19]

text: Objective: To investigate the epidemiological characteristics of a family clustering of COVID-19. Methods: Field epidemiological survey was conducted. Results: Case 1 of the long-term residents from Hubei province was the source of infection of this family clustering. There were 6 cases (from case 2 to case 7) infected in the whole incubation period. The incubation period was more than 14 days for 3 of the second-generation cases. Routes of transmission included respiratory droplets (from case 1 transmitted to case 6, from case 1 to her family members) and close contact (from case 1 to other cases in her family). All the age groups were generally susceptible, while elderly were easier to progress to critically ill. Besides respiratory symptoms, there were also gastrointestinal symptoms, of which diarrhea was the most common one. Conclusions: Family clustering had been an important part for COVID-19 cases.


title: Een man met dyspneu na een COVID-19-pneumonie./ [Chest pain and dyspnea during the recovery period of COVID-19 pneumonia]

text: A 31-year-old non-smoking male patient admitted with and intubated for COVID-19 pneumonia experienced acute chest pain and dyspnea during his recovery period. He was diagnosed with a pneumothorax based on major bullae formation due to COVID-19. The bullae were not visible after extubation and developed rapidly within a few days.


title: Epitranscriptome analysis of COVID-19 prevention and control/ 中华医学科研管理杂志

text: Objective@#The purpose of this review of COVID-19 related research is to deepen our understanding of SARS-CoV-2, which would be inspire new ideas for targeted drug development and vaccine design, and further empower the prevention and control COVID-19.@*Methods@#Through literature research and data analysis, we explored the process and mechanism of epitranscriptomics modification to regulate the replication and infectivity of COVID-19.@*Results@#Provide important ideas and technical support for the prevention and control of SARS-CoV-2 infections and emerging epidemic diseases.@*Conclusions@#Taking the new research direction of epitranscriptomics as the starting point, it is expected to open up new scientific research concepts and paradigms.


title: Tackling COVID-19 infection through complement-targeted immunotherapy

text: The complement system is an ancient part of innate immunity sensing highly pathogenic coronaviruses by mannan-binding lectin (MBL) resulting in lectin pathway activation and subsequent generation of the anaphylatoxins (AT) C3a and C5a as important effector molecules. Complement deposition on endothelial cells and high blood C5a serum levels have been reported in COVID-19 patients with severe illness, suggesting vigorous complement activation leading to systemic thrombotic microangiopathy (TMA). Complement regulator gene variants prevalent in African Americans have been associated with a higher risk for severe TMA and multi-organ injury. Strikingly, SARS-CoV-2-infected African Americans suffer from high mortality. These findings allow us to apply our knowledge from other complement-mediated diseases to COVID-19 infection to better understand severe disease pathogenesis. Here we will discuss the multiple aspects of complement activation, regulation, crosstalk with other parts of the immune system and the options to target complement in COVID-19 patients to halt disease progression and death.


Management of Orthopaedic Patients During COVID-19 Pandemic in India: A Guide


Higher level of Neutrophil-to-Lymphocyte is associated with severe COVID-19


Asymptomatic SARS-CoV-2 infection


Institutional, not home-based, isolation could contain the COVID-19 outbreak


title: Learn-Apply-Reinforce/Share Learning: Hackathons and CTFs as General Pedagogic Tools in Higher Education, and Their Applicability to Distance Learning

text: This paper lays out two teaching/learning methods that are becoming increasingly prevalent in computer science - hackathons, and Capture the Flag (CTF) competitions - and the pedagogic theory that underpins them. A case study of each is analysed, and the underpinning similarities extracted. The frameworks are then generalised to Learn-Apply-Reinforce/Share Learning - a social constructivistic method that can be used subject-independently. The applicability of this new method to distance learning is then investigated - with a mind to potential necessity to work from home - both due to increasing demand in the Higher Education sector, but also the devastating impact of crises such as the ongoing COVID-19 pandemic. Finally, a few potential extensions and future applications are discussed - including the possibilities of pivoting the method to be more research-driven, or indeed, to drive research.


Putting a balance on the aerosolization debate around SARS-CoV-2


Thoughts on Adaptive Leadership in a Challenging Time


COVID-19: lessons from the Italian reproductive medical experience


In times of crisis, anticipate mourning


title: COVID-19: The Endocrine opportunity in a pandemic

text: The 2019 Coronavirus disease (COVID-19) pandemic has disrupted the social, economical and medical system worldwide. Although it is strictly an infectious disease, its intricate bidirectional relationship with various non-communicable metabolic diseases and endocrinological factors has been observed. While diabetes, hypertension, obesity have been found to be independent risk factors for COVID-19 disease severity and mortality, more inclination towards sedentary lifestyle, psychosocial stress at this critical time may be the harbingers of metabolic syndrome. Thus, endocrinologists have a great opportunity to play their role to combat this pandemic. This paper examines how various endocrinological disorders influence the dynamics of COVID-19 and vice versa. Moreover, it also intends to review the clinical guidelines to be adopted in practice of endocrinology in this trying time.


title: Correction to: Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

text: It has been pointed out that the second paragraph of the section "Treatments for SARS-CoV-2 Infection" contains an error. The original article has been corrected.


title: Weathering the pandemic: How the Caribbean Basin can use viral and environmental patterns to predict, prepare, and respond to COVID-19

text: The 2020 coronavirus pandemic is developing at different paces throughout the world. Some areas, like the Caribbean Basin, have yet to see the virus strike at full force. When it does, there is reasonable evidence to suggest the consequent COVID-19 outbreaks will overwhelm healthcare systems and economies. This is particularly concerning in the Caribbean as pandemics can have disproportionately higher mortality impacts on lower and middle-income countries. Preliminary observations from our team and others suggest that temperature and climatological factors could influence the spread of this novel coronavirus, making spatiotemporal predictions of its infectiousness possible. This review studies geographic and time-based distribution of known respiratory viruses in the Caribbean Basin in an attempt to foresee how the pandemic will develop in this region. This review is meant to aid in planning short- and long-term interventions to manage outbreaks at the international, national, and subnational levels in the region.


Response to letter to the editor: "Lung Ultrasound early detection and monitoring in Covid-19 Pneumonia: fact and fiction"


title: Angiotensin converting enzyme: A review on expression profile and its association with human disorders with special focus on SARS-CoV-2 infection

text: Angiotensin-converting enzyme (ACE) and its homologue, ACE2, have been mostly associated with hypertensive disorder. However, recent pandemia of SARS-CoV-2 has put these proteins at the center of attention, as this virus has been shown to exploit ACE2 protein to enter cells. Clear difference in the response of affected patients to this virus has urged researchers to find the molecular basis and pathophysiology of the cell response to this virus. Different levels of expression and function of ACE proteins, underlying disorders, consumption of certain medications and the existence of certain genomic variants within ACE genes are possible explanations for the observed difference in the response of individuals to the SARS-CoV-2 infection. In the current review, we discuss the putative mechanisms for this observation.


title: COVID-19: A model for studying the evolution of contamination in Brazil

text: In the present article we introduce an epidemiological model for the investigation of the spread of epidemics caused by viruses. The model is applied specifically to COVID-19, the disease caused by the SARS-Cov-2 virus (aka"novel coronavirus"). The SIR (Susceptible - Infectious - Recovered) model is used as a basis for studying the evolution of the epidemic. Nevertheless, we have modified some of the model hypotheses in order to obtain an estimate of the contamination free of overestimated predictions. This extended model is then applied to the case of the recent advance of the epidemic in Brazil. In this regard, it is possible to obtain the evolution for the number of infectious significantly close to that provided by current data. Accordingly, we evaluate possible future scenarios for the disease spread. Regarding the population susceptibility, we consider different social behaviors in response to quarantine measures and precautions to avoid contagion. We conclude that the future scenario of the epidemic depends significantly on the social behavior adopted to date, as well as on the contagion control measures. The extent of such measures would be likely to cause thousands, millions or tens of millions of contaminations in the next few months.


title: A novel 2019: Coronavirus

text: A novel coronavirus (SCoV) is the etiological agent of severe acute respiratory syndrome (SARS) SCoV-like viruses were isolated from Himalayan palm civets found in a live-animal market in Guangdong, China Evidence of virus infection was also detected in other animals (including a raccoon dog, Nyctereutes procyonoides) and in humans working at the same market The detection of SCoV-like viruses in small, live wild mammals in a retail market indicates a route of interspecies transmission, although the natural reservoir is not known This review summarizes both classical and contemporary discoveries in the study of the molecular biology of these infectious agents, with particular emphasis on the nature and recognition of viral receptors, viral RNA synthesis, and the molecular interactions governing viral assembly


title: SARS-COV-2 and Male Reproductive Health

text: Critical challenges for the public and private health, research, and medical communities have been posed by the COVID-19 outbreak. Some of these challenges are related to the possible adverse effects of SARS-CoV-2 on male reproductive health, and whether other potential modes of transmission may occur, such as sexual transmission. Moreover, concerns have been raised in terms of whether the COVID-19 outbreak may have an impact on fertility worldwide. In this study, we will discuss the origins of SARS-CoV-2. We will further describe its mechanism of action, diagnosis, symptoms, and potential effects on the male reproductive system.


title: US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the etiologic agent associated with coronavirus disease, which emerged in late 2019. In response, we developed a diagnostic panel consisting of 3 real-time reverse transcription PCR assays targeting the nucleocapsid gene and evaluated use of these assays for detecting SARS-CoV-2 infection. All assays demonstrated a linear dynamic range of 8 orders of magnitude and an analytical limit of detection of 5 copies/reaction of quantified RNA transcripts and 1 x 10-1.5 50% tissue culture infectious dose/mL of cell-cultured SARS-CoV-2. All assays performed comparably with nasopharyngeal and oropharyngeal secretions, serum, and fecal specimens spiked with cultured virus. We obtained no false-positive amplifications with other human coronaviruses or common respiratory pathogens. Results from all 3 assays were highly correlated during clinical specimen testing. On February 4, 2020, the Food and Drug Administration issued an Emergency Use Authorization to enable emergency use of this panel.


Quis custodiet ipsos custodes: are we taking care of healthcare workers in the Italian COVID-19 outbreak?


Novel coronavirus and the central nervous system


title: COVID-19 pandemia and inherited cardiomyopathies and channelopathies: a short term and long term perspective

text: Inherited heart disease represent a very heterogenous group of cardiac disorders, characterized by inherited, acquired, and often rare disorders affecting the heart muscle (cardiomyopathies) or the cardiac electrical system (ion channel disease). They are often familial diseases, and are among the leading cause of juvenile sudden death and heart failure. The aim of this paper is to give a perspective on how to run a clinical service during an epidemic or pandemic emergency and to describe the potential COVID-19 associated risks for patients affected by inherited heart diseases.


title: SARS-CoV-2, bacterial co-infections, and AMR: the deadly trio in COVID-19?

text: Respiratory viral infections are well known to predispose patients to bacterial co-infections and superinfections. Still, there is limited reference to these in COVID-19. Do co-infections play a significant role during COVID-19? What is the impact of antimicrobial resistance?


title: A Comprehensive Review of Manifestations of Novel Coronaviruses in the Context of Deadly COVID-19 Global Pandemic

text: Since December 2019, the global pandemic caused by the highly infectious novel coronavirus 2019-nCoV (COVID-19) has been rapidly spreading. As of April 2020, the outbreak has spread to over 210 countries, with over 2,400,000 confirmed cases and over 170,000 deaths.1 COVID-19 causes a severe pneumonia characterized by fever, cough and shortness of breath. Similar coronavirus outbreaks have occurred in the past causing severe pneumonia like COVID-19, most recently, severe acute respiratory syndrome coronavirus (SARS-CoV) and middle east respiratory syndrome coronavirus (MERS-CoV). However, over time, SARS-CoV and MERS-CoV were shown to cause extrapulmonary signs and symptoms including hepatitis, acute renal failure, encephalitis, myositis and gastroenteritis. Similarly, sporadic reports of COVID-19 related extrapulmonary manifestations emerge. Unfortunately, there is no comprehensive summary of the multiorgan manifestations of COVID-19, making it difficult for clinicians to quickly educate themselves about this highly contagious and deadly pathogen. What is more, is that SARS-CoV and MERS-CoV are the closest humanity has come to combating something similar to COVID-19, however, there exists no comparison between the manifestations of any of these novel coronaviruses. In this review, we summarize the current knowledge of the manifestations of the novel coronaviruses SARS-CoV, MERS-CoV and COVID-19, with a particular focus on the latter, and highlight their differences and similarities.


Fast, portable tests come online to curb coronavirus pandemic


Response to Elmaraghi et al. re: "Maxillofacial Trauma Management During COVID-19: Multidisciplinary Recommendations"


title: Immune checkpoint inhibition in the era of COVID-19

text: The worldwide Coronavirus pandemic continues to result in significant morbidity and mortality, with almost 9 million confirmed cases to date. Approximately 80% of patients have mild disease and do not require hospitalization. A key challenge facing the medical community is predicting which patients are at risk of developing severe disease in order to initiate early supportive treatment and to facilitate enrollment into much needed prospective clinical trials; crucial for developing effective treatment strategies.


ST-segment Elevation, Myocardial Injury, and Suspected or Confirmed COVID-19 Patients: Diagnostic and Treatment Uncertainties


title: The Characteristics of 50 Hospitalized COVID-19 Patients With and Without ARDS

text: BACKGROUND: The type of pneumonia (coronavirus disease 2019, COVID-19) that is caused by the new coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) is now spreading across the world in a pandemic. Many patients with COVID-19 were admitted to the University Hospital Aachen during an outbreak that first struck the Heinsberg district in February 2020. METHODS: A comparative presentation of the clinical features of the first 50 COVID-19 patients with and without acute respiratory distress syndrome (ARDS) who were hospitalized in the University Hospital Aachen. RESULTS: 24 intubated patients were treated in the intensive care unit for ARDS of varying degrees of severity, while 26 patients who were breathing spontaneously without ARDS, but nevertheless needed supplemental oxygen, were treated in a separate isolation ward. The median age of the patients was 65 (IQR 58-76). The median latency from symptom onset to hospitalization was four days (IQR 1-8). Patients with ARDS had preexisting respiratory diseases more commonly than patients without ARDS (58% [95% confidence interval: 39; 76] versus 42% [26; 61]) and were more commonly overweight or obese (83% [64; 93] versus 42% [26; 61]). The two groups did not differ in viral burden but displayed significant differences in laboratory findings: ARDS patients had persistently elevated values for leukocytes, interleukin-6, lactate dehydrogenase, creatine kinase, and D-dimers over the period of observation. Patients without ARDS had persistently elevated inflammatory parameters and fever for at least one week, with an accompanying need for supplemental oxygen. Three of the patients with ARDS died of multiorgan failure, while four in the non-ARDS group died of respiratory insufficiency. CONCLUSION: This initial description of a cohort of COVID-19 patients with and without ARDS in Germany reveals that those with ARDS more commonly have preexisting respiratory diseases and obesity, as well as persistently elevated inflammatory markers. COVID-19 patients without ARDS may likewise require prolonged hospitalization because of persistently elevated inflammatory values with a simultaneous need for supplemental oxygen.


A COVID-19 case in Libya acquired in Saudi Arabia


title: Development of an Assessment Method for Investigating the Impact of Climate and Urban Parameters in Confirmed Cases of COVID-19: A New Challenge in Sustainable Development

text: Sustainable development has been a controversial global topic, and as a complex concept in recent years, it plays a key role in creating a favorable future for societies. Meanwhile, there are several problems in the process of implementing this approach, like epidemic diseases. Hence, in this study, the impact of climate and urban factors on confirmed cases of COVID-19 (a new type of coronavirus) with the trend and multivariate linear regression (MLR) has been investigated to propose a more accurate prediction model. For this propose, some important climate parameters, including daily average temperature, relative humidity, and wind speed, in addition to urban parameters such as population density, were considered, and their impacts on confirmed cases of COVID-19 were analyzed. The analysis was performed for three case studies in Italy, and the application of the proposed method has been investigated. The impacts of parameters have been considered with a delay time from one to nine days to find out the most suitable combination. The result of the analysis demonstrates the effectiveness of the proposed model and the impact of climate parameters on the trend of confirmed cases. The research hypothesis approved by the MLR model and the present assessment method could be applied by considering several variables that exhibit the exact delay of them to new confirmed cases of COVID-19.


title: Publisher Correction: Building an international consortium for tracking coronavirus health status

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


title: Combinatorial Group Testing and Sparse Recovery Schemes with Near-Optimal Decoding Time

text: In the long-studied problem of combinatorial group testing, one is asked to detect a set of $k$ defective items out of a population of size $n$, using $m \ll n$ disjunctive measurements. In the non-adaptive setting, the most widely used combinatorial objects are disjunct and list-disjunct matrices, which define incidence matrices of test schemes. Disjunct matrices allow the identification of the exact set of defectives, whereas list disjunct matrices identify a small superset of the defectives. Apart from the combinatorial guarantees, it is often of key interest to equip measurement designs with efficient decoding algorithms. The most efficient decoders should run in sublinear time in $n$, and ideally near-linear in the number of measurements $m$. In this work, we give several constructions with an optimal number of measurements and near-optimal decoding time for the most fundamental group testing tasks, as well as for central tasks in the compressed sensing and heavy hitters literature. For many of those tasks, the previous measurement-optimal constructions needed time either quadratic in the number of measurements or linear in the universe size. Most of our results are obtained via a clean and novel approach which avoids list-recoverable codes or related complex techniques which were present in almost every state-of-the-art work on efficiently decodable constructions of such objects.


title: Cardiovascular manifestations in severe and critical patients with COVID-19

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could cause virulent infection leading to Corona Virus Disease 2019 (COVID-19)-related pneumonia as well as multiple organ injuries. HYPOTHESIS: COVID-19 infection may result in cardiovascular manifestations leading to worse clinical outcome. METHODS: Fifty four severe and critical patients with confirmed COVID-19 were enrolled. Risk factors predicting the severity of COVID-19 were analyzed. RESULTS: Of the 54 patients (56.1 ± 13.5 years old, 66.7% male) with COVID-19, 39 were diagnosed as severe and 15 as critical cases. The occurrence of diabetes, the level of D-dimer, inflammatory and cardiac markers in critical cases were significantly higher. Troponin I (TnI) elevation occurred in 42.6% of all the severe and critical patients. Three patients experienced hypotension at admission and were all diagnosed as critical cases consequently. Hypotension was found in one severe case and seven critical cases during hospitalization. Sinus tachycardia is the most common type of arrythmia and was observed in 23 severe patients and all the critical patients. Atrioventricular block and ventricular tachycardia were observed in critical patients at end stage while bradycardia and atrial fibrillation were less common. Mild pericardial effusion was observed in one severe case and five critical cases. Three critical cases suffered new onset of heart failure. Hypotension during treatment, severe myocardial injury and pericardial effusion were independent risk factors predicting the critical status of COVID-19 infection. CONCLUSION: This study has systemically observed the impact of COVID-19 on cardiovascular system, including myocardial injury, blood pressure, arrythmia and cardiac function in severe and critical cases. Monitoring of vital signs and cardiac function of COVID-19 patients and applying potential interventions especially for those with hypotension during treatment, severe myocardial injury or pericardial effusion, is of vital importance.


title: Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis

text: BACKGROUND: In our institute in Marseille, France, we initiated early and massive screening for coronavirus disease 2019 (COVID-19). Hospitalization and early treatment with hydroxychloroquine and azithromycin (HCQ-AZ) was proposed for the positive cases. METHODS: We retrospectively report the clinical management of 3,737 screened patients, including 3,119 (83.5%) treated with HCQ-AZ (200â¯mg of oral HCQ, three times daily for ten days and 500â¯mg of oral AZ on day 1 followed by 250â¯mg daily for the next four days, respectively) for at least three days and 618 (16.5%) patients treated with other regimen ("others"). Outcomes were death, transfer to the intensive care unit (ICU), ≥10 days of hospitalization and viral shedding. RESULTS: The patients' mean age was 45 (sd 17) years, 45% were male, and the case fatality rate was 0.9%. We performed 2,065 low-dose computed tomography (CT) scans highlighting lung lesions in 592 of the 991 (59.7%) patients with minimal clinical symptoms (NEWS scoreâ¯=â¯0). A discrepancy between spontaneous dyspnoea, hypoxemia and lung lesions was observed. Clinical factors (age, comorbidities, NEWS-2 score), biological factors (lymphocytopenia; eosinopenia; decrease in blood zinc; and increase in D-dimers, lactate dehydrogenase, creatinine phosphokinase, and C-reactive protein) and moderate and severe lesions detected in low-dose CT scans were associated with poor clinical outcome. Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11-0.27), decreased risk of hospitalization ≥10 days (odds ratios 95% CI 0.38 0.27-0.54) and shorter duration of viral shedding (time to negative PCR: HR 1.29 1.17-1.42). QTc prolongation (>60â¯ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 12 cases including 3 cases with QTc> 500â¯ms. No cases of torsade de pointe or sudden death were observed. CONCLUSION: Although this is a retrospective analysis, results suggest that early diagnosis, early isolation and early treatment of COVID-19 patients, with at least 3 days of HCQ-AZ lead to a significantly better clinical outcome and a faster viral load reduction than other treatments.


Safe management of laryngectomized patients during the COVID-19 pandemic


title: Sars-CoV-2 Envelope and Membrane Proteins: Structural Differences Linked to Virus Characteristics?

text: The Coronavirus Disease 2019 (COVID-19) is a new viral infection caused by the severe acute respiratory coronavirus 2 (SARS-CoV-2). Genomic analyses have revealed that SARS-CoV-2 is related to Pangolin and Bat coronaviruses. In this report, a structural comparison between the Sars-CoV-2 Envelope and Membrane proteins from different human isolates with homologous proteins from closely related viruses is described. The analyses here reported show the high structural similarity of Envelope and Membrane proteins to the counterparts from Pangolin and Bat coronavirus isolates. However, the comparisons have also highlighted structural differences specific of Sars-CoV-2 proteins which may be correlated to the cross-species transmission and/or to the properties of the virus. Structural modelling has been applied to map the variant sites onto the predicted three-dimensional structure of the Envelope and Membrane proteins.


Anti-glomerular basement membrane disease during the COVID-19 pandemic


The UK Coronavirus Cancer Monitoring Project: protecting patients with cancer in the era of COVID-19


title: Viral RNA load as determined by cell culture as a management tool for discharge of SARS-CoV-2 patients from infectious disease wards

text: In a preliminary clinical study, we observed that the combination of hydroxychloroquine and azithromycin was effective against SARS-CoV-2 by shortening the duration of viral load in Covid-19 patients. It is of paramount importance to define when a treated patient can be considered as no longer contagious. Correlation between successful isolation of virus in cell culture and Ct value of quantitative RT-PCR targeting E gene suggests that patients with Ct above 33-34 using our RT-PCR system are not contagious and thus can be discharged from hospital care or strict confinement for non-hospitalized patients.


Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Ischemic Stroke


title: When we can trust computers (and when we can't)

text: With the relentless rise of computer power, there is a widespread expectation that computers can solve the most pressing problems of science, and even more besides. We explore the limits of computational modelling and conclude that, in the domains of science and engineering that are relatively simple and firmly grounded in theory, these methods are indeed powerful. Even so, the availability of code, data and documentation, along with a range of techniques for validation, verification and uncertainty quantification, are essential for building trust in computer generated findings. When it comes to complex systems in domains of science that are less firmly grounded in theory, notably biology and medicine, to say nothing of the social sciences and humanities, computers can create the illusion of objectivity, not least because the rise of big data and machine learning pose new challenges to reproducibility, while lacking true explanatory power. We also discuss important aspects of the natural world which cannot be solved by digital means. In the long-term, renewed emphasis on analogue methods will be necessary to temper the excessive faith currently placed in digital computation.


title: Addressing COVID-19 Among People Experiencing Homelessness: Description, Adaptation, and Early Findings of a Multiagency Response in Boston

text: People experiencing homelessness are at high risk for coronavirus disease 2019 (COVID-19). In March 2020, Boston Health Care for the Homeless Program, in partnership with city and state public health agencies, municipal leaders, and homeless service providers, developed and implemented a citywide COVID-19 care model for this vulnerable population. Components included symptom screening at shelter front doors, expedited testing at pop-up sites, isolation and management venues for symptomatic people under investigation and for people with confirmed disease, quarantine venues for asymptomatic exposed people, and contact investigation and tracing. Real-time disease surveillance efforts in a large shelter outbreak of COVID-19 during the third week of operations illustrated the need for several adaptations to the care model to better respond to the local epidemiology of illness among people experiencing homelessness. Symptom screening was de-emphasized given the high number of asymptomatic or minimally symptomatic infections discovered during mass testing; contact tracing and quarantining were phased out under the assumption of universal exposure among the sheltered population; and isolation and management venues were rapidly expanded to accommodate a surge in people with newly diagnosed COVID-19. During the first 6 weeks of operation, 429 of 1297 (33.1%) tested people were positive for COVID-19; of these, 395 people were experiencing homelessness at the time of testing, representing about 10% of the homeless adult population in Boston. Universal testing, as resources permit, is a focal point of ongoing efforts to mitigate the effect of COVID-19 on this vulnerable group of people.


L'après Covid-19 : vers une dermatologie nouvelle ?/ [After Covid-19: Towards a new dermatology?]


title: Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude?

text: In the present study we analyze the epidemiological data of COVID-19 of Tibet and high-altitude regions of Bolivia and Ecuador, and compare to lowland data, to test the hypothesis that high-altitude inhabitants (+2,500 m above sea-level) are less susceptible to develop severe adverse effects in acute SARS-CoV-2 virus infection. Analysis of available epidemiological data suggest that physiological acclimatization/adaptation that counterbalance the hypoxic environment in high-altitude may protect from severe impact of acute SARS-CoV-2 virus infection. Potential underlying mechanisms such as: (i) a compromised half-live of the virus caused by the high-altitude environment, and (ii) a hypoxia mediated down regulation of angiotensin-converting enzyme 2 (ACE2), which is the main binding target of SARS-CoV-2 virus in the pulmonary epithelium are discussed.


What can European radiologists learn from the outbreak of COVID-19 in China? A discussion with a radiologist from Wuhan


Alternatives to Invasive Ventilation in the COVID-19 Pandemic


title: Rapid Telehealth-Centered Response to COVID-19 Outbreaks in Postacute and Long-Term Care Facilities

text: Purpose: The vulnerability of postacute and long-term care (PA/LTC) facility residents to COVID-19 has manifested across the world with increasing facility outbreaks associated with high hospitalization and mortality rates. Systematic protocols to guide telehealth-centered interventions in response to COVID-19 outbreaks have yet to be delineated. This article is intended to inform PA/LTC facilities and neighboring health care partners how to collaboratively utilize telehealth-centered strategies to improve outcomes in facility outbreaks. Methods: The University of Virginia rapidly developed a multidisciplinary telehealth-centered COVID-19 facility outbreak strategy in response to a LTC facility outbreak in which 41 (out of 48) facility residents and 7 staff members tested positive. This strategy focused on supporting the facility team remotely using rapidly deployed technologic solutions. Goals included (1) early identification of patients who need their care escalated, (2) monitoring and treating patients deemed safe to remain in the facility, (3) care coordination to facilitate bidirectional transfers between the skilled nursing facility (SNF) and hospital, and (4) daily facility needs assessment related to technology, infection control, and staff well-being. To achieve these goals, a standardized approach centered on daily multidisciplinary virtual rounds and telemedicine consultation was provided. Results: Over a month since the outbreak began, 18 out of 48 (38%) facility residents required hospitalization and 6 (12.5%) died. Eleven facility residents have since returned back to the SNF after recovering from their hospitalization. No staff required hospitalization. Conclusions: Interventions that reduce hospitalizations and mortality are a critical need during the COVID-19 pandemic. The mortality and hospitalization rates seen in this PA/LTC facility outbreak are significantly lower than has been documented in other facility outbreaks. Our multidisciplinary approach centered on telemedicine should be considered as other PA/LTC facilities partner with neighboring health care systems in responding to COVID-19 outbreaks. We have begun replicating these services to additional PA/LTC facilities facing COVID-19 outbreaks.


title: Decrease of non-classical and intermediate monocyte subsets in severe acute SARS-CoV-2 infection

text: In patients with severe SARS-CoV-2 infection the development of cytokine storm induces extensive lung damage, and monocytes play a role in this pathological process. Non-classical (NC) and intermediate (INT) monocytes are known to be involved during viral and bacterial infections. In this study 30 patients with different manifestations of acute SARS-CoV-2 infection were investigated with a flow cytometric study of NC, INT and classical (CL) monocytes. Significantly reduced NC and INT monocytes and a down-regulated HLA-DR were found in acute patients with severe SARS-CoV-2 symptoms. Conversely in patients with moderate symptoms NC and INT monocytes and CD11b expression were increased. This article is protected by copyright. All rights reserved.


Radiology Residency Program Management in the COVID Era - Strategy and Reality


title: The Coincidence of 2 Epidemics, Coccidioidomycosis and SARS-CoV-2: A Case Report

text: In the middle of a pandemic, patients with cough and fever are thought to have SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). It should be remembered that in the desert southwest of the United States, we have an ongoing epidemic of coccidioidomycosis (CM). There are additionally many other respiratory illnesses that could be confused with CoV-2 or overlooked. This is a case report of CoV-2 engrafted on chronic cavitary pulmonary CM. In a time where the coronavirus pandemic is becoming rampant, we demonstrate the case of a coinfection with cavitary pulmonary CM. In this case, the importance of detection of the coronavirus and treatment of the coinfection is explored.


title: CoronaSurveys: Using Surveys with Indirect Reporting to Estimate the Incidence and Evolution of Epidemics

text: The world is suffering from a pandemic called COVID-19, caused by the SARS-CoV-2 virus. National governments have problems evaluating the reach of the epidemic, due to having limited resources and tests at their disposal. This problem is especially acute in low and middle-income countries (LMICs). Hence, any simple, cheap and flexible means of evaluating the incidence and evolution of the epidemic in a given country with a reasonable level of accuracy is useful. In this paper, we propose a technique based on (anonymous) surveys in which participants report on the health status of their contacts. This indirect reporting technique, known in the literature as network scale-up method, preserves the privacy of the participants and their contacts, and collects information from a larger fraction of the population (as compared to individual surveys). This technique has been deployed in the CoronaSurveys project, which has been collecting reports for the COVID-19 pandemic for more than two months. Results obtained by CoronaSurveys show the power and flexibility of the approach, suggesting that it could be an inexpensive and powerful tool for LMICs.


title: Nitrifying biofilms deprived of organic carbon show higher functional resilience to increases in carbon supply

text: In nitrifying biofilms, the organic carbon to ammonia nitrogen (C/N) supply ratio can influence resource competition between heterotrophic and nitrifying bacteria for oxygen and space. We investigated the impact of acute and chronic changes in carbon supply on inter-guild competition in two moving bed biofilm reactors (MBBR), operated with (R1) and without (R0) external organic carbon supply. The microbial and nitrifying community composition of the reactors differed significantly. Interestingly, acute increases in the dissolved organic carbon inhibited nitrification in R1 ten times more than in R0. A sustained increase in the carbon supply decreased nitrification efficiency and increased denitrification activity to a greater extent in R1, and also increased the proportion of potential denitrifiers in both bioreactors. The findings suggest that autotrophic biofilms subjected to increases in carbon supply show higher nitrification and lower denitrification activity than carbon-fed biofilms. This has significant implications for the design of nitrifying bioreactors. Specifically, efficient removal of organic matter before the nitrification unit can improve the robustness of the bioreactor to varying influent quality. Thus, maintaining a low C/N ratio is important in nitrifying biofilters when acute carbon stress is expected or when anoxic activity (e.g. denitrification or H2S production) is undesirable, such as in recirculating aquaculture systems (RAS).


Reply to "Indications and timing for tracheostomy in patients with SARS CoV2-related" by Ferri et al


title: Effect of Implementing Simulation Education on Health Care Worker Comfort With Nasopharyngeal Swabbing for COVID-19

text: OBJECTIVE: To determine if rapid implementation of simulation training for the nasopharyngeal swab procedure can increase provider confidence regarding procedure competency. METHODS: A simulation training exercise was designed as a departmental initiative to improve competency performing nasopharyngeal swabs during the COVID-19 pandemic. Sixty-one health care workers attended teaching sessions led by the Department of Otorhinolaryngology on proper nasopharyngeal swab technique. After a brief lecture, participants practiced their swab technique using a high-fidelity airway simulation model. Pre- and postintervention self-evaluations were measured via standardized clinical competency questionnaires on a 5-point Likert scale ranging from "No knowledge, unable to perform" up to "Highly knowledgeable and confident, independent." RESULTS: Forty-six participants in this study submitted pre- and postintervention self-assessments. Postintervention scores improved on average 1.41 points (95% CI, 1.10-1.73) out of 5 from a mean score of 3.13 to 4.54 (P < .0001). This reflects a large effect size with a Glass's delta value of 1.3. DISCUSSION: Lecture coupled with simulation-based teaching can significantly improve health care workers' confidence in performing nasopharyngeal swabs. Proper training for frontline workers performing swabs for COVID-19 is essential to improving testing accuracy and can be achieved in a simple and timely manner. IMPLICATIONS FOR PRACTICE: To meet the testing needs of the growing pandemic, many health care workers who are unfamiliar with nasopharyngeal swabs have been asked to perform this test. Simulation-based teaching sessions may improve health care workers' confidence and help prevent false-negative results. This intervention is easily reproducible in any setting where frequent nasopharyngeal swab testing occurs. LEVEL OF EVIDENCE/STUDY DESIGN: Prospective cohort study.


title: Transport of COVID-19 and other highly contagious patients by helicopter and fixed-wing air ambulance: a narrative review and experience of the Swiss air rescue Rega

text: BACKGROUND: The current COVID-19 pandemic highlights the challenges air ambulance services are facing when transporting highly infectious patients for several hours in enclosed spaces. This overview provides an example of a standard operating procedure (SOP) for infection prevention measures in HEMS missions during the COVID-19 pandemic. Furthermore, we describe different methods used by several organizations in Europe and the experience of the Swiss air rescue organization Rega in transporting these patients. Possible benefits of the use of small patient isolation units (PIU) are discussed, including the fact that accompanying medical personnel do not need to wear personal protective equipment (PPE) during the transport but can still maintain full access to the patient. Rega has developed and patented its own PIU. This device allows spontaneously breathing or mechanically ventilated patients to be transported in pressurized jet cabins, small helicopters and ambulance vehicles, without the need to change between transport units. This PIU is unique, as it remains air-tight even when there is a sudden loss of cabin pressure. CONCLUSION: A wide variety of means are being used for the aeromedical transport of infectious patients. These involve isolating either the patient or the medical crew. One benefit of PIUs is that the means of transport can be easily changed without contaminating the surroundings and while still allowing access to the patient.


Pulmonary embolism in patients with Covid-19 pneumonia


A role for selenium-dependent GPX1 in SARS-CoV-2 virulence


COVID-19: Recommendations for regional anesthesia


title: Considering the Effects of Microbiome and Diet on SARS-CoV-2 Infection: Nanotechnology Roles

text: The impact of dietary patterns and the commensal microbiome on susceptibility to and severity of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has been largely ignored to date. In this Perspective, we present a rationale for an urgent need to investigate this possible impact and therapeutic options for COVID-19 based on dietary and microbiome modifications. The mitigating role of nanotechnology with relation to the impact of SARS-CoV-2 virus is highlighted.


International Collaboration and Rapid Harmonization across Dermatologic COVID-19 Registries


title: Antiretroviral HIV drugs in COVID-19 research: promises and risks. An opinion piece

text: The unprecedented global scale of COVID-19 globally has triggered a race to discover interventions to reduce associated morbidity and mortality and rapid release of research findings prior to any degree of critical review. As with previous novel infection outbreaks, antiretrovirals are just one drug class that has been held up as a potential strategy for prophylaxis and treatment with scant evidence and risk of harm. Here we summarise the evidence for antiretrovirals to treat COVID-19 and, as a drug that has also been studied in HIV, hydroxychloroquine, and flag some of the pitfalls of using therapies that have not been evaluated robustly.


title: Calling for an exponential escalation scheme in vaccine development for COVID-19

text: PURPOSE: COVID-19 as a pandemic calls for rapid development of vaccines. METHODS: Here a proposal of a seamless, adaptive, phase 1-3 trial for accelerated vaccine development is described. RESULTS: Starting at 10, the number of vaccinated volunteers would exponentially increase by tenfold at an interval of 2 weeks; close surveillance of antibody responses, safety and efficacy is necessary. After only 16 weeks, general vaccination would be feasible if supply meets the demand. CONCLUSION: A COVID-19 vaccine would be rapidly available at a slightly increased risk for undetected late side effects or insufficient efficacy if compared with standard vaccine development schemes.


title: Alveolar macrophage dysfunction and cytokine storm in the pathogenesis of two severe COVID-19 patients

text: BACKGROUND: The novel coronavirus pneumonia COVID-19 caused by SARS-CoV-2 infection could lead to a series of clinical symptoms and severe illnesses, including acute respiratory distress syndrome (ARDS) and fatal organ failure. We report the fundamental pathological investigation in the lungs and other organs of fatal cases for the mechanistic understanding of severe COVID-19 and the development of specific therapy in these cases. METHODS: The autopsy and pathological investigations of specimens were performed on bodies of two deceased cases with COVID-19. Gross anatomy and histological investigation by Hematoxylin and eosin (HE) stained were reviewed on each patient. Alcian blue/periodic acid-Schiff (AB-PAS) staining and Masson staining were performed for the examinations of mucus, fibrin and collagen fiber in lung tissues. Immunohistochemical staining was performed on the slides of lung tissues from two patients. Real-time PCR was performed to detect the infection of SARS-CoV-2. Flow cytometry analyses were performed to detect the direct binding of S protein and the expression of ACE2 on the cell surface of macrophages. FINDINGS: The main pathological features in lungs included extensive impairment of type I alveolar epithelial cells and atypical hyperplasia of type II alveolar cells, with formation of hyaline membrane, focal hemorrhage, exudation and pulmonary edema, and pulmonary consolidation. The mucous plug with fibrinous exudate in the alveoli and the dysfunction of alveolar macrophages were characteristic abnormalities. The type II alveolar epithelial cells and macrophages in alveoli and pulmonary hilum lymphoid tissue were infected by SARS-CoV-2. S protein of SARS-CoV-2 directly bound to the macrophage via the S-protein-ACE2 interaction. INTERPRETATION: Infection of alveolar macrophage by SARS-CoV-2 might be drivers of the "cytokine storm", which might result in damages in pulmonary tissues, heart and lung, and lead to the failure of multiple organs . FUNDING: Shanghai Guangci Translational Medical Research Development Foundation, Shanghai, China.


Keep Socially (but Not Physically) Connected and Carry on: Preventing Suicide in the Age of COVID-19


title: SARS-CoV-2 Impact on Elective Orthopaedic Surgery: Implications for Post-Pandemic Recovery

text: BACKGROUND: The aim of our study was to explore the impact of elective-surgery deferment on the United States health-care system and subsequent recovery after COVID-19 containment. Using an orthopaedic elective surgery model, we aimed to answer the following: (1) What is the expected recovery time until the health-care system is back to nearly full capacity for performing elective surgery? (2) What will be the expected backlog of elective surgery over time? (3) How should health care change to address the backlog? METHODS: A Monte Carlo stochastic simulation-based analysis was performed to forecast the post-pandemic volume of elective, inpatient total joint arthroplasty and spinal fusion surgical cases. The cumulative backlog was calculated and analyzed. We tested model assumptions with sensitivity analyses. RESULTS: Assuming that elective orthopaedic surgery resumes in June 2020, it will take 7, 12, and 16 months-in optimistic, ambivalent, and pessimistic scenarios, respectively-until the health-care system can perform 90% of the expected pre-pandemic forecasted volume of surgery. In the optimistic scenario, there will be a cumulative backlog of >1 million surgical cases at 2 years after the end of elective-surgery deferment. CONCLUSIONS: The deferment of elective surgical cases during the SARS-CoV-2 pandemic will have a lasting impact on the United States health-care system. As part of disaster mitigation, it is critical to start planning for recovery now.


title: Composition of human-specific slow codons and slow di-codons in SARS-CoV and 2019-nCoV are lower than other coronaviruses suggesting a faster protein synthesis rate of SARS-CoV and 2019-nCoV

text: Translation of a genetic codon without a cognate tRNA gene is affected by both the cognate tRNA availability and the interaction with non-cognate isoacceptor tRNAs. Moreover, two consecutive slow codons (slow di-codons) lead to a much slower translation rate. Calculating the composition of host specific slow codons and slow di-codons in the viral protein coding sequences can predict the order of viral protein synthesis rates between different virus strains. Comparison of human-specific slow codon and slow di-codon compositions in the genomes of 590 coronaviruses infect humans revealed that the protein synthetic rates of 2019 novel coronavirus (2019-nCoV) and severe acute respiratory syndrome-related coronavirus (SARS-CoV) may be much faster than other coronaviruses infect humans. Analysis of host-specific slow codon and di-codon compositions provides links between viral genomic sequences and capability of virus replication in host cells that may be useful for surveillance of the transmission potential of novel viruses.


title: Disease Detectives: Using Mathematics to Forecast the Spread of Infectious Diseases

text: The COVID-19 pandemic has led to significant changes in how people are currently living their lives. To determine how to best reduce the effects of the pandemic and start reopening societies, governments have drawn insights from mathematical models of the spread of infectious diseases. We give an introduction to a family of mathematical models (called"compartmental models") and discuss how the results of analyzing these models influence government policies and human behavior, such as encouraging physical distancing to help slow the spread of the disease.


title: Assessment of Countries' Preparedness and Lockdown Effectiveness in Confronting COVID-19

text: OBJECTIVES: To assess the risks in confronting the COVID-19 pandemic and the ongoing lockdown effectiveness in each of Italy, Germany, Spain, France, and the USA using China's lockdown model simulation, and cases forecast until the plateau phase. METHODS: Quantitative and qualitative historical data analysis. Total Risk Assessment (TRA) evaluation tool was used to assess the pre-pandemic stage risks, pandemic threshold fast responsiveness, and the ongoing performance till plateau. The Infected Patient's Ratio (IPR) tool was developed to measure the number of patients resulting from one infector during the incubation period. Both IPR and TRA were used together to forecast inflection points, plateau phases, ICUs' and ventilators' breakpoints, and the Total Fatality Ratio. RESULTS: In Italy, Spain, France, Germany, and the USA, an inflection point is predicted within the first 15 days of April, to arrive at a plateau after another 30 to 80 days. Variations in IPR drop are expected due to variations in lockdown timing by each country, the extent of adherence to it, and the number of performed tests in each. CONCLUSIONS: Both qualitative (TRA) and quantitative (IPR) tools can be used together for assessing and minimizing the pandemic risks and for more precise forecasting.


title: Melatonin is a potential adjuvant to improve clinical outcomes in individuals with obesity and diabetes with coexistence of Covid-19

text: Coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a newly discovered highly pathogenic virus that was declared pandemic in March 2020 by the World Health Organization. The virus affects the respiratory system, produces an inflammatory storm that causes lung damage and respiratory dysfunction. It infects humans of all ages. The Covid-19 takes a more severe course in individuals with chronic metabolic diseases such as obesity, diabetes mellitus, and hypertension. This category of persons exhibits weak immune activity and decreased levels of endogenous antioxidants. Melatonin is a multifunctional signaling hormone synthesized and secreted primarily by the pineal gland. It is a potent antioxidant with immunomodulatory action and has remarkable anti-inflammatory effects under a variety of circumstances. Regarding Covid-19 and metabolic syndrome, adequate information about the relationship between these two comorbidities is required for better management of these patients. Since Covid-19 infection and complications involve severe inflammation and oxidative stress in people with obesity and diabetes, we anticipated the inclusion of melatonin, as powerful antioxidant, within proposed treatment protocols. In this context, melatonin is a potential and promising agent to help overcome Covid-19 infection and boost the immune system in healthy persons and obese and diabetic patients. This review summarizes some evidence from recently published reports on the utility of melatonin as a potential adjuvant in Covid-19-infected individuals with diabetes and obesity.


Reply to "Protecting against COVID-19 aerosol infection during intubation"


Experience of a second-level Rheumatology Clinic during the Covid-19 quarantine


title: Analysis of the diagnostic value of serum specific antibody testing for coronavirus disease 2019

text: The coronavirus disease 2019 (COVID-19) pandemic has spread to various regions worldwide. As of 27 April 2020, according to real-time statistics released by the World Health Organization, there have been 84,341 confirmed cases and 4,643 deaths in China, with more than 2,979,484 confirmed cases and 206,450 deaths outside China. The detection of antibodies produced during the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become an important laboratory method for the diagnosis of COVID-19. However, at present, little research on these specific antibodies has been conducted. In this study, retrospective analysis was used to explore the dynamic changes of serum IgM and IgG antibody and factors affecting diagnostic efficacy, so as to provide a theoretical basis for clinical diagnosis and treatment. This article is protected by copyright. All rights reserved.


Delivery of care remotely through telemedicine in celiac disease: Thinking beyond COVID-19: Commentary on: DLD-20-556R1 "COVID-19 pandemic perception in adults with celiac disease: an impulse to implement the use of telemedicine" by Siniscalchi M et al


Implications of gastrointestinal manifestations of COVID-19


title: Is GSK3ß a molecular target of chloroquine treatment against COVID-19?

text: The recent clinical trial reports pertaining to the efficacy of chloroquine and hydroxychloroquine against COVID-19 albeit yet to be validated with larger clinical trials, have sparked much interest globally to evaluate whether this anti-malarial drug can be repurposed for the treatment of COVID-19. In addition to its anti-viral activity, the anti-inflammatory activity of chloroquine may also contribute to its efficacy. Based on our data obtained from an animal infection model of melioidosis (a disease caused by the bacteria Burkholderia pseudomallei), treatment with chloroquine can result in the phosphorylation and consequent inhibition of glycogen synthase kinase-3ß (GSK3ß). This serine/threonine protein kinase is now recognised as a point of convergence for host inflammatory response. In view of this, it is plausible that the mechanism for the anti-inflammatory effect of chloroquine against COVID-19 involves inhibition of host GSK3ß.


title: Recomendaciones Y Manejo Práctico De La Gestante Con Covid-19: Scoping Review./ [recommendations and Practical Management of Pregnant Women with Covid-19: a Scoping Review]

text: AIM: To compile recommendations and evidence on the practical management of pregnant women with COVIC-19 in order to clarify standards of obstetric care in the face of this new disease. METHODS: Scoping review based on literaature searches in national and international health science databases (Pubmed/Medline, Biblioteca virtual en salud (BVS), Scielo, COCHRANE and CUIDEN) and websites, and additionally by a "snowball" system. MeSH terms were used: "COVID-19", "Pregnancy", "Delivery, Obstetric" "Pregnant Women" and "Maternal". As limits in the search Spanish and English languages were selected. No limits were established in relation to the year of publication or type of article. RESULTS: A total of 49 documents and articles were detected, of which 27 were analyzed, 18 were used, and 9 were discarded because they did not contain practical recommendations. The recommendations were grouped into 9 subjects: Prevention of infection in pregnant women, Prevention of infection in health care personnel attending pregnant women, Form of presentation and severity in pregnant women, Maternal-fetal transmission (vertical and perinatal), Maternal-fetal control of the pregnant woman infected with COVID-19, Control of the severely pregnant woman with COVID-19, Treatment of the pregnant woman with COVID-19, Management and route of termination of labor, Neonatal outcomes in women with COVID-19 and Breastfeeding. CONCLUSIONS: Lack of strong evidence to support many of the recommendations for pregnant women with COVID-19, as they are based on previous experience with SARS-CoV and MERS-CoV infections. Further studies are needed to confirm the appropriateness of many of the recommendations and guidelines for action in the specific case of pregnant women and COVIC-19.


The third coronavirus epidemic in the third millennium: what's next?


title: Identification of Potential Binders of the Main Protease 3CLpro of the COVID-19 via Structure-Based Ligand Design and Molecular Modeling

text: We have applied a computational strategy, using a combination of virtual screening, docking and molecular dynamics techniques, aimed at identifying possible lead compounds for the non-covalent inhibition of the main protease 3CLpro of the SARS-CoV2 Coronavirus. Based on the X-ray structure (PDB code: 6LU7), ligands were generated using a multimodal structure-based design and then docked to the monomer in the active state. Docking calculations show that ligand-binding is strikingly similar in SARS-CoV and SARS-CoV2 main proteases. The most potent docked ligands are found to share a common binding pattern with aromatic moieties connected by rotatable bonds in a pseudo-linear arrangement.


title: Acute Respiratory Distress Syndrome in a Preterm Pregnant Patient With Coronavirus Disease 2019 (COVID-19)

text: BACKGROUND: Data suggest that pregnant women are not at elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or developing severe disease compared with nonpregnant patients. However, management of pregnant patients who are critically ill with coronavirus disease 2019 (COVID-19) infection is complicated by physiologic changes and other pregnancy considerations and requires balancing maternal and fetal well-being. CASE: We report the case of a patient at 28 weeks of gestation with acute respiratory distress syndrome (ARDS) from COVID-19 infection, whose deteriorating respiratory condition prompted delivery. Our patient's oxygenation and respiratory mechanics improved within hours of delivery, though she required prolonged mechanical ventilation until postpartum day 10. Neonatal swabs for SARS-CoV-2 and COVID-19 immunoglobulin (Ig) G and IgM were negative. CONCLUSION: We describe our multidisciplinary management of a preterm pregnant patient with ARDS from COVID-19 infection and her neonate.


Disability and public health research in Australia


title: Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China

text: The study analysed healthcare workers' (HCWs) knowledge, practices, and attitudes regarding coronavirus disease 2019 (COVID-19). A cross-sectional survey was conducted from February 4th to February 8th, 2020, involving a total of 1357 HCWs across 10 hospitals in Henan, China. Of those surveyed, 89% of HCWs had sufficient knowledge of COVID-19, more than 85% feared self-infection with the virus, and 89.7% followed correct practices regarding COVID-19. In addition to knowledge level, some risk factors including work experience and job category influenced HCWs' attitudes and practice concerning COVID-19. Measures must be taken to protect HCWs from risks linked to job category, work experience, working hours, educational attainment, and frontline HCWs.


Hyperinflammatory shock in children during COVID-19 pandemic


Managing change in the urology department of a large hospital in Italy during the COVID-19 pandemic


Emergency science: Epistemological insights on the response to COVID-19 pandemics


Qureshi AI, Abd-Allah F, Alsenani F, et al. Management of acute ischemic stroke in patients with COVID-19 infection: Report of an international panel. Int J Stroke. Epub ahead of print 03 May 2020. DOI: 10.1177/1747493020923234


How Taiwan, a non-WHO member, takes actions in response to COVID-19


Problems related with anticoagulant usage during COVID-19 outbreak


title: Nonsurgical management of resectable oral cavity cancer in the wake of COVID-19: A rapid review and meta-analysis

text: OBJECTIVE: Surgery is the preferred treatment modality for oral squamous cell carcinoma (OSCC). However, due to limited resources, re-assessment of treatment paradigms in the wake of the Coronavirus Disease 2019 (COVID-19) pandemic is urgently required. In this rapid review, we described contemporary oncological outcomes for OSCC using non-surgical modalities. METHODS: A systematic literature search was conducted for articles published between January 1, 2010 and April 1, 2020 on MEDLINE and Cochrane CENTRAL. Studies were included if they contained patients with OSCC treated with either neoadjuvant, induction, or definitive radiotherapy, chemotherapy, immunotherapy, or combination thereof, and an outcome of overall survival. RESULTS: In total, 36 articles were included. Definitive radiotherapy or chemoradiotherapy were the focus of 18 articles and neoadjuvant chemotherapy or chemoradiotherapy were the focus of the other 18 articles. In early stage OSCC, definitive radiotherapy, with or without concurrent chemotherapy, was associated with a significantly increased hazard of death compared to definitive surgery (HR: 2.39, 95% CI: 1.56-3.67, I2: 63%). The hazard of death was non-significantly increased with definitive chemoradiotherapy in studies excluding early disease (HR: 1.98, 95% CI: 0.85-4.64, I2: 84%). Two recent randomized control trials have been conducted, demonstrating no survival advantage to neoadjuvant chemotherapy. CONCLUSION: This review suggests that primary radiotherapy and chemoradiotherapy are inferior to surgical management for OSCC. Strategies for surgical delay warranting consideration are sparse, but may include several neoadjuvant regimens, recognizing these regimens may not offer a survival benefit over definitive surgery alone.


IL-1R blockade is not effective in patients with hematological malignancies and severe SARS-CoV-2 infection


Is it possible to achieve 100 percent hand hygiene compliance during the coronavirus disease 2019 (COVID-19) pandemic?


title: [Perinatal and neonatal management plan for prevention and control of 2019 novel coronavirus infection (1st Edition)]

text: Since December 2019, the novel coronavirus (2019-nCoV) infection has been prevalent in China. Due to immaturity of immune function and the possibility of mother-fetal vertical transmission, neonates are particularly susceptible to 2019-nCoV. The perinatal-neonatal departments should cooperate closely and take integrated approaches, and the neonatal intensive care unit should prepare the emergency plan for 2019-nCoV infection as far as possible, so as to ensure the optimal management and treatment of potential victims. According to the latest 2019-nCoV national management plan and the actual situation, the Working Group for the Prevention and Control of Neonatal 2019-nCoV Infection in the Perinatal Period of the Editorial Committee of Chinese Journal of Contemporary Pediatrics puts forward recommendations for the prevention and control of 2019-nCoV infection in neonates.


title: Ophthalmic Manifestations Of Coronavirus (COVID-19)

text: Since December 2019, coronavirus disease 2019 (COVID-19) has become a global pandemic caused by the highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1] There have been several reports of eye redness and irritation in COVID-19 patients, both anecdotal and published, suggesting that conjunctivitis may be an ocular manifestation of SARS-CoV-2 infection A study conducted during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak detected SARS-CoV in tear samples in SARS patients in Singapore [2] Lack of eye protection was a primary risk factor of SARS-CoV transmission from SARS patients to healthcare workers in Toronto, prompting a concern that respiratory illness could be transmitted through ocular secretions [3][[4] Similar concerns have been raised with SARS-CoV-2, especially among eye care providers and those on the front lines triaging what could be initial symptoms of COVID-19 As conjunctivitis is a common eye condition, ophthalmologists may be the first medical professionals to evaluate a patient with COVID-19 Indeed, one of the first providers to voice concerns regarding the spread of Coronavirus in Chinese patients was Li Wenliang, MD, an ophthalmologist He later died from COVID-19 and was believed to have contracted the virus from an asymptomatic glaucoma patient in his clinic The authors of this article have attempted to collect the most up-to-date information on ophthalmic manifestations of COVID-19 as a resource for identifying symptoms, providing diagnostic pearls, and mitigating transmission


title: Understanding evolution of SARS-CoV-2: A perspective from analysis of genetic diversity of RdRp gene

text: Coronavirus disease 2019 emerged as the first example of "Disease X", a hypothetical disease of humans caused by an unknown infectious agent that was named as novel coronavirus and subsequently designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The origin of the outbreak at the animal market in Wuhan, China implies it as a case of zoonotic spillover. The study was designed to understand evolution of Betacoronaviruses and in particular diversification of SARS-CoV-2 using RNA dependent RNA polymerase (RdRp) gene, a stable genetic marker. Phylogenetic and population stratification analyses were carried out using maximum likelihood and Bayesian methods, respectively. Molecular phylogeny using RdRp showed that SARS-CoV-2 isolates cluster together. Bat-CoV isolate RaTG13 and Pangolin-CoVs are observed to branch off prior to SARS-CoV-2 cluster. While SARS-CoV form a single cluster, Bat-CoVs form multiple clusters. Population-based analyses revealed that both SARS-CoV-2 and SARS-CoV form separate clusters with no admixture. Bat-CoVs were found to have single and mixed ancestry and clustered as four sub-populations. Population-based analyses of Betacoronaviruses using RdRp revealed that SARS-CoV-2 is a homogeneous population. SARS-CoV-2 appears to have evolved from Bat-CoV isolate RaTG13, which diversified from a common ancestor from which Pangolin-CoVs have also evolved. The admixed Bat-CoV sub-populations indicate that bats serve as reservoirs harboring virus ensembles that are responsible for zoonotic spillovers such as SARS-CoV and SARS-CoV-2. The extent of admixed isolates of Bat-CoVs observed in population diversification studies underline the need for periodic surveillance of bats and other animal reservoirs for potential spillovers as a measure towards preparedness for emergence of zoonosis.


title: Evolutionary Multi-Objective Design of SARS-CoV-2 Protease Inhibitor Candidates

text: Computational drug design based on artificial intelligence is an emerging research area. At the time of writing this paper, the world suffers from an outbreak of the coronavirus SARS-CoV-2. A promising way to stop the virus replication is via protease inhibition. We propose an evolutionary multi-objective algorithm (EMOA) to design potential protease inhibitors for SARS-CoV-2's main protease. Based on the SELFIES representation the EMOA maximizes the binding of candidate ligands to the protein using the docking tool QuickVina 2, while at the same time taking into account further objectives like drug-likeliness or the fulfillment of filter constraints. The experimental part analyzes the evolutionary process and discusses the inhibitor candidates.


title: Kann SARS-CoV-2 das Auge infizieren?  Ein Überblick über den Rezeptorstatus in okularem Gewebe./ [Can SARS-CoV-2 infect the eye?-An overview of the receptor status in ocular tissue]

text: Is the new coronavirus SARS-CoV2 able to infect ocular tissue and thus poses a risk of infection through the tissue in addition to the risk of contact? This is the question that has occupied ophthalmologists since the beginning of the outbreak. In order to infect a certain type of tissue specific receptors for each virus and sometimes also coreceptors or other proteins must be present. The aim of this review was to summarize and reflect the current state of research with the help of the currently available literature as of 28 May 2020. At the time of the research, angiotensin-converting enzyme 2 (ACE2) was clearly identified as the receptor and transmembrane serine protease 2 (TMPRSS2) as the necessary protease to enable the infection of human cells with SARS-CoV2. In the eye both ACE2 and TMPRSS2 are expressed, although sometimes very weakly and with varying degrees in different tissues. It is noteworthy that very different results were obtained with different methods. Several reasons can account for this effect: Firstly, the method of detection or preservation of the tissue, secondly, the possibly different expression of the tested tissue samples and thirdly, a possibly rapid loss of receptor expression post-mortem. Therefore, an infection of the eye seems possible, which has already been reported in various publications. The amount of virus or receptor expression necessary to cause an infection is not known. According to current state of knowledge the eye is not considered to be a high-risk tissue due to the low ACE2 and TMPRSS2 expression. Nevertheless, appropriate protective measures are necessary for both medical personnel and patients. In cases of corneal transplantation an infection of the donor tissue with SARS-CoV2 must be excluded.