cord-003360-mkv1jc7u	2018	title: The Effect of School Closure on Hand, Foot, and Mouth Disease Transmission in Singapore: A Modeling Approach Singapore implements a school closure policy for institutional hand, foot, and mouth disease (HFMD) outbreaks, but there is a lack of empirical evidence on the effect of closure on HFMD transmission. The effects of school closure due to 1) institutional outbreaks, 2) public holidays, and 3) school vacations were assessed using a Bayesian time series modeling approach. These policies provide data that enable us to obtain three sources of information on the effect of school closure: 1) the reduction in the numbers of cases after a public holiday, when childcare centers and schools close; 2) the reduction during school vacations; and 3) the impact within childcare centers of school closure in response to an ongoing outbreak. To measure the effect of school vacations on HFMD transmission, we built time series models, fit Bayesianly, for the weekly number of children with HFMD aged 12 years and younger.
cord-253459-tcn10pho	2020	4 A transgenic mouse model to study SARS-CoV-1 infection was developed that expresses the hACE2 gene under the control of the human cytokeratin 18 promoter. To investigate the potential of this transgenic mouse strain as a model for COVID-19 infection, five K18-hACE2 mice were intranasally inoculated with 8 × 10 4 Median Tissue Culture Infectious Dose (TCID50) of SARS-CoV-2, and five mice were mock-infected with sterile Dulbecco''s Modified Eagle''s Medium (DMEM). In the mouse model expressing hACE2 under the mouse ACE2 promoter, infected mice did not exhibit any clinical symptoms other than maximal weight loss on day 3 postinfection, and those mice recovered. 10 In contrast to these models, in which mice exhibited mild symptoms and recovered, only 60% of the mice survived past day 5 in the mouse strain expressing hACE2 under the lung ciliated epithelial cell HFH4 promoter.
cord-255062-7ozdmb09	2020	This article highlights the likely benefits of face mask containers in promoting safe, appropriate, and extended use of medical masks by healthcare workers in settings where a sustainable supply of medical masks may be limited. However, if medical masks are to be worn continuously by healthcare workers for up to 8 hours or more every working day, then there should be provision to temporarily and safely store them for extended use during the day, especially when they are not visibly soiled, wet, damp, or damaged. In the wake of global supply shortages, 7 appropriately designed face mask containers could be useful in promoting safe extended use of medical masks, especially in resourcelimited healthcare settings. With the growing call for universal masking as a key costeffective strategy to combat the COVID-19 pandemic, it is my view that the benefits of face mask containers in promoting appropriate use of masks and enabling extended and safe use far outweigh the risks.
cord-255940-chb4iuis	2020	We present two COVID-19 treatment center designs that leverage lessons learned from previous outbreaks of communicable infectious diseases and provide potential solutions when caseload exceeds existing capacity, with and without access to SARS-CoV-2 testing. These designs are intended for settings in which health facilities and testing resources for COVID-19 are surpassed during the pandemic, are adaptable to local conditions and constraints, and mitigate the likelihood of nosocomial transmission while offering an option to care for hospitalized patients. To respond to the immediate crisis facing health workers and patients, we propose a COVID-19 treatment center design ( Figure 1 ) that harnesses lessons learned from other outbreaks and adheres to infection prevention and control principles recommended by the WHO for the novel coronavirus. The design assumes that two thresholds have been reached: first, the health center no longer has space to individually isolate COVID-19 patients, and second, laboratory capacity is limited or surpassed, such that rapid, accurate testing for COVID-19 may not be available, as is the reality facing our colleagues in Haiti.
cord-256852-lrz17bdx	2015	15 The U.S. Institute of Medicine (IOM) has published a report "Countering the Problem of Falsified and Substandard Drugs." 16 The IOM recommendations to "stem the global trade" in such products are laudable in advising that the U.S. Food and Drug Administration (FDA), the National Institute of Standards and Technology, and other U.S. and international pharmaceutical and financing agencies be more actively involved in setting standards and financing improvements; yet this report falls far short of making a strong call for standardized, agreed-upon quality assessment technologies; an international law convention; and a more activist, internationally recognized lead organization, all three of which are essential for stopping the many health threats of fake drugs.
cord-257377-x5xijo8m	2020	Because of the pandemic of COVID-19, the federal government of Nigeria has instituted a mandatory policy requiring everyone going out in public to wear face masks. Inappropriate use and disposal of face masks in Nigeria could promote the spread of the novel coronavirus in the country and negate the country''s efforts to contain the COVID-19 pandemic. 11 The rising spate of misuse and abuse of face masks is a source of worry for the Nigerian COVID-19 Presidential Task Force, which observed "unhygienic and ill-advised use and sharing of masks, especially multiple fittings before buying from vendors." 13 It is noteworthy that medical masks meant for healthcare workers, such as surgical masks and respirators, are being routinely worn by the general public and government officials, when there are complaints that these masks are not available in sufficient quantities in Nigerian hospitals.
cord-260444-ooi5x9p3	2020	Coinfection of SARS-CoV-2/Mycobacterium tuberculosis (MTB) in patients with HIV/AIDS has not been previously reported. 6, 7 The coinfection of SARS-CoV-2 and Mycobacterium tuberculosis (MTB) in patients with HIV infection is a matter of concern and has not been well studied. Here, we present two cases of triple coinfections (HIV/SARS-CoV-2/MTB) in patients admitted to Sao José Hospital of Infectious Diseases, Fortaleza, Ceará, Brazil. To the best of our knowledge, this is the first reported case of coinfection of SARS-CoV-2/MTB in patients with HIV/AIDS. The present article reports two cases of COVID-19 in patients with HIV/MTB coinfections. Although the risk factors for COVID-19 still need to be fully understood, the two cases presented here may indicate that HIV/MTB coinfection could be another risk factor to be considered when evaluating SARS-CoV-2-infected patients. Herein, we studied only two cases of SARS-CoV-2 and MTB coinfection in HIV-infected patients.
cord-260871-dtn5t8ka	2020	Besides, several neurological manifestations had been described as complications of two other previous outbreaks of CoV diseases (SARS ad Middle East respiratory syndrome). Several neurological manifestations were described as complications of two other previous outbreaks of CoV diseases, namely, SARS and the Middle East respiratory syndrome (MERS). Stroke is one of the most frequent neurological diseases associated with SARS-CoV-2 infection, 8 and large-vessel stroke in younger patients was recently reported in five patients. Detection of SARS coronavirus RNA in the cerebrospinal fluid of a patient with severe acute respiratory syndrome Mechanisms of host defense following severe acute respiratory syndrome-coronavirus (SARS-CoV) pulmonary infection of mice Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2 Central nervous system involvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the central nervous system
cord-264140-5cxzc3z8	2018	Our results emphasize the need for improved infection prevention and control in military environments, given the high burden of illness and potential for intense transmission of respiratory pathogens. 2 Studies among military recruits have found high rates of illness and infection with respiratory viruses. 9, 10 Studies in military populations can provide valuable information regarding the epidemiology and transmission of respiratory infections in adults because of the availability of well-defined populations that can be followed up over time. 12, 13 We also tested acute samples (from both camps) and the routine enrolment and follow-up specimens (from one camp) using a multiplex real-time PCR assay comprising 33 bacterial, viral, and fungal targets (FTD33 kit; Fast Track Diagnostics, Esch-sur-Alzette, Luxembourg). A quarter of URI cases in our study were prescribed broad-spectrum antibiotics, of whom 50% were more likely to have infections caused by viral pathogens based on multiplex PCR results.
cord-270495-2u072mtp	2020	When SARS-CoV-2 is negative and clinical indication is present (at least fever and thrombocytopenia), DENV NS1 antigen and/or IgM/IgG antibody testing may be performed. Clinicians from Singapore reported two COVID-19 cases that were misdiagnosed as dengue among patients who presented with clinical manifestations and hematology profiles, suggesting dengue infection and false-positive DENV IgM antibody using a rapid diagnostic test (RDT). COVID-19 cases were defined as inpatients who met the COVID-19 criteria based on a predetermined combination of symptoms, laboratory testing, imaging, and risk exposure at Tangerang District Hospital, Indonesia (see Supplemental Table 1 ), and had a positive nasopharyngeal or oropharyngeal real-time RT-PCR for SARS-CoV-2. None of the 42 subjects was positive for dengue NS1 or showed seroconversion or increasing DENV IgM and IgG index values, suggesting no acute DENV infection among these COVID-19 cases. The third patient did not recall having a fever before acute COVID-19 illness, suggesting asymptomatic or mild dengue, the most common presentation of DENV infection.
cord-271906-2nm55024	2020	title: Case Report: Pneumothorax and Pneumomediastinum as Uncommon Complications of COVID-19 Pneumonia—Literature Review We performed a literature review of COVID-19 pneumonia cases that developed pneumothorax, pneumomediastinum, or both. 3, 4 Herein, we report two cases of patients infected with SARS-CoV-2, who developed pneumomediastinum, and one of them also presented pneumothorax. 14 Table 1 presents a summary of case reports of patients infected with SARS-CoV-2 who presented pneumothorax, pneumomediastinum, or both. In conclusion, pneumothorax and pneumomediastinum are possible complications of COVID-19 pneumonia, causing acute decompensation that can worsen the prognosis of patients, especially those with underlying lung diseases. Pneumomediastinum and spontaneous pneumothorax as an extrapulmonary complication of COVID-19 disease Spontaneous pneumothorax and subcutaneous emphysema in COVID-19 patient: case report Secondary tension pneumothorax in a COVID-19 pneumonia patient: a case report Spontaneous pneumomediastinum in a patient with coronavirus disease 2019 pneumonia and the possible underlying mechanism Spontaneous pneumomediastinum: a probable unusual complication of coronavirus disease 2019 (COVID-19) pneumonia
cord-275243-knr3mat0	2020	title: Detection of Pulmonary Embolism in Returning Travelers with Hypoxemic Pneumonia due to COVID-19 in Reunion Island All returning travelers to Reunion Island with hypoxemic pneumonia due to COVID-19 underwent computed tomography pulmonary angiography (CTPA) and were included in the cohort. 4 The aim of this study was to evaluate the occurrence of pulmonary embolism in returning travelers with hypoxemic pneumonia due to COVID-19. 4 The aim of this study was to evaluate the occurrence of pulmonary embolism in returning travelers with hypoxemic pneumonia due to COVID-19. To our knowledge, this is the only study that has consecutively evaluated the occurrence of pulmonary embolism in returning travelers with hypoxemic pneumonia due to COVID-19. Returning travelers with hypoxemic pneumonia due to COVID-19 should be systematically screened for pulmonary embolism or deep vein thrombosis regardless of the level of D-dimers.
cord-278283-uoy54dds	2015	To summarize the changing epidemiological characteristics of malaria in Zhejiang Province, China, we collected data on malaria from the Chinese Notifiable Disease Reporting System (NDRS) and analyzed them. Malaria incidence decreased in recent years in Zhejiang Province, but there were hundreds of imported malaria cases every year and epidemiological characteristics changed. Furthermore, the number of imported cases was relative to the frequency of travel and trade to malaria-endemic areas. In summary, the number of malaria cases decreased in recent years, and no indigenous cases were reported in Zhejiang Province from 2012 to 2014. These results informed that imported cases were the emphases for the control and prevention of malaria, and measures should be taken in all months in Zhejiang Province. Measures to better intercept imported cases should include health education and preventive medication among travelers to malaria-endemic areas, the screening of malaria among travelers with high fever, and collaborating with the neighboring countries.
cord-280164-dukccrjb	2020	With other African countries, the DRC faces the challenge of striking a balance between easing public health lockdown measures to curtail the spread of SARS-CoV-2 and minimizing both economic hardships for large sectors of the population and negative impacts on health services for other infectious and noninfectious diseases. Building on the DRC''s 40 years of experience with 10 previous EVD outbreaks, we highlight the DRC''s multi-sectoral public health approach to COVID-19, which includes community-based screening, testing, contact-tracing, risk communication, community engagement, and case management. [2] [3] [4] The Democratic Republic of the Congo (DRC) recently experienced its tenth Ebola virus disease (EVD) outbreak, the second largest globally after the 2014-2016 West African epidemic, which was recently brought under control. A multi-sectoral national committee to organize the COVID-19 response was created following the diagnosis of the first confirmed cases ( Figure 2 ) using lessons learned from the tenth EVD outbreak.
cord-285369-ktg2b9jb	2020	title: Frequency of Abnormalities Detected by Point-of-Care Lung Ultrasound in Symptomatic COVID-19 Patients: Systematic Review and Meta-Analysis Hence, we aimed to pool the proportion of various reported lung abnormalities detected by LUS in symptomatic COVID-19 patients. The finding from our review highlights the potential role of this modality in the triage, diagnosis, and follow-up of COVID-19 patients. We used a proportion meta-analysis to summarize or pool the frequency of various findings on lung US (based on our scoping review, we concluded that the sensitivity, specificity, and diagnostic accuracy could not be computed from the constituent studies). Forest plot presenting (A) the pooled proportion of B-pattern and (B) consolidation (the higher frequency of subpleural or pulmonary consolidations reported by the primary study) detected by lung ultrasound in symptomatic COVID-19 patients. 2020: Point-of-care lung ultrasound findings in patients with novel coronavirus disease (COVID-19) pneumonia
cord-285428-fcrunf38	2020	Efforts to develop vaccines against Coronavirus disease-19 (COVID-19) are well advanced, based in part on experience with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). 3 Convalescent SARS antibodies given early in illness have been shown to reduce disease severity. 7 Gamma globulin prepared from immune donors or protective monoclonal antibodies offer possibilities of short-term protection for care givers and healthcare workers and, in particular, for those at high risk of severe or fatal COVID-19. To avoid possible enhancement of COVID-19, antibodies might be given to prevent SARS-CoV-2 infections after the removal or inactivation of the IgG Fc terminus. Efforts are well underway by many groups to derive monoclonal antibodies or manufacture gamma globulin from the huge cohort of COVID-19 convalescent immunes. Immune responses in COVID-19 and potential vaccines: lessons learned from SARS and MERS epidemic Perspectives on monoclonal antibody therapy as potential therapeutic intervention for Coronavirus disease-19 (COVID-19)
cord-285486-99trkti1	2020	Univariate logistic regression analysis showed that HCQ treatment was not significantly associated with decreased mortality in COVID-19 patients. So, adding HCQ to standard care did not add significant benefit, did not decrease the need for ventilation, and did not reduce mortality rates in COVID-19 patients. 1. Hydroxychloroquine group: This group included 97 patients who received HCQ 400 mg twice daily (in day 1) followed by 200 mg tablets twice daily added to the standard of care treatment adopted by the Egyptian MOH for 15 days. 18 Although cardiac toxicity is a known adverse event requiring monitoring during treatment, HCQ showed promise in treating SARS-CoV-2-infected patients with multiple comorbidities including coronary artery disease. 12 studied the change in symptom severity over 14 days in nonhospitalized patients between HCQ and control groups and did not find any significant difference (P = 0.12).
cord-285490-tpsf05ca	2020	title: Case Report: Rhabdomyolysis in a Patient with COVID-19: A Proposed Diagnostic-Therapeutic Algorithm He developed acute kidney injury requiring renal replacement therapy without reversibility, despite optimal treatment. 2 We report the case of a patient with confirmed SARS-CoV-2 infection who presented with rhabdomyolysis as a cardinal manifestation, discuss the possible mechanisms, and propose a diagnostic-therapeutic algorithm. Laboratory tests revealed grade 3 acute kidney injury (AKI) with a creatinine level of 11 mg/dL (basal value 0.7 mg/dL); increased blood levels of creatine kinase (CK) (> 400,000 U/L), lactate dehydrogenase (LDH), aspartate aminotransferase, alanine aminotransferase; and electrolyte disturbances with hyperkalemia, hyperphosphatemia, hypocalcemia, and severe metabolic acidosis. The underlying cause of muscle injury must be identified and treated, which is difficult in patients with COVID-19 because there is no specific therapy. Kidney disease is associated with in-hospital death of patients with COVID-19 Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review
cord-286543-mtjk59rp	2020	This article also identifies three responsible issues for the country''s deteriorating health care: 1) poor governance and increased corruption, 2) inadequate healthcare facilities, and 3) weak public health communication. As one of the world''s most densely populated countries (1,115 people/km 2 ) with 21.8% of people living below the poverty line, 2 Bangladesh has a healthcare system that lacks reliability, responsiveness, and empathy, and that has already been proved inadequate to deliver proper health care to the public on many occasions. 3, 5 Amid such a situation, the COVID-19 pandemic reveals many loopholes in the healthcare system that can be summarized under three themes: 1) poor governance and increased corruption, 2) inadequate healthcare facilities, and 3) weak public health communication. 6 In such a situation, many private medicals around the country were either unwilling or abstained from treating COVID-19 patients, and thus healthcare denial intensified.
cord-287247-vv0zc0gd	2020	With many LMICs implementing movement restrictions or ordering their populations to stay at home to limit SARS-CoV-2 transmission, the threat to essential health services is likely to be immediate, causing delays to diagnosis and treatment for other diseases, including malaria and NTDs. During the Ebola epidemic in West Africa, there were substantial reductions in all-cause outpatient visits and patients treated with antimalarial drugs 2 ; modeling the potential for similar disruptions in malaria control due to COVID-19 suggests that there could be up to an estimated 769,000 deaths due to malaria in 2020 (approximately double the number seen in 2018), mostly among children younger than 5 years. 58 Thus, coinfection with parasitic NTDs could result in altered risks and severity of clinical manifestations of SARS-CoV-2 infection, with the potential for decreased development of immunity with increased viral loads.
cord-294624-d71za6hi	2020	authors: Kapepula, Paulin M.; Kabengele, Jimmy K.; Kingombe, Micheline; Van Bambeke, Françoise; Tulkens, Paul M.; Sadiki Kishabongo, Antoine; Decloedt, Eric; Zumla, Adam; Tiberi, Simon; Suleman, Fatima; Tshilolo, Léon; Muyembe-TamFum, Jean-Jacques; Zumla, Alimuddin; Nachega, Jean B. Derivatives from the herb Artemisia annua have been used as traditional medicine over centuries for the treatment of fevers, malaria, and respiratory tract infections. This highlights the urgent need for further research on herbal compounds to evaluate efficacy through controlled trials, and for efficacious compounds, to establish the active ingredients, develop formulations and dosing, and define pharmacokinetics, toxicology, and safety to enable drug development. 6, 7 Among many, derivatives from the herb Artemisia annua (Figure 1 ) have been used as traditional medicine over centuries for the treatment of fevers, malaria, and respiratory tract infections. Annua for COVID-19 following claims from politicians and others in low-income countries highlights the need for hard data to establish the active ingredients; develop formulations and dosing; define the pharmacokinetics, toxicology, and safety; and evaluate efficacy through controlled trials.
cord-296363-qgoxlqoq	2020	We believe that ethical and responsible behavior of mass media, a careful advisory from the Pakistan Electronic Media Regulatory Authority, stern measures from healthcare authorities, effective maneuvers to increase public awareness on COVID-19, vigorous analysis of information by data or communications scientists, and publication of counter opinions from health professionals against such theories will go a long way in neutralizing such misleading claims. Of these, alleged poor quality of vaccines, questioning of dosing recommendations, religious prohibitions ("infidel vaccine"), and rumors related to the presence of active virus in the vaccines are some leading claims obstructing the anti-polio campaign in the country. 1 Unfortunately, a conspiracy theory against COVID-19 vaccine is currently being spread in Pakistan. A similar approach was adopted by the country when the polio vaccine campaign was hindered by a conspiracy theory claiming that these vaccines were monkey-or pig-derived products, which are forbidden in Islam.
cord-296556-fr8x8j3i	2020	10 recently reported that ivermectin is a potent inhibitor of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in vitro. 13 However, even with this dose, which is 10-fold greater than those approved by the US Food and Drug Administration, the C max values reported were ∼250 ng/mL, 13 one order of magnitude lower than effective in vitro concentrations against SARS-CoV-2. Very recently, preliminary findings on a potential effect of hydroxychloroquine combined with azithromycin against SARS-CoV-2 were widely publicized, 15 leading to a surge in demand and self-medication, which resulted in serious harm in some cases and a stock shortage that jeopardized drug availability for other critical conditions for which hydroxychloroquine or chloroquine is the standard of care, that is, vivax malaria, rheumatoid arthritis, and systemic lupus erythematosus. 20, 21 Second, boosted antiretrovirals such as lopinavir/ritonavir and darunavir/cobicistat, which have been widely used against SARS-CoV-2 based on limited evidence, and a number of other drugs, are potent inhibitors of cytochrome P 450 3A4, the main metabolic pathway for ivermectin.
cord-305073-8301zqj9	2020	We report a case of COVID-19 pneumonia with bilateral spontaneous pneumothorax with no known underlying lung disease or risk factors. Most of the reported cases of pneumothorax associated with COVID-19 lack traditional risk factors or underlying predisposing lung disease. Highresolution computed tomography (CT) chest showed multiple bilateral bullae in the lungs complicated by the pneumothorax because of rupture ( Figure 1D ). The bullous changes could represent an undiagnosed underlying pulmonary disease, which became apparent after the inflammatory changes and excessive mechanical forces introduced by the SARS-CoV-2 infection, leading to a unilateral spontaneous pneumothorax, followed by bilateral pneumothorax. Review of the literature shows 18 case reports describing COVID-19 patients with spontaneous pneumothorax. Diagnosis and treatment of severe COVID-19 complicated with spontaneous pneumothorax: a case report Spontaneous pneumothorax and subcutaneous emphysema in COVID-19 patient: case report Spontaneous pneumomediastinum in a patient with coronavirus disease 2019 pneumonia and the possible underlying mechanism
cord-306149-sd0s0jup	2020	Case fatality in Thailand has been low (1.7%), at least in part due to early stratification according to risk of disease severity and timely initiation of supportive care with affordable measures. We present our initial experience with COVID-19 in Thailand, focusing on several aspects that may have played a crucial role in curtailment of the pandemic, and elements of care for severely ill COVID-19 patients, including stratification, isolation, and affordable diagnostic approaches and supportive care measures. We also have promising experience with the "Kigali modification of the Berlin definition for acute respiratory distress syndrome (ARDS)" in the early detection and management of COVID-19 patients. In Thailand, awaiting definitive results of randomized clinical trials, critically ill COVID-19 patients receive combination therapies with at least three different mechanisms of action, including favipiravir for 10 days, depending on clinical symptoms. Respiratory support in novel coronavirus disease (COVID-19) patients, with a focus on resource-limited settings
cord-308680-moligska	2020	We report findings from the epidemiological investigation of the initial 135 COVID-19 cases in Brunei and describe the impact of control measures and travel restrictions. Regular and ongoing testing of high-risk groups to supplement the existing surveillance program and a phased easing of physical distancing measures has helped maintain suppression of the COVID-19 outbreak in Brunei, as evidenced by the identification of only six additional cases from April 5 to August 5, 2020. Here, we report findings from the first 135 COVID-19 cases, detected within the first 5 weeks of the local epidemic, along with their epidemiological, clinical, and transmission characteristics. In Hong Kong, case isolation and contact tracing were combined with other physical distancing measures (but no lockdown), which resulted in an estimated effective reproduction number near 1 for 8 weeks.
cord-309900-4nln90jn	2017	In the context of this study, we measured the effects of a secondary school education module, named Viruskenner, on knowledge, attitude, and risk behavior as these relate to virus infections. A nonrandomized intervention study was conducted between April and August 2015 to assess the effect of this 2-month education module on knowledge, attitude, and behavior of 684 secondary school students in the Netherlands, Suriname, and Indonesia. When becoming an international education module, it was interesting to see the impact of Viruskenner in different countries on knowledge, attitudes, and behavior as they relate to virus infections, and find out which educational factors play a role in these changes. During the intervention, students could use the modules'' website (www.viruskenner.nl) and other supportive resources, like a YouTube channel and a Facebook page (all in Dutch and English and available for all participating countries), to find more information on the project and on virus infections and to disseminate information about their prevention tools.
cord-310868-rqmny4r2	2020	15 For the Global South, the pandemic exacerbates the existing proliferation of substandard and falsified medical products, and these trends are likely to continue as effective drugs continue to emerge from ongoing trials. The WHO defines substandard products as "authorized medical products that fail to meet quality standards or specifications, or both" and falsified products as "products that deliberately/ fraudulently misrepresent identity, composition, or source." 16 Considering less than 30% of regulatory agencies in the world can ensure the adequacy of medicines and vaccines, 17 pandemics of COVID-19 proportion would inevitably present enormous regulatory challenges. There is a risk that when the COVID-19 pandemic further spreads in LMICs, there will be an increased potential for the distribution of falsified and counterfeit medicines, something the international community needs to be alert to and work against. In meeting these needs, governments, pharmaceutical regulatory agencies, and associate supply chains must have practical and financially supported strategies to ensure quality-assured medicines are made available for the determined need.
cord-312841-g948h572	2020	Infection of such extrapulmonary organs may serve as a reservoir for SARS-CoV-2, representing a potential source of viral shedding after the cessation of respiratory symptoms in recovered patients or in asymptomatic individuals. Considering this possibility, this perspective is focused on extrapulmonary organs affected by SARS-CoV-2 and the implications of their involvement for disease transmission, clinical management strategies, and medical countermeasure discovery and development. 17 Liver, kidney, and heart abnormalities are also observed in COVID-19 patients, 18, 19 and although SARS-CoV-2 RNA is not reported in these tissues after autopsy, the detection of viral RNA in the liver of the hamster model 20 suggests the infection of these organs in patients. The identification of non-respiratory tissue reservoirs of SARS-CoV-2 suggests that further studies are needed to address implications for COVID-19 disease progression, effects on extrapulmonary tissues harboring the virus, and development of optimal medical countermeasures and disease management strategies.
cord-312861-6ayidmj3	2020	As the global COVID-19 pandemic continues, unabated and clinical trials demonstrate limited effective pharmaceutical interventions, there is a pressing need to accelerate treatment evaluations. As the global COVID-19 pandemic continues, unabated and clinical trials demonstrate limited effective pharmaceutical interventions, there is a pressing need to accelerate treatment evaluations. We describe a clinical evaluation strategy using adaptive combination platform trials to rapidly test combination therapies to treat COVID-19. We describe a clinical evaluation strategy using adaptive combination platform trials to rapidly test combination therapies to treat COVID-19. Instead of sequentially testing monotherapies that will likely have modest clinical effects on their own, additive or synergistic effects can potentially be gained by combining antiviral drugs exploiting pharmacology throughout the spectrum of COVID-19 illness. 5, 6 This low success rate might be due to the fact that the majority of COVID-19 clinical trials (87%) are evaluating repurposed drugs as monotherapy.
cord-314921-u74jut63	2020	The patient''s swab reverse transcriptase-polymerase chain reaction test for COVID-19 was confirmed positive at midnight, and by morning, the Ministry of Health had traced approximately 90 contacts from the healthcare sector and hotel and restaurant staff; based on their degree of exposure, the patient contacts were instructed to either home quarantine or present to a quarantine facility. As the COVID-19 pandemic continues to spread to new countries, some aspects pertaining to the patient''s presentation, interventions to provide patient care, and the country''s measures of containment in response to this first case in Bhutan may be of broad interest. 6 The patient''s presentation did not fall into the case definition for COVID-19 that Bhutan was using at that time, which was limited to fever and respiratory symptoms. The public health strategies initiated by Bhutan''s Ministry of Health and government are beyond the scope of this case report, but the immediate steps pertaining to the patient''s contacts and medical staff caring for the patient are of interest.
cord-315695-9sg7s1a1	2020	It cared for patients with Ebola virus disease from West Africa; received persons exposed to other high consequence pathogens; established and maintained the Nebraska Biocontainment Unit; with partners Emory University, Bellevue Hospital, and the CDC, led the National Ebola Training and Education Center (NETEC); launched the National Quarantine Unit funded by the Health and Human Services (HHS) Assistant Secretary of Preparedness and Response office; and established the Global Center for Health Security to coordinate its other national and international health emergency initiatives. The University of Nebraska Medical Center and its clinical partner Nebraska Medicine quickly established a prospective, observational cohort study for severe emerging infections during the 2020 COVID-19 emergency, while supporting national quarantine and isolation care activities and launching an NIAID randomized, controlled drug trial.
cord-316712-1ngcwdln	2020	The first reported case of infection with the SARS-CoV-2, the virus that causes COVID-19, in India was reported on January 30, 2020 in an Indian student evacuated from Wuhan, and the first death was reported on March 12, 2020. Model-based estimates 8 produced in March 2020 had indicated that a national lockdown could reduce the number of infections at the peak of the pandemic-expected in early May-by 70-80%, depending on the degree of public compliance with physical distancing. Mortality rates (based on reported cases and deaths) appear to be low in India, as they are in most countries in the region, perhaps indicative of both limited testing and other unexplained factors. 12 At the current time, India has conducted approximately 18,000 tests per million population, a rate that is a third that of South Africa, about 60% that of Nepal, and among the lowest of any large country.
cord-318994-1xngjndu	2020	We report a case of a COVID-19 patient who developed disseminated strongyloidiasis following treatment with high-dose corticosteroids and tocilizumab. Screening for Strongyloides infection should be pursued in individuals with COVID-19 who originate from endemic regions before initiating immunosuppressive therapy. This report describes the clinical features of a case of disseminated strongyloidiasis infection and polymicrobial bacteremia in an individual who received immunosuppressive treatment for COVID-19. 11 Given our patient''s epidemiologic risk factor and development of Gram-negative bacteremia, the clinical diagnosis of disseminated strongyloidiasis was further supported. The initial Strongyloides serology on hospital day 21 was negative, but the repeat was positive on day 38. 8 This case highlights important considerations when using immunosuppressive therapies for COVID-19 treatment, particularly in patients with risk factors for prior Strongyloides infection. Clinical suspicion for disseminated strongyloidiasis should be maintained in patients from endemic areas who develop Gram-negative sepsis or meningitis.
cord-321514-knyw023l	2017	The objectives were to evaluate the microbiological agents linked with hypoxemia in hospitalized children with pneumonia from developing countries, to identify predictors of hypoxemia, and to characterize factors associated with in-hospital mortality. The objectives of the present study are to assess the microbiological agents linked to hypoxemia in hospitalized children with pneumonia in developing countries, to identify clinical and para-clinical predictors of hypoxemia and to pinpoint factors associated with death within 2 weeks after admission. The present study selectively comprised sites with better quality data on oxygen saturation (SO 2 ) at admission, mortality among pneumonia cases, and documented recording of patient follow-up during hospitalization. One of the objectives of this study was to assess microbiological agents and other predictors of hypoxemia and death in under 5-year-old hospitalized children with pneumonia from developing countries.
cord-325498-4yciuh1n	2020	title: Incident SARS-CoV-2 Infection and a Shared Latrine Incident SARS-CoV-2 Infection and a Shared Latrine. In a recent serosurvey, we found that the use of open latrines (instead of flushing toilet systems) was significantly associated with seropositivity to SARS-CoV-2 on lateral flowbased antibody testing (BIOHIT Health Care Ltd., Cheshire, United Kingdom), suggesting a contributory role for fecal-oral transmission of the disease, as previously proposed by others. Here, we present a cluster of incident cases of SARS-CoV-2 involving a woman who lived alone (house A), and a five-member family (house B) who were seronegative during the first survey. Two weeks after our baseline serosurvey, a 22-year-old grandson of the old woman moved into Atahualpa from Guayaquil (a heavily infected urban center), staying at her house and using the shared latrine. There were no other incident cases in the entire block, where only one person in a distant house had tested positive at baseline, and several other inhabitants of other houses remained seronegative (Figure 2, left) .
cord-328661-spxgox52	2019	The lack of sufficient epidemiological data and evidence on the local mosquito-borne DENV emphasizes the importance of studying the molecular evolutionary features and establishing a well-established phylogenetic tree for dengue prevention and control in Guangdong. Since 1990, however, DENV1 has been mainly isolated from the infected cases, and its continued existence in Guangdong Province indicated that endemic infectious agents of dengue may be circulating locally. With the epidemiological data since 2005 supplied by the Guangdong Provincial CDC, we studied phylogenetics, molecular characteristics, and epidemiology to strengthen the foundational research of DENV1 for the prevention of large-scale dengue epidemics, providing preventive and control measures of DF with important evidence. Based on representative strains of the E gene in lineages of the 2014 outbreak, as well as the molecular evolution database, we analyzed molecular characterization and possibility of local circulation for DENV1 since 2005 in Guangdong.
cord-331109-a8e7r80d	2020	We report two cases of SARS-CoV-2 infection complicated by paralytic ileus. Several authors have postulated that the angiotensin-converting enzyme 2 receptors, the host receptors for COVID-19, that are present on enterocytes in both the small and large bowel might mediate viral entry and resultant inflammation. We describe two cases of severe COVID-19 pneumonia who developed paralytic ileus during their disease course, which may represent one of the luminal manifestations of severe SARS-CoV-2 infection. 7 A review of 29 studies noted that 12% of patients with SARS-CoV-2 infection had gastrointestinal symptoms, including diarrhea, nausea, and vomiting. In conclusion, we report paralytic small and large bowel ileus as a complication of COVID-19. The added value of the present case report is the detailed histopathological evidence supporting a role for COVID-19-induced micro-thrombosis, thereby compromising microcirculatory function and resultant colonic bowel dilatation and perforation in the first patient.
cord-340021-pj6fywwc	2020	Based on the results of Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression, age, and suggestive chest X-ray (CXR) findings for SARS-CoV-2 infection, cardiovascular diseases, diabetes mellitus, chronic lung diseases, and intensive care units admission had significant associations with positive RT-PCR results for COVID-19 infection. This study showed that some symptoms including cough and dyspnea, as well as abnormal CXR, could be proper predictors of positive RT-PCR result for SARS-CoV-2 infection. There was a significant association between variables, including age, abnormal CXR findings, cardiovascular diseases, diabetes mellitus, chronic lung diseases, and ICU admission, with confirmative RT-PCR results for SARS-CoV-2 infection. As it is shown ( Figure 1B) , age (IG = 13.7%), cardiovascular disease (IG = 2.4%), and ICU admission (IG = 2.2%) have the most important main effects, and they have interaction effects with abnormal CXR, elevated body temperature, myalgia, sore throat, diabetes mellitus, and malignancy for the prediction of death among positive RT-PCR patients.
cord-342790-70vn1nrm	2020	As leaders of the society, we are compelled to speak up for the integrity of science, and specifically for research funding and public health decisions based on merit, with policies rooted in data. The Department of Health and Human Services justified the cut with the claim that "the grantee was not in compliance with NIH''s grant policy," but the director of the NIH Institute that funded the study later stated in congressional testimony that "it was canceled because the NIH was told to cancel it." Clearly, the actual reason for cancellation was political, apparently based on an attempt to assign blame for the COVID-19 pandemic to China, and consistent with claims that the pandemic was the result of a laboratory accident or a deliberate attempt to initiate a viral outbreak in Wuhan.
cord-344503-gw5d721n	2020	We report fatal cases of novel coronavirus disease (COVID-19) in three brothers in Iran. We report fatal cases of novel coronavirus disease in three brothers in Iran. Considering the fact that most of them who are affected by COVID-19 recover, deaths in three brothers who lived separately and had no known underlying disease suggest genetic predisposition to COVID-19 in some individuals. Considering the fact that most of them who are affected by COVID-19 recover, deaths in three brothers who lived separately and had no known underlying disease suggest genetic predisposition to COVID-19 in some individuals. Novel coronavirus disease (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was identified in late 2019 in Wuhan, China. Although most critically ill COVID-19 patients are either elderly or have underlying medical problems such as cardiovascular disease, hypertension, diabetes mellitus, or cancer, some previously healthy and even relatively young individuals have died from COVID-19.
cord-345067-kummh0g7	2020	title: Mobile Health Technology for Enhancing the COVID-19 Response in Africa: A Potential Game Changer? Mobile Health Technology for Enhancing the COVID-19 Response in Africa: A Potential Game Changer? 3 However, as lockdowns and social distancing measures are currently being lifted in stages by most African countries, governments will need to ensure that public health infrastructure and needed resources are put in place for community surveillance to identify cases and clusters of new infections through active case finding, large-scale testing, and contact tracing. 7 Mobile phone technology (mHealth) platforms are effective in improving service delivery and outcomes for many health conditions in Africa and globally, including HIV infection, tuberculosis, and chronic noncommunicable diseases. 7, 8 With the support of global mobile technology companies and small and medium enterprises within Africa, mHealth offers opportunities ranging from text messaging to mobile apps to mitigate the spread of COVID-19. COVID-19 AND MOBILE HEALTH TECHNOLOGY IN AFRICA
cord-345554-x9q6pqgw	2020	As the SARS-CoV-2 outbreak rapidly spread to pandemic proportions, the global tuberculosis (TB) and HIV care communities voiced increasing concerns. Although an estimated 58 million lives were saved through TB diagnosis and treatment between 2000 and 2018, 1 the current SARS-CoV-2 pandemic threatens to reverse these gains by overwhelming the healthcare system, disrupting patient access to care, and spurring reallocation of resources from TB and HIV services. In this issue of the AJTMH, two articles describe four patients with triple infection with drug-sensitive Mycobacterium tuberculosis, HIV, and SARS-CoV-2. Although comorbidities associated with HIV and TB may primarily drive COVID-19 disease severity in these populations, the disruption to health systems caused by the COVID-19 pandemic is likely to have a greater impact on the lives of people with HIV infection and TB than is coinfection with COVID-19.
cord-348192-ibohbjfb	2020	
cord-355850-jgcjscjq	2020	title: Assessment of Healthcare Workers'' Levels of Preparedness and Awareness Regarding COVID-19 Infection in Low-Resource Settings Less than 7% of participants received training on how to manage COVID-19 cases, whereas 20.6% of doctors and 26.3% of nurses felt that they were personally prepared for the outbreak. The questionnaire evaluates information sources, training experience with COVID-19, diagnosis and management of COVID-19 patients, use of PPE, safety precautions, isolation procedures, measures to prevent infection, and reporting procedures. In conclusion, our study has illuminated the current level of knowledge and awareness of COVID-19 among doctors and nurses, with special consideration for those working in departments responsible for caring for COVID-19 patients. The respondents had a lower level of preparedness, which highlights the importance of education and training programs for healthcare workers, to control and prevent infection from COVID-19.