The unexpectedly high asymptomatic carrier rates reported from other institutions as well as prolonged face-to-face patient care required during labor and delivery drove this decision, allowing for judicious personal protective equipment (PPE) use and decreased potential exposure for both healthcare workers and newborns. Several reports, based on expert opinion, have recommended that DCC not be performed in neonates born to mothers with confirmed or suspected COVID-19 in order to reduce the risk of secondary transmission [15, 47, 49] . For resuscitation of premature, high-risk, and newborns with anomalies born to mothers with cinfirmed or suspected COVID-19, a fully donned neonatal resuscitation team enters the room upon delivery. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection Neonatal resuscitation and postresuscitation care of infants born to mothers with suspected or confirmed SARS-CoV-2 infection
A viral genome sequence of a novel coronavirus, currently termed SARS-CoV‑2, with a disease process called COVID-19 was released 1 week later via online resources to obtain public health support in control of spread. Perhaps the most detailed study to date, shedding light on how patients may present and progress, is an analysis of the first 99 cases of confirmed novel corona pneumonia in Wuhan [12] . Nowak and Walkowiak, in a recently released review of five in vitro studies reporting on the effect of lithium in coronavirus infections, concluded that the drug does have antiviral activity and should be explored as a potential treatment or prophylaxis for COVID-19 [24] . The authors concluded "our work suggests that remdesivir may improve disease outcomes in coronavirus patients, serve to protect health care workers in area with endemic MERS-CoV and prove valuable in preventing future epidemics " [3] .
Later, the pneumonia was associated with a new coronavirus; in February 2020, the World Health Organization (WHO) gave the name COVID-19 to the new disease, while the International Committee on Taxonomy of Viruses (ICTV) gave the name SARS-CoV-2 to the virus causing it. In February 2020, the World Health Organization (WHO) gave the name COVID-19 to the new disease, while the International Committee on Taxonomy of Viruses (ICTV) gave the name SARS-CoV-2 to the virus. The estimation of the case-fatality rate (portion of deaths divided by the total number of cases) for the disease varies from 1 to 7% [24, 25] depending on the sex and age composition of the population; strategies of testing, diagnostics, and treatment; bureaucratic peculiarities of healthcare in a particular country; and congestion of healthcare systems. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China
Key epidemiological characteristics such as the basic reproductive number and the age-specific rate of developing COVID-19 symptoms after infection with SARS-CoV-2, were adapted for the Kenyan setting from a combination of published estimates and analysis of the age distribution of cases observed in the Chinese outbreak. In the scenario with no transmission from asymptomatics the observed epidemic was dominated by cases among the working-age population (Figure 3 ), who we estimated as having high rates of assortative (i.e. within same age-group) mixing ( Figure 4 ) and a small but not negligible risk of developing symptoms of COVID-19 after infection. In this modelling study we have integrated existing data on the social structure, and mobility, of the Kenyan population with rapidly evolving estimates of the fundamental epidemiology of SARS-CoV-2 so as to make the best possible prediction of the scale of the epidemic risk that Kenya faces from the first coronavirus pandemic.
Very similar information was reported in data describing household transmission in Wuhan, where children showed a 4% infection rate compared with 17% in adults. 1.6 million tests were used to identify 1''400 SARS-CoV-2-positive cases; 1000 patients had had exposure to infected people from Hubei. In Wuhan, 105 index cases of patients suffering from moderate COVID-19 symptoms (fever, cough, fatigue) were investigated for secondary transmission to 392 household contacts. The control measures that stopped the epidemic locally have included: intense infection surveillance of incoming travelers; isolation of COVID-19 cases in hospitals; contact tracing and quarantine in holiday camps; and school closure but no lock-down, thus preventing the crisis from having a negative economic impact. Model calculations showed that the containment measures (the quarantine of exposed, and the isolation of infected persons) which depleted the number of susceptible individuals for the virus, reproduced the actually observed case development.
Risk analysis revealed that wearing face mask could reduce the infection risk (odds ratio [OR], 0.127, 95% confidence interval [CI] 0.017, 0.968), while when exposed to COVID-19 patients, doctors might have higher risk of seroconversion (OR, 346.837, 95% CI 8.924, 13479.434), compared with HCWs exposed to colleagues as well as nurses and general service assistants who exposed to patients. Our study revealed that the serological testing is useful for the identification of asymptomatic or subclinical infection of SARS-CoV-2 among close contacts with COVID-19 patients. Briefly, 96-well plates were coated with 500 ng/mL of recombinant RBD or NP protein overnight, incubating with diluted were also collected and the nasopharyngeal swab samples from these patients have been repeatedly tested as negative for SARS-CoV-2 RNA at least twice at a two-day apart. Our study proved that the serological testing is useful for the identification of asymptomatic or subclinical infection of SARS-CoV-2 among close contacts with COVID-19 patients.
title: Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples from the Hong Kong Cohort and Systematic Review and Meta-analysis We performed a systematic review and meta-analysis of published gastrointestinal symptoms and detection of virus in stool, and also summarized data from a cohort of patients with COVID-19 in Hong Kong. The proportion of patients with detectable stool viral RNA was higher among those with diarrhea than those without diarrhea Table 2 including the hospital admission period, places in which the patients were recruited, sample size, age, sex, disease severity, non-gastrointestinal symptoms (fever and respiratory symptoms) on presentation, and gastrointestinal symptoms (anorexia, nausea/vomiting, diarrhea and abdominal pain/discomfort). In this meta-analysis of 4,243 COVID-19 patients from six countries, the pooled prevalence of all gastrointestinal symptoms (including anorexia, nausea/vomiting, diarrhea or abdominal pain) was 17.6%. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series
The aim of this review was to describe the current knowledge about coronavirus disease 2019 (COVID-19, which is caused by severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in children, from epidemiological, clinical, and laboratory perspectives, including knowledge on the disease course, treatment, and prognosis. This review highlights that COVID-19 in children is similar to the disease in the adult population, but with particularities regarding clinical manifestations, laboratory test results, chest imaging, and treatment. It started at the end of 2019, when many adult patients with a new form of pneumonia that was frequently fatal were admitted to Chinese hospitals; this illness was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). [11] [12] [13] This study aimed to review the current data on SARS-CoV-2 infection in children, from epidemiological, clinical, and laboratory perspectives, including data on the disease course, treatment, and prognosis. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series
En ese momento, a este nuevo coronavirus se le llamó 2019-nCoV (del inglés: 2019-novel coronavirus) y fue identificado por las autoridades sanitarias chinas como el agente causal de estos casos de neumonía atípica 1,3,4 . Hacia final de mes, el día 30 de enero la OMS declaró la enfermedad causada por el nuevo coronavirus como una emergencia de salud pública de preocupación internacional, ya que para aquel momento se habían reportado casos en todas las regiones de la OMS en solo un mes 9,11 . Concretamente la RNVE en su informe n°29 del día 7 de mayo enumera los principales síntomas presentados por el conjunto de la población española, hasta la fecha y a base de una muestra de 217,543 casos, de la siguiente manera: Entre estos hallazgos, es comúnmente observar la leucopenia y linfopenia, siendo esta última característica de COVID-19.
Recently, a new type of viral infection emerged in Wuhan City, China, and initial genomic sequencing data of this virus do not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Recently, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID19) , emerged in late 2019, and it has posed a global health threat, causing an ongoing pandemic in many countries and territories (1) . Health workers worldwide are currently making efforts to control further disease outbreaks caused by the novel CoV (originally named 2019-nCoV), which was first identified in Wuhan City, Hubei Province, China, on 12 December 2019.
In December of 2019 cases of an unknown viral pneumonia were reported from Wuhan, Hubei, China Although much uncertainty remains, regarding the natural history and demographics of COVID19 , the virus appears to primarily cause infection in adults over 51 with case fatality rates increasing dramatically with age [5] . There are, however, emerging case reports of pregnant mothers who test positive for COVID-19 infection and who remain either completely asymptomatic [23] and or manifest mild symptoms in the subsequent 24 hours following delivery. Although clinical evidence is lacking, the case numbers to date of COVID-19 in pregnancy remain very low [32] and case reports of two neonates who tested positive for SARS-CoV-2 shortly after birth lends some credence to the concern. Vertical transmission of coronavirus disease 19 (COVID-19) from infected pregnant mothers to neonates: A review An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: Maternal coronavirus infections and pregnancy outcomes
Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. CONCLUSION: In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE. 14 In this report we describe the demographical, clinical, radiological and laboratory characteristics, as well as the clinical outcomes and the risk factors for mortality, of the first 500 patients with COVID-19 admitted to San Raffaele Scientific Institute, a tertiary care academic hospital in Milan, Italy. With a clinical observation longer than one months from the last patient admitted, w e were able to identify early predictors of mortality related to patient characteristics, radiological and laboratory findings at hospital admission for COVID-19.
The World Health Organization (WHO) has officially named the infection coronavirus disease 2019 (COVID-19), and the virus has been classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS is caused by a virus that emerged in southern China in November 2002 and led to [ 8000 human infections and 774 deaths in 37 countries in the 2002-2003 period [3] ; MERS is related to a virus detected for the first time in Saudi Arabia in 2012, responsible for 2494 laboratoryconfirmed cases of infection and 858 deaths since September 2012 [4] . On January 11 and 12, 2020, the WHO received further details and information from the Chinese National Health Commission regarding the possible association of this epidemic with exposure in a fish market in Wuhan, and the Chinese authorities shared the genetic sequence of a new coronavirus, subsequently identified as SARS-CoV-2 [14] .
Since the emergence of the first case in Wuhan, China, in December 2019, tremendous research efforts have been underway to understand the mechanisms of infectivity and transmissibility of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a fatal virus responsible for abysmal survival outcomes. Data from China thus far have shown that cancer patients infected with COVID-19 are at 3.5 times the risk of requiring mechanical ventilation or ICU admission, compared to the general population [9•] . The CALAVI trial will be initiated as a randomized global clinical trial to assess the potential of acalabrutinib in the treatment of the cytokine storm associated with severely ill COVID-19 patients [86] . An exploratory meta-analysis of 32 studies showed evidence of reduced mortality after receiving various doses of convalescent plasma in patients with severe acute respiratory infections of viral etiology [92] . Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China
successfully isolated SARS-CoV-2 from throat swabs of two asymptomatic patients in a cell culture of Caco-2 cells, suggesting the potential for presymptomatic transmission [16] ; (5) Increasing studies show clear epidemiological evidence of human-to-human asymptomatic spread of COVID-19 (described in the following section); (6) Asymptomatic infection tends to be, but is not only, identified among young people (<20 years old) [14, 15, [17] [18] [19] ; And (7) the majority (>90%) of asymptomatic patients appears to have a milder clinical course during hospitalization [15] , but the severity of the symptoms of the secondary patients infected by SARS-COV-2 from asymptomatic patients varies based on their physical constitution [2, 20] . As the transmission of SARS-COV-2 may occur in the early course of infection and a high viral load in respiratory samples could be detected [13] , RT-PCR testing for this virus is more suitable for screening at earlier stages of infection in key populations, such as patients with obvious symptoms and close contacts of asymptomatic patients [35] .
The pooled proportion of asymptomatic infection among 1152 COVID‐19 children from 11 studies is 27.7% (95% CI: 16.4–42.7%), which is much higher than patients from all aged groups. However, patients infected with SARS-CoV-2 could also be asymptomatic, confirmed by positive Nucleic acid testing results during the illness. While a variety of studies on asymptomatic infection have been reported, the proportion of asymptomatic patients in confirmed COVID-19 cases is not well characterized. Original articles reporting asymptomatic infection in confirmed COVID-19 patients were included for meta-analysis. Noticeably, one study from Wuhan showed that 98/1021(9.6%) nucleic acid testing negative patients had lgG positive results, suggesting possible recovery from asymptomatic SARS-CoV-2 infection 54 . Characteristics of asymptomatic patients with SARS-CoV-2 infection in Jinan, China. Clinical features of children with SARS-CoV-2 infection: an analysis of 13 cases from Changsha, China. Epidemiological and clinical features of asymptomatic patients with SARS-CoV-2 infection
Our review aims to evaluate strategies of the most affected countries from different continents all over the world (China, Italy, Germany, France, Spain, America, Canada, Brazil, UK, India, Japan, Singapore, Iran, Korea, and Australia) for confronting the epidemic as it explains the best practices that could help other countries to overcome current or any upcoming pandemic. Most countries were forced to announce emergency measures to protect vulnerable people and block ways of transmission due to the continuous increase in confirmed cases by time as reported in Figure 3 [11] [12] [13] [14] [15] [16] . Most countries were forced to announce emergency measures to protect vulnerable people and block ways of transmission due to the continuous increase in confirmed cases by time as reported in Figure 3 [11] [12] [13] [14] [15] [16] .
As pit latrines and the use of untreated excreta as fertilizer were common in rural China, we surveyed 27 villages of Jiangxi and Hubei provinces and found that pit latrines could be a potential source of SARS-CoV-2 water pollution. Another study showed that infectious SARS-CoV-2 virus were successfully isolated from 2 of 3 patients with viral RNA-positive, indicating that infectious virus in feces was a common manifestation of COVID-19 and confirmed the potential of fecal-oral or fecal-respiratory transmission (Xiao et al., 2020b) . Coupled with the fact that villagers usually use untreated excreta as agricultural fertilizer, we believe that the use of pit latrines in rural China and other low-income countries increases the possibility of SARS-CoV-2 contaminating the surrounding natural environment and ultimately harms human health. We proposed this hypothesis to illustrate the mechanism that SARS-COV-2 might spread from the excreta of infected humans in pit latrines to potential animal hosts and then become a sustainable source of infection in rural China and other low-income countries.
On December 1, 2019, the first case of coronavirus disease 2019 (COVID-19), caused by a novel coronavirus (SARS-CoV-2), was reported in Wuhan, China, and CoVs returned to public view. In this review, we systematically compare COVID-19 and SARS in terms of epidemiology, pathogenesis and clinical characteristics and discuss the current treatment approaches, scientific advancements and Chinese experience in fighting the epidemic to combat the novel coronavirus pandemic. As the virus continued to spread, on March 11, 2020 , the WHO declared that COVID-19 is a pandemic disease, making this the first time that a coronavirus infection has been regarded as a global pandemic, in contrast to SARS in 2002, which did not reach this level. This paper summarizes the differences in the epidemiology, clinical manifestations, and treatment of SARS and COVID-19 during the two outbreaks, summarizes the lessons learned, and provides a comprehensive reference for the global epidemic prevention and treatment of reported in China and resulted in a large number of infections.
The virus was later denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and defined as the causal agent of Coronavirus Disease 2019 . Here we provide a short background on coronaviruses and their origin, and we describe in more detail the novel SARS-CoV-2 and the efforts thus far to identify effective therapies against COVID-19. The virus was later denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and defined as the causal agent of Coronavirus Disease 2019 (COVID-19). The virus was later denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and defined as the causal agent of Coronavirus Disease 2019 (COVID-19). 19 SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 At the end of December 2019, China reported the increasing occurrence of pneumonia in the city of Wuhan, Hubei province. Identification of a novel coronavirus in patients with severe acute respiratory syndrome
A confirmed case should have at least one of the following criteria: (i) a positive result for 2019-nCoV nucleic acid, using real-time PCR tests from respiratory or blood samples; (ii) a high homogeneity between viral gene sequencing from respiratory or blood samples and known 2019-nCoV; and (iii) serum samples positive for IgM or IgG to 2019-nCoV, or seroconversion in IgG, or a fourfold or more significant increase in IgG antibody titer to 2019-nCoV in the recovery phase than in the acute phase [25] . Using blood samples taken from alleged COVID-19 patients, the researchers detected antibodies targeting the spike protein that prevented the virus from killing cells in laboratory tests. showed a promising in vitro inhibitory effect of this serine protease inhibitor in SARS-CoV and 2019-nCoV on human lung cells, showing potential as a viable option for COVID-19 treatment [113] . Given that antiviral drugs have previously demonstrated reasonable inhibition of coronaviruses and therapeutic efficacy against coronavirus outbreaks, umifenovir, chloroquine, hydroxychloroquine, lopinavir-ritonavir, and ribavirin have been recommended in the latest guidelines for diagnosis and treatment of COVID-19, updated on 17 February 2020 [189] .
A suspected case has been defined as a patient with acute onset respiratory infection with fever, cough, sore throat, and an epidemiological link in the form of a history of travel 14 days prior to the onset of symptoms to countries afflicted with COVID-19, or a close contact with a confirmed or probable case of COVID-19 14 days prior to symptom onset, or some acute respiratory infection requiring hospitalization with no other etiology fully explaining the clinical presentation, as per WHO guidelines. • In patients with severe COVID-19 infection requiring supplemental oxygen, lopinavir/ritonavir combination plus hydroxychloroquine plus favipiravir 1,600 mg (eight tablets) twice daily as a loading dose followed by 600 mg (three tablets) every 8 hours for 14 days is being used. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China Clinical management of severe acute respiratory infection when COVID-19 disease is suspected.
De otorgarse un Consentimiento Informado amplio, éste debería ser única y exclusivamente para los procesos asociados con COVID-19".(71) AMCI ® Se recomienda considerar la transición del cuidado intensivo al cuidado paliativo en todo paciente con sospecha o diagnóstico de COVID-19 sin mejoría a pesar de las intervenciones óptimas, con empeoramiento progresivo de su pronóstico vital y ante un evidente deterioro; aplicando medidas generales en control de síntomas ( Manejo de secreciones -Tratamiento del dolor -Tratamiento de la disnea -Sedación paliativa), así como apoyo espiritual, siempre acompañando al paciente y nunca abandonarlo en el final de la vida. En cuanto hace referencia a la situación actual de pandemia por SARS-CoV-2 y compromiso pulmonar; Wu y cols, en Marzo de 2.020 realizaron un estudio retrospectivo de 201 pacientes con COVID-19 en China; para aquellos pacientes que desarrollaron SDRA, el tratamiento con metilprednisolona estuvo asociado con una disminución del riesgo de muerte (23/50 [46%] con esteroides vs 21/34 [62%] sin esteroides; HR, 0.38 [IC 95%, 0.20-0.72]), con las limitaciones de los estudios retrospectivo, de un solo centro, con un limitado número de pacientes (400).
In this review, we summarize the latest research progress related to COVID-19 epidemiology and the reported data of pregnant women, and discuss the current evidence of COVID-19 infections during pregnancy and its potential consequences for assisted reproductive treatments. The current outbreak of the novel 2019 coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China in December 2019 and subsequently spread to many other countries. Coronaviruses are a large family of viruses known to cause symptoms ranging from a common cold to more severe diseases, such as the severe acute respiratory syn A review of initial data on pregnancy during the COVID-19 outbreak: implications for assisted reproductive treatments Pedro AA Monteleone 1,2 , Mayra Nakano 1,2 , Victor Lazar 1 , Alecsandra P Gomes 1 , (Drosten et al., 2003; Ksiazek et al., 2003) , and MERS coronavirus (MERS-CoV) was the pathogen responsible for severe respiratory disease outbreaks in the Middle East in 2012 (Zaki et al., 2012) .
The causative virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the World Health Organization (WHO) named the new epidemic disease Coronavirus Disease (COVID-19). Several coronaviruses can infect humans, like the globally endemic human coronaviruses HCoV-229E, HCoV-NL63, HCoV-HKU1, and HCoV-OC43 that tend to cause mild respiratory disease, and the zoonotic Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV) that have a higher case fatality rate [2] . After the diagnosis of SARS-Cov2 infection was made, the prevention and quarantine are considered as the most way to stop the fast spreading of the virus, because there is no effective vaccine, drugs, or antiviral to prevent and treat this disease despite the great efforts made by the scientists and researchers around the world to develop vaccines and treatments of coronavirus.
The increased burden has substantially impacted the neurosurgery practice and intensive modifications were required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even academic activities. Operations of COVID-19 positive patients, and emergency cases, where screening can not be obtained, should be performed following level 3 protective measures. [5] [6] [7] In neurosurgery practice, intensive modifications were required in surgical scheduling, administration of inpatient and outpatient clinics, management of emergency cases, and even academic & educational activities. 26 A recent study from Wuhan City, China reported that some severe COVID-19 patients developed neurologic manifestations, such as acute cerebrovascular diseases (5.7%), and impaired consciousness (14.8%). 76, 80 Also, a patient with a mass lesion in the sellar region that underwent endonasal endoscopic surgery in Neurosurgery Department, Tongji Medical College, Wuhan City, China was diagnosed with COVID-19 after surgery, and disease was confirmed in 14 healthcare professionals in the same clinic afterwards.
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) known as COVID-19 has emerged as a major threat to human existence. The emergence of a novel severe acute respiratory syndrome coronavirus (SARS-CoV-2, renamed as COVID19) in 2019 from Wuhan, China has led to a global crisis and it has been declared as a pandemic emergency by World Health Organization (WHO) due to its fast rate of transmission among human beings [1, 2] . Coronaviruses (CoVs) are a group of genetically distinct viruses, which originated from broad ranges of hosts, including animal and bird species, and primarily cause respiratory and intestinal infections to humans and animals [1, [5] [6] [7] [8] . Transmission of COVID-19 possibly involved an adaptive evolution through an intermediate host (bat) before infecting humans. Traditional Chinese medicine in the treatment of patients infected with 2019-new coronavirus (SARS-CoV-2): a review and perspective
Since mid-December 2019, there has been a worldwide outbreak of COronaVIrus Disease 90 (COVID)-19, caused by SARS-CoV-2 (formerly 2019-nCoV or and first detected in 91 Wuhan, China. 52 However, 421 a single-center in Wuhan shared that early, low-dose and short-term (1-2mg/kg/d for 5-7 days) 422 corticosteroids was associated with a faster improvement of clinical symptoms and absorption of 423 focal lung lesions in severe cases of COVID-19. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series Early, low-dose and short-term application of corticosteroid treatment in patients with severe COVID-19 pneumonia: single-center experience from Wuhan, China.
COVID-19 is characterized by acute respiratory disease, with 80% of patients presenting mild like flu-like symptoms; however, 20% of patients may have a severe or critical clinical presentation, which likely causes multiple organ injuries (e.g., kidney, heart, blood, and nervous system). Novel coronavirus disease (COVID-19) is a newly discovered acute infectious disease caused by the SARS-CoV-2 virus, which is mainly manifested as acute respiratory diseases characterized by acute interstitial and alveolar pneumonia and can affect multiple organs such as the kidneys, the heart, the digestive tract, and blood [1] . In another study of 99 patients with COVID-19, seven cases developed various degrees of kidney injury with elevated serum creatinine (Scr) and/or blood urea nitrogen (BUN) levels, and 3 of them were diagnosed with AKI [4] . These results provide direct evidence that the SARS-CoV-2 virus can directly infect the renal tubular epithelium and podocytes, which may induce AKI in COVID-19 patients [17] .
2 While several other human coronaviruses such as HCoV-NL63, HCoV-229E, HCoV-OC43, and HCoV-HKU1 cause mild respiratory disease, others like the zoonotic Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV tend to have a higher fatality rate 6 (summarized in Table 1 ). Typical of respiratory viruses like influenza virus, SARS-CoV-2019 can spread through large droplets (with a transmission risk restricted tõ 6 ft from the patient). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series Estimating the Unreported Number of Novel Coronavirus (2019-nCoV) Cases in China in the First Half of January 2020: a data-driven Modelling analysis of the early outbreak Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: a data driven analysis in the early phase of the outbreak
Since December 2019, infections with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), a novel betacoronavirus strain responsible for coronavirus disease 2019 (COVID19) , rapidly progressed from an isolated cluster of cases in the Hubei province of east central China to a pandemic, with significant global health and economic repercussions [4, 5, 10, 24, 25, 27, 28, 44, 58, 80, 91] . Early reports from Italy and China indicated that although pulmonary diseases including ARDS and diffuse pneumonia comprise the predominant lethal complications of COVID-19, patients have also presented with or developed significant cardiac signs and symptoms [50] . COVID-19 musculoskeletal and neurologic manifestations are being reported with increased frequency, particularly in patients with more severe respiratory disease, indicating coronavirus neurotropism possibly directly related with higher viral loads, which are now detectable in cerebrospinal fluid [20] .
The disease name -COVID-19‖ and the associated virus name -SARS-CoV-2‖ were coined by the World Health Organization (WHO) and the Coronavirus Study Group of the International Committee on Virus Taxonomy, respectively, on February 11 1, 2 . Interestingly, pharyngeal swab viral nucleic acid screening results of 2,510 patients between January 23 and February 25 from a hospital fever clinic in Hunan Province (a neighboring province of Hubei) demonstrated that the positive rate of SARS-CoV-2 (1.3%) was lower than that of Influenza A (2.3%) and Influenza B (3.3%) 42 . Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial
Coronavirus disease 2019 (COVID-19) is caused by a novel single-strand ribonucleic acid (RNA) coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 primary attacks the lower respiratory system causing viral pneumonia, but it may also affect the heart, gastrointestinal system, liver, kidney, and central nervous system leading to multiple organ failure [3] . Other researchers found elevated serum troponin levels in many patients infected with COVID-19, and it was associated with more severe disease and poor prognosis [21] . The mechanism behind acute myocardial injury caused by SARS-CoV-2 infection might be related to human angiotensin-converting enzyme 2 receptor (ACE2) [20] which are highly expressed in the heart [11] . The results of previous reports indicate that cardiac injury, arrhythmia, and venous thromboembolism should be considered in any suspected or confirmed COVID-19 case and the patient should undergo a prompt clinical evaluation.
Bioinformatics analysis, satellite derived imaging data and epidemiological attributes were employed to investigate origin, immunogenic resemblance and global threat of newly pandemic SARS-CoV-2 including Bangladesh perspective. The study also prioritized the temperature comparison through satellite imaging alongside compiling and analyzing the epidemiological outbreak information on the 2019 novel coronavirus based on several open datasets on COVID-19 (SARS-CoV-2) and discussed possible threats to Bangladesh. As the outbreak of the 2019 novel coronavirus (COVID-19 [SARS-CoV-2]) is expanding rapidly, analysis of epidemiological data of COVID-19 is necessary to explore the measures of burden associated with the disease and to simultaneously gather information on determinants and interventions. Moreover, the conservancy study of immunogenic peptides predicted from the SARS-CoV-2 proteins was also compared against other human coronavirus strains (HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HKU1 and MERS-CoV). Cross-checked conservancy analysis of COVID-19 antigenic epitopes with SARS-CoV proteins showed that conservancy when crosschecked with other coronaviruses, including BufCoV-HKU26 of Bangladesh origin, was not significant ( Table 3) .
BACKGROUND: The novel coronavirus pneumonia COVID-19 caused by SARS-CoV-2 infection could lead to a serious of clinical symptoms and severe illness, including acute respiratory distress syndrome (ARDS) and fatal organ failure. INTERPRETATION: Infection of Alveolar macrophage by SARS-CoV-2 might be drivers of the "cytokine storm", which might result in damages in pulmonary tissues, heart and lung, and leading to the failure of multiple organs . One case report showed the pathological characteristics of a patient who died from severe infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by postmortem biopsies. Moreover, type II alveolar epithelial cells and macrophages in alveoli and pulmonary hilum lymphoid tissue were infected by SARS-CoV-2, as revealed by immunohistochemistry using Rp3-NP specific antibodies (Figs. [10] In the case of COVID-19, the viral infection of aggregated alveolar macrophages was obvious from early phase to the late stage, according to our study and the results in recent reports of pulmonary pathology [17, 20] .
title: Gastrointestinal symptoms and fecal nucleic acid testing of children with 2019 coronavirus disease: a systematic review and meta-analysis In order to understand the clinical manifestations and incidence of gastrointestinal symptoms of coronavirus disease (COVID-19) in children and discuss the importance of fecal nucleic acid testing.We retrospectively analyzed studies on gastrointestinal symptoms and fecal nucleic acid detection in pediatric COVID-19 patients from January 1, 2020 to August 10, 2020, including prospective clinical studies and case reports. Stata12.0 software was used for meta-analysis.The results showed that the most common gastrointestinal symptoms in children with COVID-19 were vomiting and diarrhea, with a total incidence of 17.7% (95% Cl 13.9–21.5%). At present, there is no relevant study on whether there is a difference in the positive rate of fecal nucleic acid testing in COVID-19 children with and without diarrhea. Clinical features of 33 cases in children infected with SARS-CoV-2 in Anhui Province, China: a multi-center retrospective cohort study.
Shortly after the virus was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the epidemic of coronavirus disease 2019 (COVID-19) broke out, and an information storm occurred. Based on information of SARS, Middle East respiratory syndrome (MERS), and COVID-19, the components of the epidemic (the sources, the routes of infection, and the susceptible population) will be discussed, as well as the role of natural and social factors involved. S ince the end of 2019, a novel coronavirus, namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID19) , appeared in Wuhan, Hubei Province, China. Recent results showed that SARS-CoV-2 persists longer with a higher viral load and peaks later in the respiratory tissue of patients with severe disease; this phenomenon highlights the need for the prevention and control of the epidemic. Some experts commented that people with mild or asymptomatic SARS-CoV-2 infection were not identified by epidemic prevention measures, thus accelerating the spread of the disease.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started with the detection of an increasing number of pneumonia cases of unknown origin in Wuhan, China, since December 2019. In response to the rapidly growing number of confirmed cases and deaths, some measures taken by the Chinese authorities include the quarantine of millions of its citizens with the unprecedented lockdown of many cities, in an attempt to contain the virus and slow down the spread of the disease [3] . One study in China reported a young 22-year-old male who spread SARS-CoV-2 infection to his contacts (1 relative and 6 classmates, all of which were youngsters from 16 to 23 years) just after a few-hour contact during the incubation period, when he was totally asymptomatic [18] , suggesting that the disease is highly infectious during the incubation period.
title: Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study METHODS: We did a retrospective, multicentre, cohort study of 205 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and with a pathological diagnosis of a malignant tumour in nine hospitals within Hubei, China, from Jan 13 to March 18, 2020. Multivariable regression analysis showed that receiving chemotherapy within 4 weeks before symptom onset (odds ratio [OR] 3·51 [95% CI 1·16–10·59]; p=0·026) and male sex (OR 3·86 [95% CI 1·57–9·50]; p=0·0033) were risk factors for death during admission to hospital. 5 In particular, male sex and receiving chemotherapy within 4 weeks before symptom onset were identified as risk factors for death in patients with cancer who were diagnosed with COVID-19. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China
Imaging features of multiple patchy areas of ground glass opacity and consolidation predominately in the periphery of the lungs are characteristic manifestations on chest CT and extremely helpful in the early detection and diagnosis of this disease, which aids prompt diagnosis and the eventual control of this emerging global health emergency. • Among the infected patients, characteristic findings on CT imaging include multiple, patchy, ground-glass opacity, crazy-paving pattern, and consolidation shadows, mainly distributed in the peripheral and subpleural areas of both lungs, which are very helpful for the frontline clinicians. The typical chest CT imaging characteristics of COVID-19 include multiple, peripheral, bilateral, patchy, sub-segmental, or segmental ground glass opacities and areas of consolidation, which are mostly distributed along the bronchovascular bundles and subpleural space. Furthermore, in the currently available reports, the most common chest CT findings in COVID-19 patients are the peripheral areas of ground glass opacity/consolidation (without subpleural sparing) which are bilateral in distribution [21] [22] [23] .
The country''s success mainly lies in three factors: (1) reliance on the mask policy as the main disease prevention measure and the ability to quickly expand mask production capacity; (2) use of big data and technology to enhance effective implementation of disease prevention and detection measures; and (3) strong state‐society relations favoring transparency, communication, and collaboration. I then turn to the crisis management framework, discussing how the developmental state foundations and the democratic regime lead to Taiwan''s success on mask policy, digital governance, and strong state-society collaboration and communication. Moreover, the capacity of a government to define and communicate the uncertainty the crisis brings is also an essential element in an effective response because collective sense-making can help increase citizens'' voluntary compliance. Specifically, during COVID-19, digital governance helped improve disease detection through integrated databases of people''s health records and travel history, through more accurate contact tracing, and through active surveillance tracking for people under quarantine.
Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Specifically, mental health professionals including psychiatrists, psychiatric nurses, and psychologists were deployed to provide psychological counseling and support for vulnerable populations (e.g. frontline healthcare workers, confirmed COVID-19 patients, suspected COVID-19 cases and their families) in China and for people in quarantine in South Korea. For example, group-based CBT (Waterman et al., 2018; Waterman et al., 2019) , PFA, PTL (Decosimo et al., 2019) , culturally adapted interventions such as SMART (Ng et al., 2006) , ultra-brief psychological interventions (Ping et al., 2020) and peer supports (Rastegar Kazerooni et al., 2020) have been reported to effectively mitigate the emotional impacts of COVID-19, EVD, and SARS outbreaks. Culturally-adapted and cost-effective mental health emergency systems based on evidence-based intervention methods integrated into public health emergency responses at the national and global levels are recommended to reduce the psychological impacts of infectious disease outbreaks, especially for COVID-19.
The results indicated that COVID-19-related stress, relationship quality with family, and demographic characteristics were associated with depression, anxiety, and perceived health status. A study reported that health care workers at high risk of contracting SARS were more likely to have a higher prevalence of depression and anxiety, and develop post-traumatic stress during the SARS epidemic (McAlonan et al., 2007) . In this study, we hypothesize that COVID-19-related stress, relationship quality with family, and perceived health status are associated with the risk of depression and anxiety. The questionnaire contained ten main items: unknown origin of COVID-19, fear of infection, lack of effective treatment, poor patient compliance, nursing workload, poor social support, parent-child relationship quality, couple relationship quality, relationship quality with other family members, and perceived health status. The main findings indicated that nurses experiencing COVID-19-related stress and poor relationship quality with family were more likely to develop depression and anxiety symptoms and have health concerns.
11 The causative agent was identified as a novel CoV, eventually named SARS-CoV-2, and the respiratory syndrome associated with the infection was designated as coronavirus disease-2019 (COVID-19) by the World Health Organization (WHO). In direct tests, the clinical sample is examined directly for the presence of particles, virus antigens, or viral nucleic acids, whereas indirect methods detect the serological response against the infection (Figure 2 ). 11 Culture-based methods for SARS-CoV-2 detection have been used in research and public health laboratories in different parts of the world, but virus isolation is not recommended as a routine diagnostic procedure because it has low sensitivity, it is time-consuming, and it requires BSL-3 containment. 11 In addition to unequivocally confirming the diagnosis of a SARS-CoV-2 infection, regular sequencing of a percentage of patient samples from clinical cases can be used to monitor changes in the viral genome over time and trace transmission patterns.
aktuell Infektiologie SARS-CoV-2 Infektion bei Kindern und Jugendlichen Ein Literaturüberblick der AG Infektiologie der ÖGKJ 1 F Im Dezember 2019 kam es in der chinesischen Region Hubei zum gehäuften Auftreten von Pneumoniefällen unbekannter Ätiologie [1] . Allerdings waren in dieser Altersgruppe knapp 80 % der Fälle lediglich Verdachtsfälle (ohne SARS-CoV-2-Laborbestätigung), sodass die Autoren davon ausgehen, dass ein nicht unbeträchtlicher Teil dieser schweren Verläufe durch andere Viren (v. Jedoch zeigten sich in einer diesen Kohorten vermehrte fetale Komplikationen wie Frühgeburtlichkeit oder respiratorischer Stress, wobei der direkte Zusammenhang mit SARS-CoV-2 nicht geklärt ist. So muss natürlich auf neonatalen Intensivstationen damit gerechnet werden, dass aufgrund einer SARS-CoV-2-Erkrankung der Mutter eine prämature Entbindung indiziert wird und die Frühgeborenen behandelt werden müssen. Bei den wenigen detaillierten Berichten über spezifische Symptome bei Kindern mit COVID-19 wird Fieber in 40-100 % und Husten in 40-100 % der symptomatischen Fälle beschrieben [7, 8, [15] [16] [17] [18] [19] . Bisher gibt es keine zugelassenen Medikamente zur Therapie von COVID-19 bei Erwachsenen und Kindern [32] .