title: Tracking Paths in Planar Graphs

text: We consider the NP-complete problem of tracking paths in a graph, first introduced by Banik et. al. [3]. Given an undirected graph with a source $s$ and a destination $t$, find the smallest subset of vertices whose intersection with any $s-t$ path results in a unique sequence. In this paper, we show that this problem remains NP-complete when the graph is planar and we give a 4-approximation algorithm in this setting. We also show, via Courcelle's theorem, that it can be solved in linear time for graphs of bounded-clique width, when its clique decomposition is given in advance.


Recommendations for 'responsible behaviour' is not a sufficient policy tool in public health emergencies


title: "War to the knife" against thromboinflammation to protect endothelial function of COVID-19 patients

text: In this viewpoint, we summarize the relevance of thromboinflammation in COVID-19 and discuss potential mechanisms of endothelial injury as a key point for the development of lung and distant organ dysfunction, with a focus on direct viral infection and cytokine-mediated injury. Entanglement between inflammation and coagulation and resistance to heparin provide a rationale to consider other therapeutic approaches in order to preserve endothelial function and limit microthrombosis, especially in severe forms. These strategies include nebulized heparin, N-acetylcysteine, plasma exchange and/or fresh frozen plasma, plasma derivatives to increase the level of endogenous anticoagulants (tissue factor pathway inhibitor, activated protein C, thrombomodulin, antithrombin), dipyridamole, complement blockers, different types of stem cells, and extracellular vesicles. An integrated therapy including these drugs has the potential to improve outcomes in COVID-19.


Facing COVID-19 in the hematopoietic cell transplant setting: A new challenge for transplantation physicians


title: Clinical Insights into the Gastrointestinal Manifestations of COVID-19

text: The month of December 2019 became a critical part of the time of humanity when the first case of coronavirus disease 2019 (COVID-19) was reported in the Wuhan, Hubei Province in China. As of April 13th, 2020, there have been approximately 1.9 million cases and 199,000 deaths across the world, which were associated with COVID-19. The COVID-19 is the seventh coronavirus to be identified to infect humans. In the past, Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome were the two coronaviruses that infected humans with a high fatality, particularly among the elderly. Fatalities due to COVID-19 are higher in patients older than 50 years of age or those with multimorbid conditions. The COVID-19 is mainly transmitted through respiratory droplets, with the most common symptoms being high fever, cough, myalgia, atypical symptoms included sputum production, headache, hemoptysis and diarrhea. However, the incubation period can range from 2 to 14 days without any symptoms. It is particularly true with gastrointestinal (GI) symptoms in which patients can still shed the virus even after pulmonary symptoms have resolved. Given the high percentage of COVID-19 patients that present with GI symptoms (e.g., nausea and diarrhea), screening patients for GI symptoms remain essential. Recently, cases of fecal-oral transmission of COVID-19 have been confirmed in the USA and China, indicating that the virus can replicate in both the respiratory and digestive tract. Moreover, the epidemiology, clinical characteristics, diagnostic procedures, treatments and prevention of the gastrointestinal manifestations of COVID-19 remain to be elucidated.


title: GIS-based spatial modeling of COVID-19 incidence rate in the continental United States

text: During the first 90 days of the COVID-19 outbreak in the United States, over 675,000 confirmed cases of the disease have been reported, posing unprecedented socioeconomic burden to the country. Due to inadequate research on geographic modeling of COVID-19, we investigated county-level variations of disease incidence across the continental United States. We compiled a geodatabase of 35 environmental, socioeconomic, topographic, and demographic variables that could explain the spatial variability of disease incidence. Further, we employed spatial lag and spatial error models to investigate spatial dependence and geographically weighted regression (GWR) and multiscale GWR (MGWR) models to locally examine spatial non-stationarity. The results suggested that even though incorporating spatial autocorrelation could significantly improve the performance of the global ordinary least square model, these models still represent a significantly poor performance compared to the local models. Moreover, MGWR could explain the highest variations (adj. R2: 68.1%) with the lowest AICc compared to the others. Mapping the effects of significant explanatory variables (i.e., income inequality, median household income, the proportion of black females, and the proportion of nurse practitioners) on spatial variability of COVID-19 incidence rates using MGWR could provide useful insights to policymakers for targeted interventions.


Surgical oncology at the time of COVID-19 outbreak


title: COVID-19 in 7 multiple sclerosis patients in treatment with ANTI-CD20 therapies

text: BACKGROUND AND AIM: In December 2019, the first cases of SARS-CoV-2 infection were detected in Wuhan. Within two months, it had begun to spread around the world in what became an unprecedented pandemic. Patients with Multiple Sclerosis (MS) in a state of immunosuppression may be considered at risk for complications in the COVID-19 pandemic, although there is increasing evidence postulating a possible protective role of selective immunosuppression. One group of such immunosuppressants used in MS comprises the anti-CD20 monoclonal antibodies (mAbs) ocrelizumab and rituximab. Anti-CD20 mAbs bind to the surface of B cells, causing their depletion. We describe our experience in seven cases of patients with multiple sclerosis who have been affected by SARS-COV-2 (with a clinical/serological diagnosis or PCR diagnosis) and who were being treated with anti-CD20+ monoclonal antibodies. MATERIAL AND METHODS: We review the development of patients during infection as well as the resolution of their clinical picture. We also analyze the serology status against SARS-CoV-2 after resolution of the infection. RESULTS: Although the severity of the clinical pictures was variable, patients' development was good. Not all patients, however, developed antibodies against SARS-CoV-2. CONCLUSIONS: Patients treated with anti-CD20+ have adequate resolution of COVID-19 despite the fact that the presence of antibodies against SARS-CoV-2 was not detected in all cases. It is possible that the presence of humoral immunity is not always necessary fora good clinical course of SARS-CoV-2 infection.


title: Infection prevention and control in blood purification centers during the COVID-19 epidemic: a single institution experience from Zhejiang, China

text: not available.


CoViD-19 epidemic in"Establishments for dependent elderly people"


Agroecology and the emergence of a post COVID-19 agriculture


iPad deployment for virtual evaluation in the emergency department during the COVID-19 pandemic


title: Prioritizing and Analyzing the Role of Climate and Urban Parameters in the Confirmed Cases of COVID-19 Based on Artificial Intelligence Applications

text: Nowadays, an infectious disease outbreak is considered one of the most destructive effects in the sustainable development process. The outbreak of new coronavirus (COVID-19) as an infectious disease showed that it has undesirable social, environmental, and economic impacts, and leads to serious challenges and threats. Additionally, investigating the prioritization parameters is of vital importance to reducing the negative impacts of this global crisis. Hence, the main aim of this study is to prioritize and analyze the role of certain environmental parameters. For this purpose, four cities in Italy were selected as a case study and some notable climate parameters-such as daily average temperature, relative humidity, wind speed-and an urban parameter, population density, were considered as input data set, with confirmed cases of COVID-19 being the output dataset. In this paper, two artificial intelligence techniques, including an artificial neural network (ANN) based on particle swarm optimization (PSO) algorithm and differential evolution (DE) algorithm, were used for prioritizing climate and urban parameters. The analysis is based on the feature selection process and then the obtained results from the proposed models compared to select the best one. Finally, the difference in cost function was about 0.0001 between the performances of the two models, hence, the two methods were not different in cost function, however, ANN-PSO was found to be better, because it reached to the desired precision level in lesser iterations than ANN-DE. In addition, the priority of two variables, urban parameter, and relative humidity, were the highest to predict the confirmed cases of COVID-19.


Author's reply


title: Racism is a Virus: Anti-Asian Hate and Counterhate in Social Media during the COVID-19 Crisis

text: The spread of COVID-19 has sparked racism, hate, and xenophobia in social media targeted at Chinese and broader Asian communities. However, little is known about how racial hate spreads during a pandemic and the role of counterhate speech in mitigating the spread. Here we study the evolution and spread of anti-Asian hate speech through the lens of Twitter. We create COVID-HATE, the largest dataset of anti-Asian hate and counterhate spanning three months, containing over 30 million tweets, and a social network with over 87 million nodes. By creating a novel hand-labeled dataset of 2,400 tweets, we train a text classifier to identify hate and counterhate tweets that achieves an average AUROC of 0.852. We identify 891,204 hate and 200,198 counterhate tweets in COVID-HATE. Using this data to conduct longitudinal analysis, we find that while hateful users are less engaged in the COVID-19 discussions prior to their first anti-Asian tweet, they become more vocal and engaged afterwards compared to counterhate users. We find that bots comprise 10.4% of hateful users and are more vocal and hateful compared to non-bot users. Comparing bot accounts, we show that hateful bots are more successful in attracting followers compared to counterhate bots. Analysis of the social network reveals that hateful and counterhate users interact and engage extensively with one another, instead of living in isolated polarized communities. Furthermore, we find that hate is contagious and nodes are highly likely to become hateful after being exposed to hateful content. Importantly, our analysis reveals that counterhate messages can discourage users from turning hateful in the first place. Overall, this work presents a comprehensive overview of anti-Asian hate and counterhate content during a pandemic. The COVID-HATE dataset is available at http://claws.cc.gatech.edu/covid.


title: Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic

text: BACKGROUND: Immunomodulatory therapy (IMT) is often considered for systemic treatment of non-infectious uveitis (NIU). During the evolving coronavirus disease-2019 (COVID-19) pandemic, given the concerns related to IMT and the increased risk of infections, an urgent need for guidance on the management of IMT in patients with uveitis has emerged. METHODS: A cross-sectional survey of international uveitis experts was conducted. An expert steering committee identified clinical questions on the use of IMT in patients with NIU during the COVID-19 pandemic. Using an interactive online questionnaire, guided by background experience and knowledge, 139 global uveitis experts generated consensus statements for IMT. In total, 216 statements were developed around when to initiate, continue, decrease and stop systemic and local corticosteroids, conventional immunosuppressive agents and biologics in patients with NIU. Thirty-one additional questions were added, related to general recommendations, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hydroxychloroquine. RESULTS: Highest consensus was achieved for not initiating IMT in patients who have suspected or confirmed COVID-19, and for using local over systemic corticosteroid therapy in patients who are at high-risk and very high-risk for severe or fatal COVID-19. While there was a consensus in starting or initiating NSAIDs for the treatment of scleritis in healthy patients, there was no consensus in starting hydroxychloroquine in any risk groups. CONCLUSION: Consensus guidelines were proposed based on global expert opinion and practical experience to bridge the gap between clinical needs and the absence of medical evidence, to guide the treatment of patients with NIU during the COVID-19 pandemic.


COVID-19 and Guillain-Barré syndrome


Health anxiety and behavioural changes of pregnant women during the COVID-19 pandemic


Management of the airway and lung isolation for thoracic surgery during the COVID-19 pandemic


Characteristics of Emergency Department Patients With COVID-19 at a Single Site in Northern California: Clinical Observations and Public Health Implications


title: Acetic acid disinfection as a potential adjunctive therapy for non-severe COVID-19

text: PURPOSE: SARS-CoV-2 is a new pandemic influenza caused by a coronavirus which main route of transmission is through exhaled droplets that primarily infect the nose and the nasopharynx. The aim of this paper is to evaluate the effect of acetic acid, the active component of vinegar, as a potential disinfectant agent for upper airways. METHODS: Twenty-nine patients were enrolled and divided into two groups: group 1 (14 patients) was composed of patients treated with off-label hydroxychloroquine and lopinavir/ritonavir, whereas group 2 (15 patients) was composed of patients treated with hydroxychloroquine only, combined with the inhalation of acetic acid disinfectant at a 0.34% concentration. A questionnaire-based evaluation of symptoms was performed after 15 days in both groups. RESULTS: It appears that the number of patients treated with acetic acid (group 2) that experienced improvement in individual symptoms was double that of the other group of patients (group 1), although numbers are too small for robust statistical analysis. CONCLUSIONS: Considering its potential benefits and high availability, acetic acid disinfection appears to be a promising adjunctive therapy in cases of non-severe COVID-19 and deserves further investigation.


title: Status of Pituitary Surgery During the COVID-19 Pandemic

text: Even in ideal circumstances, the performance of safe and effective endoscopic transsphenoidal pituitary surgery requires complicated orchestration of care amongst multiple medical and surgical teams in the preoperative, intraoperative, and postoperative settings. The current COVID-19 pandemic further complicates this highly orchestrated effort. Healthcare systems around the globe are working to adapt to the rapidly changing healthcare landscape as information about the SARS-CoV-2 virus is discovered and disseminated. The nature of the transsphenoidal corridor exposes the pituitary surgery team to increased risk of virus exposure.


title: Ten considerations for effectively managing the COVID-19 transition

text: Governments around the world have implemented measures to manage the transmission of coronavirus disease 2019 (COVID-19). While the majority of these measures are proving effective, they have a high social and economic cost, and response strategies are being adjusted. The World Health Organization (WHO) recommends that communities should have a voice, be informed and engaged, and participate in this transition phase. We propose ten considerations to support this principle: (1) implement a phased approach to a 'new normal'; (2) balance individual rights with the social good; (3) prioritise people at highest risk of negative consequences; (4) provide special support for healthcare workers and care staff; (5) build, strengthen and maintain trust; (6) enlist existing social norms and foster healthy new norms; (7) increase resilience and self-efficacy; (8) use clear and positive language; (9) anticipate and manage misinformation; and (10) engage with media outlets. The transition phase should also be informed by real-time data according to which governmental responses should be updated.


Covid-19 pandemic: Infection control in dental health care of infected patients-a state concept


title: TB infection and BCG vaccination: are we protected from COVID-19?

text: OBJECTIVES: The incidence of emerging coronavirus disease 2019 (COVID-19) disease is variable across the different parts of the world. Apart from travel patterns, other factors determining this difference may include host immune response. The aim of this study was to assess the effect of tuberculosis (TB) endemicity and Bacille Calmette-Guerin (BCG) coverage on COVID-19. STUDY DESIGN: This was a cross-sectional study. METHODS: We reviewed available data regarding TB incidence, BCG coverage (as per the World Health Organization), and COVID-19 incidence of 174 countries. We divided the countries into four cohorts depending on annual TB incidence and BCG coverage. RESULTS: Countries with high TB incidence had lower COVID-19 than countries with low TB incidence. Similarly, countries with high BCG coverage had lower incidence of COVID-19, suggesting some protective mechanisms in TB-endemic areas. However, the ecological differences and different testing strategies between countries could not be accounted for in this analysis. CONCLUSION: Higher TB incidence and BCG coverage were found to be associated with lesser incidence of COVID-19. This outcome paves the way for further research into pathogenesis and immune response in COVID-19.


title: SOCRATES: an online tool leveraging a social contact data sharing initiative to assess mitigation strategies for COVID-19

text: OBJECTIVE: Establishing a social contact data sharing initiative and an interactive tool to assess mitigation strategies for COVID-19. RESULTS: We organized data sharing of published social contact surveys via online repositories and formatting guidelines. We analyzed this social contact data in terms of weighted social contact matrices, next generation matrices, relative incidence and R[Formula: see text]. We incorporated location-specific physical distancing measures (e.g. school closure or at work) and capture their effect on transmission dynamics. All methods have been implemented in an online application based on R Shiny and applied to COVID-19 with age-specific susceptibility and infectiousness. Using our online tool with the available social contact data, we illustrate that physical distancing could have a considerable impact on reducing transmission for COVID-19. The effect itself depends on assumptions made about disease-specific characteristics and the choice of intervention(s).


Apnea neonatal como manifestación inicial de infección por SARS-CoV-2./ [Neonatal apnea as initial manifestation of SARS-CoV-2 infection]


title: Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study

text: BACKGROUND: The COVID-19 pandemic is challenging advanced health systems, which are dealing with an overwhelming number of patients in need of intensive care for respiratory failure, often requiring intubation. Prone positioning in intubated patients is known to reduce mortality in moderate-to-severe acute respiratory distress syndrome. We aimed to investigate feasibility and effect on gas exchange of prone positioning in awake, non-intubated patients with COVID-19-related pneumonia. METHODS: In this prospective, feasibility, cohort study, patients aged 18-75 years with a confirmed diagnosis of COVID-19-related pneumonia receiving supplemental oxygen or non-invasive continuous positive airway pressure were recruited from San Gerardo Hospital, Monza, Italy. We collected baseline data on demographics, anthropometrics, arterial blood gas, and ventilation parameters. After baseline data collection, patients were helped into the prone position, which was maintained for a minimum duration of 3 h. Clinical data were re-collected 10 min after prone positioning and 1 h after returning to the supine position. The main study outcome was the variation in oxygenation (partial pressure of oxygen [PaO2]/fractional concentration of oxygen in inspired air [FiO2]) between baseline and resupination, as an index of pulmonary recruitment. This study is registered on ClinicalTrials.gov, NCT04365959, and is now complete. FINDINGS: Between March 20 and April 9, 2020, we enrolled 56 patients, of whom 44 (79%) were male; the mean age was 57·4 years (SD 7·4) and the mean BMI was 27·5 kg/m2 (3·7). Prone positioning was feasible (ie, maintained for at least 3 h) in 47 patients (83·9% [95% CI 71·7 to 92·4]). Oxygenation substantially improved from supine to prone positioning (PaO2/FiO2 ratio 180·5 mm Hg [SD 76·6] in supine position vs 285·5 mm Hg [112·9] in prone position; p<0·0001). After resupination, improved oxygenation was maintained in 23 patients (50·0% [95% CI 34·9-65·1]; ie, responders); however, this improvement was on average not significant compared with before prone positioning (PaO2/FiO2 ratio 192·9 mm Hg [100·9] 1 h after resupination; p=0·29). Patients who maintained increased oxygenation had increased levels of inflammatory markers (C-reactive protein: 12·7 mg/L [SD 6·9] in responders vs 8·4 mg/L [6·2] in non-responders; and platelets: 241·1â×â103/µL [101·9] vs 319·8â×â103/µL [120·6]) and shorter time between admission to hospital and prone positioning (2·7 days [SD 2·1] in responders vs 4·6 days [3·7] in non-responders) than did those for whom improved oxygenation was not maintained. 13 (28%) of 46 patients were eventually intubated, seven (30%) of 23 responders and six (26%) of 23 non-responders (p=0·74). Five patients died during follow-up due to underlying disease, unrelated to study procedure. INTERPRETATION: Prone positioning was feasible and effective in rapidly ameliorating blood oxygenation in awake patients with COVID-19-related pneumonia requiring oxygen supplementation. The effect was maintained after resupination in half of the patients. Further studies are warranted to ascertain the potential benefit of this technique in improving final respiratory and global outcomes. FUNDING: University of Milan-Bicocca.


title: La atención farmacéutica en pacientes ingresados. (Gestión de la crisis pandemia COVID-19. Un nuevo desafío para los servicios de farmacia)./ Pharmaceutical care in hospitalized patients. (Management of the COVID-19 pandemic crisis. A new challenge for pharmacy services)

text: During the pandemic caused by the SARS-CoV-2 virus, pharmacy services have had to adapt their service portfolio, and yet ensure efficient, equitable and quality pharmaceutical care. Given the limited scientific evidence available, most drugs have been used off-label or in the context of clinical trials, which should be the preferred option in order to create new evidence. Among kind different situations we have faced are the increase in workload, the expansion of coverage to new wards and ICUs and shortages, which have caused the use of alternative drugs and even other routes of administration. Given that covid-19 affects elderly population with greater severity and many of them are polymedicated, great effort have been focused on monitoring interactions, both pharmacokinetic and pharmacodynamic (specially prolongation of the QT interval), monitoring correct concentrations of electrolytes, nutritional support, adaptation of chemotherapy treatment protocols and anticoagulant management, among others. The use of personal protective equipment added difficulty for nursing work and some measures had been taken to minimize the number of entries into the rooms. Eventually, team's split to guarantee care, the challenge of teleworking, remote validation, telemedicine and telepharmacy for communication between professionals and patients, as well as training in this pandemic situation have been a challenge for our profession. These difficulties have risen up new learning opportunities we hope will be useful to us in the event we have to face similar situations in the future.


Radiology training in the COVID-19 era: our new normal


title: 4-month-old boy coinfected with COVID-19 and adenovirus

text: A 4-month-old boy with a history of muscular ventricular septal defect and atopic dermatitis presented with decreased oral intake, loose stools, stuffy nose, mild cough and diaphoresis. The patient had an in-home exposure to COVID-19. The initial respiratory pathogen panel was positive for adenovirus, consistent with his symptoms. The following day, the COVID-19 PCR was also positive. The patient was treated with supportive care, isolation precautions were implemented and the patient was discharged on day 4. This case demonstrates the importance of testing for COVID-19 even if a patient tests positive for another virus due to the possibility of coinfection, especially in children, in order to limit spread of COVID-19 to others.


title: An effective approach to reduce the penetration potential of Sars-Cov-2 and other viruses by spike protein: Through surface particle electrostatic charge negotiation

text: The objective of this paper is to provide a mathematical model to construct a barrier that may be useful to prevent the penetration of different viruses (Eg. SARS-COV-2) as well as charged aerosols through the concept of electrostatic charge negotiation. (Fusion for the opposite types of charges and repulsion for the similar types of charges). Reviewing the works of different authors, regarding charges, surface charge densities ({\sigma}), charge mobility ({\mu}) and electrostatic potentials of different aerosols under varied experimental conditions, a similar intensive study has also been carried out to investigate the electron donating and accepting (hole donating) properties of the spike proteins (S-proteins) of different RNA and DNA viruses, including SARS-COV-2. Based upon the above transport properties of electrons of different particles having different dimensions, a mathematical model has been established to find out the penetration potential of those particles under different electrostatic fields. An intensive study have been carried out to find out the generation of electrostatic charges due to the surface emission of electrons (SEE), when a conducting material like silk, nylon or wool makes a friction with the Gr IV elements like Germanium or Silicon, it creates an opposite layer of charges in the outer conducting surface and the inner semiconducting surface separated by a dielectric materials. This opposite charge barriers may be considered as Inversion layers (IL). The electrostatic charges accumulated in the layers between the Gr IV Ge is sufficient enough to either fuse or repel the charges of the spike proteins of the RNA, DNA viruses including SARS-Cov-2 (RNA virus) or the aerosols.


title: The orthopaedic and traumatology scenario during Covid-19 outbreak in Italy: chronicles of a silent war

text: BACKGROUND: From February 21, the day of hospitalisation in ICU of the first diagnosed case of Covid-19, the social situation and the hospitals' organisation throughout Italy dramatically changed. METHODS: The CIO (Club Italiano dell'Osteosintesi) is an Italian society devoted to the study of traumatology that counts members spread in public and private hospitals throughout the country. Fifteen members of the CIO, Chairmen of 15 Orthopaedic and Trauma Units of level 1 or 2 trauma centres in Italy, have been involved in the study. They were asked to record data about surgical, outpatients clinics and ER activity from the 23rd of February to the 4th of April 2020. The data collected were compared with the data of the same timeframe of the previous year (2019). RESULTS: Comparing with last year, overall outpatient activity reduced up to 75%, overall Emergency Room (ER) trauma consultations up to 71%, elective surgical activity reduced up to 100% within two weeks and trauma surgery excluding femoral neck fractures up to 50%. The surgical treatment of femoral neck fractures showed a stable reduction from 15 to 20% without a significant variation during the timeframe. CONCLUSIONS: Covid-19 outbreak showed a tremendous impact on all orthopaedic trauma activities throughout the country except for the surgical treatment of femoral neck fractures, which, although reduced, did not change in percentage within the analysed timeframe.


title: Characteristics of asymptomatic patients with SARS-CoV-2 infection in Jinan, China

text: Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is continuously and rapidly circulating at present. Asymptomatic patients have been proven to be contagious and thus pose a significant infection control challenge. Here we describe the characteristics of asymptomatic patients with SARS-CoV-2 infection in Jinan, Shandong province, China. A total of 47 patients with confirmed COVID-19 were recruited. Among them, 11 patients were categorized as asymptomatic cases. We found that the asymptomatic patients in Jinan were relatively young and were mainly clustered cases. The laboratory indicators and lung lesion on chest CT were mild. No special factors were found accounting for the presence or absence of symptoms. The presence of asymptomatic patients increased the difficulty of screening. It is necessary to strengthen the identification of such patients in the future.


The use of UV fluorescent powder for COVID-19 airway management simulation training


When a global pandemic complicates cancer care: Although oncologists and their patients are accustomed to fighting tough battles against a lethal disease, Coronavirus Disease 2019 (COVID-19) has posed an unprecedented challenge


Drug-Induced Liver Injury and COVID-19 Infection: The Rules Remain the Same


title: Maximizing virtual meetings and conferences: a review of best practices

text: PURPOSE: In the current COVID-19 pandemic, it is more important than ever to maximize communication in the scientific and medical community. In the context of academic meetings and conferences, there is the growing need for a set of guidelines secondary to the COVID-19 pandemic, and the growing environmental and economic challenges that large academic and medical conferences face. These Virtual Meetings Best Practices were established in response to the scant evidence and guidance on the topic. METHODS: These best practice guidelines were developed from a scoping review of peer-reviewed literature, grey literature and lay literature. MEDLINE and Embase databases were scoped for relevant, non-duplicate articles. For lay articles, Google searches were utilized. The recommendations that comprise this document are a compilation of nonexperimental descriptive studies (e.g. case studies) and expert committee reports, opinions and/or experience of respected authorities, and lay articles. RESULTS: We identified four phases of the meeting cycle: Pre-planning considerations, Planning, Accomplishing conference goals through execution, gauging Response and Engaging the target audience for future cycles (PrePARE). Akin to the Plan, Do, Study, Act Cycle of quality improvement interventions, this document is meant to drive meaningful initial and subsequent interventions in the meetings of the medical and academic community. This covers actions and preparation for registration, scheduling, speakers, attendees, event type, technology, monetization/marketing, dealing with disruptions, post-event deliverables, response and engagement strategies. Enhanced access to integrated, high-quality and efficient virtual meetings will establish a new norm as an effective alternative for innovative health research, education and information dissemination in orthopaedics and beyond. CONCLUSIONS: Given the uncertainty of whether large in-person gatherings will be permitted, advisable or responsible later into the summer of 2020 and beyond, these guidelines will aid events being converted and scheduled as virtual-only meetings. As we move forward in the era of increased utility and utilization of virtual conferencing, these guidelines will serve as a benchmark and standard for surgeons in the field.


Guidance and best practices for nuclear cardiology laboratories during the coronavirus disease 2019 (COVID-19) pandemic: An Information Statement from ASNC and SNMMI


title: Assurer les soins aux patients souffrant de troubles psychiques en France pendant l'épidémie à SARS-CoV-2./ [Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review]

text: OBJECTIVE: The lack of ressources and coordination to face the epidemic of coronavirus raises concerns for the health of patients with mental disorders in a country where we keep in memory the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims at proposing guidance to ensure mental health care during the SARS-CoV epidemy in France. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature and local initiatives in France. RESULTS: We identified four types of major vulnerabilities in patients suffering from mental disorders during this pandemic: (1) medical comorbidities that are more frequently found in patients suffering from mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which represent risk factors for severe infections with Covid-19; (2) age (the elderly constituting the population most vulnerable to coronavirus); (3) cognitive and behavioral troubles which can hamper compliance with confinement and hygiene measures and finally and (4) psychosocial vulnerability due to stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly adapted to psychiatric establishments in a context of major shortage of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds are closed, wards have a high density of patients, mental health community facilities are closed, medical teams are understaffed and poorly trained to face infectious diseases. We could also face major issues in referring patients with acute mental disorders to intensive care units. To maintain continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of Covid+ units. These units are under the dual supervision of a psychiatrist and of an internist/infectious disease specialist; all new entrants should be placed in quarantine for 14 days; the nurse staff should benefit from specific training, from daily medical check-ups and from close psychological support. Family visits would be prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management should be organized with the possibility of home visits, in order to support them when they get back home and to help them to cope with the experience of confinement, which is at risk to induce recurrences of mental disorders. The total or partial closure of mental health community facilities is particularly disturbing for patients but a regular follow-up is possible with telemedicine and should include the monitoring of the suicide risk and psychoeducation strategies; developing support platforms could also be very helpful in this context. Private psychiatrists have also a crucial role of information with their patients on confinement and barrier measures, but also on measures to prevent the psychological risks inherent to confinement: maintenance of sleep regularity, physical exercise, social interactions, stress management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic. DISCUSSION: French mental healthcare is now in a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the containment of the general population.


Letter to the Editor: Angiotensin-converting enzyme 2: an ally or a Trojan horse? Implications to SARS-CoV-2-related cardiovascular complications


Olfactory and gustatory dysfunctions in COVID-19. First reports of Latin-American ethnic patients


title: Greek Traditional Dance as a Practice for Managing Stress and Anxiety in Cancer Patients

text: Stress and anxiety levels in cancer patients tend to decrease by performing bodily-kinesthetic and musical activities. The hypothesis of the present study is that attending lessons in Greek traditional dance is an effective method for managing anxiety and stress in patients diagnosed with cancer of any type both during and after treatment. The study was conducted on 300 cancer patients (150 experimental subjects, 150 controls) selected by Attica hospitals and nonprofit cancer patients' organizations. Each patient in the experimental group attended an 8-week Greek traditional dance lesson program. Lessons were held twice per week, lasting 60 min each. A similar group of cancer patients not participating in any organized physical activity during the same time period served as a control group. Data were collected using the Depression Anxiety Stress Scale 21 (Dass-21) questionnaire and subjected to reliability analysis (Cronbach's alpha) and deviation-dependent analysis (one-way repeated). Both stress and anxiety values decreased significantly in the experimental group (stress value: initial mean = 16.27, second mean = 2.58, final mean = 6.77, p < 0.001; anxiety value: initial mean = 15.59, second mean = 2.81, final mean = 5.35, p < 0.001). In contrast, no significant fluctuation was observed in the control group. Thus, there was a significant decrease in stress and anxiety values in cancer patients who attended Greek traditional dances lessons with important psychotherapeutic significance.


On the use of corticosteroids for 2019-nCoV pneumonia


title: Evaluation of COVID 19 infection in 279 cancer patients treated during a 90-day period in 2020 pandemic

text: BACKGROUND: The aim of this study was investigation of COVID-19 disease and its outcome in cancer patients who needed treatment, in a 90-day period. METHODS: Cancer patient who required treatment, were evaluated for potential COVID-19 infection in a 90-day period, starting from beginning of this epidemic in Iran, January, to April 19, 2020. For treatment of solid tumor patients, if they did not have symptoms related to COVID-19, just chest X-ray was requested. If they showed COVID-19 related symptoms, high resolution CT scan of lungs was requested. For hematology cancer patients, PCR test for COVID-19 infection was requested as well. Protection measures were considered for personnel of oncology wards. RESULTS: 279 Patients were followed up in this 90-day period. No COVID-19 infection was observed in 92 cases of breast cancer, 14 cases of gastric cancer and 12 cases of pancreaticobiliary cancer. However, in 72 cases of colon cancer, 11 cases of lung cancer, 5 cases brain tumors and 12 cases ovarian cancer; 4 cases of COVID-19 were observed. In the hematology cancers group, which included 14 cases of Hodgkin's disease, 23 cases of lymphoproliferative disorder, 12 cases of acute leukemia and 12 cases of multiple myeloma; 3 cases of COVID-19 were observed. CONCLUSION: Patients with cancer who need treatment can be treated by taking some measures. These measures include observing individual and collective protection principles in patients and health-care personnel, increasing patients' awareness particularly about self-care behavior, performing a COVID-19 test, and taking a chest X-ray, before the treatment starts.


title: Treatment of Hepatocellular Carcinoma (HCC) during the COVID-19 Outbreak: The Working Group Report of JAMTT-HCC

text: This contingency guide was formulated on the premise that delivering standard treatment for hepatocellular carcinoma (HCC) has come under strain due to the COVID-19 pandemic. Measures required are likely to vary largely across regions and individual institutions, depending on the level of the strain imposed by the pandemic (e.g., number of inpatients infected with COVID-19 and the availability of resources, including personal protective equipment and inpatient beds). Also, models suggest that second and third waves of COVID-19 will occur before effective vaccines and medicines become widely available in Japan (expected time, 2-3 years). This guide should serve as a good reference for best practices in the management of HCC in light of the possible risk of impending collapse of the healthcare system due to a surge in COVID-19 infections.


title: Evaluación de la teleconsulta en el paciente urológico durante la pandemia COVID-19./ Evaluación de la teleconsulta en el paciente urológico durante la pandemia COVID-19./ Evaluation of teleconsultation system in the urological patient during the COVID-19 pandemic

text: INTRODUCTION: The global pandemic of COVID-19 has led to rapid implementation of telemedicine, but there is little information on patient satisfaction of this system as an alternative to face-to-face care. OBJECTIVE: To evaluate urological patient satisfaction with teleconsultation during the COVID-19 pandemic. MATERIAL AND METHODS: Observational, prospective, cross-sectional, non-interventional study carried out by telephone survey during the period considered as the peak of the pandemic (March-April 2020). A quality survey composed of 11 questions on urological care provided by physicians during the COVID-19 pandemic was conducted, selecting a representative sample of patients attended by teleconsultation. RESULTS: Two hundred patients were contacted by telephone to answer a survey on the quality of teleconsultation. The distribution of patients surveyed among the specialized consultations was homogeneous with the number of consultations cited in the period; 18% of them required assistance from family members. Sixty percent of patients avoided going to a medical center during the pandemic. Of the surveyed patients, 42% had cancelled diagnostic tests, 59% had cancelled medical consultations, 3.5% had cancelled treatments and 1% had cancelled interventions. Ten percent reported a worsening of urological symptoms during confinement. According to physicians, consultations were effectively delivered in 72% of cases, with teleconsultation being carried out by their usual urologist in 81%. Teleconsultation overall satisfaction level was 9 (IQI8-10), and 61.5% of respondents consider teleconsultation as a «health care option¼ after the healthcare crisis. CONCLUSION: Teleconsultation has been evaluated with a high level of satisfaction during the COVID-19 pandemic, offering continuous care to urological patients during the healthcare crisis. The perceived quality offers a field of optional telematic assistance in selected patients, which should be re-evaluated in a period without confinement measures.


title: CANINE DISTEMPER VIRUS IN THE SEA OTTER (ENHYDRA LUTRIS) POPULATION IN WASHINGTON STATE, USA

text: Before 2001, all serosurveys for morbilliviruses in sea otters (Enhydra lutris) in California, Washington, and Alaska, USA, documented a 0% seroprevalence. The first published serologic detections of morbillivirus in sea otters occurred in 2001-02 in live-captured Washington sea otters, with a documented 80% seroprevalence. We conducted a retrospective study of sea otter cases from 1989 to 2010 compiled at the US Geological Survey, National Wildlife Health Center to identify cases of morbilliviral disease in Washington sea otters and to characterize the disease using immunohistochemistry, reverse transcription (RT)-PCR, genetic sequencing, virus isolation, and serology. We identified six cases of morbilliviral disease and 12 cases of morbilliviral infection in this population of sea otters during 2000-10. Significant histologic findings included inflammation in the white and gray matter of the brain characterized by lymphoplasmacytic perivascular cuffing, neuronal necrosis, and satellitosis in gray matter and by spongiosis, myelin degeneration, spheroids, and gemistocytes in white matter. Intranuclear and intracytoplasmic viral inclusion bodies were found in neurons, Purkinje cells, and glia. Immunohistochemistry for canine distemper virus (CDV) showed positive staining in neurons, glial cells, and cell processes. A pan-morbillivirus RT-PCR with subsequent restriction endonuclease digestion or sequencing identified CDV. Virus isolation was not successful. Two sea otters with morbilliviral encephalitis showed greater antibody titers to CDV than phocine distemper virus. Histologic changes were confined to the central nervous system and resembled neurologic canine distemper in domestic dogs. Cases of sea otters with morbilliviral infection without histologic changes could represent early infections or incompletely cleared sublethal infections. We found that morbillivirus was present in the Washington sea otter population as early as 2000, and we provide a description of the pathology of canine distemper in sea otters.


COVID-19: community CPAP and NIV should be stopped unless medically necessary to support life


title: Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship

text: We investigated the clinical course of individuals with 2019 novel coronavirus disease (COVID-19) who were transferred from the Diamond Princess cruise ship to 12 local hospitals. The conditions and clinical courses of patients with pneumonia were compared with those of patients without pneumonia. Among 70 patients (median age: 67 years) analyzed, the major symptoms were fever (64.3%), cough (54.3%), and general fatigue (24.3%). Forty-three patients (61.4%) had pneumonia. Higher body temperature, heart rate, and respiratory rate as well as higher of lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and C-reactive protein (CRP) levels and lower serum albumin level and lymphocyte count were associated with the presence of pneumonia. Ground-glass opacity was found in 97.7% of the patients with pneumonia. Patients were administered neuraminidase inhibitors (20%), lopinavir/ritonavir (32.9%), and ciclesonide inhalation (11.4%). Mechanical ventilation and veno-venous extracorporeal membrane oxygenation was performed on 14 (20%) and 2 (2.9%) patients, respectively; two patients died. The median duration of intubation was 12 days. The patients with COVID-19 transferred to local hospitals during the outbreak had severe conditions and needed close monitoring. The severity of COVID-19 depends on the presence of pneumonia. High serum LDH, AST and CRP levels and low serum albumin level and lymphocyte count were found to be predictors of pneumonia. It was challenging for local hospitals to admit and treat these patients during the outbreak of COVID-19. Assessment of severity was crucial to manage a large number of patients.


title: Using Computer Vision to enhance Safety of Workforce in Manufacturing in a Post COVID World

text: The COVID-19 pandemic forced governments across the world to impose lockdowns to prevent virus transmissions. This resulted in the shutdown of all economic activity and accordingly the production at manufacturing plants across most sectors was halted. While there is an urgency to resume production, there is an even greater need to ensure the safety of the workforce at the plant site. Reports indicate that maintaining social distancing and wearing face masks while at work clearly reduces the risk of transmission. We decided to use computer vision on CCTV feeds to monitor worker activity and detect violations which trigger real time voice alerts on the shop floor. This paper describes an efficient and economic approach of using AI to create a safe environment in a manufacturing setup. We demonstrate our approach to build a robust social distancing measurement algorithm using a mix of modern-day deep learning and classic projective geometry techniques. We have deployed our solution at manufacturing plants across the Aditya Birla Group (ABG). We have also described our face mask detection approach which provides a high accuracy across a range of customized masks.


Dear Dermatoethicist:The Ethics of Charging Patients an Infection Control Fee in the Context of COVID-19


title: COVID-19 and Moral Imperialism in Multinational Clinical Research

text: A TV debate in April 2020 between two French doctors regarding the benefits of testing a coronavirus vaccine in Africa where there are no masks or treatments available has led to international criticism. This case highlights a problematic ethical double standard in multinational clinical research: trials that would be considered unethical in high income countries (e.g., placebo-controlled where there is an existing treatment) are nonetheless justified in low-and-middle-income countries because the existing standards of care are less (i.e., no access to a treatment). Underlying this ethical double standard in some multinational clinical trials is a moral imperialism and persistent colonialist thinking that must be rejected.


title: [Supporting the battle against COVID-19 in E'zhou, Hubei Province: the experience of Guizhou medical team]

text: To suppress the rapid spread of coronavirus disease 2019 (COVID-19) in Hubei province, a medical rescue team consisting of 860 members was sent to E'zhou, one of the hard-hit cities in east Hubei. A total of 414 of the team members, whose core members were from Guizhou Medical University and its Affiliated Hospital, took over the full operation of Leishan hospital of E'zhou, a makeshift hospital built for treating COVID-19 patients. Under the instructions by the E'zhou Medical Team Front Command, the staff made quick responses to the surging number of patients with COVID-19 and rapidly formulated treatment plans based on the local conditions. The medical team efficiently carried out the operations and successfully completed the rescue mission. Herein the authors, as members of Guizhou Medical Team supporting COVID-19 containment in E'zhou, analyze and summarize the experiences of Guizhou Medical Team with the organization, implementation and logistic support of medical rescue operations, which may provide reference for future rescue missions in a similar scenario.


title: Rapid point-of-care serology testing for sars-cov-2/ Snabbtest for covid-19-antikroppar bor utforas av utbildad personal

text: Increasing evidence indicates immunity against severe acute respiratory syndrome coronavirus 2 (sars-cov-2) after covid-19, but it remains unclear for how long the protection remains Serology testing seems to have a higher sensitivity than molecular diagnostics from 8 days after onset of symtoms, and should be part of risk assessment and epidemiological studies of COVID-19 The performance of commercial serological point-of-care (POC) lateral flow tests are highly manufacturer-dependant Low sensitivity increases the risk of false negative results and could result in unnecessary quarantine of test persons with developed antibodies Low specificity increases the risk of false positive results and could lead to false assumptions of immunity Carefully selected serological POC tests for sars-cov-2 can be used in large scale testing but should only be used by licensed medical staff able to understand their limitations and interpret the results


Assessing the impact of lockdown: Fresh challenges for the care of haematology patients in the COVID-19 pandemic


The Power of Telehealth Has Been Unleashed


Analysis of clinical and demographic heterogeneity of patients dying from COVID-19 in Brazil versus China and Italy


Protecting patients with IBD during the COVID-19 pandemic


EDITORIAL: COVID-19 and Anxiety and Depression in 2020


COVID-19: Stay Cool toward Corticosteroids


title: North American COVID-19 ST-segment elevation myocardial infarction (NACMI) registry: Rationale, design, and implications

text: Background: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that causes coronavirus disease 2019 (COVID-19), has resulted in a global pandemic. Patients with cardiovascular risk factors or established cardiovascular disease are more likely to experience severe or critical COVID-19 illness and myocardial injury is a key extra-pulmonary manifestation. These patients frequently present with ST-elevation on an electrocardiogram (ECG) due to multiple etiologies including obstructive, non-obstructive, and/or angiographically normal coronary arteries. The incidence of ST-elevation myocardial infarction (STEMI) mimics in COVID-19 positive hospitalized patients, and the association with morbidity and mortality is unknown. Understanding the natural history and appropriate management of COVID-19 patients presenting with ST elevation is essential to inform patient management decisions and protect healthcare workers. Methods: The Society for Cardiovascular Angiography and Interventions (SCAI) and The Canadian Association of Interventional Cardiology (CAIC) in conjunction with the American College of Cardiology Interventional Council have collaborated to create a multi-center observational registry, North American COVID-19 ST-Segment Elevation Myocardial Infarction (NACMI). This registry will enroll confirmed COVID-19 patients and persons under investigation (PUI) with new ST-segment elevation or new onset left bundle branch block (LBBB) on the ECG with clinical suspicion of myocardial ischemia. We will compare demographics, clinical findings, outcomes and management of these patients with a historical control group of over 15,000 consecutive STEMI activation patients from the Midwest STEMI Consortium using propensity matching. The primary clinical outcome will be in- hospital major adverse cardiovascular events (MACE) defined as composite of all-cause mortality, stroke, recurrent MI, and repeat unplanned revascularization in COVID-19 confirmed or PUI. Secondary outcomes will include the following: reporting of etiologies of ST Elevation; cardiovascular mortality due to myocardial infarction, cardiac arrest and /or shock; individual components of the primary outcome; composite primary outcome at one year; as well as ECG and angiographic characteristics. Conclusion: The multicenter NACMI registry will collect data regarding ST elevation on ECG in COVID-19 patients to determine the etiology and associated clinical outcomes. The collaboration and speed with which this registry has been created, refined, and promoted serves as a template for future research endeavors.


Will we see protection or reinfection in COVID-19?


title: The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study

text: The containment measures implemented to reduce the progression of the COVID-19 pandemic can increase the risk of serious mental disorders, including obsessive-compulsive disorder (OCD). The general fear of getting infected and the importance given to personal hygiene, may have a negative impact on this clinical population. In a group of patients with OCD who had completed an evidence-based therapeutic path for OCD before the quarantine, this study evaluated the changes on OCD symptoms during the quarantine and investigated the effects of contamination symptoms and remission state before the quarantine on OCD symptom worsening during the quarantine. The Yale-Brown Obsessive Compulsive (Y-BOCS) Severity score, administered before the quarantine, was re-administered after six weeks since the beginning of the complete lockdown. A significant increase in obsession and compulsion severity emerged. Remission status on OCD symptoms and having contamination symptoms before the quarantine were significantly associated with more elevated OCD symptom worsening during the quarantine. To our knowledge, this is the first study which assessed OCD symptoms at the COVID-19 time. Our results support the need to improve relapse prevention during the period of social restrictions and develop alternative strategies such as online consultations and digital psychiatric management.


Immune Thrombocytopenic Purpura in a Patient with Covid-19


title: [Dynamic basic reproduction number based evaluation for current prevention and control of COVID-19 outbreak in China]

text: Objective: To evaluate the current status of the prevention and control of coronavirus disease (COVID-19) outbreak in China, establish a predictive model to evaluate the effects of the current prevention and control strategies, and provide scientific information for decision-making departments. Methods: Based on the epidemic data of COVID-19 openly accessed from national health authorities, we estimated the dynamic basic reproduction number R(0)(t) to evaluate the effects of the current COVID-19 prevention and control strategies in all the provinces (municipalities and autonomous regions) as well as in Wuhan and the changes in infectivity of COVID-19 over time. Results: For the stability of the results, 24 provinces (municipality) with more than 100 confirmed COVID-19 cases were included in the analysis. At the beginning of the outbreak, the R(0)(t) showed unstable trend with big variances. As the strengthening of the prevention and control strategies, R(0)(t) began to show a downward trend in late January, and became stable in February. By the time of data analysis, 18 provinces (municipality) (75%) had the R(0)(t)s less than 1. The results could be used for the decision making to free population floating conditionally. Conclusions: Dynamic R(0)(t) is useful in the evaluation of the change in infectivity of COVID-19, the prevention and control strategies for the COVID-19 outbreak have shown preliminary effects, if continues, it is expected to control the COVID-19 outbreak in China in near future.


title: Dynamic basic reproduction number based evaluation for current prevention and control of COVID-19 outbreak in China/ 中华流行病学杂志

text: Objective@#To evaluate the current status of the prevention and control of coronavirus disease (COVID-19) outbreak in China, establish a predictive model to evaluate the effects of the current prevention and control strategies, and provide scientific information for decision- making departments.@*Methods@#Based on the epidemic data of COVID-19 openly accessed from national health authorities, we estimated the dynamic basic reproduction number R0(t) to evaluate the effects of the current COVID-19 prevention and control strategies in all the provinces (municipalities and autonomous regions) as well as in Wuhan and the changes in infectivity of COVID-19 over time.@*Results@#For the stability of the results, 24 provinces (municipality) with more than 100 confirmed COVID-19 cases were included in the analysis. At the beginning of the outbreak, the R0(t) showed unstable trend with big variances. As the strengthening of the prevention and control strategies, R0(t) began to show a downward trend in late January, and became stable in February. By the time of data analysis, 18 provinces (municipality) (75%) had the R0(t)s less than 1. The results could be used for the decision making to free population floating conditionally.@* Conclusions@#Dynamic R0(t) is useful in the evaluation of the change in infectivity of COVID-19, the prevention and control strategies for the COVID-19 outbreak have shown preliminary effects, if continues, it is expected to control the COVID-19 outbreak in China in near future.


title: The clinical and immunological features of pediatric COVID-19 patients in China

text: In December 2019, the corona virus disease 2019 (COVID-19) caused by novel coronavirus (SARS-CoV-2) emerged in Wuhan, China and rapidly spread worldwide. Few information on clinical features and immunological profile of COVID-19 in paediatrics. The clinical features and treatment outcomes of twelve paediatric patients confirmed as COVID-19 were analyzed. The immunological features of children patients was investigated and compared with twenty adult patients. The median age was 14.5-years (range from 0.64 to 17), and six of the patients were male. The average incubation period was 8 days. Clinically, cough (9/12, 75%) and fever (7/12, 58.3%) were the most common symptoms. Four patients (33.3%) had diarrhea during the disease. As to the immune profile, children had higher amount of total T cell, CD8+ T cell and B cell but lower CRP levels than adults (P < 0.05). Ground-glass opacity (GGO) and local patchy shadowing were the typical radiological findings on chest CT scan. All patients received antiviral and symptomatic treatment and the symptom relieved in 3-4 days after admitted to hospital. The paediatric patients showed mild symptom but with longer incubation period. Children infected with SARS-CoV-2 had different immune profile with higher T cell amount and low inflammatory factors level, which might ascribed to the mild clinical symptom. We advise that nucleic acid test or examination of serum IgM/IgG antibodies against SARS-CoV-2 should be taken for children with exposure history regardless of clinical symptom.


The COVID-19 Pandemic: A View From Vietnam


Understanding the emerging coronavirus: what it means for health security and infection prevention


title: COVID-19 tsunami: the first case of a spinal cord injury patient in Italy

text: INTRODUCTION: We present the report of the first, to our best knowledge, case of COVID-19 in a tetraplegic person. CASE PRESENTATION: A 56-year-old male with AIS A C4 tetraplegia developed fever during the night, without any prodrome. His general practitioner suspected a urinary tract infection and prescribed him antibiotic therapy. After 2 days of antibiotic therapy the fever still persisted, so the individual was admitted to the local hospital and treated with broad-spectrum antibiotics. After 2 days he was transferred to our spinal unit. Considering the worsening of the chest X-ray and fever despite 48 h of broad-spectrum antibiotic therapy, we strongly suspected viral pneumonia. SARS-CoV-2 was detected and antiviral therapy with Lopinavir/Ritonavir, associated with hydroxychloroquine, was promptly started. Fever ceased after 2 days of therapy. DISCUSSION: Blood test and chest X-ray findings in this patient were similar to previously published findings regarding COVID-19. One difference between this case and the known clinical course of COVID-19 is that did not develop cough. Another interesting feature of our case is that, despite tetraplegia, the clinical course was not severe. Persons with COVID-19 remain asymptomatic, these results underscore the need for rehabilitation and SCI professionals to have a high index of suspicion for COVID-19 in their inpatient and outpatient clients. Only inpatient with fever hase being tested for COVID-19. All new patients are submitted to SARS-COV-2 Test. Moreover, routine testing of patients who have to participate in therapy in common gym areas may be warranted.


Androgen deprivation and SARS-CoV-2 in men with prostate cancer


title: Co-infection with respiratory pathogens among COVID-2019 cases

text: Accumulating evidence shows that microbial co-infection increases the risk of disease severity in humans. There have been few studies about SARS-CoV-2 co-infection with other pathogens. In this retrospective study, 257 laboratory-confirmed COVID-19 patients in Jiangsu Province were enrolled from January 22 to February 2, 2020. They were re-confirmed by real-time RT-PCR and tested for 39 respiratory pathogens. In total, 24 respiratory pathogens were found among the patients, and 242 (94.2 %) patients were co-infected with one or more pathogens. Bacterial co-infections were dominant in all COVID-19 patients, Streptococcus pneumoniae was the most common, followed by Klebsiella pneumoniae and Haemophilus influenzae. The highest and lowest rates of co-infections were found in patients aged 15-44 and below 15, respectively. Most co-infections occurred within 1-4 days of onset of COVID-19 disease. In addition, the proportion of viral co-infections, fungal co-infections and bacterial-fungal co-infections were the highest severe COVID-19 cases. These results will provide a helpful reference for diagnosis and clinical treatment of COVID-19 patients.


title: SARS-CoV-2 spike glycoprotein-binding proteins expressed by upper respiratory tract bacteria may prevent severe viral infection

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a major global challenge. The virus infects host cells using its spike glycoprotein (S-protein) and has significantly higher infectivity and mortality rates among the aged population. Here, based on bioinformatic analysis, I provide evidence that some members of the upper respiratory tract (URT) commensal bacteria express viral S-protein -binding proteins. Based on this analysis and available data showing a decline in the population of these bacteria in the elderly, I propose that some URT commensal bacteria hamper SARS-CoV-2 infectivity and that a decline in the population of these bacteria contributes to the severity of infection. Further studies should provide a better understanding of the interaction of URT bacteria and SARS-CoV-2, which may lead to new therapeutic approaches.


title: SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart

text: Coronavirus disease (COVID-19) is a serious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The symptoms of the disease range from asymptomatic to mild respiratory symptoms and even potentially life-threatening cardiovascular and pulmonary complications. Cardiac complications include acute myocardial injury, arrhythmias, cardiogenic shock and even sudden death. Furthermore, drug interactions with COVID-19 therapies may place the patient at risk for arrhythmias, cardiomyopathy and sudden death. In this review, we summarise the cardiac manifestations of COVID-19 infection and propose a simplified algorithm for patient management during the COVID-19 pandemic.


First case of Covid-19 presented with cerebral venous thrombosis: A rare and dreaded case


title: Dermovilite exsudativa vegetante crônica com apresentação clínica atípica em um equino: relato de caso/ Chronic hypertrophic pododermatitis with atipical clínical presentation in one equine: case report/ Dermovilitis exudativa crónica con presentación clínica atípica en un equino: relato de caso

text: O presente trabalho tem como objetivo descrever um caso clínico de dermovilite exsudativa vegetante crônica em um equino que apresentava lesões profundas na área lateral da coroa do membro posterior esquerdo e nas ranilhas dos membros anteriores, ao exame histopatológico verificou-se superfície irregular, brancoacinzentado e firme, compacto e brancacento ao corte. Este animal foi tratado conforme indicação da literatura, no qual houve leve melhora. Porém após iniciar-se a utilização local do metronidazol observou-se completa resolução da lesão. Vale ressaltar que a forma de tratamento recomendada ainda é controversa. Mesmo sendo considerada uma enfermidade esporádica, a adoção de técnicas adequadas de manejo e higiene das baias é imprescindível para evitar o desenvolvimento desta afecção.(AU)


Cardiothoracic Surgical Advocacy in a Time of COVID-19


title: [Chest CT findings and their dynamic changes in patients with COVID-19]

text: ObjectiveTo define chest CT findings and their dynamic changes in patients with coronavirus disease 2019 (COVID-19) from disease onset to the cure.MethodWe analyzed the clinical and chest CT data of 6 patients with RT-PCR-confirmed COVID-19. According to the time from the disease onset to the cure or from the onset to each CT scan, the total of 30 chest CT scans were divided into 4 stages, namely stage 1 (0-4 days), stage 2 (5-9 days), stage 3 (10-14 days), and stage 4 (over 14 days). A semi-quantitative scoring system was used to quantitatively assess the pulmonary involvement on the basis of the involved area. The differences in chest CT signs and the lung injury scores based on CT findings were compared among the 4 stages.ResultsIn stage 1, ground-glass opacities (GGO) was found frequently in the subpleura, and the CT score was the lowest at 4.00±0.40. Stage 2 was characterized by an increased and mixed density (crazy-paving pattern) with mild consolidation of the lungs, and the CT score reached its peak level of 7.38±3.34 (P < 0.05). In stage 3, an expanded range of consolidation and linear lesions were found in the lungs, and the total CT score averaged 6.86±2.91. In stage 4, a gradual resolution of the consolidation occurred with more linear lesions in the lungs, and the total CT score was 6.21±1.56. The CT scores of the lower lobes were significantly higher compared with those of the middle/upper lobes (P < 0.05) in stage 3 and stage 4.ConclusionChest CT scans allows dynamic monitoring of the changes in the distribution, density and extent of the pulmonary lesions in the 4 stages, which are closely correlated with the evolution of the disease course of COVID-19.


title: Using Internet-Based Psychological Measurement to Capture the Deteriorating Community Mental Health Profile During COVID-19: Observational Study

text: BACKGROUND: The coronavirus disease (COVID-19) is expected to have widespread and pervasive implications for mental health in terms of deteriorating outcomes and increased health service use, leading to calls for empirical research on mental health during the pandemic. Internet-based psychological measurement can play an important role in collecting imperative data, assisting to guide evidence-based decision making in practice and policy, and subsequently facilitating immediate reporting of measurement results to participants. OBJECTIVE: The aim of this study is to use an internet-based mental health measurement platform to compare the mental health profile of community members during COVID-19 with community members assessed before the pandemic. METHODS: This study uses an internet-based self-assessment tool to collect data on psychological distress, mental well-being, and resilience in community cohorts during (n=673) and prior to the pandemic (two cohorts, n=1264 and n=340). RESULTS: Our findings demonstrate significantly worse outcomes on all mental health measures for participants measured during COVID-19 compared to those measured before (P<.001 for all outcomes, effect sizes ranging between Cohen d=0.32 to Cohen d=0.81. Participants who demonstrated problematic scores for at least one of the mental health outcomes increased from 58% (n=197/340) before COVID-19 to 79% (n=532/673) during COVID-19, leading to only 21% (n=141) of measured participants displaying good mental health during the pandemic. CONCLUSIONS: The results clearly demonstrate deterioration in mental health outcomes during COVID-19. Although further research is needed, our findings support the serious mental health implications of the pandemic and highlight the utility of internet-based data collection tools in providing evidence to innovate and strengthen practice and policy during and after the pandemic.


Letter: Neurosurgery and Coronavirus (COVID-19) Epidemic: Doing our Part


The Imperative of Early Treatment for Children with COVID-19 Infection


Late-Onset Neonatal Sepsis in a Patient with Covid-19


COVID-19-related collapse of transplantation systems: A heterogeneous recovery?


title: COVID-19 presenting with ophthalmoparesis from cranial nerve palsy

text: Neurological complications of COVID-19 are not well described. We report two patients who were diagnosed with COVID-19 after presenting with diplopia and ophthalmoparesis.


title: Beak and feather disease virus (BFDV) prevalence, load and excretion in seven species of wild caught common Australian parrots

text: Pathogens pose a major risk to wild host populations, especially in the face of ongoing biodiversity declines. Beak and feather disease virus (BFDV) can affect most if not all members of one of the largest and most threatened bird orders world-wide, the Psittaciformes. Signs of disease can be severe and mortality rates high. Its broad host range makes it a risk to threatened species in particular, because infection can occur via spill-over from abundant hosts. Despite these risks, surveillance of BFDV in locally abundant wild host species has been lacking. We used qPCR and haemagglutination assays to investigate BFDV prevalence, load and shedding in seven abundant host species in the wild in south-east Australia: Crimson Rosellas (Platycercus elegans), Eastern Rosellas (Platycercus eximius), Galahs (Eolophus roseicapillus), Sulphur-crested Cockatoos (Cacatua galerita), Blue-winged Parrots (Neophema chrysostoma), Rainbow Lorikeets (Trichoglossus moluccanus) and Red-rumped Parrots (Psephotus haematonotus). We found BFDV infection in clinically normal birds in six of the seven species sampled. We focused our analysis on the four most commonly caught species, namely Crimson Rosellas (BFDV prevalence in blood samples: 41.8%), Sulphur-crested Cockatoos (20.0%), Blue-winged Parrots (11.8%) and Galahs (8.8%). Species, but not sex, was a significant predictor for BFDV prevalence and load. 56.1% of BFDV positive individuals were excreting BFDV antigen into their feathers, indicative of active viral replication with shedding. Being BFDV positive in blood samples predicted shedding in Crimson Rosellas. Our study confirms that BFDV is endemic in our study region, and can inform targeted disease management by providing comparative data on interspecies variation in virus prevalence, load and shedding.


title: Does poor glucose control increase the severity and mortality in patients with diabetes and COVID-19?

text: BACKGROUND AND AIM: Diabetes in often associated with an increased severity and mortality in patients with COVID-19. We aimed to find out whether the severity and mortality in patients with diabetes with COVID-19 has any correlation to the level of glycemic control. METHODS: A Boolean search was made in PubMed database using the specific keywords related to our objectives up till May 14, 2020 and full text of article retrieved with the supplements published in English language. RESULTS: Two studies available so far have studied the outcomes of severity and mortality in patients with diabetes stratified on glycemic control. Both the studies have unequivocally found that patients with poorly-controlled hyperglycemia (blood glucose >180 mg/dl) have significantly higher level of poor prognostic markers biochemically, compared to the well-controlled arms (blood glucose <180 mg/dl). Moreover, significant increase in severity and mortality was observed in cohorts with poorly-controlled blood glucose due to any cause (diabetes or stress hyperglycemia), compared to the well-controlled cohorts with COVID-19, even after the adjustment of multiple confounders. CONCLUSIONS: Poorly-controlled hyperglycemia increases the severity and mortality in patients with COVID-19. All treating physician must strive for a good glycemic control (blood glucose <180 mg/dl) in patients with or without diabetes.


Distant learning of BLS amid the COVID-19 pandemic: Influence of the outbreak on lay trainees' willingness to attempt CPR, and the motivating effect of the training


The reproductive number of COVID-19 is higher compared to SARS coronavirus


Professional commitment to ethical discussions needed from epidemiologists in the COVID-19 pandemic


title: Fear, xenophobia and collectivism as predictors of well-being during Coronavirus disease 2019: An empirical study from India

text: BACKGROUND: The Coronavirus disease 2019 (COVID-19) has emerged as a global health threat. Biological disasters like this can generate immense prejudice, xenophobia, stigma and othering, all of which have adverse consequences on health and well-being. In a country as diverse and populous in India, such crisis can trigger communalism and mutual blame. Keeping this in context, this study explored the relationship between well-being and xenophobic attitudes towards Muslims, collectivism and fear of COVID-19 in India. METHODS: The study was carried out on 600 non-Islamic Indians (231 males, 366 females and 3 others; mean age: 38.76 years), using convenience sampling. An online survey containing Fear of Coronavirus scale, Warwick-Edinburgh Mental Well-Being Scale and Collectivism Scale was used. Xenophobia was assessed using two scales: generalized prejudice towards Muslims and specific xenophobic tendencies towards Muslims during COVID-19. The data were analysed using correlational methods and multiple regression. RESULTS: The findings showed that positively significant relationship exists between well-being and age as well as with collectivism, while an inversely significant relationship between well-being and fear of COVID-19 was found. The results of the multiple regression analysis shows that fear of COVID-19, age, collectivism and generalized xenophobia, in the order of their importance, together contributed to nearly 20% of variance in well-being. CONCLUSION: The findings are reflective of the importance of collectivism in enhancing well-being in these times of uncertainty. Xenophobia, one of the common offshoots of pandemics, can also harm the overall well-being. Implications are discussed in the light of India's diverse socio-religious background and global context.


title: Acute Symptomatic Seizures in Critically Ill Patients with COVID-19: Is There an Association?

text: BACKGROUND: The coronavirus disease of 2019 (COVID-19) emerged as a global pandemic. Historically, the group of human coronaviruses can also affect the central nervous system leading to neurological symptoms; however, the causative mechanisms of the neurological manifestations of COVID-19 disease are not well known. Seizures have not been directly reported as a part of COVID-19 outside of patients with previously known brain injury or epilepsy. We report two cases of acute symptomatic seizures, in non-epileptic patients, associated with severe COVID-19 disease. CASE PRESENTATIONS: Two advanced-age, non-epileptic, male patients presented to our northeast Ohio-based health system with concern for infection in Mid-March 2020. Both had a history of lung disease and during their hospitalization tested positive for SARS-CoV-2. They developed acute encephalopathy days into their hospitalization with clinical and electrographic seizures. Resolution of seizures was achieved with levetiracetam. DISCUSSION: Patients with COVID-19 disease are at an elevated risk for seizures, and the mechanism of these seizures is likely multifactorial. Clinical (motor) seizures may not be readily detected in this population due to the expansive utilization of sedatives and paralytics for respiratory optimization strategies. Many of these patients are also not electrographically monitored for seizures due to limited resources, multifactorial risk for acute encephalopathy, and the risk of cross-contamination. Previously, several neurological symptoms were seen in patients with more advanced COVID-19 disease, and these were thought to be secondary to multi-system organ failure and/or disseminated intravascular coagulopathy-related brain injury. However, these patients may also have an advanced breakdown of the blood-brain barrier precipitated by pro-inflammatory cytokine reactions. The neurotropic effect and neuroinvasiveness of SARS-Coronavirus-2 have not been directly established. CONCLUSIONS: Acute symptomatic seizures are possible in patients with COVID-19 disease. These seizures are likely multifactorial in origin, including cortical irritation due to blood-brain barrier breakdown, precipitated by the cytokine reaction as a part of the viral infection. Patients with clinical signs of seizures or otherwise unexplained encephalopathy may benefit from electroencephalography monitoring and/or empiric anti-epileptic therapy. Further studies are needed to elucidate the risk of seizures and benefit of monitoring in this population.


title: Linking the Supersymmetric Standard Model to the Cosmological Constant

text: String theory has no parameter except the string scale $M_S$, so the Planck scale $M_\text{Pl}$, the supersymmetry-breaking scale, the EW scale $m_\text{EW}$ as well as the vacuum energy density (cosmological constant) $\Lambda$ are to be determined dynamically at any local minimum solution in the string theory landscape. Here we consider a model that links the supersymmetric electroweak phenomenology (bottom up) to the string theory motivated flux compactification approach (top down). In this model, supersymmetry is broken by a combination of the racetrack K\"ahler uplift mechanism, which naturally allows an exponentially small positive $\Lambda$ in a local minimum, and the anti-D3-brane in the KKLT scenario. In the absence of the Higgs doublets in the supersymmetric standard model, one has either a small $\Lambda$ or a big enough SUSY-breaking scale, but not both. The introduction of the Higgs fields (with their soft terms) allows a small $\Lambda$ and a big enough SUSY-breaking scale simultaneously. Since an exponentially small $\Lambda$ is statistically preferred (as the properly normalized probability distribution $P(\Lambda)$ diverges at $\Lambda=0^{+}$), identifying the observed $\Lambda_{\rm obs}$ to the median value $\Lambda_{50\%}$ yields $m_{\rm EW} \sim 100$ GeV. We also find that the warped anti-D3-brane tension has a SUSY-breaking scale of $100m_{\rm EW}$ in the landscape while the SUSY-breaking scale that directly correlates with the Higgs fields in the visible sector has a value of $m_{\rm EW}$.


Virus against virus: a potential treatment for 2019-nCov (SARS-CoV-2) and other RNA viruses


title: Modeling behavioral change and COVID-19 containment in Mexico: A trade-off between lockdown and compliance

text: Sanitary Emergency Measures (SEM) were implemented in Mexico on March 30th, 2020 requiring the suspension of non-essential activities. This action followed a Healthy Distance Sanitary action on March 23rd, 2020. The aim of both measures was to reduce community transmission of COVID-19 in Mexico by lowering the effective contact rate. Using a modification of the Kermack-McKendrick SEIR model we explore the effect of behavioral changes required to lower community transmission by introducing a time-varying contact rate, and the consequences of disease spread in a population subject to suspension of non-essential activities. Our study shows that there exists a trade-off between the proportion of the population under SEM and the average time an individual is committed to all the behavioral changes needed to achieve an effective social distancing. This trade-off generates an optimum value for the proportion of the population under strict mitigation measures, significantly below 1 in some cases, that minimizes maximum COVID-19 incidence. We study the population-level impact of three key factors: the implementation of behavior change control measures, the time horizon necessary to reduce the effective contact rate and the proportion of people under SEM in combating COVID-19. Our model is fitted to the available data. The initial phase of the epidemic, from February 17th to March 23rd, 2020, is used to estimate the contact rates, infectious periods and mortality rate using both confirmed cases (by date of symptoms initiation), and daily mortality. Data on deaths after March 23rd, 2020 is used to estimate the mortality rate after the mitigation measures are implemented. Our simulations indicate that the most likely dates for maximum incidence are between late May and early June, 2020 under a scenario of high SEM compliance and low SEM abandonment rate.


title: Detection of bovine viral diarrhea virus genotype 1 in aerosol by a real time RT-PCR assay

text: BACKGROUND: As a pestivirus of the Flaviviridae family, bovine viral diarrhea virus (BVDV), has imposed a large burden on animal husbandry worldwide, and such virus can be transmitted mainly through direct contact with other infected animals and probably via aerosols. In the present study, we aimed to develop a real-time RT-PCR method for detection of BVDV-1 in aerosol samples. METHODS: A pair of primers specific for highly conserved regions of the BVDV-1 5'-UTR was designed. The standard curve and sensitivity of the developed assay were assessed based on 10-fold serial dilutions of RNA molecular standard. The specificity of the assay was evaluated with other pestiviruses and infectious bovine viruses. The clinical performance was examined by testing 169 aerosol samples. RESULTS: The results showed that a good linear relationship existed between the standard curve and the concentration of template. The lowest detection limit was 5.2 RNA molecules per reaction. This assay was specific for detection of BVDV-1, and no amplification was found for other pestiviruses such as classical swine fever virus (CSFV), border disease virus (BDV), and common infectious bovine viruses, including BVDV-2, infectious bovine rhinotracheitis virus (IBRV), bovine parainfluenza virus type 3 (BPIV-3), bovine respiratory syncytial virus (BRSV), bovine ephemeral fever virus (BEFV) and bovine coronavirus (BcoV). The assay was highly reproducible with low variation coefficient values (CVs) for intra-assay and inter-assay. A total of 169 aerosol samples collected from six dairy herds were tested using this method. The results showed that the positive detection rate of BVDV-1 was 17.2% (29/169), which was significantly higher compared with the conventional RT-PCR. Additionally, the positive samples (n = 29) detected by real-time RT-PCR were verified by BVDV RPA-LFD, and a concordance rate of 100% was obtained between them. CONCLUSIONS: Taken together, we developed a real-time RT-PCR assay for quantitative analysis of BVDV-1 in aerosol samples, and our finding provided valuable insights into the risk on aerosol transmission of BVDV-1.


Oral cancer and periodontal disease increase the risk of COVID 19? A mechanism mediated through furin and cathepsin overexpression


Impacto de la pandemia COVID-19 en andrología. Recomendaciones en la práctica clínica diaria./ [Impact of the pandemic COVID-19 in andrology. Recommendations in daily clinical practice]


title: [Early detection and disease assessment of patients with novel coronavirus pneumonia]

text: In December 2019, the outbreak of novel coronavirus (2019- nCoV) in wuhan, China, attracting attention worldwidely. The novel coronavirus has the characteristics of rapid transmission, atypical clinical symptoms, and easy to affect both lungs, leading to missed diagnosis and misdiagnosis, as well as difficult to detection and assessment at early stage. Fever, cough, myalgia, weakness, dyspnea and imagings may be helpful for the early detection of novel coronavirus pneumonia. At the same time, the rate of disease progression, fever, CT manifestations, hypoxia degree, age, basic diseases, and laboratory indicators can also be used to evaluate the severity of the novel coronavirus pneumonia.


Vascular Surgery in Unreal Times


title: EMA advice on the use of NSAIDs for Covid-19

text: Every month, DTB scans sources of information on treatments, disease management and other healthcare topics for key items to bring to our readers' attention and help them keep up to date. To do this, we produce succinct, contextualised summaries of the information concerned.


title: Recommendations for coronavirus disease 2019 (COVID-19) prevention and infection control in the radiology department: Chinese experience

text: The coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, is gradually spreading worldwide. For diagnosis, chest computed tomography is a conventional, noninvasive imaging modality that is very accurate for detection and evaluation of pneumonia and is an important adjunct to real-time reverse transcription polymerase chain reaction diagnosis of the virus. Previous studies have reported typical computed tomography imaging features indicative of COVID-19, such as multifocal ground-glass opacities with or without consolidation. With the sharply increasing demand for computed tomography examination during the outbreak, ensuring appropriate infection control in radiology departments is challenging. Thus, advanced training and education in standardized infection control and prevention practice are essential. The purpose of this brief review is to summarize such training and education for clinical management of this outbreak for radiology department personnel. We will describe standard transmission-based precautions, workflow for computed tomography examination of fever patients, and decontamination management of a radiology department.


Impact of COVID-19 pandemic on health system & Sustainable Development Goal 3


Inhaled NO and COVID-19


title: Covid-19

text: Contents / What is COVID-19? : Iwata, Kentaro;review:COVID-19 : Kutsuna, Satoshi ;Testing and diagnosis of COVID-19 : Uehara, Yuki ;Drugs listed as drug candidates for treatment of COVID-19 : Yamada, Kazunori ;Talking about COVID-19 : Iwata, Kentaro ;Front line of infection control : Iwata, Kentaro, Sakamoto, Fumie ;11 articles to learn about COVID19 : Kurahara, Yu ;COVID-19 infection control on February 25 : Iwata, Kentaro, Oka, Hideaki, Shibata, Ayako ;Inpatient response to COVID-19 : Iwata, Kentaro ;Why the Tokyo Olympics shouldn't be held in the summer of 2020 (and the decision to postpone it was right) : Iwata, Kentaro


COVID 2019 outbreak: The disappointment in Indian teachers


The COVID-19 Pandemic: Making Sense of Rumor and Fear


COVID-19 pandemic and the reduction in ST-elevation myocardial infarction admissions


Surgeons' response to COVID-19 - Preparing from the sideline


title: COVID-19: is there a link between the course of infection and pharmacological agents in diabetes?

text: BACKGROUND: The Coronavirus disease 2019 (COVID-19) and type 2 diabetes (T2D) are two pandemics that share the dramatic impact on global mortality and economic resources. COVID-19 largely exhibits mild to moderate clinical manifestations. However, severe pneumonia with high fatality rate may occur, especially in the elderly and in patients with underlying conditions, such as diabetes and cardiovascular disease. SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) binds to the angiotensin-converting enzyme 2 (ACE2), a ubiquitous trans-membrane carboxypeptidase, to enter the cells. AIMS: This short review discusses some open questions about the link between COVID-19 and diabetes, principally focusing on the possible effects of commonly used drugs in patients with diabetes. RESULTS: Preclinical studies have reported that angiotensin receptor blockers (ARBs) and ACE inhibitors might increase ACE2 expression in several cell types. Hence, it has been speculated that the treatment with these agents might influence the course of the infection, and both harmful and beneficial effects have been supposed. Other pharmacological agents are thought to increase ACE2 expression, including statins and proliferator-activated receptor gamma (PPAR-Î³) agonists. All these drug classes are broadly adopted in T2D. Besides ACE2, other unknown co-factors might be involved in cell infection. It has been recently observed that dipeptidyl peptidase-4 (DPP4), the receptor for MERS-CoV (Middle East respiratory syndrome-related coronavirus) and ACE2 have similar expression profiles in the lung. DPP4 has important metabolic and immune functions and is a target for commonly used therapies in T2D. CONCLUSIONS: Although clinical data supporting an influence of all these drugs on the course of the disease are limited, this is an interesting background for further research that might help unravel the complex mechanisms underlying the link between COVID-19 and diabetes.


Psychiatry's Niche Role in the COVID-19 Pandemic


title: Clinical use of Convalescent Plasma in the COVID-19 pandemic; a transfusion-focussed gap analysis with recommendations for future research priorities

text: BACKGROUND AND OBJECTIVES: Use of convalescent plasma for Coronavirus disease 2019 (COVID-19) treatment has gained interest worldwide. However, there is lack of evidence on its dosing, safety and effectiveness. Until data from clinical studies are available to provide solid evidence for worldwide applicable guidelines, there is a need to provide guidance to the transfusion community and researchers on this emergent therapeutic option. This paper aims to identify existing key gaps in current knowledge in the clinical application of COVID-19 convalescent plasma (CCP). MATERIALS AND METHODS: The International Society of Blood Transfusion (ISBT) initiated a multidisciplinary working group with worldwide representation from all six continents with the aim of reviewing existing practices on CCP use from donor, product and patient perspectives. A subgroup of clinical transfusion professionals was formed to draft a document for CCP clinical application to identify the gaps in knowledge in existing literature. RESULTS: Gaps in knowledge were identified in the following main domains: study design, patient eligibility, CCP dose, frequency and timing of CCP administration, parameters to assess response to CCP treatment and long-term outcome, adverse events, and CCP application in less resourced countries as well as in paediatrics and neonates. CONCLUSION: This paper outlines a framework of gaps in the knowledge of clinical deployment of CPP that were identified as being most relevant. Studies to address the identified gaps are required to provide better evidence on the effectiveness and safety of CCP use.


ResearchCOVID-19 Preparedness in Michigan Nursing Homes


Prolonged viral persistence in COVID-19 second trimester pregnant patient


High IL-6/IFN-Î³ ratio could be associated with severe disease in COVID-19 patients


COVID-19 and Asian American Pacific Islanders


title: An antibiotic stewardship programme to reduce inappropriate antibiotic prescribing for acute respiratory infections in rural Chinese primary care facilities: study protocol for a clustered randomised controlled trial

text: BACKGROUND: Inappropriate prescribing of antibiotics for acute respiratory infections at the primary care level represents the major source of antibiotic misuse in healthcare, and is a major driver for antimicrobial resistance worldwide. In this study we will develop, pilot and evaluate the effectiveness of a comprehensive antibiotic stewardship programme in China's primary care hospitals to reduce inappropriate prescribing of antibiotics for acute respiratory infections among all ages. METHODS: We will use a parallel-group, cluster-randomised, controlled, superiority trial with blinded outcome evaluation but unblinded treatment (providers and patients). We will randomise 34 primary care hospitals from two counties within Guangdong province into the intervention and control arm (1:1 overall ratio) stratified by county (8:9 within-county ratio). In the control arm, antibiotic prescribing and management will continue through usual care. In the intervention arm, we will implement an antibiotic stewardship programme targeting family physicians and patients/caregivers. The family physician components include: (1) training using new operational guidelines, (2) improved management and peer-review of antibiotic prescribing, (3) improved electronic medical records and smart phone app facilitation. The patient/caregiver component involves patient education via family physicians, leaflets and videos. The primary outcome is the proportion of prescriptions for acute respiratory infections (excluding pneumonia) that contain any antibiotic(s). Secondary outcomes will address how frequently specific classes of antibiotics are prescribed, how frequently key non-antibiotic alternatives are prescribed and the costs of consultations. We will conduct a qualitative process evaluation to explore operational questions regarding acceptability, cultural appropriateness and burden of technology use, as well as a cost-effectiveness analysis and a long-term benefit evaluation. The duration of the intervention will be 12 months, with another 24 months' post-trial long-term follow-up. DISCUSSION: Our study is one of the first trials to evaluate the effect of an antibiotic stewardship programme in primary care settings in a low- or middle-income country (LMIC). All interventional activities will be designed to be embedded into routine primary care with strong local ownership. Through the trial we intend to impact on clinical practice and national policy in antibiotic prescription for primary care facilities in rural China and other LMICs. TRIAL REGISTRATION: ISRCTN, ID: ISRCTN96892547. Registered on 18 August 2019.


Science in the time of COVID-19