121
AJR Am J Roentgenol
. 2020 Jun;214(6):1206-1210. doi: 10.2214/AJR.20.22927. Epub 2020 Mar 4.
Déjà Vu or Jamais Vu? How the Severe Acute Respiratory Syndrome Experience Influenced a Singapore Radiology Department's Response to the Coronavirus Disease (COVID-19) Epidemic
Lionel Tim-Ee Cheng 1, Lai Peng Chan 1, Ban Hock Tan 2, Robert Chun Chen 1, Kiang Hiong Tay 3, Moi Lin Ling 4, Bien Soo Tan 5
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PMID: 32130047 DOI: 10.2214/AJR.20.22927
Abstract
OBJECTIVE. This article shares the ground operational perspective of how a tertiary hospital radiology department in Singapore is responding to the coronavirus disease (COVID-19) epidemic. This same department was also deeply impacted by the severe acute respiratory syndrome (SARS) outbreak in 2003. CONCLUSION. Though similar to SARS, the COVID-19 outbreak has several differences. We share how lessons from 2003 are applied and modified in our ongoing operational response to this evolving novel pathogen.

Keywords: COVID-19; SARS; infection control; novel coronavirus; outbreak; radiology operations.

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122
Comment Vaccine
. 2019 Dec 10;37(52):7530-7531. doi: 10.1016/j.vaccine.2019.09.107.
Letter to the Editor
Adriano Arguedas 1, Bradford D Gessner 2, Scott Williams 2, Mark A Fletcher 2, Raul Isturiz 2, Rene Reinert 2, Luis Jodar 2
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PMID: 31783978 DOI: 10.1016/j.vaccine.2019.09.107
Comment in
Authors' reply to: Letter from Arguedas et al.
Kim MJ, Kim JH, Chun BC, Yang KS.
Vaccine. 2019 Dec 10;37(52):7532-7533. doi: 10.1016/j.vaccine.2019.09.110.
PMID: 31783979 No abstract available.
Comment on
Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study.
Kim JH, Chun BC, Song JY, Kim HY, Bae IG, Kim DM, Choi YH, Jun YH, Choi WS, Kang SH, Kwon HH, Jeong HW, Kee SY, Hur J, Chung JW, Yoon YK, Sohn JW, Yang KS, Kim MJ.
Vaccine. 2019 May 9;37(21):2797-2804. doi: 10.1016/j.vaccine.2019.04.017. Epub 2019 Apr 17.
PMID: 31005428
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123
Sci Total Environ
. 2020 Jul 10;725:138539. doi: 10.1016/j.scitotenv.2020.138539. Epub 2020 Apr 6.
Evaluation of the Lockdowns for the SARS-CoV-2 Epidemic in Italy and Spain After One Month Follow Up
Aurelio Tobías 1
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PMID: 32304973 PMCID: PMC7195141 DOI: 10.1016/j.scitotenv.2020.138539
Free PMC article
Abstract
From the end of February, the SARS-CoV-2 epidemic in Spain has been following the footsteps of that in Italy very closely. We have analyzed the trends of incident cases, deaths, and intensive care unit admissions (ICU) in both countries before and after their respective national lockdowns using an interrupted time-series design. Data was analyzed with quasi-Poisson regression using an interaction model to estimate the change in trends. After the first lockdown, incidence trends were considerably reduced in both countries. However, although the slopes have been flattened for all outcomes, the trends kept rising. During the second lockdown, implementing more restrictive measures for mobility, it has been a change in the trend slopes for both countries in daily incident cases and ICUs. This improvement indicates that the efforts overtaken are being successful in flattening the epidemic curve, and reinforcing the belief that we must hold on.

Keywords: Intensive care unit admissions; Interrupted time-series; Lockdown; Mortality; SARS-CoV-2.

Copyright © 2020. Published by Elsevier B.V.

Conflict of interest statement
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Cited by 4 articles6 references2 figures
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124
Sci Total Environ
. 2020 Jul 10;725:138401. doi: 10.1016/j.scitotenv.2020.138401. Epub 2020 Apr 6.
A Field Indoor Air Measurement of SARS-CoV-2 in the Patient Rooms of the Largest Hospital in Iran
Sasan Faridi 1, Sadegh Niazi 2, Kaveh Sadeghi 3, Kazem Naddafi 1, Jila Yavarian 3, Mansour Shamsipour 4, Nazanin Zahra Shafiei Jandaghi 3, Khosro Sadeghniiat 5, Ramin Nabizadeh 1, Masud Yunesian 1, Fatemeh Momeniha 6, Adel Mokamel 7, Mohammad Sadegh Hassanvand 8, Talat MokhtariAzad 9
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PMID: 32283308 PMCID: PMC7194859 DOI: 10.1016/j.scitotenv.2020.138401
Free PMC article
Abstract
The coronavirus disease 2019 (COVID-19) emerged in Wuhan city, China, in late 2019 and has rapidly spread throughout the world. The major route of transmission of SARS-CoV-2 is in contention, with the airborne route a likely transmission pathway for carrying the virus within indoor environments. Until now, there has been no evidence for detection of airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and this may have implication for the potential spread of the COVID-19. We investigated the air of patient rooms with confirmed COVID-19 in the largest hospital in Iran, on March 17, 2020. To collect the SARS-CoV-2 particles, ten air samples were collected into the sterile standard midget impingers containing 20 mL DMEM with 100 μg/mL streptomycin, 100 U/mL penicillin and 1% antifoam reagent for 1 h. Besides, indoor particle number concentrations, CO2, relative humidity and temperature were recorded throughout the sampling duration. Viral RNA was extracted from samples taken from the impingers and Reverse-Transcription PCR (RT-PCR) was applied to confirm the positivity of collected samples based on the virus genome sequence. Fortunately, in this study all air samples which were collected 2 to 5 m from the patients' beds with confirmed COVID-19 were negative. Despite we indicated that all air samples were negative, however, we suggest further in vivo experiments should be conducted using actual patient cough, sneeze and breath aerosols in order to show the possibility of generation of the airborne size carrier aerosols and the viability fraction of the embedded virus in those carrier aerosols.

Keywords: Airborne; COVID-19; Iran; Outbreak; SARS-CoV-2; Tehran.

Copyright © 2020 Elsevier B.V. All rights reserved.

Conflict of interest statement
Declaration of competing interest The authors declared no conflicts of interests.

Cited by 2 articles18 references2 figures
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125
Case Reports Chest
. 2019 Dec;156(6):e117-e120. doi: 10.1016/j.chest.2019.05.041.
A 65-Year-Old Man With Pulmonary Opacities and Worsening Cough
Wesley Pidcock 1, Florence Chau-Etchapare 1, Susan Murin 2
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PMID: 31812209 DOI: 10.1016/j.chest.2019.05.041
Abstract
A 65-year-old man was referred for evaluation of several years of chest congestion and cough productive of yellow sputum as well as recently noted abnormalities on chest imaging. He denied dyspnea, weight loss, fevers, chills, or hemoptysis. He had no history of systemic illness, pneumonia, other respiratory illness, gastroesophageal reflux, or sinusitis. He had a remote smoking history. He worked as a railroad conductor and had occupational exposure to asbestos, as well as to other uncharacterized dusts and fumes. The patient spent most of his life in Washington and California and regularly traveled through the California Central Valley. Other travel history included trips to Southeast Asia, Iceland, and Europe in the remote past. The patient had one dog but no exposure to other animals. His only medication was loratadine, taken daily for allergic rhinitis. He applied petroleum jelly to his nares nightly to moisturize his nasal passages.

Copyright © 2019. Published by Elsevier Inc.

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126
Lancet
. 2020 May 30;395(10238):1715-1725. doi: 10.1016/S0140-6736(20)30854-0. Epub 2020 May 12.
Estimating Excess 1-year Mortality Associated With the COVID-19 Pandemic According to Underlying Conditions and Age: A Population-Based Cohort Study
Amitava Banerjee 1, Laura Pasea 2, Steve Harris 3, Arturo Gonzalez-Izquierdo 2, Ana Torralbo 2, Laura Shallcross 2, Mahdad Noursadeghi 4, Deenan Pillay 4, Neil Sebire 5, Chris Holmes 6, Christina Pagel 7, Wai Keong Wong 3, Claudia Langenberg 8, Bryan Williams 9, Spiros Denaxas 10, Harry Hemingway 11
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PMID: 32405103 PMCID: PMC7217641 DOI: 10.1016/S0140-6736(20)30854-0
Free PMC article
Abstract
Background: The medical, societal, and economic impact of the coronavirus disease 2019 (COVID-19) pandemic has unknown effects on overall population mortality. Previous models of population mortality are based on death over days among infected people, nearly all of whom thus far have underlying conditions. Models have not incorporated information on high-risk conditions or their longer-term baseline (pre-COVID-19) mortality. We estimated the excess number of deaths over 1 year under different COVID-19 incidence scenarios based on varying levels of transmission suppression and differing mortality impacts based on different relative risks for the disease.

Methods: In this population-based cohort study, we used linked primary and secondary care electronic health records from England (Health Data Research UK-CALIBER). We report prevalence of underlying conditions defined by Public Health England guidelines (from March 16, 2020) in individuals aged 30 years or older registered with a practice between 1997 and 2017, using validated, openly available phenotypes for each condition. We estimated 1-year mortality in each condition, developing simple models (and a tool for calculation) of excess COVID-19-related deaths, assuming relative impact (as relative risks [RRs]) of the COVID-19 pandemic (compared with background mortality) of 1·5, 2·0, and 3·0 at differing infection rate scenarios, including full suppression (0·001%), partial suppression (1%), mitigation (10%), and do nothing (80%). We also developed an online, public, prototype risk calculator for excess death estimation.

Findings: We included 3 862 012 individuals (1 957 935 [50·7%] women and 1 904 077 [49·3%] men). We estimated that more than 20% of the study population are in the high-risk category, of whom 13·7% were older than 70 years and 6·3% were aged 70 years or younger with at least one underlying condition. 1-year mortality in the high-risk population was estimated to be 4·46% (95% CI 4·41-4·51). Age and underlying conditions combined to influence background risk, varying markedly across conditions. In a full suppression scenario in the UK population, we estimated that there would be two excess deaths (vs baseline deaths) with an RR of 1·5, four with an RR of 2·0, and seven with an RR of 3·0. In a mitigation scenario, we estimated 18 374 excess deaths with an RR of 1·5, 36 749 with an RR of 2·0, and 73 498 with an RR of 3·0. In a do nothing scenario, we estimated 146 996 excess deaths with an RR of 1·5, 293 991 with an RR of 2·0, and 587 982 with an RR of 3·0.

Interpretation: We provide policy makers, researchers, and the public a simple model and an online tool for understanding excess mortality over 1 year from the COVID-19 pandemic, based on age, sex, and underlying condition-specific estimates. These results signal the need for sustained stringent suppression measures as well as sustained efforts to target those at highest risk because of underlying conditions with a range of preventive interventions. Countries should assess the overall (direct and indirect) effects of the pandemic on excess mortality.

Funding: National Institute for Health Research University College London Hospitals Biomedical Research Centre, Health Data Research UK.

Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Cited by 1 article33 references4 figures
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127
Pediatr Blood Cancer
. 2020 Jul;67(7):e28318. doi: 10.1002/pbc.28318. Epub 2020 Apr 22.
How Young Patients With Cancer Perceive the COVID-19 (Coronavirus) Epidemic in Milan, Italy: Is There Room for Other Fears?
Michela Casanova 1, Elena Pagani Bagliacca 1, Matteo Silva 1, Carlo Patriarca 2, Laura Veneroni 1, Carlo Alfredo Clerici 3 4, Filippo Spreafico 1, Roberto Luksch 1, Monica Terenziani 1, Cristina Meazza 1, Marta Podda 1, Veronica Biassoni 1, Elisabetta Schiavello 1, Stefano Chiaravalli 1, Nadia Puma 1, Luca Bergamaschi 1, Giovanna Gattuso 1, Giovanna Sironi 1, Maura Massimino 1, Andrea Ferrari 1
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PMID: 32240567 DOI: 10.1002/pbc.28318
Abstract
The rapid spread of coronavirus disease 2019 epidemic in Italy, in particular in the Milan focal point, required drastic measures and led to panic in the population. While in our center we did not change our approach to the treatment of our young patients with cancer, we developed a qualitative survey to assess their perception of the risk and level of stress. The survey showed that a relatively large proportion of young patients felt personally at risk of severe complications. We believe that we need to adequately inform our patients, focusing on hygienic measures and personal protection and prompt reporting of any suspicious symptoms.

Keywords: COVID-19; adolescents; coronavirus; epidemic; fear; perception; survey.

© 2020 Wiley Periodicals, Inc.

Cited by 1 article16 references
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128
J Am Coll Surg
. 2020 Jun;230(6):1064-1073. doi: 10.1016/j.jamcollsurg.2020.04.007. Epub 2020 Apr 9.
Rapid Response of an Academic Surgical Department to the COVID-19 Pandemic: Implications for Patients, Surgeons, and the Community
Elizabeth M Lancaster 1, Julie A Sosa 1, Amanda Sammann 2, Logan Pierce 3, Wen Shen 1, Michael C Conte 4, Elizabeth C Wick 5
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PMID: 32278726 PMCID: PMC7194622 DOI: 10.1016/j.jamcollsurg.2020.04.007
Free PMC article
Abstract
Background: As the coronavirus disease 2019 (COVID-19) pandemic continues to spread, swift actions and preparation are critical for ensuring the best outcomes for patients and providers. We aim to describe our hospital and Department of Surgery's experience in preparing for the COVID-19 pandemic and caring for surgical patients during this unprecedented time.

Study design: This is a descriptive study outlining the strategy of a single academic health system for addressing the following 4 critical issues facing surgical departments during the COVID-19 pandemic: developing a cohesive leadership team and system for frequent communication throughout the department; ensuring adequate hospital capacity to care for an anticipated influx of COVID-19 patients; safeguarding supplies of blood products and personal protective equipment to protect patients and providers; and preparing for an unstable workforce due to illness and competing personal priorities, such as childcare.

Results: Through collaborative efforts within the Department of Surgery and hospital, we provided concise and regular communication, reduced operating room volume by 80%, secured a 4-week supply of personal protective equipment, and created reduced staffing protocols with back-up staffing plans.

Conclusions: By developing an enabling infrastructure, a department can nimbly respond to crises like COVID-19 by promoting trust among colleagues and emphasizing an unwavering commitment to excellent patient care. Sharing principles and practical applications of these changes is important to optimize responses across the country and the world.

Copyright © 2020 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

19 references5 figures
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129
Virulence
. 2020 Dec;11(1):482-485. doi: 10.1080/21505594.2020.1767357.
A Case Series Describing the Epidemiology and Clinical Characteristics of COVID-19 Infection in Jilin Province
Na Du 1, Haiying Chen 1, Qing Zhang 1, Lihe Che 1, Lixin Lou 1, Xiaohua Li 1, Kaiyu Zhang 1, Wanguo Bao 1
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PMID: 32441574 DOI: 10.1080/21505594.2020.1767357
Abstract
Since its outbreak in Wuhan, Hubei Province China, 2019-coronavirus infected disease (COVID-19) had been widely spread all over the world, the control of which calls for a better understanding of its epidemiology and clinical characteristics. We included 12 confirmed cases of COVID-19 in First Affiliated Hospital of Jilin University from 23 January 2020 to 11 February 2020, which were retrospectively analyzed for epidemiological, demographic, clinical, laboratory, and radiological features. All the patients were confirmed by nucleic acid detection, the average age of whom was 45.25 years (range, 23-79 years). Most patients had a history of Wuhan traveling or had contact with Wuhan travelers or infected cases. Obvious family cluster was observed. Clinical manifestations included fever (12/12), fatigue (10/12), cough (6/12), sore throat (4/12), headache (3/12), and diarrhea (2/12). Only three out of eight patients had pneumonia manifestation on radiography. Most patients had a normal white blood cell (WBC) count and normal or reduced lymphocyte (LY) count. Pneumonia changes were observed in all the four patients who underwent a chest CT scan. Only one elderly patient developed severe pneumonia, while all the rest were mild disease and had a self-limiting course.

Keywords: COVID-19; Jilin; SARS-CoV-2; clinical characteristic; epidemiology; severe acute respiratory syndrome.

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130
Indian J Med Microbiol
. Jul-Sep 2019;37(3):370-375. doi: 10.4103/ijmm.IJMM_18_439.
Frequencies of Regulatory Subsets of CD4 + TH Cells in Peripheral Blood in Mycobacterium Tuberculosis-Infected Individuals and Healthy Contacts in a High-Burden Setting From Assam, Northeast India
Lahari Saikia 1, Trinayan Deka 2, Pranjal Deori 3, Rasmi Roy 4, Md Ezaz Hussain 2, Reema Nath 2
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PMID: 32003335 DOI: 10.4103/ijmm.IJMM_18_439
Free article
Abstract
Background: Mycobacterium tuberculosis (Mtb) adapts many strategies to persist and replicate inside human tissue. One such strategy is the manipulation of CD4+ TH cells for subset interconversion to regulatory subsets. The aim of the present study is to get an insight of dynamic changes of CD4+ TH cells to regulatory subsets, CD4+ CD25+ forkhead box P3 (Foxp3)+ T-cells and CD4+ CD25+ Foxp3+ programmed death molecule-1 (Foxp3+) T-cells, in peripheral blood in Mtb-infected individuals and healthy contacts in a high-burden setting from Assam, Northeast India.

Materials and methods: A case-control study was conducted in newly diagnosed active pulmonary tuberculosis (APTBs) patients and 2 sets of controls: (i) individuals infected with latent tuberculosis infection (LTBI) and (ii) healthy close tuberculosis healthy contacts (HCs). The frequencies of different subsets of CD4+ cells with regulatory markers were measured in peripheral blood in 3 groups of study participants.

Results and observations: Frequencies of CD4+ CD25+ Foxp3+ T-cells (1.84 ± 1.40 vs. 4.32 ± 1.82 vs. 11.30 ± 3.66), CD4+ CD25+ Foxp3+ PD1+ T-cells (0.37 ± 1.28 vs. 2.99 ± 3.69 vs. 14.54 ± 5.10) and ligand (PD-L1)-positive CD4+ TH cells (0.80 ± 0.45 vs. 2.28 ± 0.95 vs. 7.13 ± 2.02) were significantly increased from HCs to LTBIs to APTB patients, respectively (P < 0.0001). No significant changes in frequencies of total CD4+ cells were observed between APTBs (29.51 ± 11.93), LTBIs (29.23 ± 8.16) and HCs (28.16 ± 9.73) whereas the mean ratios of CD4+ to CD4+ CD25+ FoxP3+ were significantly decreased from 34.34 ± 47.56 in HCs to 7.96 ± 5.8 in LTBIs to 3.12 ± 2.58 in APTBs (P < 0.0001). Significant decrease in mean ratios of CD4+ CD25+ FoxP3+ to CD4+ CD25+ FoxP3+ PD1+ were also observed from 4.97 ± 1.09 in HCs to 1.44 ± 0.49 in LTBIs to 0.78 ± 0.72 in APTBs.

Conclusion: CD4+ TH cells change dynamically to regulatory subsets depending on the status of infection and a shift of response towards excessive regulatory T-cells, and PD-1/PD-L1 production may help in the development of active infection in latently infected individuals. These immunological parameters may be used, as potential biomarkers to see the changing dynamics of Mtb infection.

Keywords: CD4+TH cells; Treg cells; programmed death molecule-1/programmed death molecule ligand 1 pathway; tuberculosis.

Conflict of interest statement
None

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131
Review J Am Acad Orthop Surg
. 2020 Jun 1;28(11):471-476. doi: 10.5435/JAAOS-D-20-00371.
A Bioethical Perspective for Navigating Moral Dilemmas Amidst the COVID-19 Pandemic
Alexandra M Dunham 1, Travis N Rieder, Casey J Humbyrd
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PMID: 32282442 PMCID: PMC7197334 DOI: 10.5435/JAAOS-D-20-00371
Free PMC article
Abstract
The Coronavirus disease 2019 pandemic has been an unprecedented challenge to healthcare systems and clinicians around the globe. As the virus has spread, critical questions arose about how to best deliver health care in emergency situations where material and personnel resources become scarce. Clinicians who excel at caring for the individual patient at the bedside are now being reoriented into a system where they are being asked to see the collective public as their responsibility. As such, the clinical ethics that clinicians are accustomed to practicing are being modified by a framework of public health ethics defined by the presence of a global pandemic. There are many unknowns about Coronavirus disease 2019, which makes it difficult to provide consistent recommendations and guidelines that uniformly apply to all situations. This lack of consensus leads to the clinicians' confusion and distress. Real-life dilemmas about how to allocate resources and provide care in hotspot cities make explicit the need for careful ethical analysis, but the need runs far deeper than that; even when not trading some lives against others, the responsibilities of both individual clinicians and the broader healthcare system are changing in the face of this crisis.

Conflict of interest statement
None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Dunham, Dr. Rieder, and Dr. Humbyrd.

Cited by 1 article36 references
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132
Editorial Eur Respir J
. 2019 Mar 18;53(3):1900104. doi: 10.1183/13993003.00104-2019. Print 2019 Mar.
TB, You're a Long Time Cured
James M Trauer 1
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PMID: 30886025 DOI: 10.1183/13993003.00104-2019
Conflict of interest statement
Conflict of interest: J.M. Trauer has nothing to disclose.

Comment on
Chronic pulmonary aspergillosis commonly complicates treated pulmonary tuberculosis with residual cavitation.
Page ID, Byanyima R, Hosmane S, Onyachi N, Opira C, Richardson M, Sawyer R, Sharman A, Denning DW.
Eur Respir J. 2019 Mar 18;53(3):1801184. doi: 10.1183/13993003.01184-2018. Print 2019 Mar.
PMID: 30705126 Free PMC article.
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133
J Clin Microbiol
. 2020 May 26;58(6):e00588-20. doi: 10.1128/JCM.00588-20. Print 2020 May 26.
A Pandemic in Times of Global Tourism: Superspreading and Exportation of COVID-19 Cases From a Ski Area in Austria
Carlos L Correa-Martínez 1, Stefanie Kampmeier 1, Philipp Kümpers 2, Vera Schwierzeck 3, Marc Hennies 4, Wali Hafezi 4, Joachim Kühn 4, Hermann Pavenstädt 2, Stephan Ludwig 4, Alexander Mellmann 3
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PMID: 32245833 DOI: 10.1128/JCM.00588-20
Free article
Abstract
No abstract available
Keywords: Austria; COVID-19; SARS-CoV-2; exported cases; pandemic; superspreading; tourism.

Cited by 1 article
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134
Eur J Epidemiol
. 2020 May;35(5):401-409. doi: 10.1007/s10654-020-00646-z. Epub 2020 May 18.
Burden and Prevalence of Prognostic Factors for Severe COVID-19 in Sweden
Katalin Gémes 1, Mats Talbäck 1, Karin Modig 1, Anders Ahlbom 1, Anita Berglund 1, Maria Feychting 1, Anthony A Matthews 2
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PMID: 32424571 PMCID: PMC7233678 DOI: 10.1007/s10654-020-00646-z
Free PMC article
Abstract
The World Health Organization and European Centre for Disease Prevention and Control suggest that individuals over the age of 70 years or with underlying cardiovascular disease, cancer, chronic obstructive pulmonary disease, asthma, or diabetes are at increased risk of severe COVID-19. However, the prevalence of these prognostic factors is unknown in many countries. We aimed to describe the burden and prevalence of prognostic factors of severe COVID-19 at national and county level in Sweden. We calculated the burden and prevalence of prognostic factors for severe COVID-19 based on records from the Swedish national health care and population registers for 3 years before 1st January 2016. 9,624,428 individuals were included in the study population. 22.1% had at least one prognostic factor for severe COVID-19 (2,131,319 individuals), and 1.6% had at least three factors (154,746 individuals). The prevalence of underlying medical conditions ranged from 0.8% with chronic obstructive pulmonary disease (78,516 individuals) to 7.4% with cardiovascular disease (708,090 individuals), and the county specific prevalence of at least one prognostic factor ranged from 19.2% in Stockholm (416,988 individuals) to 25.9% in Kalmar (60,005 individuals). We show that one in five individuals in Sweden is at increased risk of severe COVID-19. When compared with the critical care capacity at a local and national level, these results can aid authorities in optimally planning healthcare resources during the current pandemic. Findings can also be applied to underlying assumptions of disease burden in modelling efforts to support COVID-19 planning.

Keywords: Burden of disease; COVID-19; Prevalence; Prognostic factors.

Conflict of interest statement
All authors have nothing to disclose.

31 references2 figures
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135
Multicenter Study Infection
. 2020 Jun;48(3):445-452. doi: 10.1007/s15010-020-01427-2. Epub 2020 Apr 16.
Clinical Characteristics of COVID-19 in Children Compared With Adults in Shandong Province, China
Wenjun Du 1, Jinhong Yu 1, Hui Wang 2, Xiaoguo Zhang 1, Shouwei Zhang 2, Qiang Li 3, Zhongfa Zhang 4
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PMID: 32301099 PMCID: PMC7161094 DOI: 10.1007/s15010-020-01427-2
Free PMC article
Abstract
Aims and background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.

Methods: Retrospectively, two research centers' case series of 67 consecutive hospitalized cases including 53 adult and 14 children cases with COVID-19 between 23 Jan 2020 and 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.

Results: Most cases in children were mild (21.4%) and conventional cases (78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough (21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults (p = 0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils count did in children compared with adults (p = 0.02). There was a lower level of CRP (p = 0.00) in children compared with adults. There were 8 (57.1%) asymptomatic cases and 6 (42.9%) symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients (p = 0.03). Even among asymptomatic patients, 5 (62.5%) cases had lung injuries including 3 (60%) cases with bilateral involvement, which was not different compared with that of symptomatic cases (p = 0.58, p = 0.74).

Conclusions: The clinical symptoms of children are mild, there is substantial lung injury even among children, but that there is less clinical disease, perhaps because of a less pronounced inflammatory response, and that the occurrence of this pattern appears to inversely correlate with age.

Keywords: Children; Clinical characteristics; Coronavirus disease 2019; Severe acute respiratory syndrome coronavirus-2.

Conflict of interest statement
The authors have no conflicts of interest to disclose.

20 references1 figure
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136
Int J Environ Res Public Health
. 2020 May 15;17(10):E3459. doi: 10.3390/ijerph17103459.
Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia
Ugo Consolo 1, Pierantonio Bellini 1, Davide Bencivenni 1, Cristina Iani 2, Vittorio Checchi 1
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PMID: 32429193 DOI: 10.3390/ijerph17103459
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Abstract
The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and the second highest in Europe. An anonymous online survey composed of 40 questions has been sent to dentists practicing in the area of Modena and Reggio Emilia, one of the areas in Italy most affected by COVID-19. The survey was aimed at highlighting the practical and emotional consequences of COVID-19 emergence on daily clinical practice. Specifically, it assessed dentists' behavioral responses, emotions and concerns following the Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20), as well as the dentists' perception of infection likelihood for themselves and patients. Furthermore, the psychological impact of COVID-19 was assessed by means of the Generalized Anxiety Disorder-7 test (GAD-7), that measures the presence and severity of anxiety symptoms. Using local dental associations (ANDI-Associazione Nazionale Dentisti Italiani, CAO-Commissione Albo Odontoiatri) lists, the survey was sent by email to all dentists in the district of Modena and Reggio Emilia (874 practitioners) and was completed by 356 of them (40%). All dental practitioners closed or reduced their activity to urgent procedures, 38.2% prior to and 61.8% after the DM-10M20. All reported a routinely use of the most common protective personal equipment (PPE), but also admitted that the use of PPE had to be modified during COVID-19 pandemic. A high percentage of patients canceled their previous appointments after the DM-10M20. Almost 85% of the dentists reported being worried of contracting the infection during clinical activity. The results of the GAD-7 (General Anxiety Disorder-7) evaluation showed that 9% of respondents reported a severe anxiety. To conclude, the COVID-19 emergency is having a highly negative impact on the activity of dentists practicing in the area of Modena and Reggio Emilia. All respondents reported practice closure or strong activity reduction. The perception of this negative impact was accompanied by feelings of concern (70.2%), anxiety (46.4%) and fear (42.4%). The majority of them (89.6%) reported concerns about their professional future and the hope for economic measures to help dental practitioners.

Keywords: COVID-19; Sars-CoV-2; anxiety; dental practice; epidemiology; survey.

Conflict of interest statement
The authors declare no conflict of interest.

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137
Review J Am Acad Orthop Surg
. 2020 Jun 1;28(11):e465-e468. doi: 10.5435/JAAOS-D-20-00392.
The American Board of Orthopaedic Surgery Response to COVID-19
Rick W Wright 1, April D Armstrong, Frederick M Azar, Michael S Bednar, James E Carpenter, Jack B Evans, John M Flynn, Kevin L Garvin, Joshua J Jacobs, James D Kang, Douglas W Lundy, Gregory A Mencio, Peter M Murray, Charles L Nelson, Terrance Peabody, Scott E Porter, James R Roberson, Charles L Saltzman, Wayne J Sebastianelli, Lisa A Taitsman, Ann E Van Heest, David F Martin
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PMID: 32324709 PMCID: PMC7195847 DOI: 10.5435/JAAOS-D-20-00392
Free PMC article
Abstract
The COVID-19 pandemic has disrupted every aspect of society in a way never previously experienced by our nation's orthopaedic surgeons. In response to the challenges the American Board of Orthopaedic Surgery has taken steps to adapt our Board Certification and Continuous Certification processes. These changes were made to provide flexibility for as many Candidates and Diplomates as possible to participate while maintaining our high standards. The American Board of Orthopaedic Surgery is first and foremost committed to the safety and well-being of our patients, physicians, and families while striving to remain responsive to the changing circumstances affecting our Candidates and Diplomates.

Conflict of interest statement
None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Wright, Dr. Armstrong, Dr. Azar, Dr. Bednar, Evans, Dr. Flynn, Dr. Jacobs, Dr. Kang, Dr. Lundy, Dr. Mencio, Dr. Murray, Dr. Nelson, Dr. Peabody, Dr. Porter, Dr. Roberson, Dr. Saltzman, Dr. Sebastianelli, Dr. Taitsman, Dr. Van Heest, and Dr. Martin.

8 references
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138
Pediatr Blood Cancer
. 2020 Jul;67(7):e28327. doi: 10.1002/pbc.28327. Epub 2020 Apr 24.
Early Advice on Managing Children With Cancer During the COVID-19 Pandemic and a Call for Sharing Experiences
Eric Bouffet 1, Julia Challinor 2, Michael Sullivan 3, Andrea Biondi 4, Carlos Rodriguez-Galindo 5, Kathy Pritchard-Jones 6
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PMID: 32239747 DOI: 10.1002/pbc.28327
Comment in
Comment on: "Early advice on managing children with cancer during the COVID-19 pandemic and a call for sharing experiences".
Verdú-Amorós J, Bautista F, Rubio-San-Simón A, Grasa Lozano CD, Madero L, de Rojas T.
Pediatr Blood Cancer. 2020 Jul;67(7):e28377. doi: 10.1002/pbc.28377. Epub 2020 May 4.
PMID: 32367636 No abstract available.
Cited by 5 articles10 references
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139
J Am Coll Surg
. 2020 Jun;230(6):1094-1097. doi: 10.1016/j.jamcollsurg.2020.03.026. Epub 2020 Apr 3.
Residency and Fellowship Program Accreditation: Effects of the Novel Coronavirus (COVID-19) Pandemic
John R Potts 3rd 1
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PMID: 32251848 PMCID: PMC7194857 DOI: 10.1016/j.jamcollsurg.2020.03.026
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5 references
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140
Int J Environ Res Public Health
. 2020 May 16;17(10):E3481. doi: 10.3390/ijerph17103481.
Understanding Knowledge and Behaviors Related to CoViD-19 Epidemic in Italian Undergraduate Students: The EPICO Study
Francesca Gallè 1, Elita Anna Sabella 2, Giovanna Da Molin 2, Osvalda De Giglio 3, Giuseppina Caggiano 3, Valeria Di Onofrio 4, Stefano Ferracuti 5, Maria Teresa Montagna 3, Giorgio Liguori 1, Giovanni Battista Orsi 6, Christian Napoli 7
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PMID: 32429432 DOI: 10.3390/ijerph17103481
Free article
Abstract
Background: On February 2020, the novel coronavirus (2019-nCoV) epidemic began in Italy. In order to contain the spread of the virus, the Italian government adopted emergency measures nationwide, including closure of schools and universities, workplaces and subsequently lockdown. This survey was carried out among Italian undergraduates to explore their level of knowledge about the epidemic and the behaviors they adopted during the lockdown. Methods: An electronic questionnaire was administered to the students attending three Italian universities. Results: A good level of knowledge about the epidemic and its control was registered in the sample, mainly among students attending life sciences degree courses. The majority of the students did not modify their diet and smoking habits, while a great part of the sample reported a decrease in physical activity (PA). Conclusions: Students from life sciences courses showed a higher awareness regarding the infection and the control measures. The lockdown caused an important reduction of PA. Preventive interventions should transform the restrictive measures also as an opportunity to improve lifestyle.

Keywords: CoViD−19; behaviors; knowledge; quarantine; undergraduates.

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141
Editorial Am J Rhinol Allergy
. 2020 Jan;34(1):6-8. doi: 10.1177/1945892419893875.
Editorial
Gurston G Nyquist 1
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PMID: 31816264 DOI: 10.1177/1945892419893875
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142
Int J Environ Res Public Health
. 2020 May 17;17(10):E3493. doi: 10.3390/ijerph17103493.
Distribution of the SARS-CoV-2 Pandemic and Its Monthly Forecast Based on Seasonal Climate Patterns
Nicola Scafetta 1
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PMID: 32429517 DOI: 10.3390/ijerph17103493
Free article
Abstract
This paper investigates whether the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) pandemic could have been favored by specific weather conditions and other factors. It is found that the 2020 winter weather in the region of Wuhan (Hubei, Central China)-where the virus first broke out in December and spread widely from January to February 2020-was strikingly similar to that of the Northern Italian provinces of Milan, Brescia and Bergamo, where the pandemic broke out from February to March. The statistical analysis was extended to cover the United States of America, which overtook Italy and China as the country with the highest number of confirmed COronaVIrus Disease 19 (COVID-19) cases, and then to the entire world. The found correlation patterns suggest that the COVID-19 lethality significantly worsens (4 times on average) under weather temperatures between 4 ∘ C and 12 ∘ C and relative humidity between 60% and 80%. Possible co-factors such as median population age and air pollution were also investigated suggesting an important influence of the former but not of the latter, at least, on a synoptic scale. Based on these results, specific isotherm world maps were generated to locate, month by month, the world regions that share similar temperature ranges. From February to March, the 4-12 ∘ C isotherm zone extended mostly from Central China toward Iran, Turkey, West-Mediterranean Europe (Italy, Spain and France) up to the United State of America, optimally coinciding with the geographic regions most affected by the pandemic from February to March. It is predicted that in the spring, as the weather gets warm, the pandemic will likely worsen in northern regions (United Kingdom, Germany, East Europe, Russia and North America) while the situation will likely improve in the southern regions (Italy and Spain). However, in autumn, the pandemic could come back and affect the same regions again. The Tropical Zone and the entire Southern Hemisphere, but in restricted colder southern regions, could avoid a strong pandemic because of the sufficiently warm weather during the entire year and because of the lower median age of their population. Google-Earth-Pro interactive-maps covering the entire world are provided as supplementary files.

Keywords: COVID-19; SARS-CoV-2; air pollution; climatic zones; epidemic forecasting; pandemic geographical distribution; population median age; weather conditions.

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143
JAMA Netw Open
. 2020 May 1;3(5):e209666. doi: 10.1001/jamanetworkopen.2020.9666.
Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China
Xiaoquan Lai 1, Minghuan Wang 2, Chuan Qin 2, Li Tan 1, Lusen Ran 2, Daiqi Chen 2, Han Zhang 2, Ke Shang 2, Chen Xia 3, Shaokang Wang 3, Shabei Xu 2, Wei Wang 2
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PMID: 32437575 PMCID: PMC7243089 DOI: 10.1001/jamanetworkopen.2020.9666
Free PMC article
Abstract
Importance: Health care workers (HCWs) have high infection risk owing to treating patients with coronavirus disease 2019 (COVID-19). However, research on their infection risk and clinical characteristics is limited.

Objectives: To explore infection risk and clinical characteristics of HCWs with COVID-19 and to discuss possible prevention measures.

Design, setting, and participants: This single-center case series included 9684 HCWs in Tongji Hospital, Wuhan, China. Data were collected from January 1 to February 9, 2020.

Exposures: Confirmed COVID-19.

Main outcomes and measures: Exposure, epidemiological, and demographic information was collected by a structured questionnaire. Clinical, laboratory, and radiologic information was collected from electronic medical records. A total of 335 medical staff were randomly sampled to estimate the prevalence of subclinical infection among a high-risk, asymptomatic population. Samples from surfaces in health care settings were also collected.

Results: Overall, 110 of 9684 HCWs in Tongji Hospital tested positive for COVID-19, with an infection rate of 1.1%. Of them, 70 (71.8%) were women, and they had a median (interquartile range) age of 36.5 (30.0-47.0) years. Seventeen (15.5%) worked in fever clinics or wards, indicating an infection rate of 0.5% (17 of 3110) among first-line HCWs. A total of 93 of 6574 non-first-line HCWs (1.4%) were infected. Non-first-line nurses younger than 45 years were more likely to be infected compared with first-line physicians aged 45 years or older (incident rate ratio, 16.1; 95% CI, 7.1-36.3; P < .001). The prevalence of subclinical infection was 0.74% (1 of 135) among asymptomatic first-line HCWs and 1.0% (2 of 200) among non-first-line HCWs. No environmental surfaces tested positive. Overall, 93 of 110 HCWs (84.5%) with COVID-19 had nonsevere disease, while 1 (0.9%) died. The 5 most common symptoms were fever (67 [60.9%]), myalgia or fatigue (66 [60.0%]), cough (62 [56.4%]), sore throat (55 [50.0%]), and muscle ache (50 [45.5%]). Contact with indexed patients (65 [59.1%]) and colleagues with infection (12 [10.9%]) as well as community-acquired infection (14 [12.7%]) were the main routes of exposure for HCWs.

Conclusions and relevance: In this case series, most infections among HCWs occurred during the early stage of disease outbreak. That non-first-line HCWs had a higher infection rate than first-line HCWs differed from observation of previous viral disease epidemics. Rapid identification of staff with potential infection and routine screening among asymptomatic staff could help protect HCWs.

Conflict of interest statement
Conflict of Interest Disclosures: None reported.

Comment in
doi: 10.1001/jamanetworkopen.2020.9687
22 references1 figure
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144
Comment Br J Surg
. 2020 Jun;107(7):e190. doi: 10.1002/bjs.11645. Epub 2020 Apr 30.
Covid-19-related Pancreatic Injury
R Mukherjee 1 2, A Smith 2, R Sutton 1
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PMID: 32352160 DOI: 10.1002/bjs.11645
Comment in
Author response to: Covid-19-related pancreatic injury.
Spinelli A, Pellino G, Danese S.
Br J Surg. 2020 Jun;107(7):e191. doi: 10.1002/bjs.11648. Epub 2020 Apr 30.
PMID: 32352162 No abstract available.
Comment on
COVID-19 pandemic: perspectives on an unfolding crisis.
Spinelli A, Pellino G.
Br J Surg. 2020 Jun;107(7):785-787. doi: 10.1002/bjs.11627. Epub 2020 Mar 23.
PMID: 32191340 Free PMC article.
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145
J R Soc Interface
. 2019 Jun 28;16(155):20190080. doi: 10.1098/rsif.2019.0080. Epub 2019 Jun 12.
Improved Forecasts of Influenza-Associated Hospitalization Rates With Google Search Trends
Sasikiran Kandula 1, Sen Pei 1, Jeffrey Shaman 1
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PMID: 31185818 PMCID: PMC6597779 DOI: 10.1098/rsif.2019.0080
Free PMC article
Abstract
Reliable forecasts of influenza-associated hospitalizations during seasonal outbreaks can help health systems better prepare for patient surges. Within the USA, public health surveillance systems collect and distribute near real-time weekly hospitalization rates, a key observational metric that makes real-time forecast of this outcome possible. In this paper, we describe a method to forecast hospitalization rates using a population level transmission model in combination with a data assimilation technique. Using this method, we generated retrospective forecasts of hospitalization rates for five age groups and the overall population during five seasons in the USA and quantified forecast accuracy for both near-term and seasonal targets. Additionally, we describe methods to correct for under-reporting of hospitalization rates (backcast) and to estimate hospitalization rates from publicly available online search trends data (nowcast). Forecasts based on surveillance rates alone were reasonably accurate in predicting peak hospitalization rates (within ± 25% of the actual peak rate, three weeks before peak). The error in predicting rates one to four weeks ahead, remained constant for the duration of the seasons, even during periods of increased influenza incidence. An improvement in forecast quality across all age groups, seasons and targets was observed when backcasts and nowcasts supplemented surveillance data. These results suggest that the model-inference framework can provide reasonably accurate real-time forecasts of influenza hospitalizations; backcasts and nowcasts offer a way to improve system tolerance to observational errors.

Keywords: forecasting; hospitalization; influenza-like illness; search trends; supervised learning.

Conflict of interest statement
J.S. and Columbia University declare partial ownership of SK Analytics. S.K. was a consultant for SK Analytics.

Cited by 1 article42 references5 figures
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146
Int J Mol Sci
. 2020 May 21;21(10):E3627. doi: 10.3390/ijms21103627.
Smoking-Mediated Upregulation of the Androgen Pathway Leads to Increased SARS-CoV-2 Susceptibility
Jaideep Chakladar 1 2, Neil Shende 1 2, Wei Tse Li 1 2, Mahadevan Rajasekaran 3 4, Eric Y Chang 5 6, Weg M Ongkeko 1 2
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PMID: 32455539 DOI: 10.3390/ijms21103627
Free article
Abstract
The COVID-19 pandemic is marked by a wide range of clinical disease courses, ranging from asymptomatic to deadly. There have been many studies seeking to explore the correlations between COVID-19 clinical outcomes and various clinical variables, including age, sex, race, underlying medical problems, and social habits. In particular, the relationship between smoking and COVID-19 outcome is controversial, with multiple conflicting reports in the current literature. In this study, we aim to analyze how smoking may affect the SARS-CoV-2 infection rate. We analyzed sequencing data from lung and oral epithelial samples obtained from The Cancer Genome Atlas (TCGA). We found that the receptor and transmembrane protease necessary for SARS-CoV-2 entry into host cells, ACE2 and TMPRSS2, respectively, were upregulated in smoking samples from both lung and oral epithelial tissue. We then explored the mechanistic hypothesis that smoking may upregulate ACE2 expression through the upregulation of the androgen pathway. ACE2 and TMPRSS2 upregulation were both correlated to androgen pathway enrichment and the specific upregulation of central pathway regulatory genes. These data provide a potential model for the increased susceptibility of smoking patients to COVID-19 and encourage further exploration into the androgen and tobacco upregulation of ACE2 to understand the potential clinical ramifications.

Keywords: ACE2; COVID-19; SARS-CoV-2; TMPRSS2; androgen; smoking.

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147
Nature
. 2020 Mar;579(7800):480-481. doi: 10.1038/d41586-020-00823-w.
Scientists Exposed to Coronavirus Wonder: Why Weren't We Notified?
Amy Maxmen
PMID: 32203382 DOI: 10.1038/d41586-020-00823-w
Abstract
No abstract available
Keywords: Ebola virus; Genomics; Infection; Virology.

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148
Review Am J Dent
. 2020 Jun;33(3):129-134.
Transmission Routes of SARS-CoV-2 and Protective Measures in Dental Clinics During the COVID-19 Pandemic
Yingxiao Pan 1, Hengyi Liu 2, Chen Chu 1, Xin Li 1, Siyu Liu 3, Shulai Lu 4
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PMID: 32470237
Abstract
Results: The outbreak of coronavirus disease 2019 (COVID-19) has become a primary challenging public health issue for not only China but also the world. On March 11, 2020, the World Health Organization declared that the pandemic of COVID-19 had become a public health emergency of global concern. As of May 12, 2020 COVID-19 has been reported in over 180 countries/regions, with a total of 4,178,156 confirmed cases and over 280,000 deaths. The risk of cross-infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be elevated between dental specialists and patients due to the peculiarity of dental practice. Therefore, detailed and effective infection control measures are imminently needed to prevent nosocomial coronavirus infection. This paper, based on proven effective experience, relevant guidelines, and research, not only presents the fundamental knowledge about the name, etiologic characteristics, epidemiologic characteristics and clinical manifestations of COVID-19, transmission routes and risk points of SARS-CoV-2 in dental clinics but also provides recommended protective measures for dental professionals to interdict the transmission of SARS-CoV-2 in dental clinics. Classification schemes as well as color identification according to the results of the questionnaire survey and temperature measurement in precheck and triages are innovations proposed in this paper.

Clinical significance: This paper, based on proven effective experience, relevant guidelines, and research, not only presents the fundamental knowledge about the name, etiologic characteristics, epidemiologic characteristics and clinical manifestations of COVID-19, transmission routes and risk points of SARS-CoV-2 in dental clinics but also provides recommended protective measures for dental professionals to interdict the transmission of SARS-CoV-2 in dental clinics.

Copyright©American Journal of Dentistry.

Conflict of interest statement
The authors declared no conflict of interest.

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149
Indian Pediatr
. 2020 May 15;57(5):480-481. doi: 10.1007/s13312-020-1833-7. Epub 2020 Apr 9.
Impact of COVID-19 on Children and Pediatricians
Rajesh K Kulkarni 1, Aarti A Kinikar 2, Ajay Chandanwale 3
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PMID: 32273488 PMCID: PMC7240247 DOI: 10.1007/s13312-020-1833-7
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7 references
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150
J Clin Microbiol
. 2020 May 26;58(6):e00590-20. doi: 10.1128/JCM.00590-20. Print 2020 May 26.
Evaluation of Saline, Phosphate-Buffered Saline, and Minimum Essential Medium as Potential Alternatives to Viral Transport Media for SARS-CoV-2 Testing
Kyle G Rodino 1, Mark J Espy 1, Seanne P Buckwalter 1, Robert C Walchak 1, Jeffery J Germer 1, Emily Fernholz 1, Aimee Boerger 1, Audrey N Schuetz 1, Joseph D Yao 1, Matthew J Binnicker 2
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PMID: 32229604 DOI: 10.1128/JCM.00590-20
Abstract
No abstract available
Keywords: PCR; SARS-CoV-2; VTM; coronavirus; transport.

Cited by 1 article
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151
Comparative Study JMIR Public Health Surveill
. 2020 May 28;6(2):e19464. doi: 10.2196/19464.
Comparison of Transmissibility of Coronavirus Between Symptomatic and Asymptomatic Patients: Reanalysis of the Ningbo COVID-19 Data
Guosheng Yin 1, Huaqing Jin 1
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PMID: 32442131 DOI: 10.2196/19464
Free article
Abstract
Background: Since the outbreak of the novel coronavirus disease (COVID-19) in December 2019, the coronavirus has spread all over the world at an unprecedented rate. The transmissibility of the coronavirus from asymptomatic patients to healthy individuals has received enormous attention. An important study using COVID-19 data from the city of Ningbo, China, was carried out to estimate and compare the transmission rates of the coronavirus by the symptomatic and asymptomatic patients. However, in the original analysis, the usual chi-square tests were unduly used for some contingency tables with small cell counts including zero, which may violate the assumptions for the chi-square test.

Objective: We reanalyze the data from the city of Ningbo with more appropriate statistical methods to draw more reliable and sound conclusions on the transmission rates of the coronavirus by the symptomatic and asymptomatic patients.

Methods: We excluded the cases associated with the super-spreader and adopted a more appropriate statistical method, including the permutation test and the Fisher exact test, to reanalyze the COVID-19 data from the city of Ningbo.

Results: After excluding the cases related to the super-spreader, the Fisher exact test yields a P value of .84, which indicates stronger evidence of no difference in the transmission rates compared with the original analysis. The odds ratio of the coronavirus transmission rates between the symptomatic and asymptomatic patients is 1.2 with a 95% confidence interval 0.5-2.8.

Conclusions: Through a more in-depth and comprehensive statistical analysis of the Ningbo data, we concluded that there is no difference in the transmission rates of coronavirus between symptomatic and asymptomatic patients.

Keywords: COVID-19; Fisher exact test; analysis; asymptomatic case; close contact; coronavirus; immunology; transmission; transmission rate; virus.

©Guosheng Yin, Huaqing Jin. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 28.05.2020.

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152
Comment Br J Surg
. 2020 Jun;107(7):e182. doi: 10.1002/bjs.11657. Epub 2020 Apr 27.
Acute Pancreatitis in a COVID-19 Patient
E R Anand 1, C Major 1, O Pickering 1, M Nelson 1
Affiliations expand
PMID: 32339257 DOI: 10.1002/bjs.11657
Comment on
COVID-19 pandemic: perspectives on an unfolding crisis.
Spinelli A, Pellino G.
Br J Surg. 2020 Jun;107(7):785-787. doi: 10.1002/bjs.11627. Epub 2020 Mar 23.
PMID: 32191340 Free PMC article.
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153
Am J Med Genet A
. 2020 Jun;182(6):1302-1308. doi: 10.1002/ajmg.a.61595. Epub 2020 Apr 23.
Medical Genetics Education in the Midst of the COVID-19 Pandemic: Shared Resources
Debra S Regier 1, Wendy E Smith 2, Heather M Byers 3
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PMID: 32323908 PMCID: PMC7264783 DOI: 10.1002/ajmg.a.61595
Free PMC article
Abstract
In the midst of the COVID-19 pandemic, it is appropriate that our focus is on patient care and preparation. However, the genetics community is well poised to fill in the educational gap created by medical students transitioning to limiting patient contact, creation of telemedicine patient care, and online learning modules. Our history of agility in learning and teaching is now only inhibited by the time constraints of current clinical demands on the genetics community. This publication is designed to offer ideas and resources for quickly transitioning our education to meet the current demands in the time of a pandemic. Not only will this allow us to continue our strong history of education, it will enhance our strong commitment to using modern educational techniques and tools to address the genetics workforce issues that have defined the recent past. We have the opportunity to aggressively educate for trainees that now have the capacity to learn, and to lead the way in showing how the genetics community rallies together no matter the challenge.

Keywords: Communities of practice; Genetics education; Telemedicine education.

© 2020 Wiley Periodicals, Inc.

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154
Editorial Eur Respir J
. 2019 Feb 28;53(2):1802469. doi: 10.1183/13993003.02469-2018. Print 2019 Feb.
Biomarkers in Community-Acquired Pneumonia: Still Searching for the One
Oriol Sibila 1 2, Marcos I Restrepo 3
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PMID: 30819808 DOI: 10.1183/13993003.02469-2018
Conflict of interest statement
Conflict of interest: O. Sibila has nothing to disclose. Conflict of interest: M.I. Restrepo has nothing to disclose.

Comment on
Fibroblast growth factor 21 predicts outcome in community-acquired pneumonia: secondary analysis of two randomised controlled trials.
Ebrahimi F, Wolffenbuttel C, Blum CA, Baumgartner C, Mueller B, Schuetz P, Meier C, Kraenzlin M, Christ-Crain M, Betz MJ.
Eur Respir J. 2019 Feb 28;53(2):1800973. doi: 10.1183/13993003.00973-2018. Print 2019 Feb.
PMID: 30578395
Cited by 3 articles
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155
Multicenter Study Knee Surg Sports Traumatol Arthrosc
. 2020 Jun;28(6):1712-1719. doi: 10.1007/s00167-020-06033-1. Epub 2020 May 2.
Disruption of Joint Arthroplasty Services in Europe During the COVID-19 Pandemic: An Online Survey Within the European Hip Society (EHS) and the European Knee Associates (EKA)
M Thaler 1, Ismail Khosravi 2, M T Hirschmann 3 4, N P Kort 5, L Zagra 6, J A Epinette 7, M C Liebensteiner 1
Affiliations expand
PMID: 32361927 PMCID: PMC7195619 DOI: 10.1007/s00167-020-06033-1
Free PMC article
Abstract
Purpose: The aim of the present study was to evaluate the impact of the coronavirus (COVID-19) pandemic on joint arthroplasty service in Europe by conducting an online survey of arthroplasty surgeons.

Methods: The survey was conducted in the European Hip Society (EHS) and the European Knee Associates (EKA). The survey consisted of 20 questions (single, multiple choice, ranked). Four topics were addressed: (1) origin and surgical experience of the participant (four questions); (2) potential disruption of arthroplasty surgeries (12 questions); (3) influence of the COVID-19 pandemic on the particular arthroplasty surgeon (four questions); (4) a matrix provided 14 different arthroplasty surgeries and the participant was asked to state whether dedicated surgery was stopped, delayed or cancelled.

Results: Two-hundred and seventy-two surgeons (217 EHS, 55 EKA) from 40 different countries participated. Of the respondents, 25.7% stated that all surgeries were cancelled in their departments, while 68.4% responded that elective inpatient procedures were no longer being performed. With regard to the specific surgical procedures, nearly all primary TJA were cancelled (92.6%) as well as aseptic revisions (94.7%). In most hospitals, periprosthetic fractures (87.2%), hip arthroplasty for femoral neck fractures and septic revisions for acute infections (75.8%) were still being performed.

Conclusion: During the current 2020 COVID-19 pandemic, we are experiencing a near-total shutdown of TJA. A massive cutback was observed for primary TJA and revision TJA, even in massively failed TJA with collapse, dislocation, component failure or imminent dislocation. Only life-threatening pathologies like periprosthetic fractures and acute septic TJA are currently undergoing surgical treatment.

Level of evidence: V.

Keywords: COVID-19; Coronavirus disease 2019; Disruption; Health care; Orthopaedic surgery; Pandemic; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Total joint arthroplasty.

Conflict of interest statement
The authors declare that they have no competing interest.

19 references4 figures
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156
Infect Dis (Lond)
. 2020 Jul;52(7):498-505. doi: 10.1080/23744235.2020.1759817. Epub 2020 May 6.
Risk Factors for Disease Progression in Hospitalized Patients With COVID-19: A Retrospective Cohort Study
Wei Hou 1, Wei Zhang 1, Ronghua Jin 1, Lianchun Liang 1, Bin Xu 1, Zhongjie Hu 1
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PMID: 32370577 PMCID: PMC7212540 DOI: 10.1080/23744235.2020.1759817
Free PMC article
Abstract
Background: To investigate the risk factors related to aggravation and clinical outcomes in coronavirus disease 2019 (COVID-19) patients.Methods: We performed a retrospective study on the risk factors for disease progression of cases with COVID-19. Based on the clinical types, the patients were divided into a progression group and an improvement group. Multivariable logistic regression and ROC curve analysis were performed to explore the risk factors for disease progression.Results: A total of 101 patients were included in this study; diseases progression occurred in 17 patients, 84 patients improved, 6 were transferred to intensive care unit (ICU), and 5 died. The mean time to obtain negative nucleic acid results was 12.5 ± 5.0 days. Multivariate logistic analysis indicated that age (OR, 0.104; p = .002), C-reactive protein (CRP) (OR, 0.093; p < .001) and lymphocyte count (OR, 3.397; p = .022) were risk factors for disease progression. ROC curve analysis revealed that the AUC of age, CRP and lymphocyte count for disease progression were 0.873, 0.911 and 0.817, respectively.Conclusions: Older age increased CRP and decreased lymphocyte count resulted in potential risk factors for COVID-19 progression. This may be helpful in identifying patients whose condition worsens at an early stage.

Keywords: COVID-19; risk factors outcome.

21 references2 figures
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157
Review Ren Fail
. 2020 Nov;42(1):483-488. doi: 10.1080/0886022X.2020.1764369.
Is There a Role for Blood Purification Therapies Targeting Cytokine Storm Syndrome in Critically Severe COVID-19 Patients?
Gang Chen 1, Yangzhong Zhou 2, Jie Ma 1, Peng Xia 1, Yan Qin 1, Xuemei Li 1
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PMID: 32438839 DOI: 10.1080/0886022X.2020.1764369
Abstract
The coronavirus disease-19 (COVID-19) has spread over many countries and regions since the end of 2019, becoming the most severe public health event at present. Most of the critical cases developed multiple organ dysfunction, including acute kidney injury (AKI). Cytokine storm syndrome (CSS) may complicate the process of severe COVID-19 patients. This manuscript reviews the different aspects of blood purification in critically ill patients with AKI and increased inflammatory factors, and examines its potential role in severe COVID-19 treatment. Continuous renal replacement therapy (CRRT) has been practiced in many sepsis patients with AKI. Still, the timing and dosing need further robust evidence. In addition to the traditional CRRT, the high-throughput membrane with adsorption function and cytokine adsorption column are two representatives of recently emerging novel membrane technologies. Their potential in removing inflammatory factors and other toxins prospects for the treatment of severe COVID-19.

Keywords: COVID-19; Cytosorb; acute kidney injury; blood purification; cytokine storm; oXiris.

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158
Zhonghua Liu Xing Bing Xue Za Zhi
. 2020 Mar 10;41(3):358-362. doi: 10.3760/cma.j.issn.0254-6450.2020.03.015.
[Epidemiological Characteristics of a Case Infected With Avian Influenza A (H5N6) Virus Associated With Exposure to Aerosol]
[Article in Chinese]
Y H Liu 1, J Y Lu 1, W H Liu 1, Y Ma 1, L Cao 1, K B Li 1, T G Li 1, Z B Zhang 1, Z C Yang 1
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PMID: 32294835 DOI: 10.3760/cma.j.issn.0254-6450.2020.03.015
Abstract in English , Chinese
Objective: To investigate the epidemiological and clinical characteristics of a case infected with avian influenza A (H5N6) virus associated with exposure to aerosol and provide evidence for the prevention and control of human infection with avian influenza virus. Methods: Epidemiological investigation was conducted to identify the history of exposure, infection route, and disease progression. Real-time fluorescent quantitative RT-PCR was used to test the samples collected from the case, close contacts, environment and poultry market. Results: The case had no history of exposure to live poultry and poultry market. But before the onset the case had a history of exposure to the live poultry placed in a car with doors and windows closed. The samples collected from the case's lower respiratory tract and the remaining frozen chicken meat were all influenza A (H5N6) virus positive. Conclusions: The source of infection was the live poultry, and the infection route might be the exposure to aerosol in a car with doors and windows closed, where the poultry were temporarily stored. It is necessary to promote centralized poultry slaughtering, cold chain distribution and fresh poultry sale, as well as strengthen health education and establish the concept of consuming fresh poultry.

Keywords: Aerosol; Epidemiological investigation; Influenza A (H5N6).

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159
BMJ Glob Health
. 2020 May;5(5):e002699. doi: 10.1136/bmjgh-2020-002699.
The Relatively Young and Rural Population May Limit the Spread and Severity of COVID-19 in Africa: A Modelling Study
Binta Zahra Diop 1, Marieme Ngom 2, Clémence Pougué Biyong 3, John N Pougué Biyong 4
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PMID: 32451367 DOI: 10.1136/bmjgh-2020-002699
Abstract
Introduction: A novel coronavirus disease 2019 (COVID-19) has spread to all regions of the world. There is great uncertainty regarding how countries' characteristics will affect the spread of the epidemic; to date, there are few studies that attempt to predict the spread of the epidemic in African countries. In this paper, we investigate the role of demographic patterns, urbanisation and comorbidities on the possible trajectories of COVID-19 in Ghana, Kenya and Senegal.

Methods: We use an augmented deterministic Susceptible-Infected-Recovered model to predict the true spread of the disease, under the containment measures taken so far. We disaggregate the infected compartment into asymptomatic, mildly symptomatic and severely symptomatic to match observed clinical development of COVID-19. We also account for age structures, urbanisation and comorbidities (HIV, tuberculosis, anaemia).

Results: In our baseline model, we project that the peak of active cases will occur in July, subject to the effectiveness of policy measures. When accounting for the urbanisation, and factoring in comorbidities, the peak may occur between 2 June and 17 June (Ghana), 22 July and 29 August (Kenya) and, finally, 28 May and 15 June (Senegal). Successful containment policies could lead to lower rates of severe infections. While most cases will be mild, we project in the absence of policies further containing the spread, that between 0.78% and 1.03%, 0.61% and 1.22%, and 0.60% and 0.84% of individuals in Ghana, Kenya and Senegal, respectively, may develop severe symptoms at the time of the peak of the epidemic.

Conclusion: Compared with Europe, Africa's younger and rural population may modify the severity of the epidemic. The large youth population may lead to more infections but most of these infections will be asymptomatic or mild, and will probably go undetected. The higher prevalence of underlying conditions must be considered.

Keywords: epidemiology; health policy.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Conflict of interest statement
Competing interests: None declared.

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160
Editorial J Gen Intern Med
. 2019 Jun;34(6):783-784. doi: 10.1007/s11606-019-04871-5.
So Many Nudges, So Little Time: Can Cost-effectiveness Tell Us When It Is Worthwhile to Try to Change Provider Behavior?
David Atkins 1
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PMID: 30877456 PMCID: PMC6544771 DOI: 10.1007/s11606-019-04871-5
Free PMC article
Comment on
Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: a Cost-Effectiveness Analysis.
Gong CL, Zangwill KM, Hay JW, Meeker D, Doctor JN.
J Gen Intern Med. 2019 Jun;34(6):846-854. doi: 10.1007/s11606-018-4467-x. Epub 2018 May 8.
PMID: 29740788 Free PMC article.
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161
Stroke
. 2020 Jun;51(6):1910-1912. doi: 10.1161/STROKEAHA.120.030023. Epub 2020 Apr 1.
Temporary Emergency Guidance to US Stroke Centers During the Coronavirus Disease 2019 (COVID-19) Pandemic: On Behalf of the American Heart Association/American Stroke Association Stroke Council Leadership
AHA/ASA Stroke Council Leadership
PMID: 32233972 DOI: 10.1161/STROKEAHA.120.030023
Abstract
No abstract available
Keywords: emergencies; epidemic; guidelines; stroke; treatment.

Cited by 2 articles
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162
J Am Coll Surg
. 2020 Jun;230(6):1119-1120. doi: 10.1016/j.jamcollsurg.2020.03.028. Epub 2020 Apr 10.
Surgeons, Ethics, and COVID-19: Early Lessons Learned
Peter Angelos 1
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PMID: 32283270 PMCID: PMC7151452 DOI: 10.1016/j.jamcollsurg.2020.03.028
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163
Eur J Epidemiol
. 2020 May;35(5):389-399. doi: 10.1007/s10654-020-00649-w. Epub 2020 May 19.
Dynamic Interventions to Control COVID-19 Pandemic: A Multivariate Prediction Modelling Study Comparing 16 Worldwide Countries
Rajiv Chowdhury 1, Kevin Heng 2 3, Md Shajedur Rahman Shawon 4, Gabriel Goh 5, Daisy Okonofua 6, Carolina Ochoa-Rosales 7 8, Valentina Gonzalez-Jaramillo 9, Abbas Bhuiya 10, Daniel Reidpath 11, Shamini Prathapan 12, Sara Shahzad 6, Christian L Althaus 9, Nathalia Gonzalez-Jaramillo 9, Oscar H Franco 13, Global Dynamic Interventions Strategies for COVID-19 Collaborative Group
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PMID: 32430840 PMCID: PMC7237242 DOI: 10.1007/s10654-020-00649-w
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Abstract
To date, non-pharmacological interventions (NPI) have been the mainstay for controlling the coronavirus disease-2019 (COVID-19) pandemic. While NPIs are effective in preventing health systems overload, these long-term measures are likely to have significant adverse economic consequences. Therefore, many countries are currently considering to lift the NPIs-increasing the likelihood of disease resurgence. In this regard, dynamic NPIs, with intervals of relaxed social distancing, may provide a more suitable alternative. However, the ideal frequency and duration of intermittent NPIs, and the ideal "break" when interventions can be temporarily relaxed, remain uncertain, especially in resource-poor settings. We employed a multivariate prediction model, based on up-to-date transmission and clinical parameters, to simulate outbreak trajectories in 16 countries, from diverse regions and economic categories. In each country, we then modelled the impacts on intensive care unit (ICU) admissions and deaths over an 18-month period for following scenarios: (1) no intervention, (2) consecutive cycles of mitigation measures followed by a relaxation period, and (3) consecutive cycles of suppression measures followed by a relaxation period. We defined these dynamic interventions based on reduction of the mean reproduction number during each cycle, assuming a basic reproduction number (R0) of 2.2 for no intervention, and subsequent effective reproduction numbers (R) of 0.8 and 0.5 for illustrative dynamic mitigation and suppression interventions, respectively. We found that dynamic cycles of 50-day mitigation followed by a 30-day relaxation reduced transmission, however, were unsuccessful in lowering ICU hospitalizations below manageable limits. By contrast, dynamic cycles of 50-day suppression followed by a 30-day relaxation kept the ICU demands below the national capacities. Additionally, we estimated that a significant number of new infections and deaths, especially in resource-poor countries, would be averted if these dynamic suppression measures were kept in place over an 18-month period. This multi-country analysis demonstrates that intermittent reductions of R below 1 through a potential combination of suppression interventions and relaxation can be an effective strategy for COVID-19 pandemic control. Such a "schedule" of social distancing might be particularly relevant to low-income countries, where a single, prolonged suppression intervention is unsustainable. Efficient implementation of dynamic suppression interventions, therefore, confers a pragmatic option to: (1) prevent critical care overload and deaths, (2) gain time to develop preventive and clinical measures, and (3) reduce economic hardship globally.

Keywords: COVID-19; Dynamic interventions; Epidemiology; Infectious disease; Prediction modelling.

30 references2 figures
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164
Nucleic Acid Ther
. 2020 Jun;30(3):129-132. doi: 10.1089/nat.2020.0868. Epub 2020 Apr 13.
Oligonucleotides and the COVID-19 Pandemic: A Perspective
John J Rossi 1, Daniel Rossi 2
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PMID: 32297843 PMCID: PMC7249453 DOI: 10.1089/nat.2020.0868
Free PMC article
Abstract
The present global health emergency involving the emergence and rapid spread of a novel coronavirus has prompted the world scientific community to consider how it can help to fight this growing viral pandemic. With few safe and effective drugs available to combat this threat to humanity and the normal functioning of our society, the oligonucleotide research community is uniquely positioned to apply its technology and expertise to help alleviate the crisis, thanks to its capacity for rational drug design, swift development cycles, and pursuing targets undruggable by conventional treatment strategies.

Keywords: chemistry optimization; coronavirus; virus–host interactions.

Conflict of interest statement
D.R. is the interim president of iSTAT Therapeutics, Inc., which is developing products related to research described in this article. D.R. and iSTAT Therapeutics may financially benefit if the company is successful in marketing its products that are related to this research.

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165
Review Int J Environ Res Public Health
. 2020 May 15;17(10):E3445. doi: 10.3390/ijerph17103445.
The Need for the Right Socio-Economic and Cultural Fit in the COVID-19 Response in Sub-Saharan Africa: Examining Demographic, Economic Political, Health, and Socio-Cultural Differentials in COVID-19 Morbidity and Mortality
Andre M N Renzaho 1 2 3
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PMID: 32429123 DOI: 10.3390/ijerph17103445
Free article
Abstract
The coronavirus disease (COVID-19) has spread quickly across the globe with devastating effects on the global economy as well as the regional and societies' socio-economic fabrics and the way of life for vast populations. The nonhomogeneous continent faces local contextual complexities that require locally relevant and culturally appropriate COVID-19 interventions. This paper examines demographic, economic, political, health, and socio-cultural differentials in COVID-19 morbidity and mortality. The health systems need to be strengthened through extending the health workforce by mobilizing and engaging the diaspora, and implementing the International Health Regulations (2005) core capacities. In the absence of adequate social protection and welfare programs targeting the poor during the pandemic, sub-Saharan African countries need to put in place flexible but effective policies and legislation approaches that harness and formalise the informal trade and remove supply chain barriers. This could include strengthening cross-border trade facilities such as adequate pro-poor, gender-sensitive, and streamlined cross-border customs, tax regimes, and information flow. The emphasis should be on cross-border infrastructure that not only facilitates trade through efficient border administration but can also effectively manage cross-border health threats. There is an urgent need to strengthen social protection systems to make them responsive to crises, and embed them within human rights-based approaches to better support vulnerable populations and enact health and social security benefits. The COVI-19 response needs to adhere to the well-established 'do no harm' principle to prevent further damage or suffering as a result of the pandemic and examined through local lenses to inform peace-building initiatives that may yield long-term gains in the post-COVID-19 recovery efforts.

Keywords: COVID-19; coronavirus disease; health systems; morbidity; mortality; sub-Saharan Africa.

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166
Knee Surg Sports Traumatol Arthrosc
. 2020 Jun;28(6):1705-1711. doi: 10.1007/s00167-020-06032-2. Epub 2020 Apr 30.
Massive Cutback in Orthopaedic Healthcare Services Due to the COVID-19 Pandemic
M C Liebensteiner 1, I Khosravi 2, M T Hirschmann 3 4, P R Heuberer 5, Board of the AGA-Society of Arthroscopy and Joint-Surgery; M Thaler 1
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PMID: 32356047 PMCID: PMC7192059 DOI: 10.1007/s00167-020-06032-2
Free PMC article
Abstract
Purpose: Due to the lack of evidence, it was the aim of the study to investigate current possible cutbacks in orthopaedic healthcare due to the coronavirus disease 2019 pandemic (COVID-19).

Methods: An online survey was performed of orthopaedic surgeons in the German-speaking Arthroscopy Society (Gesellschaft für Arthroskopie und Gelenkchirurgie, AGA). The survey consisted of 20 questions concerning four topics: four questions addressed the origin and surgical experience of the participant, 12 questions dealt with potential cutbacks in orthopaedic healthcare and 4 questions addressed the influence of the pandemic on the particular surgeon.

Results: Of 4234 contacted orthopaedic surgeons, 1399 responded. Regarding arthroscopic procedures between 10 and 30% of the participants stated that these were still being performed-with actual percentages depending on the specific joint and procedure. Only 6.2% of the participants stated that elective total joint arthroplasty was still being performed at their centre. In addition, physical rehabilitation and surgeons' postoperative follow-ups were severely affected.

Conclusion: Orthopaedic healthcare services in Austria, Germany, and Switzerland are suffering a drastic cutback due to COVID-19. A drastic reduction in arthroscopic procedures like rotator cuff repair and cruciate ligament reconstruction and an almost total shutdown of elective total joint arthroplasty were reported. Long-term consequences cannot be predicted yet. The described disruption in orthopaedic healthcare services has to be viewed as historic.

Level of evidence: V.

Keywords: Arthroplasty; Arthroscopy; COVID-19; Coronavirus disease 2019; Health-care; Ligament reconstruction; Orthopaedic; Rotator cuff; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2.

Conflict of interest statement
The authors declare that they have no conflict of interest.

9 references3 figures
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167
Review J Am Acad Orthop Surg
. 2020 Jun 1;28(11):e477-e486. doi: 10.5435/JAAOS-D-20-00391.
Recommendations for the Care of Pediatric Orthopaedic Patients During the COVID-19 Pandemic
Sarah Farrell 1, Emily K Schaeffer, Kishore Mulpuri
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PMID: 32301817 PMCID: PMC7197339 DOI: 10.5435/JAAOS-D-20-00391
Free PMC article
Abstract
The COVID-19 pandemic has necessitated modifications to pediatric orthopaedic practice to protect patients, families, and healthcare workers and to minimize viral transmission. It is critical to balance the benefits of alterations to current practice to reduce the chances of COVID-19 infection, with the potential long-term impact on patients. Early experiences of the pandemic from orthopaedic surgeons in China, Singapore, and Italy have provided the opportunity to take proactive and preventive measures to protect all involved in pediatric orthopaedic care. These guidelines, based on expert opinion and best available evidence, provide a framework for the management of pediatric orthopaedic patients during the COVID-19 pandemic. General principles include limiting procedures to urgent cases such as traumatic injuries and deferring outpatient visits during the acute phase of the pandemic. Nonsurgical methods should be considered where possible. For patients with developmental or chronic orthopaedic conditions, it may be possible to delay treatment for 2 to 4 months without substantial detrimental long-term impact.

Conflict of interest statement
None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Farrell, Dr. Schaeffer, Dr. Mulpuri.

26 references
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168
J Med Virol
. 2019 Aug;91(8):1415-1422. doi: 10.1002/jmv.25473. Epub 2019 Apr 9.
Differential Age-Specific Distribution of Influenza Virus Types and Subtypes in Tropical Singapore, 2011 to 2017
Li Wei Ang 1 2, Lin Cui 3, Tze Minn Mak 3, Yixiang Ng 2, Yee Sin Leo 4, Vernon Jian Ming Lee 2, Raymond Tzer-Pin Lin 3
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PMID: 30927452 DOI: 10.1002/jmv.25473
Abstract
Surveillance and reporting of epidemiological features of seasonal influenza mostly are aggregates across all-ages. We investigated age-specific differences in distribution of influenza virus (sub)types in tropical Singapore, using laboratory-confirmed virological data collected under the national influenza surveillance programme from 2011 to 2017. The proportion of influenza-positive specimens from outpatients with influenza-like illness was used as an indicator of influenza activity in the community. The highest influenza positivity for age groups of 5 to 14 years and 15 to 64 years coincided in the same month in 5 out of the 7 years under study. Influenza positivity was lowest in young children <5 years of age compared with older age groups. Influenza A(H3N2) was most prevalent in the community except in 2012 when a predominance of influenza B was observed. The dominant virus (sub)type varied across the years in children <5 years and 5 to 14 years of age. Influenza A(H3N2) was the predominant circulating virus subtype among elderly persons aged ≥65 years during the 7-year period, and among adults aged 15 to 64 years since 2013. Knowledge about the age-specific differences in distribution of influenza virus (sub)types helps to facilitate better understanding of seasonal epidemics and to inform targeted strategies in prevention and control of influenza virus transmission.

Keywords: epidemiology; influenza; seasonal.

© 2019 Wiley Periodicals, Inc.

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169
Pediatr Blood Cancer
. 2020 Jul;67(7):e28397. doi: 10.1002/pbc.28397. Epub 2020 May 8.
COVID-19 Infection in Children and Adolescents With Cancer in Madrid
Teresa de Rojas 1, Antonio Pérez-Martínez 2, Elena Cela 3, Marta Baragaño 4, Victor Galán 2, Cristina Mata 3, Alba Peretó 5, Luis Madero 4 5
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PMID: 32383819 PMCID: PMC7235530 DOI: 10.1002/pbc.28397
Free PMC article
Conflict of interest statement
The authors declare that there is no conflict of interest.

10 references
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170
Case Reports J Coll Physicians Surg Pak
. 2019 Dec;29(12):S148-S150. doi: 10.29271/jcpsp.2019.12.S148.
Benign Broncho-esophageal Fistula Presenting as Unresolved Pneumonia
Waseem M Hajjar 1, Lamyaa A Althawadi 1, Nada A Bin Semaih 1, Adnan W Hajjar 1, Sami A Al-Nassar 1
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PMID: 31779772 DOI: 10.29271/jcpsp.2019.12.S148
Abstract
Benign acquired broncho-esophageal fistula (BEF) in adults is a very rare entity and has not been reported properly in the literature, compared to malignant BEF. Nonetheless, infection has predisposed most of the reported benign acquired BEF cases. We report here a case of tuberculous BEF, in a patient with a history of pulmonary tuberculosis (TB). He presented with recurrent chest infections, and choking. Upper gastrointestinal (GI) endoscopy showed BEF due to tuberculous mediastinal lymphadenopathy, and the patient was managed by surgery successfully. He was prepared for surgery for one month by nutritional support and anti-tuberculous treatment.

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171
Anat Sci Educ
. 2020 May;13(3):301-311. doi: 10.1002/ase.1967. Epub 2020 May 9.
Strength, Weakness, Opportunity, Threat (SWOT) Analysis of the Adaptations to Anatomical Education in the United Kingdom and Republic of Ireland in Response to the Covid-19 Pandemic
Georga J Longhurst 1, Danya M Stone 2, Kate Dulohery 3, Deirdre Scully 4, Thomas Campbell 5, Claire F Smith 2
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PMID: 32306550 PMCID: PMC7264742 DOI: 10.1002/ase.1967
Free PMC article
Abstract
The Covid-19 pandemic has driven the fastest changes to higher education across the globe, necessitated by social distancing measures preventing face-to-face teaching. This has led to an almost immediate switch to distance learning by higher education institutions. Anatomy faces some unique challenges. Intrinsically, anatomy is a three-dimensional subject that requires a sound understanding of the relationships between structures, often achieved by the study of human cadaveric material, models, and virtual resources. This study sought to identify the approaches taken in the United Kingdom and Republic of Ireland to deliver anatomical education through online means. Data were collected from 14 different universities in the United Kingdom and Republic of Ireland and compared adopting a thematic analysis approach. Once themes were generated, they were collectively brought together using a strength, weakness, opportunity, threat (SWOT) analysis. Key themes included the opportunity to develop new online resources and the chance to engage in new academic collaborations. Academics frequently mentioned the challenge that time constrains could place on the quality and effectiveness of these resources; especially as in many cases the aim of these resources was to compensate for a lack of exposure to cadaveric exposure. Comparisons of the actions taken by multiple higher education institutions reveal the ways that academics have tried to balance this demand. Discussions will facilitate decisions being made by higher education institutions regarding adapting the curriculum and assessment methods in anatomy.

Keywords: Covid-19; Gross anatomy education; anatomy; assessment; distance learning; medical education; online education; pedagogy; undergraduate education.

© 2020 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.

97 references1 figure
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172
Lancet
. 2020 May 30;395(10238):1705-1714. doi: 10.1016/S0140-6736(20)31030-8. Epub 2020 May 14.
Use of Renin-Angiotensin-Aldosterone System Inhibitors and Risk of COVID-19 Requiring Admission to Hospital: A Case-Population Study
Francisco J de Abajo 1, Sara Rodríguez-Martín 2, Victoria Lerma 3, Gina Mejía-Abril 4, Mónica Aguilar 5, Amelia García-Luque 6, Leonor Laredo 7, Olga Laosa 8, Gustavo A Centeno-Soto 9, Maria Ángeles Gálvez 5, Miguel Puerro 6, Esperanza González-Rojano 7, Laura Pedraza 10, Itziar de Pablo 5, Francisco Abad-Santos 4, Leocadio Rodríguez-Mañas 11, Miguel Gil 12, Aurelio Tobías 13, Antonio Rodríguez-Miguel 2, Diego Rodríguez-Puyol 14, MED-ACE2-COVID19 study group
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PMID: 32416785 PMCID: PMC7255214 DOI: 10.1016/S0140-6736(20)31030-8
Free PMC article
Abstract
Background: Concerns have been raised about the possibility that inhibitors of the renin-angiotensin-aldosterone system (RAAS) could predispose individuals to severe COVID-19; however, epidemiological evidence is lacking. We report the results of a case-population study done in Madrid, Spain, since the outbreak of COVID-19.

Methods: In this case-population study, we consecutively selected patients aged 18 years or older with a PCR-confirmed diagnosis of COVID-19 requiring admission to hospital from seven hospitals in Madrid, who had been admitted between March 1 and March 24, 2020. As a reference group, we randomly sampled ten patients per case, individually matched for age, sex, region (ie, Madrid), and date of admission to hospital (month and day; index date), from Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria (BIFAP), a Spanish primary health-care database, in its last available year (2018). We extracted information on comorbidities and prescriptions up to the month before index date (ie, current use) from electronic clinical records of both cases and controls. The outcome of interest was admission to hospital of patients with COVID-19. To minimise confounding by indication, the main analysis focused on assessing the association between COVID-19 requiring admission to hospital and use of RAAS inhibitors compared with use of other antihypertensive drugs. We calculated odds ratios (ORs) and 95% CIs, adjusted for age, sex, and cardiovascular comorbidities and risk factors, using conditional logistic regression. The protocol of the study was registered in the EU electronic Register of Post-Authorisation Studies, EUPAS34437.

Findings: We collected data for 1139 cases and 11 390 population controls. Among cases, 444 (39·0%) were female and the mean age was 69·1 years (SD 15·4), and despite being matched on sex and age, a significantly higher proportion of cases had pre-existing cardiovascular disease (OR 1·98, 95% CI 1·62-2·41) and risk factors (1·46, 1·23-1·73) than did controls. Compared with users of other antihypertensive drugs, users of RAAS inhibitors had an adjusted OR for COVID-19 requiring admission to hospital of 0·94 (95% CI 0·77-1·15). No increased risk was observed with either angiotensin-converting enzyme inhibitors (adjusted OR 0·80, 0·64-1·00) or angiotensin-receptor blockers (1·10, 0·88-1·37). Sex, age, and background cardiovascular risk did not modify the adjusted OR between use of RAAS inhibitors and COVID-19 requiring admission to hospital, whereas a decreased risk of COVID-19 requiring admission to hospital was found among patients with diabetes who were users of RAAS inhibitors (adjusted OR 0·53, 95% CI 0·34-0·80). The adjusted ORs were similar across severity degrees of COVID-19.

Interpretation: RAAS inhibitors do not increase the risk of COVID-19 requiring admission to hospital, including fatal cases and those admitted to intensive care units, and should not be discontinued to prevent a severe case of COVID-19.

Funding: Instituto de Salud Carlos III.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Comment in
Hypertension, renin-angiotensin-aldosterone system inhibition, and COVID-19.
Williams B, Zhang Y.
Lancet. 2020 May 30;395(10238):1671-1673. doi: 10.1016/S0140-6736(20)31131-4. Epub 2020 May 14.
PMID: 32416786 Free PMC article. No abstract available.
Cited by 1 article34 references2 figures
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173
Review Sci Total Environ
. 2020 Jul 10;725:138858. doi: 10.1016/j.scitotenv.2020.138858. Epub 2020 Apr 23.
Restructured Society and Environment: A Review on Potential Technological Strategies to Control the COVID-19 Pandemic
Rajvikram Madurai Elavarasan 1, Rishi Pugazhendhi 2
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PMID: 32336562 PMCID: PMC7180041 DOI: 10.1016/j.scitotenv.2020.138858
Free PMC article
Abstract
The emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in China at December 2019 had led to a global outbreak of coronavirus disease 2019 (COVID-19) and the disease started to spread all over the world and became an international public health issue. The entire humanity has to fight in this war against the unexpected and each and every individual role is important. Healthcare system is doing exceptional work and the government is taking various measures that help the society to control the spread. Public, on the other hand, coordinates with the policies and act accordingly in most state of affairs. But the role of technologies in assisting different social bodies to fight against the pandemic remains hidden. The intention of our study is to uncover the hidden roles of technologies that ultimately help for controlling the pandemic. On investigating, it is found that the strategies utilizing potential technologies would yield better benefits and these technological strategies can be framed either to control the pandemic or to support the confinement of the society during pandemic which in turn aids in controlling the spreading of infection. This study enlightens the various implemented technologies that assists the healthcare systems, government and public in diverse aspects for fighting against COVID-19. Furthermore, the technological swift that happened during the pandemic and their influence in the environment and society is discussed. Besides the implemented technologies, this work also deals with untapped potential technologies that have prospective applications in controlling the pandemic circumstances. Alongside the various discussion, our suggested solution for certain situational issues is also presented.

Keywords: Artificial intelligence; COVID-19; Environment; Healthcare system; Society; Technology.

Copyright © 2020 Elsevier B.V. All rights reserved.

Conflict of interest statement
Declaration of competing interest The authors declare no conflict of interest.

Cited by 1 article155 references10 figures
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174
Singapore Med J
. 2020 Jun 2. doi: 10.11622/smedj.2020084. Online ahead of print.
Safety, Tolerability and Efficacy of LEGA-Kid® Mechanical Percussion Device Versus Conventional Chest Physiotherapy in Children: A Randomised, Single-Blind Controlled Study
Yuen Ling Hue 1, Lucy Chai See Lum 2, Siti Hawa Ahmad 3, Soon Sin Tan 1, Shin Yee Wong 2, Anna Marie Nathan 2, Kah Peng Eg 2, Melissa de Bruyne Ming May Choon 1
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PMID: 32480437 DOI: 10.11622/smedj.2020084
Abstract
Introduction: Chest physiotherapy (CPT) may benefit children aged < 5 years who suffer from lower respiratory tract infection (LRTI). However, its effects are technique-dependent. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI.

Methods: Children aged 5 months to 5 years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid®. Outcomes measured at pre-intervention and 2 hours post-intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score.

Results: All 30 enrolled patients had significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT.

Conclusion: Children receiving either manual or mechanical CPT showed improvements in respiratory distress symptoms with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements of moderately severe respiratory distress. The LEGA-Kid mechanical CPT method was superior in reducing RR.

Keywords: children; lower respiratory tract infections; manual chest physiotherapy; mechanical percussor; nebulised hypertonic saline.

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175
Review Bull Environ Contam Toxicol
. 2020 Jun;104(6):724-726. doi: 10.1007/s00128-020-02877-y. Epub 2020 May 11.
The Influence of COVID-19 on Air Quality in India: A Boon or Inutile
Sneha Gautam 1
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PMID: 32394052 PMCID: PMC7212731 DOI: 10.1007/s00128-020-02877-y
Free PMC article
Abstract
Corona virus diseases-2019 (COVID-19), an infectious disease identified in late December, 2019, in Wuhan city of China, was declared a pandemic by the World Health Organization. Most countries including India have announced some sort of lockdown to reduce the effects of COVID-19 and discontinue the transmission of novel coronavirus. Major negative effects on the social and surrounding environment have been reported due to COVID-19, however positive effects have also been observed with respect to air quality. Secondary results have been taken from National Aeronautics and Space Administration (NASA), indicating significant reduction (50%) in air quality of Indian region. This perspective highlights the effects of the lockdown due to COVID-19 on aerosol optical thickness specifically in India.

Keywords: Air quality; COVID-19; Environmental pollution; India.

13 references1 figure
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176
Pediatr Blood Cancer
. 2020 Jul;67(7):e28409. doi: 10.1002/pbc.28409. Epub 2020 May 13.
The COVID-19 Pandemic: A Rapid Global Response for Children With Cancer From SIOP, COG, SIOP-E, SIOP-PODC, IPSO, PROS, CCI, and St Jude Global
Michael Sullivan 1, Eric Bouffet 2, Carlos Rodriguez-Galindo 3, Sandra Luna-Fineman 4, Muhammad Saghir Khan 5, Pam Kearns 6, Douglas S Hawkins 7, Julia Challinor 8, Lisa Morrissey 9, Jörg Fuchs 10, Karen Marcus 11, Adriana Balduzzi 12, Luisa Basset-Salom 13, Miguela Caniza 14, Justin N Baker 15, Rejin Kebudi 16, Laila Hessissen 17, Richard Sullivan 18, Kathy Pritchard-Jones 19
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PMID: 32400924 PMCID: PMC7235469 DOI: 10.1002/pbc.28409
Free PMC article
Abstract
The COVID-19 pandemic is one of the most serious global challenges to delivering affordable and equitable treatment to children with cancer we have witnessed in the last few decades. This Special Report aims to summarize general principles for continuing multidisciplinary care during the SARS-CoV-2 (COVID-19) pandemic. With contributions from the leadership of the International Society for Pediatric Oncology (SIOP), Children's Oncology Group (COG), St Jude Global program, and Childhood Cancer International, we have sought to provide a framework for healthcare teams caring for children with cancer during the pandemic. We anticipate the burden will fall particularly heavily on children, their families, and cancer services in low- and middle-income countries. Therefore, we have brought together the relevant clinical leads from SIOP Europe, COG, and SIOP-PODC (Pediatric Oncology in Developing Countries) to focus on the six most curable cancers that are part of the WHO Global Initiative in Childhood Cancer. We provide some practical advice for adapting diagnostic and treatment protocols for children with cancer during the pandemic, the measures taken to contain it (e.g., extreme social distancing), and how to prepare for the anticipated recovery period.

Keywords: Burkitt lymphoma; COVID-19; Hodgkin lymphoma; SARS-CoV-2; WHO Global Initiative on Childhood Cancer; Wilms tumor; acute lymphoblastic leukemia; childhood cancer; low-grade glioma; nephroblastoma; pediatrics; retinoblastoma.

© 2020 Wiley Periodicals, Inc.

Conflict of interest statement
The authors declare no conflicts of interest.

74 references
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177
Orv Hetil
. 2020 Jun;161(24):983-992. doi: 10.1556/650.2020.31873.
[Possibilities of Telemedicine Regarding the COVID-19 Pandemic in Light of the International and Hungarian Experiences and Recommendations]
[Article in Hungarian]
Zsuzsa Győrffy 1, Sándor Békási 2 3, Noémi Szathmári-Mészáros 4, Orsolya Németh 4
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PMID: 32469844 DOI: 10.1556/650.2020.31873
Abstract
The COVID-19 outbreak was formally announced as a pandemic by WHO on the 11th of March, 2020. This attracts attention to the possibilities of telemedicine again. In support of stopping the spread of the novel coronavirus infection, whilst keeping the healthcare system running and minimizing the risk of being infected, we also need to find new ways, methods, and platforms to deal with this pandemic. By providing a literature overview and sharing practical guidelines, including the special example of Hungarian teledentistry, we present both international and Hungarian initiatives to involve telemedicine on different levels of healthcare systems regarding COVID-19. Both international and national data show that telemedicine can play a major role in the triage process, early identification, diagnosis and treatment of infected individuals, and management of patient pathways in a way that ensures the medical team does not come into contact with potentially infected patients. It also plays an important role in remote monitoring of medical conditions and care of patients with chronic diseases and reconnects vulnerable groups of healthcare personnel to the care system. In addition to the potential benefits of telemedicine, we must not forget the limitations of this method. However, it is important to emphasize that due to its wide availability, telemedicine services can provide sufficient flexibility for both primary and specialist care (outpatient and inpatient clinical care). For that very reason, it is an urgent need to define the national professional guidelines, legal and financing possibilities in this field in a long-term sustainable way.* Orv Hetil. 2020; 161(24): 983-992. *Disclaimer: We closed the writing of this manuscript on the 30th of April, 2020. The COVID-19 pandemic and related research studies still have been changing dynamically since then.

Keywords: COVID-19; COVID–19; doctor-patient relationship; orvos-beteg kapcsolat; telemedicina; telemedicine; triage; triázs.

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178
Observational Study Respir Res
. 2020 May 24;21(1):125. doi: 10.1186/s12931-020-01385-1.
The Pulmonary Sequalae in Discharged Patients With COVID-19: A Short-Term Observational Study
Dehan Liu 1 2, Wanshu Zhang 1 2, Feng Pan 1 2, Lin Li 1 2, Lian Yang 3 4, Dandan Zheng 5, Jiazheng Wang 5, Bo Liang 1 2
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PMID: 32448391 PMCID: PMC7245637 DOI: 10.1186/s12931-020-01385-1
Free PMC article
Abstract
Background: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia were discharged from hospitals in Wuhan, China. We aimed to determine the cumulative percentage of complete radiological resolution at each time point, to explore the relevant affecting factors, and to describe the chest CT findings at different time points after hospital discharge.

Methods: Patients with COVID-19 pneumonia confirmed by RT-PCR who were discharged consecutively from the hospital between 5 February 2020 and 10 March 2020 and who underwent serial chest CT scans on schedule were enrolled. The radiological characteristics of all patients were collected and analysed. The total CT score was the sum of non-GGO involvement determined at discharge. Afterwards, all patients underwent chest CT scans during the 1st, 2nd, and 3rd weeks after discharge. Imaging features and distributions were analysed across different time points.

Results: A total of 149 patients who completed all CT scans were evaluated; there were 67 (45.0%) men and 82 (55.0%) women, with a median age of 43 years old (IQR 36-56). The cumulative percentage of complete radiological resolution was 8.1% (12 patients), 41.6% (62), 50.3% (75), and 53.0% (79) at discharge and during the 1st, 2nd, and 3rd weeks after discharge, respectively. Patients ≤44 years old showed a significantly higher cumulative percentage of complete radiological resolution than patients > 44 years old at the 3-week follow-up. The predominant patterns of abnormalities observed at discharge were ground-glass opacity (GGO) (125 [83.9%]), fibrous stripe (81 [54.4%]), and thickening of the adjacent pleura (33 [22.1%]). The positive count of GGO, fibrous stripe and thickening of the adjacent pleura gradually decreased, while GGO and fibrous stripe showed obvious resolution during the first week and the third week after discharge, respectively. "Tinted" sign and bronchovascular bundle distortion as two special features were discovered during the evolution.

Conclusion: Lung lesions in COVID-19 pneumonia patients can be absorbed completely during short-term follow-up with no sequelae. Two weeks after discharge might be the optimal time point for early radiological estimation.

Keywords: COVID-19; CT; Discharge; Fibrous stripe; Follow-up; GGO; Sequalae.

Conflict of interest statement
The authors declare that they have no competing interests.

16 references4 figures
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179
Radiol Med
. 2020 Jun;125(6):600-603. doi: 10.1007/s11547-020-01217-8. Epub 2020 May 15.
Radiotherapy During COVID-19 Pandemic. How to Create a No Fly Zone: A Northern Italy Experience
Giampaolo Montesi 1, Saide Di Biase 2, Sara Chierchini 2, Giovanni Pavanato 2, Graziella Elia Virdis 2, Edgardo Contato 3, Giovanni Mandoliti 2
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PMID: 32415473 PMCID: PMC7227174 DOI: 10.1007/s11547-020-01217-8
Free PMC article
Abstract
Background: SARS-CoV-2 pandemic represents a troubling health emergency but also a main challenge for the clinical governance of the system. Discontinuation of radiation treatments is not desirable and potentially life-threatening. On the other hand, accesses to hospital expose cancer patients to an increased risk of COVID-19 infection. We report our extended protocol, draft to manage clinical activities in our radiotherapy department, by minimizing contagion risks.

Methods: We used telephonic screening to assess the need for patient admission. A telephonic triage was performed to identify the presence of COVID-19 infection risk factors or symptoms. New treatments were stratified according to priority codes. A reserved entrance to radiotherapy department was assured for patients and staff. Surgical disposable mask was required for patients and caregivers. The activities were distributed during the whole workday, avoiding overlap to reduce aggregation.

Results: From 1st February 2020 to 31 March 2020, we reported an increase in the number of first medical examinations and treatments, compared to the same period of the previous year. Outpatients first medical examinations have been spread over the 12 working hours. No COVID-19 cases were detected.

Conclusion: During COVID-19 pandemic, we introduced procedures that allowed us to ensure the continuity in oncological cares, with limited risks of infection for patients and staff.

Keywords: COVID-19; Coronavirus; Pandemic; Radiation oncology; Radiotherapy; SARS-CoV-2.

Conflict of interest statement
The authors declare that they have no conflict of interest.

11 references2 figures
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180
JCI Insight
. 2020 May 21;5(10):139292. doi: 10.1172/jci.insight.139292.
COVID-19 in Older Adults: Clinical, Psychosocial, and Public Health Considerations
John P Mills 1, Keith S Kaye 1, Lona Mody 2 3
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PMID: 32302293 DOI: 10.1172/jci.insight.139292
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181
Review BMJ
. 2020 May 26;369:m1936. doi: 10.1136/bmj.m1936.
Scope, Quality, and Inclusivity of Clinical Guidelines Produced Early in the covid-19 Pandemic: Rapid Review
Andrew Dagens 1, Louise Sigfrid 2, Erhui Cai 2, Sam Lipworth 3, Vincent Cheung 4, Eli Harris 5, Peter Bannister 6, Ishmeala Rigby 6, Peter Horby 2
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PMID: 32457027 DOI: 10.1136/bmj.m1936
Abstract
Objective: To appraise the availability, quality, and inclusivity of clinical guidelines produced in the early stage of the coronavirus disease 2019 (covid-19) pandemic.

Design: Rapid review.

Data sources: Ovid Medline, Ovid Embase, Ovid Global Health, Scopus, Web of Science Core Collection, and WHO Global Index Medicus, searched from inception to 14 Mar 2020. Search strategies applied the CADTH database guidelines search filter, with no limits applied to search results. Further studies were identified through searches of grey literature using the ISARIC network.

Inclusion criteria: Clinical guidelines for the management of covid-19, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS) produced by international and national scientific organisations and government and non-governmental organisations relating to global health were included, with no exclusions for language. Regional/hospital guidelines were excluded. Only the earliest version of any guideline was included.

Quality assessment: Quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. The quality and contents of early covid-19 guidelines were also compared with recent clinical guidelines for MERS and SARS.

Results: 2836 studies were identified, of which 2794 were excluded after screening. Forty two guidelines were considered eligible for inclusion, with 18 being specific to covid-19. Overall, the clinical guidelines lacked detail and covered a narrow range of topics. Recommendations varied in relation to, for example, the use of antiviral drugs. The overall quality was poor, particularly in the domains of stakeholder involvement, applicability, and editorial independence. Links between evidence and recommendations were limited. Minimal provision was made for vulnerable groups such as pregnant women, children, and older people.

Conclusions: Guidelines available early in the covid-19 pandemic had methodological weaknesses and neglected vulnerable groups such as older people. A framework for development of clinical guidelines during public health emergencies is needed to ensure rigorous methods and the inclusion of vulnerable populations.

Systematic review registration: PROSPERO CRD42020167361.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.

Conflict of interest statement
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from the Wellcome Trust for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

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182
Proc Natl Acad Sci U S A
. 2020 Jan 28;117(4):2122-2132. doi: 10.1073/pnas.1915152117. Epub 2020 Jan 13.
A Molecularly Engineered Antiviral Banana Lectin Inhibits Fusion and Is Efficacious Against Influenza Virus Infection in Vivo
Evelyn M Covés-Datson 1 2, Steven R King 3 4, Maureen Legendre 3, Auroni Gupta 3, Susana M Chan 4 5, Emily Gitlin 3, Vikram V Kulkarni 6, Jezreel Pantaleón García 6, Donald F Smee 7, Elke Lipka 4, Scott E Evans 6, E Bart Tarbet 7, Akira Ono 2, David M Markovitz 8 5 9 10
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PMID: 31932446 PMCID: PMC6995028 DOI: 10.1073/pnas.1915152117
Free PMC article
Abstract
There is a strong need for a new broad-spectrum antiinfluenza therapeutic, as vaccination and existing treatments are only moderately effective. We previously engineered a lectin, H84T banana lectin (H84T), to retain broad-spectrum activity against multiple influenza strains, including pandemic and avian, while largely eliminating the potentially harmful mitogenicity of the parent compound. The amino acid mutation at position 84 from histidine to threonine minimizes the mitogenicity of the wild-type lectin while maintaining antiinfluenza activity in vitro. We now report that in a lethal mouse model H84T is indeed nonmitogenic, and both early and delayed therapeutic administration of H84T intraperitoneally are highly protective, as is H84T administered subcutaneously. Mechanistically, attachment, which we anticipated to be inhibited by H84T, was only somewhat decreased by the lectin. Instead, H84T is internalized into the late endosomal/lysosomal compartment and inhibits virus-endosome fusion. These studies reveal that H84T is efficacious against influenza virus in vivo, and that the loss of mitogenicity seen previously in tissue culture is also seen in vivo, underscoring the potential utility of H84T as a broad-spectrum antiinfluenza agent.

Keywords: antiviral; hemagglutinin; influenza virus; lectin; membrane fusion.

Copyright © 2020 the Author(s). Published by PNAS.

Conflict of interest statement
Competing interest statement: D.M.M. is an inventor on a patent for H84T BanLec and the founder of the company Virule, which aims to commercialize H84T BanLec.

Cited by 1 article59 references7 figures
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183
J Med Internet Res
. 2020 May 22;22(5):e19434. doi: 10.2196/19434.
Telehealth Home Support During COVID-19 Confinement for Community-Dwelling Older Adults With Mild Cognitive Impairment or Mild Dementia: Survey Study
Jessica Marian Goodman-Casanova 1, Elena Dura-Perez 1, Jose Guzman-Parra 1, Antonio Cuesta-Vargas 2, Fermin Mayoral-Cleries 1
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PMID: 32401215 PMCID: PMC7247465 DOI: 10.2196/19434
Free PMC article
Abstract
Background: The public health emergency of coronavirus disease (COVID-19) is rapidly evolving worldwide; some countries, including Spain, have implemented restrictive measures. Populations that are vulnerable to this outbreak and its physical and mental health effects include community-dwelling older adults with mild cognitive impairment or mild dementia. Telehealth is a potential tool to deliver health care and decrease exposure risk.

Objective: The aims of this study were to explore the impact of confinement on the health and well-being of community-dwelling older adults with mild cognitive impairment or mild dementia, to provide television-based and telephone-based health and social support, and to study the effects of a television-based assistive integrated technology, TV-AssistDem (TeleVision-based ASSistive Integrated Service to supporT European adults living with mild DEMentia or mild cognitive impairment).

Methods: A telephone-based survey was administered in Spain to 93 participants in the TV-AssistDem clinical trial from March 25 to April 6, 2020.

Results: Of the respondents, 60/93 (65%) were women. The mean age was 73.34 (SD 6.07), and 69/93 (74%) lived accompanied. Lockdown measures forced 17/93 respondents (18%) to change their living arrangements. Health status was found to be optimal in 89/93 respondents (96%), with no COVID-19 symptoms. Grocery and pharmacy outings were performed by family members of 68/93 participants (73%); 57 (61%) reported overall well-being, and 65 (70%) maintained their sleep quality. However, participants living alone reported greater negative feelings and more sleeping problems. Regarding leisure activities, 53/93 respondents (57%) took walks, 32 (35%) played memory games, 55 (60%) watched television, and 91 (98%) telephoned relatives. 58/93 (64%) respondents reported accessing moderate or too much COVID-19 information, 89 (97%) received it from television, and 56 (62%) stated that their understanding of the information was extreme. 39/93 (39%) respondents had contacted health and social services, while 29 (31%) requested information regarding these services during the telephone call. There were no significant differences in health and well-being between the intervention and control groups. Respondents with TV-AssistDem performed more memory exercises (24/93, 52% vs 8/93, 17.4%; P<.001) than control respondents.

Conclusions: Our findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population. However, those living alone reported greater negative psychological effects and sleeping problems. Measures adopted to address the negative experiences of confinement included keeping informed about the situation, accessing health and social services, having a support network that prevents risk of exposure to COVID-19 and guarantees food and medical supplies, a daily routine with maintained sleeping habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and ensuring social connectedness using technology. Television sets were preferred technological devices to access COVID-19 information, watch television as a recreational activity, and perform memory exercises as an intellectual activity. Television-based telehealth support using TV-AssistDem demonstrated potential for cognitive stimulation.

Trial registration: ClinicalTrials.gov NCT03653234; https://clinicaltrials.gov/ct2/show/NCT03653234.

Keywords: COVID-19; cognitive impairment; confinement; coronavirus; dementia; elderly; emergency response; mental health; older adults; physical health; public health; telehealth; well-being.

©Jessica Marian Goodman-Casanova, Elena Dura-Perez, Jose Guzman-Parra, Antonio Cuesta-Vargas, Fermin Mayoral-Cleries. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.05.2020.

Conflict of interest statement
Conflicts of Interest: None declared.

28 references3 figures
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184
Review Spec Care Dentist
. 2020 May;40(3):219-226. doi: 10.1111/scd.12472. Epub 2020 May 24.
Modifications of Emergency Dental Clinic Protocols to Combat COVID-19 Transmission
Robert Hollinshead Long 1, Tyrous David Ward 1, Michael Edward Pruett 1, John Finklea Coleman 1, Marc Charles Plaisance Jr 1
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PMID: 32447777 DOI: 10.1111/scd.12472
Abstract
During the COVID-19 pandemic, incidence rates for dental diseases will continue unabated. However, the intent to prevent the spread of this lethal respiratory disease will likely lead to reduced treatment access due to restrictions on population movements. These changes have the potential to increase dental-related emergency department visits and subsequently contribute to greater viral transmission. Moreover, dentists experience unique challenges with preventing transmission due to frequent aerosol-producing procedures. This paper presents reviews and protocols implemented by directors and residents at the Dental College of Georgia to manage a dental emergency clinic during the COVID-19 pandemic. The methods presented include committee-based prioritization of dental patients, a multilayered screening process, team rotations with social and temporal spacing, and modified treatment room protocols. These efforts aid in the reduction of viral transmission, conservation of personal protective equipment, and expand provider availability. These protocols transcend a university and hospital-based models and are applicable to private and corporate models.

Keywords: COVID-19; dentistry; emergency.

© 2020 Special Care Dentistry Association and Wiley Periodicals, Inc.

54 references
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185
Editorial Eur Respir J
. 2019 Dec 12;54(6):1902111. doi: 10.1183/13993003.02111-2019. Print 2019 Dec.
Macrolide Combination Therapy for Hospitalised CAP Patients? An Individualised Approach Supported by Machine Learning
Carolina Garcia-Vidal 1, Catia Cillóniz 2, Antoni Torres 3
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PMID: 31831676 DOI: 10.1183/13993003.02111-2019
Conflict of interest statement
Conflict of interest: C. Garcia-Vidal has nothing to disclose. Conflict of interest: C. Cilloniz has nothing to disclose. Conflict of interest: A. Torres has nothing to disclose.

Comment on
Macrolide combination therapy for patients hospitalised with community-acquired pneumonia? An individualised approach supported by machine learning.
König R, Cao X, Oswald M, Forstner C, Rohde G, Rupp J, Witzenrath M, Welte T, Kolditz M, Pletz M; CAPNETZ study group.
Eur Respir J. 2019 Dec 12;54(6):1900824. doi: 10.1183/13993003.00824-2019. Print 2019 Dec.
PMID: 31537702
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186
Comment Eur Respir J
. 2020 May 27;55(5):2001112. doi: 10.1183/13993003.01112-2020. Print 2020 May.
Association Between Age and Clinical Characteristics and Outcomes of COVID-19
Yang Liu 1 2, Bei Mao 1 2, Shuo Liang 1 2, Jia-Wei Yang 1 2, Hai-Wen Lu 1 2, Yan-Hua Chai 1 2, Lan Wang 3, Li Zhang 1, Qiu-Hong Li 1, Lan Zhao 1, Yan He 1, Xiao-Long Gu 4, Xiao-Bin Ji 5, Li Li 6, Zhi-Jun Jie 7, Qiang Li 8, Xiang-Yang Li 9, Hong-Zhou Lu 10, Wen-Hong Zhang 11, Yuan-Lin Song 12, Jie-Ming Qu 13 2, Jin-Fu Xu 1 2, Shanghai Clinical Treatment Experts Group for COVID-19
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PMID: 32312864 PMCID: PMC7173682 DOI: 10.1183/13993003.01112-2020
Free PMC article
Conflict of interest statement
Conflict of interest: Yang Liu has nothing to disclose. Conflict of interest: Bei Mao has nothing to disclose. Conflict of interest: Shuo Liang has nothing to disclose. Conflict of interest: Jia-Wei Yang has nothing to disclose. Conflict of interest: Hai-Wen Lu has nothing to disclose. Conflict of interest: Yan-Hua Chai has nothing to disclose. Conflict of interest: Lan Wang has nothing to disclose. Conflict of interest: Li Zhang has nothing to disclose. Conflict of interest: Qiu-Hong Li has nothing to disclose. Conflict of interest: Lan Zhao has nothing to disclose. Conflict of interest: Yan He has nothing to disclose. Conflict of interest: Xiao-Long Gu has nothing to disclose. Conflict of interest: Xiao-Bin Ji has nothing to disclose. Conflict of interest: Li Li has nothing to disclose. Conflict of interest: Zhi-Jun Jie has nothing to disclose. Conflict of interest: Qiang Li has nothing to disclose. Conflict of interest: Xiang-Yang Li has nothing to disclose. Conflict of interest: Hong-Zhou Lu has nothing to disclose. Conflict of interest: Wen-Hong Zhang has nothing to disclose. Conflict of interest: Yuan-Lin Song has nothing to disclose. Conflict of interest: Jie-Ming Qu has nothing to disclose. Conflict of interest: Jin-Fu Xu has nothing to disclose.

Comment on
[Interpretation of "Guidelines for the Diagnosis and Treatment of Novel Coronavirus (2019-nCoV) Infection by the National Health Commission (Trial Version 5)"].
Lin L, Li TS.
Zhonghua Yi Xue Za Zhi. 2020 Feb 7;100(0):E001. doi: 10.3760/cma.j.issn.0376-2491.2020.0001. Online ahead of print.
PMID: 32033513 Chinese.
15 references
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187
Infect Genet Evol
. 2020 Jan;77:104077. doi: 10.1016/j.meegid.2019.104077. Epub 2019 Oct 24.
Down-regulation of lincRNA-EPS Regulates Apoptosis and Autophagy in BCG-infected RAW264.7 Macrophages via JNK/MAPK Signaling Pathway
Zunqiong Ke 1, Jianwu Lu 2, Jietao Zhu 2, Zhongwei Yang 3, Zhixiong Jin 3, Leyong Yuan 4
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PMID: 31669366 DOI: 10.1016/j.meegid.2019.104077
Abstract
Macrophages play a major role in the control and elimination of invading Mycobacterium tuberculosis (Mtb). Long intergenic noncoding RNA erythroid prosurvival (lincRNA-EPS) plays an important role in regulating various biologic processes in macrophages, including inflammatory responses, cell apoptosis, and autophagy. Whereas the effect of lincRNA-EPS in regulating the immune response of macrophages to Mtb is little studied. This study aimed to explore lincRNA-EPS expression in monocytes from patients with active pulmonary tuberculosis (PTB) and from healthy individuals. We also sought to investigate the effect of lincRNA-EPS on Bacillus Calmette-Guérin (BCG)-infected macrophages apoptosis and autophagy. Our study found that lincRNA-EPS expression was down-regulated in the monocytes from patients with active PTB compared with healthy individuals, accompanied by significant attenuated monocyte apoptosis and enhanced autophagy. In vitro, knockdown of lincRNA-EPS inhibited apoptosis and promoted autophagy in BCG-infected RAW264.7 macrophages. Moreover, we revealed that lincRNA-EPS regulated apoptosis and autophagy of BCG-infected RAW264.7 macrophages via JNK/MAPK signaling pathway. In conclusion, our findings demonstrated that knockdown of lincRNA-EPS inhibits apoptosis and enhances autophagy by activating the JNK/MAPK signaling pathway in BCG-infected RAW264.7 macrophages. Suggesting that lincRNA-EPS could serve as a new potential therapeutic target for PTB.

Keywords: Apoptosis; Autophagy; Macrophages; Mycobacterium tuberculosis; lincRNA-EPS.

Copyright © 2019 Elsevier B.V. All rights reserved.

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188
Infect Genet Evol
. 2020 Jan;77:104093. doi: 10.1016/j.meegid.2019.104093. Epub 2019 Oct 31.
MAL Adaptor (TIRAP) S180L Polymorphism and Severity of Disease Among Tuberculosis Patients
Rajagopalan Saranathan 1, Pattabiraman Sathyamurthi 1, Kannan Thiruvengadam 2, Selvachithiram Murugesan 1, Shri Vijay Bala Yogendra Shivakumar 3, Narayanan Sivaramakrishnan Gomathi 4, Dhanasekaran Kavitha 5, Mandar Paradkar 6, Rohini Puvaneshwari 1, Muthuramalingam Kannan 1, Annamalai Madheswaran 1, Neeta Pradhan 6, Vandana Kulkarni 6, Akshay N Gupte 7, Nikhil Gupte 8, Vidya Mave 8, Robert C Bollinger 9, Amita Gupta 9, Chandrasekaran Padmapriyadarsini 10, Luke Elizabeth Hanna 11, C-TRIUMPh Study Team
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PMID: 31678649 DOI: 10.1016/j.meegid.2019.104093
Abstract
Objective: Though several genetic variants have been recognized to be associated with susceptibility to Tuberculosis (TB) infection and disease, a recent observation on the association of TIRAP C975T (S180L) variants with TB disease severity in mice model prompted us to assess their relevance in humans. In addition, TIRAP variants have also been reported to be associated with varied circulating Interferon-gamma induced protein (IP-10) levels. We investigated the association of TIRAP variants with severity of TB disease and IP-10 production in humans, which may be useful in predicting poor clinical outcome.

Methods: Culture positive symptomatic adult pulmonary TB (PTB) patients enrolled between August 2014 and October 2017 were included in this investigation. Allelic discrimination PCR and conventional IP-10 quantification methods were employed for genotyping and IP-10 measurement followed by statistical investigations to analyse patients' variables.

Results: Among 211 participants, C/C allele was identified in 70% (n = 147); 26% (n = 55) and 4% (n = 9) had C/T and T/T alleles respectively. There was no significant association between TIRAP variants and smear grade, chest-X-ray score, symptom severity score and circulating IP-10 levels. However, significant association was observed between i) circulating IP-10 levels and time to Mycobacterium Growth Indicator Tube (MGIT) culture conversion (p =0.032); ii) smear grade among active TB patients and circulating IP-10 levels (p =0 .032).

Conclusions: Although mice experiments showed promising results with more severe disease in C/C and T/T individuals, we did not observe any such association in humans.

Keywords: IP-10; Interferon-gamma; Mal adaptor; S180L variant; TIRAP; Tuberculosis.

Copyright © 2019 Elsevier B.V. All rights reserved.

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189
Editorial Nature
. 2020 Mar;579(7800):471-472. doi: 10.1038/d41586-020-00882-z.
We're With You
No authors listed
PMID: 32210389 DOI: 10.1038/d41586-020-00882-z
Abstract
No abstract available
Keywords: Diseases; Infection; Public health; Publishing; Research management.

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190
Multicenter Study Infect Control Hosp Epidemiol
. 2019 Dec;40(12):1348-1355. doi: 10.1017/ice.2019.295. Epub 2019 Oct 21.
Impact of an Electronic Best-Practice Advisory in Combination With Prescriber Education on Antibiotic Prescribing for Ambulatory Adults With Acute, Uncomplicated Bronchitis Within a Large Integrated Health System
Courtney M Pagels 1, Thomas J Dilworth 1, Lynne Fehrenbacher 2, Maharaj Singh 3, Charles F Brummitt 1
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PMID: 31631834 DOI: 10.1017/ice.2019.295
Abstract
Objective: To determine the impact of a passive, prescriber-directed, electronic best-practice advisory coupled with prescriber education on the rate of antibiotic prescribing for acute, uncomplicated bronchitis in ambulatory adults across a large health system.

Design: This study was a quasi-experiment examining antibiotic prescribing for ambulatory adults with acute bronchitis from January 1, 2016 through December 31, 2018. The intervention was implemented in December 2016 for emergency departments and urgent care clinics followed by ambulatory clinics in September 2017.

Setting: Outpatient settings across a health system, including 15 emergency departments, >30 urgent care clinics, and >150 ambulatory clinics.

Participants: All adults with a primary diagnosis of acute bronchitis who were seen and discharged from a study site were included.

Interventions: A passive, prescriber-directed, best-practice advisory for treatment of acute bronchitis in the electronic health record and an optional, online education module regarding acute bronchitis.

Results: The study included 81,975 ambulatory adults with a primary diagnosis of acute bronchitis during the preintervention period (19.8% >65 years of age; 61.9% female) and 89,571 ambulatory adults during the postintervention period (16.5% >65 years of age; 61.1% female). Antibiotic prescribing rates decreased from 60.8% (49,877 of 81,975 patients) preintervention to 51.4% (46,018 of 89,571 patients) postintervention (absolute difference, 9.4%; P < .001). The largest reduction occurred in the emergency departments.

Conclusions: An electronic best practice advisory combined with prescriber education was associated with a statistically significant reduction in antibiotic prescribing for adults with acute bronchitis. Future studies should incorporate patient education and address prescriber-reported barriers to appropriate antibiotic prescribing.

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191
Int J Environ Res Public Health
. 2020 May 17;17(10):E3497. doi: 10.3390/ijerph17103497.
Emerging Adults and COVID-19: The Role of Individualism-Collectivism on Perceived Risks and Psychological Maladjustment
Alessandro Germani 1, Livia Buratta 1, Elisa Delvecchio 1, Claudia Mazzeschi 1
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PMID: 32429536 DOI: 10.3390/ijerph17103497
Free article
Abstract
The outbreak of the coronavirus disease 2019 (COVID-19) has dramatically changed our habits and routines. Uncertainty, insecurity, instability for the present and future, and reduced autonomy and self-directedness, are common feelings at the time of COVID-19. These aspects are very important during emerging adulthood. In spite of the fact that medical reports suggest that youth are less prone to experience COVID-19 infections, emerging adults might be at higher risk for their psychological adjustment. Emerging adults showed higher concerns about their role as a possible asymptomatic carrier than being positive with COVID-19 themselves. Both worries and concerns about COVID-19 and psychological maladjustment may be related to cultural factors. Individualism, collectivism, equality, and hierarchy seem to be meaningful perspectives to take into account. A total of 1183 Italian emerging adults were asked to fill out an online survey during the second week of the national lockdown in Italy. Results showed they reported an accurate perceived knowledge about COVID-19. At the same time, they showed higher worries and concerns about COVID-19 for their relatives, followed by more general/social worries. The lowest score included worries about COVID-19 related to themselves. State anxiety and stress levels were above the normal cutoff, confirming the challenges that emerging adults are facing during the pandemic. On one hand, emerging adults' collectivistic orientation was related to higher perceived risks of infection; on the other hand, it predicted lower psychological maladjustment, controlling for socio-demographic variables. The study suggests that to fight the COVID-19 pandemic and decrease levels of psychological maladjustment in emerging adulthood, individuals' cultural orientation such as the wish of sharing common goals with others, interdependence, and sociability, have to be emphasized and promoted as protective factors.

Keywords: anxiety; emerging adulthood; lockdown; stress; youth.

Conflict of interest statement
The authors declare no conflicts of interest.

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192
Int J Antimicrob Agents
. 2020 May;55(5):105968. doi: 10.1016/j.ijantimicag.2020.105968. Epub 2020 Apr 4.
COVID-19 in the Eastern Mediterranean Region and Saudi Arabia: Prevention and Therapeutic Strategies
Jaffar A Al-Tawfiq 1, Ziad A Memish 2
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PMID: 32259576 DOI: 10.1016/j.ijantimicag.2020.105968
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193
Int J Environ Res Public Health
. 2020 May 18;17(10):E3513. doi: 10.3390/ijerph17103513.
The Psychological Causes of Panic Buying Following a Health Crisis
Kum Fai Yuen 1, Xueqin Wang 1 2, Fei Ma 3, Kevin X Li 2
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PMID: 32443427 DOI: 10.3390/ijerph17103513
Free article
Abstract
Attributed to the recent COVID-19 pandemic, panic buying is now a frequent occurrence in many countries, leading to stockouts and supply chain disruptions. Consequently, it has received much attention from academics and the retail industry. The aim of this study is to review, identify, and synthesise the psychological causes of panic buying, which is a relatively new and unexplored area in consumer behaviour research. A systematic review of the related literature is conducted. The review suggests that panic buying is influenced by (1) individuals' perception of the threat of the health crisis and scarcity of products; (2) fear of the unknown, which is caused by negative emotions and uncertainty; (3) coping behaviour, which views panic buying as a venue to relieve anxiety and regain control over the crisis; and (4) social psychological factors, which account for the influence of the social network of an individual. This study contributes to the literature by consolidating the scarce and scattered research on the causes of panic buying, drawing greater theoretical insights into each cause and also offers some implications for health professionals, policy makers, and retailers on implementing appropriate policies and strategies to manage panic buying. Recommendations for future research are also provided.

Keywords: COVID-19; determinants; health crisis; panic buying; purchasing behaviour.

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194
Comment Vaccine
. 2019 Dec 10;37(52):7532-7533. doi: 10.1016/j.vaccine.2019.09.110.
Authors' Reply To: Letter From Arguedas Et Al
Min Ja Kim 1, Jong Hun Kim 2, Byung Chul Chun 3, Kyung Sook Yang 4
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PMID: 31783979 DOI: 10.1016/j.vaccine.2019.09.110
Comment on
Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study.
Kim JH, Chun BC, Song JY, Kim HY, Bae IG, Kim DM, Choi YH, Jun YH, Choi WS, Kang SH, Kwon HH, Jeong HW, Kee SY, Hur J, Chung JW, Yoon YK, Sohn JW, Yang KS, Kim MJ.
Vaccine. 2019 May 9;37(21):2797-2804. doi: 10.1016/j.vaccine.2019.04.017. Epub 2019 Apr 17.
PMID: 31005428
Letter to the editor.
Arguedas A, Gessner BD, Williams S, Fletcher MA, Isturiz R, Reinert R, Jodar L.
Vaccine. 2019 Dec 10;37(52):7530-7531. doi: 10.1016/j.vaccine.2019.09.107.
PMID: 31783978 No abstract available.
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195
Zhonghua Er Ke Za Zhi
. 2020 May 2;58(5):351-354. doi: 10.3760/cma.j.cn112140-20200302-00167.
[Epidemiology and Clinical Features of Highly Pathogenic Human Coronavirus Infection in Children]
[Article in Chinese]
X R Long 1, J Zhu 1, R Q Zhao 1, H M Xu 1
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PMID: 32223839 DOI: 10.3760/cma.j.cn112140-20200302-00167
Abstract
人冠状病毒最早于20世纪60年代被分离，是儿童呼吸道感染的重要病原。已发现7种可导致人类疾病的冠状病毒，其中严重急性呼吸综合征冠状病毒、中东呼吸综合征冠状病毒及2019新型冠状病毒传染性及致病性强，严重威胁人类健康及全球经济。本综述重点阐述以上3种高致病性人冠状病毒在儿童中的特点，以期为未来疫情的监测和防控提供参考。.

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196
Review United European Gastroenterol J
. 2020 Jun;8(5):509-519. doi: 10.1177/2050640620924157.
Liver Injury in COVID-19: The Current Evidence
Saleh A Alqahtani 1 2, Jörn M Schattenberg 3
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PMID: 32450787 DOI: 10.1177/2050640620924157
Abstract
Patients with novel coronavirus disease 2019 (COVID-19) experience various degrees of liver function abnormalities. Liver injury requires extensive work-up and continuous surveillance and can be multifactorial and heterogeneous in nature. In the context of COVID-19, clinicians will have to determine whether liver injury is related to an underlying liver disease, drugs used for the treatment of COVID-19, direct effect of the virus, or a complicated disease course. Recent studies proposed several theories on potential mechanisms of liver injury in these patients. This review summarizes current evidence related to hepatobiliary complications in COVID-19, provides an overview of the available case series and critically elucidates the proposed mechanisms and provides recommendations for clinicians.

Keywords: COVID-19; SARS-CoV2; cholangiocytes; cytokine storm; liver function test; liver injury; lymphopenia.

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197
Pediatr Blood Cancer
. 2020 Jul;67(7):e28400. doi: 10.1002/pbc.28400. Epub 2020 May 13.
COVID-19 and Childhood Acute Lymphoblastic Leukemia
Jeffrey W Taub 1, Yubin Ge 2, Ana C Xavier 3
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PMID: 32400927 PMCID: PMC7235492 DOI: 10.1002/pbc.28400
Free PMC article
Conflict of interest statement
The authors declare that there is no conflict of interest.

5 references
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198
Pediatr Allergy Immunol
. 2019 Sep;30(6):662-665. doi: 10.1111/pai.13067. Epub 2019 May 28.
Peach Tree Pollen and Pru P 9 May Induce Rhinoconjunctivitis and Asthma in Children
Maria Luisa Somoza 1, María Garrido-Arandia 2, Laura Victorio Puche 3, José Damián López-Sánchez 4, Natalia Blanca-López 1, Elisa Haroun-Diaz 1, Alejandro Romero Sahagún 2, Araceli Díaz-Perales 2, Gabriela Canto 1, Miguel Blanca 1
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PMID: 31050832 DOI: 10.1111/pai.13067
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199
Am J Rhinol Allergy
. 2020 Jan;34(1):35-42. doi: 10.1177/1945892419870450. Epub 2019 Aug 20.
Cystic Fibrosis: The Sense of Smell
Antonella M Di Lullo 1 2, Paola Iacotucci 3, Marika Comegna 2 4, Felice Amato 2 4, Pasquale Dolce 5, Giuseppe Castaldo 2 4, Elena Cantone 1, Vincenzo Carnovale 3, Maurizio Iengo 1
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PMID: 31430187 DOI: 10.1177/1945892419870450
Abstract
No abstract available
Keywords: SNOTT-22; VAS; anosmia; chronic rhinosinusitis; cystic fibrosis; hyposmia; nasal polyps; normosmia; quality of life; smell.

Cited by 2 articles
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200
Monaldi Arch Chest Dis
. 2020 May 21;90(2). doi: 10.4081/monaldi.2020.1325.
Extrapolation of Mortality in COVID-19: Exploring the Role of Age, Sex, Co-Morbidities and Health-Care Related Occupation
Shahir Asfahan 1, Kunal Deokar 2, Naveen Dutt 3, Ram Niwas 4, Priyank Jain 5, Mehul Agarwal 6
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PMID: 32447949 DOI: 10.4081/monaldi.2020.1325
Free article
Abstract
We used a publicly available data of 44,672 patients reported by China's centre for disease control to study the role of age, sex, co-morbidities and health-care related occupation on COVID-19 mortality. The data is in the form of absolute numbers and proportions. Using the percentages, retrospective synthetic data of 100 survivors and 100 deaths were generated using random number libraries so that proportions of ages, genders, co-morbidities, and occupations were constant as in the original data. Logistic regression of the four predictor factors of age, sex, co-morbidities and occupation revealed that only age and comorbidities significantly affected mortality. Sex and occupation when adjusted for other factors in the equation were not significant predictors of mortality. Age and presence of co-morbidities correlated negatively with survival with co-efficient of -1.23 and -2.33 respectively. Odds ratio (OR) for dying from COVID-19 for every 10-year increase in age was 3.4 compared to the previous band of 10 years. OR for dying of COVID-19 was 10.3 for the presence of any of the co-morbidities. Our findings could help in triaging the patients in the emergency room and emphasize the need to protect the elderly and those with comorbidities from getting exposed.

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