cord-027892-5ik9f6nx	2020	First, we could not describe the details of symptoms or the differential diagnosis in the text because of the word limit; therefore, we sincerely appreciate the authors/editors providing us the opportunity to describe the details of neuroleptic malignant syndrome (NMS) in patients with COVID-19 infection. The authors proposed a possible diagnosis of serotonin syndrome (SS) in our reported two cases of NMS following COVID-19 infection because both cases fulfilled the Sternbach''s criteria of SS [1] . In case 1, hyperreactivity symptoms such as tremor and myoclonus were not observed. This patient had loose stools and watery stools since the time of admission, but no apparent improvement was observed even after the discontinuation of the causative drugs. In case 2, hyperreactivity and rigidity findings such as tremor and myoclonus were not recognized. Neuroleptic malignant syndrome in patients with COVID-19 Neuroleptic malignant syndrome in patients with COVID-19
cord-253657-fminkpas	2020	title: Vie scope® laryngoscope versus Macintosh laryngoscope with personal protective equipment during intubation of COVID-19 resuscitation patient The aim of this study was to evaluate intubation performance by paramedics wearing PPE-AGP using Macintosh laryngoscope and Vie Scope® laryngoscope under simulated resuscitation of COVID-19 patient. The study participants then attended a 20-minute practical training course during which they performed endotracheal intubation using Vie Scope® under normal airway conditions. During the target study, paramedics dressed in full PPE-AGP were to perform endotracheal intubation with continuous chest compression. Endotracheal intubation was performed using Macintosh laryngoscope (MAC; blade no.3) as well as with Vie Scope® laryngoscope (VSC). In conclusion, under the conditions of intubation performed by paramedics wearing PPE-AGP with continuous chest compression, the results of the study indicate higher efficiency of intubation with Vie Scope® compared to Macintosh laryngoscope in terms of both the efficiency of the first intubation attempt and the time of the procedure.
cord-254919-fi3inp67	2020	title: Nitrous oxide inhalant abuse and massive pulmonary embolism in COVID-19 A patient presented to the emergency department with altered mental status and lower extremity weakness in the setting of nitrous oxide inhalant abuse and Coronavirus Disease-2019 (COVID-19) infection. Given the high concern for pulmonary embolism with the above findings, computed tomography (CT) was performed and analysis of 183 confirmed COVID-19 patients demonstrating an 11.5% death rate. This patient''s coagulopathy may have been secondary to a combination of COVID-19 infection and N2O inhalant abuse leading to hyperhomocysteinemia. There are case reports illustrating a higher risk of VTE associated with chronic N2O inhalant abuse [6, 7] . Nitrous oxide leads to decreased Vitamin B12 levels with chronic abuse, which leads to increased homocysteinemia by inhibition of methionine synthase [7] . Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy Pulmonary embolism and deep vein thrombosis caused by nitrous oxide abuse: A case report
cord-255267-o8k5ep9y	2020	title: Personal ventilation hood for protecting healthcare workers from aerosol-transmissible diseases In terms of healthcare workers'' safety, the hood ensures lower close contact with the patients, primarily perform medical and surgical procedures that can potentially generate aerosolized particles include intubation and bronchoscopy. The hood protects patients that would be required to undergo several tests differently, radiology, physical therapy, pulmonary, and laboratory. Even in situations where a patient needs to be moved to another facility, the hood could limit the exposure to other patients and hospital personnel. We urged that with the protection provided to both patient and hospital personnel, visitors of the health facility are protected from possible exposure. Are Powered Air Purifying Respirators a Solution for Protecting Healthcare Workers from Emerging Aerosol-Transmissible Diseases? Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient
cord-256688-yy7abob9	2020	DISCUSSION: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for causing COVID-19, is primarily transmitted from person-to-person through close contact (approximately 6 ft) by respiratory droplets. Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), previously referred to as 2019-nCoV, is the virus responsible for causing Coronavirus Disease 2019 (COVID-19) [3] [4] [5] [6] [7] . An emergency medicine approach to COVID-19 should focus on identifying and isolating patients at risk for infection, informing hospital infection prevention and local public health authorities, and engaging infectious disease and other specialists early in care. Emergency physicians should obtain a detailed travel history from all patients and suspect COVID-19 in patients presenting with symptoms of an acute upper respiratory illness and fever. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts
cord-257535-v8dwkngi	2020	In mid-March Washington state took measures to limit the spread of infection, by closing educational facilities, closing non-essential services, and a stay at home order (SAHO) 7 . After March 25 th the fatality rate increased slightly, and then showed a decreasing trend and lower percent increase in new cases ( Figure 2 ). However, their percent increase in cases over the past two weeks has decreased comparably to states in which a SAHO was in effect earlier ( Figure 2 ). To address the first issue, an executive order was issued, allowing the state to increase J o u r n a l P r e -p r o o f hospital capacity 14 . The new rules allow for patient transfers to ambulatory surgery centers, freeing hospital beds for the critically ill 19 There is an association between implementing social distancing and a lowering of the percent increase of cases. During Coronavirus Briefing, Governor Cuomo Issues Executive Order Allowing State to Increase Hospital Capacity.
cord-258662-6y45gb0t	2020	key: cord-258662-6y45gb0t authors: Butt, Nausharwan; Arshid, Awais; Ahmad, Sarah Aftab; Khalid, Nauman; Kayani, Waleed Tallat title: Cardiovascular complications in COVID-19 date: 2020-07-19 journal: Am J Emerg Med DOI: 10.1016/j.ajem.2020.07.032 sha: doc_id: 258662 cord_uid: 6y45gb0t nan In summary, COVID-19 is associated with significant cardiovascular complications which may also include pericarditis, pericardial effusion and Takotsubo (stress) cardiomyopathy. Further larger studies are required to evaluate this association. Cardiovascular complications in COVID-19 SARS-CoV-2 detection in the pericardial fluid of a patient with cardiac tamponade COVID-19 (SARS-Cov-2) and the heart -An ominous association All authors have no sources of funding to disclose The authors have no conflict of interest to declare.
cord-258676-6kgxpcwc	2020	SARS-CoV-2 is the name of the virus responsible for causing COVID-19 disease, which is highly infectious and lethal.With exponentially increasing infections, proportionate fatalities are being reported both from developed and under developed countries. Hence, there is an urgent requirement for conducting academic research on several aspects of this highly contagious disease, to find effective means of containment and treatment of the disease, for now, and in future. We have identified some opportunities for academic research related to COVID-19 and have also provided suggestions to contain, prevent and treat this viral infection. There is an urgent need to identify and study the areas of academic research which will be impacted by COVID-19 [3] . COVID-19 pandemic is a public health emergency of international concern.It has posed new challenges to the global research community. With the help of academic research, there is a need for a better understanding of the COVID-19 and its socio-economic ramifications on society.
cord-263753-p3evgngz	2020	While the peak DEX-doses >0.8 µg/kg/hr and daily cumulative DEX-doses >12.9 µg/kg/day have been described to be associated with an elevated withdrawal incidence [7] , lack of presentation of the contextual DEXdose administered in the COVID-19 patient featured in the Stockton and Kyle-Sidell case-report, captivates attention [1] . (iii) In addition, once on invasive mechanical ventilation, a precision approach to sedation in COVID-19 patients, as epitomized by Payen et al, appears to be prudent centralising the focus on inter-individual variability and synchronizing the level of ventilator support to the subsequent target of sedation, thereby directing the subsequent choice of sedative agents, including DEX [8, 9] . Dexmedetomidine and worsening hypoxemia in the setting of COVID-19: A case report Dexmedetomidine-Associated Hyperpyrexia in Three Critically Ill Patients With Coronavirus Disease Incidence of dexmedetomidine withdrawal in adult critically Ill patients: a pilot study Sedation for critically ill patients with COVID-19: Which specificities?
cord-264257-iu67n7qw	2010	title: The impact of H1N1 influenza A virus pandemic on the emergency medical service in Kobe To investigate the impacts of the H1N1 influenza pandemic on EMS, we studied the situation of EMS during the epidemic provided by the emergency paramedics. The number of hospitals with which the paramedics negotiated for patients'' transfer was comparable between the 2 periods ( Fig. 3 and Table 1 ), whereas the sojourn time at the site was prolonged in the postepidemic period (mean, 17.0 minutes; range, 4.0-70 minutes) compared with the preepidemic period (mean, 14.0 minutes; range, 1.0Fig. 1 The number of febrile patients who called an ambulance remained unchanged during the study period. Considering that the number of hospitals with which the paramedics negotiated for patients'' transfer was comparable between the 2 periods, this extra time was required to provide the hospitalists with precise information on febrile patients, including symptoms and records of oversea travel.
cord-265098-u5qssib9	2020	title: Effect of COVID-19 outbreak on the treatment time of patients with acute ST-segment elevation myocardial infarction OBJECTIVE: To explore the effect of COVID-19 outbreak on the treatment time of patients with ST-segment elevation myocardial infarction (STEMI) in Hangzhou, China. METHODS: We retrospectively reviewed the data of STEMI patients admitted to the Hangzhou Chest Pain Center (CPC) during a COVID-19 epidemic period in 2020 (24 cases) and the same period in 2019 (29 cases). Cumulative mortality was showed in Kaplan-Meier survival curves after the surgery in the 2020 group was significantly different higher than the 2019 group during the 28 days.The diagnosis and treatment process of STEMI patients during an epidemic should be optimized to improve their prognosis. Suggestions on management strategies for ST-segment elevation acute myocardial infarction (STEMI) combined with novel coronavirus infection Impact of symptom onset to first medical contact time on the prognosis of patients with acute ST-segment elevation myocardial infarction
cord-268049-7xqln70d	2020	DISCUSSION: Patients presenting with SARS-CoV-2 infection are at high risk for acute respiratory failure requiring airway management. [29] [30] [31] [32] Based on currently available evidence, the WHO states that "HFNC and NIV systems with good interface fitting do not create widespread dispersion of exhaled air and therefore should be associated with [a] low risk of airborne transmission." 15 The risk of respiratory pathogen transmission when using HFNC is subject to a variety of factors, including the duration of support, maximal flow rate, patient sneezing or coughing, cannula fit, and patient cooperation. 35 Many guidelines, including those by Australian and New Zealand Intensive Care Society (ANZICS), the WHO, and the Surviving Sepsis Campaign recommend the use of HFNC in COVID-19 patients presenting with acute hypoxemic respiratory failure unresponsive to conventional oxygen therapy. 20 Notably, the SCCM guidelines on the management of critically ill patients with COVID-19 recommend "a trial of NIV with close monitoring and shortinterval assessment for worsening of respiratory failure" if HFNC is not available and there is no urgent indication for intubation.
cord-268526-gh9sy7sl	2019	Then, the participants performed three sessions of continuous chest compressions, each with a duration of 2 min, while undergoing real-time fit testing. CONCLUSIONS: Even if the participants passed the QNFT, the N95 respirator did not provide adequate protection against respiratory infections during chest compression. Thus, we compared the respirator failure (FF < 100) rates during chest compression between a partially passed group (the overall fit factor was adequate, but at least one specific exercise was failed; the PPG) and an all passed group (group that passed all exercises: the APG). Therefore, our findings are clinically significant in terms of the safety of HCWs who are at high risk for airborne disease transmission during chest compression even when wearing adequately fit-tested N95 respirators. This study indicated that N95 respirators may not provide consistent protection against respiratory infection for HCWs. The QNFT failure rates during chest compression after the user-seal-check did not differ between the two groups.
cord-268840-m3fp9q3p	2020	Sonographic characteristics like bilateral lung involvement, B – profile, spared areas and confluent B – lines or waterfall sign were significantly associated (p < 0.01) with clinical severity (more frequent with increasing disease severity). [2] The clinical spectrum of COVID-19 patients range from asymptomatic to critical illness, which can include severe acute respiratory distress (ARDS) requiring ventilatory support [3] [4] [5] [6] . [12] Confirmed COVID-19 patients were categorised by the treating physician (also performed the ultrasound) according to their severity of illness according to Chinese CDC definitions (mild disease: patients with respiratory tract infection, not fulfilling criteria for severe and critical disease, severe disease: any of the following signs or symptoms like shortness of breath, respiratory rate > 30/min or oxygen saturation < 93%, and critical disease: patients requiring intensive care for organ failure or invasive ventilation) [11] .
cord-278413-vad80mg5	2020	title: Psychiatric emergency department volume during Covid-19 pandemic One commonly reported phenomenon in the first months of the Covid-19 era in the United States has been the reduction in emergency department (ED) visits and hospitalizations of patients with heart attacks, strokes and other acute, non-Covid illnesses. The psychiatric emergency service (PES) is staffed 24 hours per day and treats patients 16 years and older. At YNHH, PES and overall ED volumes for January, February and early March 2020 were similar to prior years (see Table 1 ). PES volume decreased less than overall ED volume, suggesting that patients may be less willing or able to defer their need for acute psychiatric care as opposed to other acute medical care. That the rate of hospitalization of psychiatric patients was just slightly higher than prior years may indicate that the overall acuity in PES was similar to previous years.
cord-286348-3p7gz8wi	2020	We analysed demographic, clinical, echocardiographic and outcome parameters in patients admitted for AHF during the study period of 16 weeks (March 25 to July 14, 2020; starting from the day when lockdown was imposed by Government of India) and compared this data with a control period of 16 weeks (Dec 05, 2019 to March 24, 2020; when there was no lockdown and number of COVID-19 attributed death ≤10). We analysed demographic, clinical, echocardiographic and outcome parameters in patients admitted for AHF during the study period of 16 weeks (March 25 to July 14, 2020; starting from the day when lockdown was imposed by Government of India) and compared this data with a control period of 16 weeks (Dec 05, 2019 to March 24, 2020; when there was no lockdown and number of COVID-19 attributed death ≤10).
cord-286977-330p60oh	2020	title: Plastic blanket drowning kit: A protection barrier to immediate resuscitation at the beach in the Covid-19 era. OBJECTIVE: Introducing a new, simple and inexpensive portable equipment for lifeguards, consisting of a pre-assembled full-size plastic blanket with a mask and HEPA filter, which could offer significant time-saving advantages to reduce COVID-19 risk transmission in the first few minutes of CPR after water rescue, avoiding the negative impact of delayed ventilation. METHOD: A pilot study was carried out to determine the feasibility of the pre-assembled kit of face-mask and HEPA filter adapted on a pre-set plastic-blanket. The PPE kit consists of a pre-assembled full-size transparent plastic blanket with an adaptation to a ventilation face mask with a High Efficiency Particulate Air (HEPA) filter. Plastic blanket drowning kit: a protection barrier to immediate resuscitation at the beach in the Covid-19 era.
cord-289684-rvbofsmb	2020	We present a case report of a woman infected with COVID-19 and diagnosed with parotitis. The patient was prescribed a course of amoxicillin/clavulanate to J o u r n a l P r e -p r o o f treat a possible concomitant bacterial parotitis and advised to apply warm compresses, massage the gland, use sialagogues to increase salivary flow and stay hydrated. Typically, viral parotitis is characterized by a prodrome of flu-like symptoms followed 2-4 days later by gradual swelling of the bilateral parotid glands, though unilateral involvement is seen in up to 25% of cases [6, 7] . Physical exam findings in suppurative parotitis include induration and tenderness of the parotid gland and purulent discharge from the duct orifice with massaging the gland [6, 7] . While we believe this was a viral-induced parotitis, given the unilateral presentation we treated her for possible bacterial co-infection. At the time we evaluated this patient there were no reports of COVID-19 associated parotitis.
cord-290684-3f6prlqy	2020	title: Use of high-flow nasal cannula and noninvasive ventilation in patients with COVID-19: A multicenter observational study BACKGROUND: The use of high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) in patients with COVID-19 is debated. CONCLUSIONS: In critically ill patients with COVID-19 who used HFNC and NIV as first-line therapy, the duration of HFNC + NIV, intubation rate and mortality did not differ between two groups. The Asian Critical Care Clinical Trials Group has suggested that the HFNC and NIV only can be used in COVID-19 patients with mild acute respiratory distress syndrome (ARDS) [21] .
cord-293535-9bj5ev1a	2020	title: The influence of corticosteroid on patients with COVID-19 infection: A meta-analysis Therefore, we aim to perform this meta-analysis to identify the roles of corticosteroids in patients with or without severe COVID-19. An electronic search was performed in Pubmed, Embase, Cochrane library, and China National Knowledge Infrastructure (CNKI), using the keywords "steroid" or "corticosteroid" or "cortisol" or "prednisolone" or "prednisone" or "glucocorticoid" or "hydrocortisone" or "dexamethasone" or "methylprednisolone" AND "novel coronavirus" or "2019-nCoV" or "COVID-19" or "SARS-CoV-2" between 2019 and present time (i.e., up to May 7th, 2020) and without language restrictions. A total of 466 studies were originally identified based on our search criteria, 411 of which were excluded after title, abstract or full text reading since they were review articles, editorial materials or letters, and did not report the use of corticosteroid in patients with or without severe COVID-19. Correction to: Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from
cord-294736-ji4jz3h6	2020	title: Acute myocarditis associated with COVID-19 infection() We present the case of a 20-year-old male patient without previous history of cardiovascular disease who was admitted to our hospital with a new onset febrile sensation and chest pain. Cardiac MRI showed myocardial edema and late gadolinium enhancement compatible with myocarditis associated with COVID-19 infection. This case showed that acute myocarditis can be the initial presentation of patients with COVID-19 infection. Acute or fulminant myocarditis as well as heart failure have been reported with Middle East respiratory syndrome coronavirus and could be expected to occur with SARS-CoV-2, given the similar pathogenicity [2] . Previous severe acute respiratory syndrome (SARS) beta-coronavirus infections could be associated with tachyarrhythmias and signs and symptoms of heart failure [3] . Association of Coronavirus Disease 2019 (COVID-19) With Myocardial Injury and Mortality Cardiovascular complications of severe acute respiratory syndrome Cardiac Involvement in a Patient With Coronavirus Disease
cord-297671-3d3gcn6k	2020	We describe three previously healthy children, admitted from our emergency department (ED) to our free-standing children''s hospital, as the first documented cases of croup as a manifestation of SARS-CoV-2 infection. All three cases (ages 11 months, 2 years, and 9 years old) presented with non-specific upper-respiratory-tract symptoms that developed into a barky cough with associated stridor at rest and respiratory distress. The novel 2019 coronavirus SARS-CoV-2, responsible for COVID-19 disease, commonly presents in children with fever, cough or shortness of breath. [7] After an electronic health record database review, we describe this ca 1 se series of our ED''s only three cases, between March 1, 2020 and July 31, 2020, of children who received nebulized racemic epinephrine (NRE) and had a positive SARS-CoV-2 infection. [15] Pediatric croup patients who received ≥3 NRE in one children''s hospital were more likely to need intensive care management.
cord-298640-zwg8ueyb	2020	The use of personal protective equipment in the COVID-19 pandemic era American Journal of Emergency Medicine xxx (xxxx) xxx YAJEM-158899; No of Pages 2 At present, it is recommended to apply various types of equipment, including, in particular, partial protection of the environment through the use of surgical masks or ordinary face masks by persons with confirmed or potential SARS-CoV-2 infection; this may reduce the risk of infecting people in the environment, including medical personnel [3, 7] . At present, performing a number of procedures in emergency medicine is associated with additional problems and risks for medical personnel. Emergency physicians, anesthesiologists and intensive care specialists, as well as the relevant scientific societies issue recommendations concerning endotracheal intubation or other procedures dangerous for the medical personnel [1, 2] . COVID 19 a challenge for emergency medicine and every health care professional
cord-300132-lbbibqv3	2020	title: Association between COVID-19 diagnosis and presenting chief complaint from New York City triage data Conclusion: A novel high risk COVID-19 patient population was identified from chief complaint data, which is different from current suggested CDC guidelines, and may help triage systems to better isolate COVID-19 patients. Conclusion: A novel high risk COVID-19 patient population was identified from chief complaint data, which is different from current suggested CDC guidelines, and may help triage systems to better isolate COVID-19 patients. This study aimed to investigate the association between different triage chief complaints and COVID-19 status by retroactively looking at a large set of COVID-19 RT-PCR testing done in the ED. It is important for physicians in the ED to test elderly patients for COVID-19 if they present with atypical chief complaints as described above in order to reduce spread of the disease amongst a vulnerable population and increase quality of care.
cord-301623-uza6gu4r	2020	This scoping review aimed to summarize the available evidence on cardiopulmonary resuscitation in prone position (''reverse CPR'') and knowledge or research gaps to be further evaluated. RESULTS: We included 1 study on manikins, 31 case reports (29 during surgery requiring prone position) and 2 nonrandomized studies describing reverse CPR. This scoping review aimed to summarize the available evidence on the cardiopulmonary resuscitation in prone position ("reverse CPR") and to highlight possible knowledge or research gaps to be further evaluated. We collected data regarding the type of study (e.g. design and country), population characteristics at baseline (e.g. age, main disease), setting (e.g. operatory room, ICU), occurred events (e.g. rhythm and cause of the cardiac arrest), intervention (e.g. prone or standard CPR) and outcomes (e.g. mortality, return of spontaneous circulation -ROSC).
cord-308807-9yggo5yk	2020	On October 23, 2020, the U.S. reached a new pandemic record of 83,010 daily cases, 1 and all signs point toward an impending "second wave" or "third surge." Given the association between advanced age and COVID-19 severity, 2 our objective was to compare the geographic distribution of U.S. EPs age  60 years to the cumulative distribution of confirmed COVID-19 cases, to highlight the potential risks faced by this vulnerable population of clinicians. Emergency departments could also amend operations to prioritize reduction of nosocomial transmission risk among advanced age EPs (e.g., allocating critically limited PPE to higher-risk physicians, geographically cohorting patients with suspected or confirmed COVID-19 infection within an emergency department). States were grouped into color-coordinated quintiles based on relative proportion of older EPs, and cumulative COVID-19 case volumes were adjusted with a logarithmic scale to create proportionally-sized data points.
cord-310207-lfub6y5m	2020	title: Covid-19 associated Guillain-Barre Syndrome: Contrasting tale of four patients from a tertiary care centre in India OBJECTIVE: In this brief communication we report four cases of Covid-19 who presented to our hospital with features suggestive of Guillain-Barre Syndrome (GBS). DISCUSSION: The mechanisms by which SARS-CoV-2 causes neurologic damage are multifaceted, including direct damage to specific receptors, cytokine-related injury, secondary hypoxia, and retrograde travel along nerve fibres. One patient who presented with respiratory complaints and X-ray changes along with neurological deficits continued to deteriorate even after starting treatment for both GBS and Covid-19, and eventually succumbed to the disease. All our patients developed features of GBS, 5-10 days after the onset of Covid-19 symptoms, which is similar to the interval seen with Guillain-Barré syndrome that occurs secondary to other infections [9] . Atypical clinical presentation of COVID-19: a case of Guillain-Barrè Syndrome related to SARS-Cov-2 infection
cord-311353-ozqfsuh8	2020	title: The role of Chinese medicine in COVID-19 pneumonia: A systematic review and meta-analysis INTRODUCTION: Chinese medicine (CM) has been used to treat Novel Coronavirus 2019 (COVID-19) pneumonia in China. This meta-analysis was conducted to evaluate the clinical efficacy and safety of CM in the treatment of COVID-19 pneumonia. CONCLUSION: According to the allocated data, CM has demonstrated clinical efficacy and safety on COVID-19 pneumonia, which need to be confirmed by high quality, multiple-center, large sample randomized controlled trials. Therefore, the meta-analysis method will be used to systematically review the clinical efficacy and safety of CM for COVID-19 pneumonia. Studies meeting the following criteria were included: (1) randomized controlled trials (RCTs) using CM (including Chinese herbal medicine, Chinese patent medicine and Chinese medicine injections) to treat COVID-19 pneumonia regardless of J o u r n a l P r e -p r o o f meta-analysis.
cord-312623-ktswh3fu	2020	title: Mucormycosis with orbital compartment syndrome in a patient with COVID-19 I describe a novel case of COVID-19 in a previously healthy 33-year-old female who presented for altered mental status and proptosis. I describe a novel case of COVID-19 in a previously healthy 33-year-old female who presented for altered mental status and proptosis. She was ultimately diagnosed with mucormycosis and orbital compartment syndrome, in addition to COVID-19. Herein I present a case of rhino-orbital-cerebral mucormycosis in a patient who presented to the Emergency Department with altered mental status, proptosis, and COVID-19 infection. The most common clinical presentation of mucormycosis is rhino-orbital-cerebral infection, believed to be secondary to inhalation of spores into the paranasal sinuses of a susceptible host [1] . Seventy percent of rhino-orbital-cerebral mucormycosis cases have been found to be in patients with diabetes mellitus, most of whom had also developed ketoacidosis at the time of presentation.
cord-316513-dbzj101e	2020	title: Utilizing technology as a method of contact tracing and surveillance to minimize the risk of contracting COVID-19 infection A call for new methods of testing and surveillance on a large scale will be important if we hope to control the spread of SARS-CoV-2 infections. On example is the Oura ring (Ooura Health Ltd.''s, Oulu, Finland) which can detect physiologic changes and alert the possibility of infection. For example, one study at West Virginia Univeristy, Rockefeller Neuroscience Institute predicted symptoms 24 hours prior to onset based on physiologic changes detected by the Oura ring, and aim to achieve a 3-day forecast in the future. In addition, early detection and contact tracing has the potential to conserve hospital resources that have become scarce throughout the pandemic. CDC Diagnostic Test for COVID-19 WVU Rockefeller Neuroscience Institute and Oura Health unveil study to predict the outbreak of COVID-19 in healthcare professionals
cord-317784-fl9zbgad	2020	However, recently [3] it was demonstrated that propofol infusion increases ACE2 mediated conversion of angiotensin II to angiotensin, which results in a fall in angiotensin II levels and an elevation of angiotensin 1 to7; and these exhibit protective effects of lungs by way of recovery of endothelial cell function via an up-regulation of ACE2-Ang -Mas axis, subsequent to phosphorylation of endothelial nitric oxide (NO) synthase to generate NO, and regulation of apoptosis-related protein such as bcl-2, caspase9. Propofol prevents human umbilical vein endothelial cell injury from ang II-induced apoptosis by activating the ACE2-(1-7)-Mas axis and eNOS phosphorylation Propofol stimulates nitric oxide release from cultured porcine aortic endothelial cells Effects of propofol on endothelial cells subjected to a peroxynitrite donor Effects of propofol on hemodynamic and inflammatory responses to endotoxemia in rats
cord-318188-baat9464	2020	We investigated the protective effect and usefulness of loose-fitting powered air-purifying respirators (PAPRs) during chest compression. We measured the concentrations of ambient aerosol and particles inside the loose-fitting PAPR during chest compression, and this ratio was set as the simulated workplace protecting factor (SWPF). The purpose of this study was to investigate the protective effect of loose-fitting PAPRs during chest compressions. We measured the concentrations of ambient aerosol and particles inside the loose-fitting PAPR''s hood during chest compression, and this ratio was set as the simulated workplace protecting factor (SWPF). A previous simulation study showed that the N95 respirator failed to provide sufficient protection, with the fit factor falling below 100 in 73% of participants during chest compressions [7] . In this study, most participants (81%) did not think that the loose-fitting PAPR interfered with the ability to perform chest compression. In conclusion, the loose-fitting PAPRs provided sufficient respiratory protection and comfort during chest compression.
cord-322297-euqmv6rw	2018	The outcome was the daily number of people who visited the emergency departments in Seoul from 2015 to 2016 with a diagnostic code for psychiatric diseases (International Classification of Disease-1oth version, Mental and Behavioral Disease, F00-F99, including F00-F09 (Organic, including symptomatic, mental disorders), F10-F19 (Mental and behavioral disorders due to psychoactive substance use), F20-F29 (Schizophrenia, schizotypal and delusional disorders), F30-F39 (Mood [affective] disorders), F40-F48 (Neurotic, stress-related and somatoform disorders), F50-F59 (Behavioral syndromes associated with physiological disturbances and physical factors), F60-F69 (Disorders of adult personality and behavior), F70-F79 (Mental retardation), F80-F89 (Disorders of psychological development), F90-F98 (Behavioral and emotional disorders with onset usually occurring in childhood and adolescence), and F99-F99 (Unspecified mental disorder)). We found a significant association between the PM 2.5 concentration and emergency department visits for psychiatric diseases on lag 1 day in the adjusted models.
cord-322778-a411t2wg	2020	We therefore conducted this retrospective study to evaluate the diagnostic performance of CT in patients presenting to ED with COVID-19 suspicion compared with both RT-PCR, which is currently used as a gold standard, and a clinical adjudication committee decision. After the completion of the study, the adjudication committee, blinded to the RT-PCR results, retrospectively reviewed the ED admission charts of all patients and graded the probability of COVID-19 by integrating data from several parts of the chart: the history section, the results of the clinical examination and the laboratory tests. After integrating the results of RT-PCR (integrating serial analyses if available) and the clinical follow-up in the referral hospital, their final consensus decision was considered as the reference diagnosis for COVID-19 infection. The study primary endpoints were the test diagnostic characteristics; specifically, sensitivity, specificity, positive and negative predictive values of CT first in comparison to RT-PCR as gold standard and, second, to the final adjudication committee decision.
cord-322887-md446f9p	2020	This paper was of note to us because it included a meta-analysis on acute respiratory distress syndrome (ARDS) and cardiac injury, based on two papers -one by Shi (2) and another by Wu (3). On reading the paper by Wu, we have significant concerns about the inclusion of this study in Santoso''s meta-analysis as we believe it currently underpins an inaccurate conclusion that cardiac injury is not significantly associated with increased risk of ARDS in COVID-19 by Santoso. However, from what we currently have access to, it seems most likely that Santoso''s meta-analysis for ARDS has been based on composite endpoint data. Moreover, the conclusion of Santoso runs counter to Shi''s JAMA Cardiology paper, which was the other paper included in Santoso''s meta-analysis, which did report on purely ARDS cases and cardiac injury and did find a statistically significant association. Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis
cord-330704-4piesfxu	2020	MATERIALS & METHODS: In this retrospective cohort study, patients with confirmed diagnosis of COVID-19 and AHRF receiving NIV in general wards were recruited from two university-affiliated hospitals. However, there were major concerns that HFNC or NIV may create risks for health care workers (HCWs) because of SARS-CoV-2 transmission via aerosols [6] while the data on the efficacy of noninvasive modalities in COVID-19-associated AHRF are still limited [6] [7] [8] . This study suggests that the use of NIV is feasible in acute hypoxemic respiratory failure in patients with COVID-19 outside intensive care unit and can be considered as an effective means to improve oxygenation in patients not responding to conventional oxygen therapy. In summary, we have shown that NIV is feasible in patients with COVID-19 with acute hypoxemic respiratory failure outside the intensive care unit, and it can be considered as a valuable option for the management of AHRF in these patients.
cord-333176-6v7ficfk	2020	SARS-CoV-2 infection is well-documented to cause severe pneumonia, however, thrombosis and thrombotic complications, such as ischemic stroke, have also been documented in a variety of patient demographics. 5,6 This is likely due to the presence of asymptomatic or mildly symptomatic transmission of SARS-CoV-2, and its current prevalence in the human population supports the infective potential of this novel coronavirus. 37 Imbalance of the interactions between ACE2 and the RAS axis may also contribute to the thromboembolic events seen in SARS-CoV-2 infection. 44, 45 Ischemic stroke due to occlusion of large arteries has been a documented complication of SARS-CoV infection in patients with minimal to no risk factors. 46 SARS-CoV-2 infection seems to also increase risk of developing ischemic stroke, among other neurological consequences. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Ischemic Stroke
cord-333797-six8wzxz	2020	J o u r n a l P r e -p r o o f COVID-19 infections and diabetes have been linked since early reports identified patients with diabetes mellitus having worse clinical outcomes. 2 However, there has only been one case reported on COVID-19 infection precipitating a new diagnosis of diabetes mellitus type II. Testing in the ED revealed hyperglycemia, anion gap metabolic acidosis and ketonuria which confirmed the patient to be in diabetic ketoacidosis (DKA). We report a case of DKA precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus. There has been one prior case report of DKA and new onset diabetes mellitus in the setting of COVID-19 infection. Patients with elevated blood sugar and no history of diabetes should be evaluated for the possibility of new onset diabetes mellitus and DKA, especially in the setting of concomitant COVID-19 infection. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus
cord-333827-zpdnzwle	2020	title: Potential risk factors for case fatality rate of novel coronavirus (COVID-19) in China: A pooled analysis of individual patient data This study aims to perform the meta-analysis of risk factors for the case fatality rate (CFR) of the 2019 novel coronavirus (COVID-19). After comparing the patients between fatal cases and non-fatal cases, several important factors are found to significantly increase the CFR in patients with COVID-19, and include the age ranging 60–70 (OR = 1.85; 95% CI = 1.62 to 2.11; P < .00001) and especially≥70 (OR = 8.45; 95% CI = 7.47 to 9.55; P < .00001), sex of male (OR = 1.88; 95% CI = 1.30 to 2.73; P = .0008), occupation of retirees (OR = 4.27; 95% CI = 2.50 to 7.28; P < .00001), and severe cases (OR = 691.76; 95% CI = 4.82 to 99,265.63; P = .01).
cord-333872-shhugvx0	2020	title: The conundrum of rising Covid19 infection among health care workers: An emerging paradigm Such asymptomatic infected HCWs can transmit infection unknowingly to the patients and other HCWs. At one of the London hospital, sample for RT-PCR testing for covid19 taken from asymptomatic and healthy HCWs at multiple point of time. In a total number of 1,479 health care worker''s sample, 1.1% to 7.1% (at different point of time) were found positive for Covid19 [9] . COVID-19 and the Risk to Health Care Workers: A Case Report Death from Covid-19 of 23 Health Care Workers in China COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19 COVID-19: PCR screening of asymptomatic health-care workers at London hospital COVID-19: the case for health-care worker screening to prevent hospital transmission
cord-334416-4tslee57	2020	title: Social distancing during the COVID-19 pandemic: Staying home save lives With the incidence of COVID-19 increasing, it may only be time before the healthcare system becomes overwhelmed and forces physicians to triage treatment among critically ill patients. Social distancing is the practice of increasing the space between people in order to decrease the chance of spreading illness. Nationwide measures taken to minimize contact with potentially infected individuals include cancelling travel from China and Europe [10] . Social distancing has the potential to slow the rate of infection and reduce the peak of incidence, and then fewer critically ill patients would need care on any one day. Delaying the peak incidence to the summer holds potential for healthcare facilities to dedicate more resources to those ill with COVID-19. Social distancing is a realistic solution that all individuals can take part in to reduce the risk of infection while increasing available resources to critically ill patients, during this pandemic.
cord-334705-vclkuink	2020	We sought to characterize perceptions of public health recommendations and explore the decision to seek medical care for common symptoms. To understand the impact on individual medical decision making, we asked participants to describe their approach to care for common symptoms before and during the pandemic, classifying behaviors according to escalation of care: 1) stay home and see if it gets better ("wait and see"); 2) call my doctor; 3) present to an emergency department (ED), urgent care (UC), or call 911. Most participants worry about their own and their family''s health, their ability to obtain medical care, and prolonged, severe illness if they contracted COVID-19. In the weeks following the initiation of public health recommendations, public perceptions were overall favorable and participants reported adherence to mandates in the setting of worry about personal health and reluctance to seek emergency care for COVID-19-related symptoms.
cord-336005-nm34bfsl	2020	Although there appears to be an increased incidence of thromboembolic disease in patients with COVID-19 infection, recommendations regarding anticoagulation are lacking. We present the case of a 61-year-old woman with clinically significant venous and arterial thromboemboli in the setting of COVID-19 infection requiring tissue plasminogen activator (tPA). In addition, there is no clear guidance as to whether anticoagulation should be initiated for emergency department (ED) patients with presumed COVID-19 and elevated D-dimer. The patient''s CXR demonstrated bilateral peripheral opacities consistent with COVID-19 infection ( Figure 1 ) and her D-dimer returned elevated at 8,264ng/mL. Based on the patient''s hypoxemia, persistent tachycardia, and marked D-dimer elevation, we ordered a CT pulmonary angiogram which revealed multiple filling defects in the thoracic and abdominal aorta representing thromboemboli as well as diffuse bilateral ground glass opacities in the lungs (Figure 2) . Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China
cord-338814-r9ym1h3m	2020	title: Using social media for telemedicine during the COVID-19 epidemic As the first country to discover COVID-19, China has taken strict precautionary measures. The Chinese government strives to raise public awareness of prevention and protection by providing daily monitoring and updates on websites and social media [4] . Social media played an essential role during the COVID-19 epidemic. The government should support and encourage medical personnel to participate in science education on social media. Because the strict quarantine measures make it difficult for patients to see a doctor, it is urgent to establish an appropriate telemedicine and appointment system. The emergence of the virus pandemic will make the public health system and community health service institutions face special and lasting epidemic prevention situation. An investigation of transmission control measur es during the first 50 days of the COVID-19 epidemic in China Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics
cord-338855-1hfj8qj9	2020	title: Traditional chinese medicine and COVID-19: should emergency practitioners use it? Classical herbal formulas, such as Yu Ping Feng San, Sang Ju Yin and Yin Qiao San, were highly sought out for prevention and treatment of In this issue of The American Journal of Emergency Medicine, Sun and coworkers present an adept metanalysis supporting the clinical efficacy and safety of using TCM herbal prescriptions for the treatment of COVID-19. For example, we are concerned that the depicted results reflect a steady state of illness, whereas in TCM, measures can vary depending on which herbal formulations are administered, and the stage or rate of infection in each patient. Clinical features of patients infected with 2019 novel coronavirus in Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Traditional Chinese Medicine treatment of COVID-19 The role of Chinese Medicine in COVID-19 pneumonia: A systematic review and meta-analysis
cord-338863-0jlp9lb4	2020	A systematic review found that 53% of individuals who endure trauma experienced PTG (4), enjoying greater life satisfaction, happiness, psychological, emotional, and even physical wellbeing (5) . While COVID-19 has already resulted in negative outcomes for HCWs, individuals can still strive for greater appreciation of life, improved self-esteem, and positive approaches to daily responsibilities (16) . Mindfulness interventions facilitate self-awareness and presence, with studies repeatedly demonstrating positive effects of meditation on sleep and other mental and physical health outcomes (30) . Effect of Positive Psychological Intervention on Posttraumatic Growth among Primary Healthcare Workers in China: A Preliminary Prospective Study Psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on healthcare workers in China. Preserving mental health and resilience in frontline healthcare workers during COVID-19. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic
cord-338922-wew3hety	2020	title: Impact of COVID-19 on professional and personal responsibilities of Massachusetts physicians 4 This study examines changes in the professional status and personal responsibilities of physicians related to the COVID-19 pandemic and the stay-at-home advisories. They were selected to characterize effects of a single state''s stay-at-home advisory among physicians with different clinical impacts from COVID-19. More men (28.9%) reported increased hours spent on professional responsibilities compared to women (15.9%, p=0.02). We report an early perspective of the personal and professional impacts of the COVID-19 pandemic on EM and pediatric physicians. Our study supports concerns for increased professional gender disparities during the pandemic stayat-home advisory, 2 including fewer scientific publication submissions by women compared to men. 7 In our study, female physicians invested more time in child and household care and less time on selfcare and professional responsibilities, compared to men.
cord-339864-rv5zw972	2020	In Iran, social media accounts circulated false stories of curing COVID-19 by drinking high-proof alcohol, poisoning over 2,000 people due to the inadvertent consumption of methanol with bleach to hide its color [5] . In Madagascar, President Andry Rojoelina launched an herbal coronavirus "cure" produced from the artemisia plant, yet the WHO stated that the tonic is not evidence-based and is potentially toxic [9] . These herbal formulas contain a combination of many herbs and the exact proprietary mixture is not available, posing a major health risk to patients due to their potential toxicity, contamination, or adulteration [10] . The implications of medicating with herbal-based formulas is serious and dangerous because there is no scientific evidence suggesting that these alternative remedies can prevent or cure COVID-19. The spread of nonevidence-based COVID-19 treatments or cures will undoubtedly worsen the magnitude of the pandemic.
cord-341060-otvoo99j	2020	Keywords: COVID-19, massive pulmonary embolism, thrombolysis, acute respiratory distress syndrome, point-of-care ultrasound. Recently, a preliminary analysis of a large US cohort of critically ill patients with severe novel SARS-CoV-2 disease (COVID-19) has suggested the benefit of systemic anticoagulation on their J o u r n a l P r e -p r o o f anticoagulation in patients with severe COVID-19, and Padua prediction score ≥4 or D-dimer>3.0 μg/mL has been previously suggested due to the increased occurrence of pulmonary embolism (PE) [3, 4] . Point-of-care-cardiac ultrasound modified four-chamber view (day-2) revealing a large thrombus in a dysfunctional right heart "en-route" to the pulmonary circulation in our critically ill COVID-19 patient. Point-of-care-cardiac ultrasound modified four-chamber view (day-5) depicting no thrombi in the right heart, and normalization of right ventricular function in our critically ill COVID-19 patient. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy
cord-341527-03rh966o	2020	Here, we report a case of dexmedetomidine use in the setting of worsening hypoxemia, whereby oxygenation improved and intubation was avoided. Well known pharmacologic properties of the drug, namely the lack of respiratory depression and its anti-delirium effects, as well as other possible physiologic effects, suggest potential benefit for patients being managed with a delayed intubation approach. If dexmedetomidine can improve compliance with non-invasive oxygen support (the current recommended first-line therapy) while promoting better oxygenation, it may also decrease the need for mechanical ventilation and thus improve mortality. While early intubation was the initial recommended strategy for COVID-19 hypoxemia, a large case series in the US as well as data coming out of Britain, China, and Italy suggests a high mortality for patients requiring invasive ventilation [2] . In this case, we believe dexmedetomidine helped one patient avoid mechanical ventilation by improving compliance with non-invasive ventilation and promoting better oxygenation.
cord-344120-7t5ce2hb	2020	CONCLUSION: According to level 1 evidence reviewed here, the most effective SARS-Co-V-2 pharmacologic treatments include remdesivir for mild to severe disease, and a triple regimen therapy consisting of lopinavir-ritonavir, ribavirin and interferon beta-1b for mild to moderate disease. 20 Another randomized controlled open-label trial in 199 hospitalized patients with confirmed SARS-CoV-2 with severe COVID-19 was done to compare the clinical effectiveness of lopinavir-ritonavir to standard care alone. According to the level 1 evidence reviewed here, the most effective treatments against SARS-CoV-2, measured by time to negative RT-PCR and time to clinical improvement, are remdesivir therapy and a triple medication regimen (lopinavir-ritonavir, ribavirin, and interferon beta-1b). First, in patients with severe COVID-19, treatment with lopinavir-ritonavir showed no significant difference in time to clinical improvement, mortality at day 28, or detectable viral load compared to standard care alone.
cord-344136-k5gh0s6y	2020	RESULTS: In 41 studies with 10,335 COVID-19 patients, the serum creatinine (sCr) in severe cases was much higher than that in non-severe cases (SMD = 0.34, 95% CI: 0.29–0.39), with a similar trend for blood urea nitrogen (BUN) (SMD = 0.66, 95%CI: 0.51–0.81), hematuria (OR = 1.59, 95% CI: 1.15–2.19), and proteinuria (OR = 2.92, 95% CI: 1.58–5.38). Pooled analysis of four studies among 792 COVID-19 patients revealed that the incidence of AKI was statistically higher in non-survival group (30.72%) compared with survival group Our meta-analysis including 14094 subjects from 52 studies explored the potential relationship between renal impairment as well as AKI and the clinical outcome J o u r n a l P r e -p r o o f Journal Pre-proof (severity and mortality) of COVID-19 patients. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study
cord-344154-j5jjl0ok	2020	This study was a single-center, prospective, double-blinded, randomized-controlled, three-armed trial comparing magnesium, metoclopramide, and prochlorperazine for the treatment of migraine. 15 Secondary endpoints included change in pain score from baseline to 60 minutes and 120 minutes after initiation of infusion (as defined on a 11-point NRS), ED length of stay, and J o u r n a l P r e -p r o o f Journal Pre-proof necessity for rescue analgesia at any time following the study drug administration. No statistically significant differences in change in pain scores were found between all three treatment arms; however, a post hoc noninferiority analysis revealed that when compared to prochlorperazine and metoclopramide, IV magnesium was non-inferior ( figure 3) . The results of the MAGraine study demonstrated that IV magnesium sulfate, metoclopramide, and prochlorperazine were effective in decreasing pain scores for migraines at 30, 60, and 120 minutes, however one agent was not superior to the rest.
cord-345510-togrmvlk	2020	title: Rapid outdoor non-compression intubation (RONCI) of cardiac arrests to mitigate COVID-19 exposure to emergency department staff The COVID-19 pandemic has introduced numerous challenges for Health Care Professionals including exposing Emergency Department (ED) staff to the SARS-CoV-2 virus during Cardiopulmonary Resuscitation (CPR). We propose a novel technique for rapid outdoor non-compression intubation (RONCI) of cardiac arrest patients while en route from the ambulance bay to the resuscitation bay to further decrease the risk of viral aerosolization. 5 We present a case of an outdoor non-compression intubation of a patient in cardiac arrest to minimize COVID-19 exposure to staff while still providing standard Advanced Cardiac Life Support (ACLS). Non-compression intubation is suggested by ED resuscitation experts and the American Heart Association (AHA) to minimize COVID-19 exposure to staff. 5 The AHA recommends that the "provider…with the best chance of first-pass success" should perform the intubations in suspected COVID-19 infected patients in cardiac arrest.
cord-349355-k48s9sum	2020	Here we report a case of a 52 year old male who presented with a spontaneous pneumomediastinum in COVID-19 pneumonia, followed by a severe course of disease. Here we present a case of spontaneous pneumomediastinum in COVID-19 pneumonia, and discuss the possible mechanism underlying this association as well as clinical implications. Furthermore, a recent case series described three cases of COVID-19 pneumonia that were complicated by spontaneous pneumomediastinum and pneumothorax, all of which were followed by a severe course of disease with fatal outcome [13] . J o u r n a l P r e -p r o o f Therefore, further research is warranted to assess whether spontaneous pneumomediastinum is an indicator of disease severity in COVID-19 pneumonia. Spontaneous pneumomediastinum is a rare complication of COVID-19 pneumonia and was associated with a severe course of disease in our patient. Future studies are warranted to assess whether spontaneous pneumomediastinum is an indicator of disease severity in COVID-19 pneumonia.
cord-349561-4mkiwg9k	2020	BACKGROUND: Acute chloroquine and hydroxychloroquine toxicity is characterized by a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias and is associated with significant morbidity and mortality. Following the United States Food and Drug Administration emergency use authorization for chloroquine and hydroxychloroquine in the treatment of SARS-CoV-2, many additional clinical trials with randomization, blinding, and larger sample sizes were initiated to determine the benefit and risks. 59 While unlikely to occur in acute overdose, cardiomyopathy is described in case reports of patients presenting with chronic chloroquine and/or hydroxychloroquine toxicity. 59 While unlikely to occur in acute overdose, cardiomyopathy is described in case reports of patients presenting with chronic chloroquine and/or hydroxychloroquine toxicity. Although case report literature describes the finding in chloroquine and hydroxychloroquine use, the largest chart review to date examining these drugs in patients with G6PD noted no occurrence of hemolysis.
cord-349909-hmyv1nep	2020	BACKGROUND: We sought to examine racial and ethnic disparities in test positivity rate and mortality among emergency department (ED) patients tested for COVID-19 within an integrated public health system in Northern California. Results from ED-based testing can identify racial and ethnic disparities in COVID-19 testing, test positivity rates, and mortality associated with COVID-19 infection and can be used by health departments to inform policy. We pre-specified the regression model to contain COVID-19 positivity as the dependent variable, with the following predictor variables: race and ethnicity; age; medical co-morbidities (that may influence disease severity); documented epidemiologic concern (defined as healthcare worker or living with elderly family members); skilled nursing facility residence; whether or not a patient had a PCP (to control for access to medical care); and which AHS ED conducted the test to control for geographic and hospital site clustering.
cord-350045-85jug39x	2020	Due to the current situation of the COVID-19 pandemic, we can predict how the morbidity of health care workers will develop based on data on other viruses from the coronavirus group. In global research on SARS-CoV-1, MERS-CoV and SARS-CoV-2, it can be seen that a very large percentage of the number of infected people are health professionals struggling with them in various medical facilities. In the Netherlands a survey was conducted from 6-8 March 2020 on 1097 health care workers, among whom the percentage of infected was 4.1%. 4 Currently, the total number of infected healthcare workers on SARS-CoV-2 is unknown due to the steadily increasing number of infections and the lack of global data on the problem. The data on SARS-CoV-1 and MERS-CoV can predict how much health care workers may be infected despite the lack of up-to-date data on SARS-CoV-2. Risks to healthcare workers with emerging diseases: lessons from MERS-CoV, Ebola, SARS, and avian flu
cord-350473-f47i7y5h	2020	The sensitivity of PCR tests have been estimated at 71%, resulting in ~30% of infected patients having a negative finding. The second type of test is serologic, which detects immunoglobulins (IgG and IgM) specific for SARS-CoV-2 and provides an estimation of population virus exposure 4 . Many FDA-approved serologic tests have high sensitivity and specificity. To address the development of a reliable test, the Department of Health & Human Services (HHS) provided funding for the development of Simplexa COVID-19 Direct Assay and to QIAGEN to accelerate development of their RPS2 test 15 . Additionally, HHS is purchasing the ID NOW COVID-19 rapid point-of-care test (Abbott Diagnostics Scarborough Inc.) for public health labs (Table 1) 16 . Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients than nasopharyngeal swabs
cord-352656-hpuhjbki	2020	The following operational metrics were collected: median daily visits, COVID-19 specific J o u r n a l P r e -p r o o f visits, patients LWBS, door to diagnostic evaluation by a qualified medical professional ("doorto-doc" time), hospitalization rate, decision to admit to ED departure (boarding time), and median ED LOS. The evaluation of operational metrics revealed the very high-volume urban academic ED experienced the greatest improvements, with LWBS, ED LOS, boarding time, and door-to-doc time decreasing by 89.5%, 36.1%, 49.4% and 83.8% respectively (all p<0.001) ( Table 3) . The above data demonstrate a trend of decreased ED patient visits across a single health system during the initial stages of the COVID-19 pandemic, in conjunction with greater improvements in ED operational metrics observed at a large urban academic center compared to smaller community hospitals within the same health system.
cord-353698-gj8sx3zy	2020	title: Adapted Diving Mask (ADM) device as respiratory support with oxygen output during COVID-19 pandemic The most extended therapeutic approach for COVID-19 is based on two main strategies [10] [11] [12] [13] : pharmacological treatment directed toward several physiological targets (viremia, immunological reactions, prothrombotic reactions) and hemodynamic and respiratory support with positive end-expiratory pressure (PEEP) in addition to mechanical ventilation. A descriptive case series study of twenty-five patients with acute respiratory syndrome secondary to SARS-CoV2 infection was performed at a Spanish center, Hospital Universitario Infanta Leonor of Madrid, between March 30 and April 18, 2020. Table 4 shows the different variables used to analyze the improvement in the intervention and the mean value of all oxygen saturation measurements for all days that ADM therapy was used in those patients who prolonged its time of use.
cord-354468-bew35s8q	2020	title: Discharge in pandemic: Suspected Covid-19 patients returning to the Emergency Department within 72 hours for admission In this paper, we focus on ED disposition decision-making in New York City during the Covid-19 pandemic, by identifying patients suspected of Covid-19 who are discharged yet ultimately require hospital return and admission within 72 hours. Case subjects were identified as those patients suspected of Covid-19 and discharged from the ED but who returned to an ED within the system in 72 hours and required admission. This analysis of suspected Covid-19 patients aimed to describe key features of the initial ED visit that may ultimately influence the likelihood of ED return for admission within 72 hours of discharge. Prior to the emergence of Covid-19, several studies assessing return admission indicated associations with increasing age, disease severity, ambulance transport, gastrointestinal or infectious disease symptoms, and prolonged time in the ED.