# pos

id: cord-301157-tu3iig9o
pos: NNP
token:
  https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/national-andregional-populations/regional-ethnic-diversity/latest#ethnic-groups-by-area

lemma:
  https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/national-andregional-populations/regional-ethnic-diversity/latest#ethnic-groups-by-area


# ent

id: cord-273567-8fp3a9h8
type: GGP
entity:
  Parkinson s disease A recent study using telephone interviews of 100 people with Parkinson s disease


id: cord-273567-8fp3a9h8
type: GGP
entity:
  Parkinson s disease younger and older reported having actively sought information question 6 In comparison to the controls more patients with Parkinson s disease


id: cord-273567-8fp3a9h8
type: GGP
entity:
  Parkinson s disease The NMSQuest study Validation of the non motor symptoms questionnaire NMS Quest Comparison of anonymous versus nonanonymous responses to a medication adherence questionnaire in patients with Parkinson s disease Clusters of non adherences to medication in neurological patients Data on adherence to medication in neurological patients using the German Stendal


id: cord-283407-3zb6ufum
type: GGP
entity:
  SC i e 35 4 vs 20 7 with comparable overall procedure time and without major adverse events 68 Moreover in the same multicentre randomized study proposed by Rex et


id: cord-336810-77wq9laa
type: WORK_OF_ART
entity:
  Complex Immunometabolic Profiling Reveals the Activation of Cellular Immunity and Biliary Lesions in Patients with Severe COVID 19 date 2020


id: cord-280111-6hiuzkvz
type: ORG
entity:
  Available Technologies Applications and Benefits of Teleorthodontics A Literature Review and Possible Applications


id: cord-254148-wc762p6v
type: CELL_LINE
entity:
  AbbVie GmbH UCB Pharma GmbH Desitin GmbH Bial Deutschland GmbH Zambon Deutschland GmbH Fagron GmbH Co KG Grünenthal GmbH


id: cord-254148-wc762p6v
type: GGP
entity:
  Parkinson s disease A multicountry Delphi panel approach Collective physician perspectives on nonoral medication approaches


id: cord-254148-wc762p6v
type: GGP
entity:
  Parkinson s disease A randomized controlled trial Dysphagia in Parkinson s Disease A Guideline for Parkinson s Disease Nurse Specialists with Recommendations for Clinical Practice The cost effectiveness of specialized nursing interventions


id: cord-254148-wc762p6v
type: GGP
entity:
  Parkinson s disease The NICE PD study protocol for a randomized controlled clinical trial Specialist palliative care for Parkinson s disease Palliative care for Parkinson s


id: cord-254148-wc762p6v
type: GGP
entity:
  Parkinson s disease An integrative review Patientenperspektive auf die Versorgungssituation im Krankheitsbild Morbus Parkinson


id: cord-254148-wc762p6v
type: GGP
entity:
  Parkinson s disease on health outcome and costs Randomized controlled trial This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution Acknowledgments Travel costs for experts meeting by DPG Tino


id: cord-252902-qtfx49qp
type: EVENT
entity:
  the Preconception Period for Women with Overweight or Obesity A Qualitative Study Using the Information Motivation Behavioural


id: cord-252902-qtfx49qp
type: ORG
entity:
  A Review of the Impact of Maternal Obesity on the Cognitive Function and Mental Health of the Offspring Managing


id: cord-273351-vq3budip
type: CELL_LINE
entity:
  Coronavirus Disease 2019 COVID 19 A Systematic Echocardiographic Study Characterization of the Inflammatory Response to Severe COVID 19 Illness Immune Inflammatory Parameters


id: cord-273351-vq3budip
type: WORK_OF_ART
entity:
  2019 COVID 19 A Systematic Echocardiographic Study Characterization of the Inflammatory Response to Severe COVID 19 Illness Immune Inflammatory Parameters


id: cord-284301-fg3hk94b
type: ORG
entity:
  the Scientific and Standardization Committee on Perioperative and Critical Care of the International Society on Thrombosis


id: cord-284301-fg3hk94b
type: ORG
entity:
  Scientific and Standardization Committee Communications Towards a Definition Clinical and Laboratory Criteria


id: cord-284301-fg3hk94b
type: ORG
entity:
  Antiphospholipid Antibodies in Patients with Covid 19 COVID 19 Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure Clinical Research in Intensive Care and Sepsis Trial Group for Global Evaluation and Research


id: cord-294910-gnc04ax1
type: WORK_OF_ART
entity:
  A Trial of Lopinavir Ritonavir in Adults Hospitalized with Severe Covid 19 Excess Mortality Estimation During the COVID 19 Pandemic Preliminary Data


id: cord-294910-gnc04ax1
type: ORG
entity:
  Infraestrutura Nacional de Computação Distribuída INCD National Infrastructure for Distributed Computation


id: cord-252687-7084pfqm
type: PROTEIN
entity:
  serum interleukin 6 IL6 52 Huang et al conducted a study in which patients with severe infections admitted to the intensive care unit


id: cord-013457-rqon1adg
type: ORG
entity:
  Impact of Exercise Rehabilitation on Exercise Capacity and Quality of Life in Heart Failure Individual Participant Meta Analysis Impact


id: cord-013457-rqon1adg
type: ORG
entity:
  the European Association of Preventive Cardiology Tracking Cardiac Rehabilitation Participation and Completion


id: cord-013457-rqon1adg
type: ORG
entity:
  Digital Biomarkers to Assess Response to Cardiac Rehabilitation Observational Study Six Minute Walk Test for Assessing Physical Functional Capacity in Chronic Heart Failure


id: cord-290135-ax5ck4qw
type: ORG
entity:
  The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism Parathyroid


id: cord-262996-zxn86z6k
type: ORG
entity:
  Injuries Associated With Standing Electric Scooter Use Craniofacial Injuries Seen With the Introduction of Bicycle Share Electric Scooters


id: cord-011965-n0re0u5u
type: ORG
entity:
  United Eur European Society of Clinical M Infectious D European Society of Clinical Microbiology and Infectious Diseases Update


id: cord-011965-n0re0u5u
type: WORK_OF_ART
entity:
  Treating Steroid Refractory Intestinal Acute Graft vs Host Disease With Fecal Microbiota Transplantation A Pilot Study Challenges


id: cord-011965-n0re0u5u
type: DISEASE
entity:
  gastrointestinal nervous system skin and gynecological diseases 3 In Western countries the first description of ancestral FMT


id: cord-315696-43wmazxa
type: WORK_OF_ART
entity:
  Hospitalized Patients with Kidney Disease Solid Organ Transplantation During the COVID 19 Pandemic Front Immunol


id: cord-315696-43wmazxa
type: EVENT
entity:
  the Times of COVID 19 A Literature Review Challenges in Abdominal Organ Transplantation During the COVID 19 Pandemic Front Early Outcomes of Outpatient Management of Kidney Transplant Recipients


id: cord-325307-agaau27o
type: WORK_OF_ART
entity:
  Petechial Skin Rash Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection Digitate Papulosquamous Eruption Associated With Severe Acute Respiratory Syndrome Coronavirus 2


id: cord-286298-pn9nwl64
type: CELL_LINE
entity:
  China USA Japan Australia and Taiwan revealed 99 97 100 identity with 100 query coverage also confirmed by our phylogenetic analysis Figure 2


id: cord-286298-pn9nwl64
type: WORK_OF_ART
entity:
  The COVID 19 Pandemic A Comprehensive Review of Taxonomy Genetics Epidemiology Diagnosis Treatment and Control date


id: cord-286298-pn9nwl64
type: CHEMICAL
entity:
  lopinavir ritonavir arbidol interferon alpha favipiravir chloroquine phosphate darunavir cobicistat oseltamivir


id: cord-264355-9quf59td
type: ORG
entity:
  Health Committee s Report on Unexplained Viral Pneumonia Novel Human Virus Pneumonia Cases Linked to Seafood Market


id: cord-333959-8ermzrmr
type: GGP
entity:
  Parkinson s disease Unsupervised virtual reality based exercise program improves hip muscle strength and balance control in older adults A


id: cord-320823-a1fq6mno
type: CELL_LINE
entity:
  China COVID 19 and Cardiovascular Disease Association of Cardiovascular Disease With Coronavirus Disease 2019 COVID 19 Severity A Meta


id: cord-332180-dw4h69tp
type: ORG
entity:
  Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease COVID 19 Abnormal


id: cord-332180-dw4h69tp
type: WORK_OF_ART
entity:
  a Marker of Organ Dysfunction in Sepsis Electrolyte Imbalances in Patients with Severe Coronavirus Disease


id: cord-318211-hhp84ygq
type: ORG
entity:
  the American College of Obstetricians and Gynecologist Task Force on Hypertension in Pregnancy Hypertension


id: cord-318211-hhp84ygq
type: DISEASE
entity:
  axial polydactyly hydrops fetalis interventricular septal defect tricuspidal insufficiency micrognathia trigonocephaly


id: cord-345728-41k1bljo
type: ORG
entity:
  Spinal Cord Injury Body Position Influences Which Neural Structures Are Recruited by Lumbar Transcutaneous Spinal Cord Stimulation Altering


id: cord-345728-41k1bljo
type: ORG
entity:
  Transcutaneous Spinal Cord Stimulation Induces Temporary Attenuation of Spasticity in Individuals with Spinal Cord Injury Priming Neural Circuits


id: cord-315188-a9pvugjt
type: GGP
entity:
  angiotensin II receptor blockers ARB p 0 006 calcium channel blockers CCB p 0 047 dipeptidyl peptidase 4 inhibitors DPP4i p 0


id: cord-325014-n7mnhk2v
type: WORK_OF_ART
entity:
  Laboratory Testing for Coronavirus Disease 2019 COVID 19 in Suspected Human Cases Survey Tool and Guidance Rapid Simple Flexible Behavioural Insights on COVID 19 Available


id: cord-306438-db2rqz4d
type: DNA
entity:
  human coronavirus OC43 HCoV OC43 human coronavirus HKU1 HCoV HKU1 SARS CoV human coronavirus 229E HCoV 229E human coronavirus NL63 HCoV NL63 and human coronavirus NL63 HCoV NL63 1 2 3 4 5 6 Coronaviruses CoVs


id: cord-310304-f28tjmi8
type: FAC
entity:
  the Gene Source of Gammacoronavirus and Deltacoronavirus Committee on Taxonomy of Viruses Virus Taxonomy Outbreak


id: cord-310304-f28tjmi8
type: WORK_OF_ART
entity:
  Alarmingly High Rate Virus Hits Blacks People with Hypertension New York State Department of Health COVID


id: cord-310304-f28tjmi8
type: ORG
entity:
  World Health Organization Chronic Obstructive Pulmonary Disease Fact Sheet World Health Organization Commission on Social Determinants of Health Final Report Closing the Gap in a Generation Health Equity Through Action


id: cord-333520-v2sb90rc
type: PROTEIN
entity:
  hepatocyte growth factor HGF leukemia inhibitory factor LIF fibroblast growth factor FGF vascular endothelial growth factor VEGF epidermal growth factor EGF


id: cord-333520-v2sb90rc
type: GGP
entity:
  angiotensin 1 7 AT1R ang II type 1 receptor ACEIs angiotensin converting enzyme inhibitors ARBs angiotensin receptor blockers


id: cord-333520-v2sb90rc
type: GGP
entity:
  ang I angiotensin I ang II angiotensin II ang 1 7 angiotensin 1 7 AT1R ang II type 1 receptor ACEIs angiotensin converting enzyme inhibitors ARBs angiotensin receptor blockers


id: cord-333520-v2sb90rc
type: GGP
entity:
  LIF fibroblast growth factor FGF vascular endothelial growth factor VEGF epidermal growth factor EGF


id: cord-333520-v2sb90rc
type: WORK_OF_ART
entity:
  Akt Modified Human Umbilical Cord Mesenchymal Stem Cells Improve Cardiac Regeneration and Promote Angiogenesis


id: cord-333520-v2sb90rc
type: WORK_OF_ART
entity:
  Activating Platelet Derived Growth Factor D Stem Cells Transl Extracellular Vesicles From Notch Activated Cardiac Mesenchymal Stem Cells Promote Myocyte Proliferation and


id: cord-333520-v2sb90rc
type: WORK_OF_ART
entity:
  Mesenchymal Stem Cell Derived Exosomes Improve the Microenvironment of Infarcted Myocardium Contributing to Angiogenesis and Anti Inflammation


id: cord-301157-tu3iig9o
type: GGP
entity:
  inotropes p 0 03 and composite parameters for cardiac injury were more common Composite parameters as declared Troponin Troponin T BNP


id: cord-301157-tu3iig9o
type: GGP
entity:
  inotropes p 0 03 and composite parameters for cardiac injury were more common in those who were seropositive 14 14 SARS CoV 2


id: cord-301157-tu3iig9o
type: WORK_OF_ART
entity:
  Presentation Treatment Response and Short Term Outcomes in Paediatric Multisystem Inflammatory Syndrome


id: cord-301157-tu3iig9o
type: ORG
entity:
  A European League Against Rheumatism American College of Rheumatology Paediatric Rheumatology International Trials Organisation Collaborative Initiative Development


id: cord-301157-tu3iig9o
type: ORG
entity:
  Seize SARS CoV 2 for Its Preferential Involvement of Posterior Circulation Manifesting as Severe Posterior Reversible Encephalopathy Syndrome


id: cord-292341-uo54ghf3
type: ORG
entity:
  the University Hospital of Padova Division of Infectious and Tropical Diseases Respiratory Disease Unit


id: cord-320882-cr0ccsnp
type: ORG
entity:
  the Review of the Health Effects of Electronic Nicotine Delivery Systems Public Health Consequences of E Cigarettes


id: cord-290286-3t0roikx
type: ORG
entity:
  Racial and Ethnic Disparities in Employment Outcomes for Persons With Traumatic Brain Injury A Longitudinal Investigation


id: cord-290286-3t0roikx
type: ORG
entity:
  Working Age Individuals After Moderate to Severe Traumatic Brain Injury A National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems Study Occupational Categories


id: cord-327610-cm3vkpcn
type: ORG
entity:
  Mechanisms and Management of Asthma Exacerbations Precision Medicine and Phenotypes Endotypes Genotypes Regiotypes


id: cord-327610-cm3vkpcn
type: ORG
entity:
  New Molecular Targets for the Treatment of Neutrophilic Diseases Models of Respiratory Infections Virus Induced Asthma Exacerbations


id: cord-327610-cm3vkpcn
type: WORK_OF_ART
entity:
  The Innate Cytokines Il 25 IL 33 and TSLP Cooperate in the Induction of Type 2 Innate Lymphoid Cell Exansion and Mucous Metaplasia


id: cord-327610-cm3vkpcn
type: WORK_OF_ART
entity:
  Inhibitory Effects of Resveratrol on Airway Remodeling by Transforming Growth Factor β Smad Signaling Pathway


id: cord-287102-o19uwryp
type: WORK_OF_ART
entity:
  the Treatment of Influenza Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome Bacterial Coinfection


id: cord-336257-f6yglaz8
type: ORG
entity:
  Somatization Obsessive Compulsive Interpersonal Sensitivity Depression Anxiety Anger Hostility Phobic Anxiety Paranoid Ideation Psychoticism and Sleep Disturbance A Global Severity


id: cord-336257-f6yglaz8
type: ORG
entity:
  Somatization Obsessive Compulsive Interpersonal Sensitivity Depression Anxiety Anger Hostility Phobic Anxiety Paranoid Ideation Psychoticism and Sleep Disturbance


id: cord-289034-yl3emjef
type: WORK_OF_ART
entity:
  A Case of Severe Hypermetabolism Of Nonthyroid Origin With A Defect In The Maintenance of Mitochondrial Respiratory Control A Correlated Clinical Biochemical and Morphological Study Mitochondrial diseases Contribution


id: cord-289034-yl3emjef
type: WORK_OF_ART
entity:
  The Role of Mitochondria in Inflammation From Cancer to Neurodegenerative Disorders Mitochondrial Dysfunction in Aging and Cancer Melatonin Inhibits COVID 19


id: cord-289034-yl3emjef
type: DISEASE
entity:
  hereditary paragangliomas pheochromocytomas neuroblastomas gastrointestinal tumors renal cell cancers


id: cord-325559-di8lljoi
type: PROTEIN
entity:
  alanine aminotransferase aspartate aminotransferase creatinine creatine kinase lactate dehydrogenase cardiac troponin I N terminal probrain


id: cord-325559-di8lljoi
type: PROTEIN
entity:
  CCL2 chemokine C C motif ligand 2 MCP 1 monocyte chemoattractant protein 1 CXCL10 C X C motif chemokine 10 IP


id: cord-325559-di8lljoi
type: PROTEIN
entity:
  protein 10 CCL3 chemokine C C motif ligand 3 MIP 1A macrophage inflammatory protein 1 alpha GSCF granulocyte colony stimulating factor TNFα tumor necrosis factor alpha CXCL1 C X C motif chemokine 1 CXCL5 C X C motif chemokine 5


id: cord-325559-di8lljoi
type: PROTEIN
entity:
  myohemoglobin cardiac troponin I and N terminal probrain natriuretic peptide 23 Liver Gastrointestinal tract SARS CoV 2 RNA


id: cord-325559-di8lljoi
type: GGP
entity:
  creatine kinase isoenzyme myocardial band CK MB myohemoglobin cardiac troponin I and N terminal probrain natriuretic peptide


id: cord-315634-fkm6slkc
type: ORG
entity:
  the Difficult Airway Society the Association of Anaesthetists the Intensive Care Society the Faculty of Intensive Care Medicine


id: cord-315634-fkm6slkc
type: DISEASE
entity:
  hypertension cardiopathy coronaropathy chronic renal failure chronic obstructive pulmonary disease diabetes mellitus obesity stroke


id: cord-315634-fkm6slkc
type: DISEASE
entity:
  hypertension cardiopathy coronaropathy chronic renal failure chronic obstructive pulmonary disease diabetes mellitus obesity


id: cord-309273-gtvi37gh
type: GGP
entity:
  Parkinson s disease Generalized expectancies for internal versus external control of reinforcement Personality in Adulthood Personality and sedentary behavior A systematic review and meta


id: cord-309273-gtvi37gh
type: LAW
entity:
  the COVID 19 Outbreak Testing a Moderated Mediation Model and Machine Learning Algorithms Psychological


# url

id: cord-301157-tu3iig9o
domain: www.ethnicity-facts-figures.service.gov.uk
url:
  http://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/national-andregional-populations/regional-ethnic-diversity/latest#ethnic-groups-by-area


# bib

id: cord-011426-jn29kica
author: Portero de la Cruz, Silvia
date: 2020-04-02
txt: ./txt/cord-011426-jn29kica.txt
cache: ./cache/cord-011426-jn29kica.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230883/
doi: 10.3390/jcm9041007
summary:
  title: A Multicenter Study into Burnout, Perceived Stress, Job Satisfaction, Coping Strategies, and General Health among Emergency Department Nursing Staff The aims of this study were to estimate burnout, perceived stress, job satisfaction, coping and general health levels experienced by nurses working in emergency departments in Spain and to analyze the relationships between sociodemographic, occupational, and psychological variables and the occurrence of burnout syndrome among these professionals. An ad hoc questionnaire was prepared to collect sociodemographic and work data, and the Maslach Burnout Inventory, the Perceived Stress Scale, the Font–Roja Questionnaire, the Brief Cope Orientation to Problem Experience and the General Health Questionnaire were used. Lack of physical exercise, gender, years worked at an emergency department, anxiety, social dysfunction, and avoidance coping were significant predictors of the dimensions of burnout. Work related stress, burnout, job satisfaction and general health of nurses: A follow-up study

title:
  A Multicenter Study into Burnout, Perceived Stress, Job Satisfaction, Coping Strategies, and General Health among Emergency Department Nursing Staff

abstract:
  Burnout is a major problem among nurses working in emergency departments and is closely related to a high turnover of personnel, nursing errors, and patient dissatisfaction. The aims of this study were to estimate burnout, perceived stress, job satisfaction, coping and general health levels experienced by nurses working in emergency departments in Spain and to analyze the relationships between sociodemographic, occupational, and psychological variables and the occurrence of burnout syndrome among these professionals. A cross-sectional study was conducted in four emergency departments in Andalusia (Spain) from March to December 2016. The study sample was composed of n = 171 nurses. An ad hoc questionnaire was prepared to collect sociodemographic and work data, and the Maslach Burnout Inventory, the Perceived Stress Scale, the Font–Roja Questionnaire, the Brief Cope Orientation to Problem Experience and the General Health Questionnaire were used. The prevalence of high burnout was 8.19%. The levels of perceived stress and job satisfaction were moderate. The most frequent clinical manifestations were social dysfunction and somatic symptoms, and problem-focused coping was the strategy most used by nurses. Lack of physical exercise, gender, years worked at an emergency department, anxiety, social dysfunction, and avoidance coping were significant predictors of the dimensions of burnout.


id: cord-011965-n0re0u5u
title: Fecal Microbiota Transplantation: Screening and Selection to Choose the Optimal Donor
author: Bibbò, Stefano
date: 2020-06-05
txt: ./txt/cord-011965-n0re0u5u.txt
cache: ./cache/cord-011965-n0re0u5u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356099/
doi: 10.3390/jcm9061757
summary:
  In this narrative review, we discuss most recent evidence on the screening and selection of the stool donor, with reference to recent studies that have identified specific microbiological features for clinical conditions such as Clostridioides difficile infection, irritable bowel syndrome, inflammatory bowel disease, and metabolic disorders. Therefore, in this narrative review, we report the most recent evidences on the screening and selection of the stool donor, with special efforts to describe findings that may lead to the optimal donor in several disease looking for an "optimal microbiota" to be transplanted (CDI, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and other emerging pathological conditions). Moreover, recent evidences showed that the efficacy of FMT in recurrent CDI treatment, in clinical trials and in other healthcare settings seems to be linked to different variables, such as the delivery methods of fecal infusate, the bowel preparation, the number of infusion, the disease severity, and in particular to the microbial diversity and composition of the transplanted stools [32, 44, 67] .

abstract:
  In the past decade, fecal microbiota transplantation (FMT) has rapidly spread worldwide in clinical practice as a highly effective treatment option against recurrent Clostridioides difficile infection. Moreover, new evidence also supports a role for FMT in other conditions, such as inflammatory bowel disease, functional gastrointestinal disorders, or metabolic disorders. Recently, some studies have identified specific microbial characteristics associated with clinical improvement after FMT, in different disorders, paving the way for a microbiota-based precision medicine approach. Moreover, donor screening has become increasingly more complex over years, along with standardization of FMT and the increasing number of stool banks. In this narrative review, we discuss most recent evidence on the screening and selection of the stool donor, with reference to recent studies that have identified specific microbiological features for clinical conditions such as Clostridioides difficile infection, irritable bowel syndrome, inflammatory bowel disease, and metabolic disorders.


id: cord-013457-rqon1adg
author: De Cannière, Hélène
date: 2020-09-29
txt: ./txt/cord-013457-rqon1adg.txt
cache: ./cache/cord-013457-rqon1adg.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601310/
doi: 10.3390/jcm9103160
summary:
  The goal of the study was to obtain a better understanding of the short-term progression of functional capacity throughout multidisciplinary CR, measured as the change in walking distance between baseline six-minute walking test (6MWT) and four consecutive follow-up tests. Although the majority of studies on home-and center-based CR programs report data on changes in exercise capacity measured at baseline and on completion of the intervention limited information is available on the short-term progression in exercise capacity throughout the CR [20] [21] [22] . A one-way repeated measures ANOVA was conducted to determine whether there were statistically significant differences in mean 6MWT distance (6MWD) over the period of a three-month rehabilitation program. Future studies should investigate whether similar progression patterns emerge in both center-based (including with larger patient groups) and in home-based CR programs and whether this short-term information on progression can be used to optimize outcomes by improving exercise capacity and motivation.

title:
  Short-Term Exercise Progression of Cardiovascular Patients throughout Cardiac Rehabilitation: An Observational Study

abstract:
  Cardiac rehabilitation (CR) is a highly recommended secondary prevention measure for patients with diagnosed cardiovascular disease. Unfortunately, participation rates are low due to enrollment and adherence issues. As such, new CR delivery strategies are of interest, as to improve overall CR delivery. The goal of the study was to obtain a better understanding of the short-term progression of functional capacity throughout multidisciplinary CR, measured as the change in walking distance between baseline six-minute walking test (6MWT) and four consecutive follow-up tests. One-hundred-and-twenty-nine patients diagnosed with cardiovascular disease participated in the study, of which 89 patients who completed the whole study protocol were included in the statistical analysis. A one-way repeated measures ANOVA was conducted to determine whether there was a significant change in mean 6MWT distance (6MWD) throughout CR. A three-way-mixed ANOVA was performed to determine the influence of categorical variables on the progression in 6MWD between groups. Significant differences in mean 6MWD between consecutive measurements were observed. Two subgroups were identified based on the change in distance between baseline and end-of-study. Patients who increased most showed a linear progression. In the other group progression leveled off halfway through rehabilitation. Moreover, the improvement during the initial phase of CR seemed to be indicative for overall progression. The current study adds to the understanding of the short-term progression in exercise capacity of patients diagnosed with cardiovascular disease throughout a CR program. The results are not only of interest for CR in general, but could be particularly relevant in the setting of home-based CR.


id: cord-252687-7084pfqm
title: Ischemic Stroke among the Symptoms Caused by the COVID-19 Infection
author: Szelenberger, Rafal
date: 2020-08-19
txt: ./txt/cord-252687-7084pfqm.txt
cache: ./cache/cord-252687-7084pfqm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32825182/
doi: 10.3390/jcm9092688
summary:
  Many clinical studies have shown an association between SARS-CoV-2 infection and hypercoagulability diagnosed on the basis of abnormal coagulation parameters, including activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer and C-reactive protein level. In this review, the potential mechanism and the effect of the SARS-CoV-2 viral infection on the development of ischemic stroke in COVID-19 patients were carefully studied. study, in which most non-survivor COVID-19 patients'' (71.4%) blood tests showed prolonged prothrombin time and an increased D-dimer levels, which indicated the state after activation of the plasma coagulation system [14] . The accumulation of immune cells in the vascular wall in response to the viral infection, especially among patients with ischemic risk factors, induces endothelial dysfunction, migration and proliferation of cells, activation of coagulation cascade and production of fibrous plaques.

abstract:
  The 2019 global pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been declared a public health emergency of international concern by the World Health Organization (WHO). The WHO recognized the spread of COVID-19 as a pandemic on 11 March 2020. Based on statistics from 10 August 2020, more than 20.2 million cases of COVID-19 have been reported resulting in more than 738,000 deaths. This completely new coronavirus has spread worldwide in a short period, causing economic crises and healthcare system failures worldwide. Initially, it was thought that the main health threat was associated with respiratory system failures, but since then, SARS-CoV-2 has been linked to a broad spectrum of symptoms indicating neurological manifestations, including ischemic stroke. Current knowledge about SARS-CoV-2 and its complications is very limited because of its rapidly evolving character. However, further research is undoubtedly necessary to understand the causes of neurological abnormalities, including acute cerebrovascular disease. The viral infection is inextricably associated with the activation of the immune system and the release of pro-inflammatory factors, that can stimulate the host organism to defend itself. However, the body’s immune response is a double-edged sword that on one hand, destroys the virus but also disrupts the homeostasis leading to serious complications, including thrombosis. Numerous studies have linked coagulopathies with COVID-19, however, there is great uncertainty regarding it functions on the molecular level. In this review, a detailed insight into the biological processes associated with ischemic stroke in COVID-19 patients and suggest a possible explanation for this phenomenon is provided.


id: cord-252902-qtfx49qp
author: Scott, Jodie
date: 2020-10-19
txt: ./txt/cord-252902-qtfx49qp.txt
cache: ./cache/cord-252902-qtfx49qp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33086583/
doi: 10.3390/jcm9103351
summary:
  A qualitative study focused on improving health in women of childbearing age identified that dietary knowledge, cooking skills and the time and cost of preparing healthy food were significant barriers to adopting a healthier diet [23] . This study aims to develop an understanding of preconception health awareness, potential barriers to adopting a healthier lifestyle, motivations, current behaviours and the practical skills required to change behaviour, for women with overweight or obesity. trying to conceive, or have already had children and trying to conceive again, you know, you''ve got another body to look after, like it''s not just you any more" (Sasha, Obese class II) Many women felt a sense of personal autonomy in choosing to improve their health-recognising that their lifestyle choices were modifiable and to have a healthy life, they had to take stock of their habits and change their mindset.

title:
  Creating Healthy Change in the Preconception Period for Women with Overweight or Obesity: A Qualitative Study Using the Information–Motivation–Behavioural Skills Model

abstract:
  Worldwide, half of women begin a pregnancy with overweight or obesity, which increases the risk of pregnancy and birth complications and adversely affects the lifelong health of the offspring. In order for metabolic changes to influence the gestational environment, research suggests that weight loss should take place before conception. This study aimed to understand women’s emotional and social contexts, knowledge, motivations, skills and self-efficacy in making healthy change. Semi-structured interviews conducted with twenty-three women with overweight or obesity, informed by the Information–Motivation–Behavioural Skills (IMB) model, were analysed using reflexive thematic analysis. Information-related themes identified included poor health risk knowledge, healthy food decisions and health versus convenience. The Motivation themes comprised taking responsibility, flexible options, social expectations, interpersonal challenges and accountability. Behavioural Skills entailed themes such as the mental battle, time management, self-care and inspiration. An environmental factor was identified in affordability—limiting access to healthier alternatives. Women wanted simple, flexible options that considered family commitments, time and budgetary constraints. Unprompted, several mentioned the importance of psychological support in managing setbacks, stress and maintaining motivation. Strategies for enhancing self-efficacy and motivational support are required to enable longstanding health behaviour change. Findings will inform intervention mapping development of an eHealth solution for women preconception.


id: cord-254148-wc762p6v
title: Recommendations for Standards of Network Care for Patients with Parkinson’s Disease in Germany
author: Prell, Tino
date: 2020-05-13
txt: ./txt/cord-254148-wc762p6v.txt
cache: ./cache/cord-254148-wc762p6v.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9051455
doi: 10.3390/jcm9051455
summary:
  title: Recommendations for Standards of Network Care for Patients with Parkinson''s Disease in Germany Thus, one recommendation for standard of care in the initial phase of the disease course is physician awareness of the first signs of PD (which could be achieved with better information and secondary prevention standards in the network) and early referral of patients to a movement disorder specialist (which could be achieved by specific disease management programmes). For these patients, at the border between inpatient and outpatient care and the need for sophisticated treatment strategies, the new comprehensive, individual, and interdisciplinary concept of a PD day clinic has proven to be effective [25] . In general, a neurologist should be responsible for long-term medical care of patients with PD, and movement disorder specialists should be involved when there is a special issue.

abstract:
  Although our understanding of Parkinson’s disease (PD) has improved and effective treatments are available, caring for people with PD remains a challenge. The large heterogeneity in terms of motor symptoms, nonmotor symptoms, and disease progression makes tailored individual therapy and individual timing of treatment necessary. On the other hand, only limited resources are available for a growing number of patients, and the high quality of treatment cannot be guaranteed across the board. At this point, networks can help to make better use of resources and improve care. The working group PD Networks and Integrated Care, part of the German Parkinson Society, is entrusted to convene clinicians, therapists, nurses, researchers, and patients to promote the development of PD networks. This article summarizes the work carried out by the working group PD Networks and Integrated Care in the development of standards of network care for patients with PD in Germany.


id: cord-262693-z9dolxky
author: Nishiura, Hiroshi
date: 2020-02-11
txt: ./txt/cord-262693-z9dolxky.txt
cache: ./cache/cord-262693-z9dolxky.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9020488
doi: 10.3390/jcm9020488
summary:
  title: Initial Cluster of Novel Coronavirus (2019-nCoV) Infections in Wuhan, China Is Consistent with Substantial Human-to-Human Transmission Reanalysis of the epidemic curve from the initial cluster of cases with novel coronavirus (2019-nCoV) in December 2019 indicates substantial human-to-human transmission. To support the hypothesis of zoonotic origin of 2019-nCoV stemming from the Huanan seafood market, the index case should have had exposure history related to the market and the virus should have been identified from animals sold at the market. The clinical summary of the earliest cases of 2019 novel coronavirus (2019-nCoV) infections in Wuhan, China was recently published [1] , showing the majority of cases were exposed to the Huanan seafood market, which also had wild animals, suggesting the possibility of zoonotic transmission in the market. Second, without identifying the virus in Second, assuming a constant SI of 8 days, the epidemic curve of cases by the date of illness onset can be transformed to that by generation of cases.

title:
  Initial Cluster of Novel Coronavirus (2019-nCoV) Infections in Wuhan, China Is Consistent with Substantial Human-to-Human Transmission

abstract:
  Reanalysis of the epidemic curve from the initial cluster of cases with novel coronavirus (2019-nCoV) in December 2019 indicates substantial human-to-human transmission. It is possible that the common exposure history at a seafood market in Wuhan originated from the human-to-human transmission events within the market, and the early, strong emphasis that market exposure indicated animal-to-human transmission was potentially the result of observer bias. To support the hypothesis of zoonotic origin of 2019-nCoV stemming from the Huanan seafood market, the index case should have had exposure history related to the market and the virus should have been identified from animals sold at the market. As these requirements remain unmet, zoonotic spillover at the market must not be overemphasized.


id: cord-262996-zxn86z6k
author: Störmann, Philipp
date: 2020-05-22
txt: ./txt/cord-262996-zxn86z6k.txt
cache: ./cache/cord-262996-zxn86z6k.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32455862/
doi: 10.3390/jcm9051569
summary:
  This retrospective two-center study included a total of 76 patients who presented to the emergency department following E-scooter-related accidents. Likewise, worldwide data on injury patterns related to the use of E-scooters are sparse, mainly due to the short time period since their introduction to the public. We hypothesize that E-scooter-related accidents result in typical high-energy injuries and that the rate of use of protective gear is low. The aim of this study was therefore to identify injury patterns following E-scooter accidents and to evaluate the need for in-hospital and surgical treatment associated with these specific injuries. All patients involved in an accident with an E-scooter who presented by ambulance or independently to the emergency department of one of the two hospitals were included in this prospective observational study. These significant injury patterns are not only due to the high speed and short reaction time associated with E-scooter use, as mentioned above, but also due to the very low rate of use of protective measures, such as helmets.

title:
  Characteristics and Injury Patterns in Electric-Scooter Related Accidents—A Prospective Two-Center Report from Germany

abstract:
  Since the introduction of rental E-scooters in Germany in mid-June 2019, the safety of this new means of transport has been the subject of extensive public debate. However, valid data on injuries and usage habits are not yet available. This retrospective two-center study included a total of 76 patients who presented to the emergency department following E-scooter-related accidents. The mean age was 34.3 ± 12.4 years and 69.7% of the patients were male. About half of the patients were admitted by ambulance (42.1%). Fractures were found in 48.6% of patients, and 27.6% required surgical treatment due to a fracture. The upper extremities were the most commonly affected body region, followed by injuries to the lower extremity and to the head and face. Only one patient had worn a helmet. In-hospital treatment was necessary for 26.3% of the cases. Patients presented to the emergency department mainly during the weekend and on-call times. This is the first report on E-scooter-related injuries in Germany. Accidents with E-scooters can cause serious injuries and, therefore, represent a further burden to emergency departments. The use of E-scooters appears to be mostly recreational, and the rate of use of protective gear is low.


id: cord-264355-9quf59td
author: Jung, Sung-mok
date: 2020-02-27
txt: ./txt/cord-264355-9quf59td.txt
cache: ./cache/cord-264355-9quf59td.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9030637
doi: 10.3390/jcm9030637
summary:
  Because the only information on 30 December 2019 was that cases had symptoms of atypical pneumonia, the distances between the ongoing outbreak and the eleven known pathogens were all zero; thus, all eleven candidate pathogens initially showed an identical probability of 8.3% (i.e., 1/12, when the possibility of Disease X is accounted for). Because the only information on 30 December 2019 was that cases had symptoms of atypical pneumonia, the distances between the ongoing outbreak and the eleven known pathogens were all zero; thus, all eleven candidate pathogens initially showed an identical probability of 8.3% (i.e., 1/12, when the possibility of Disease X is accounted for). Real-time estimation of the probability that the ongoing pneumonia outbreak is driven by each candidate pathogen, given available information on different days. Real-time estimation of the probability that the ongoing pneumonia outbreak is driven by each candidate pathogen, given available information on different days.

title:
  Epidemiological Identification of A Novel Pathogen in Real Time: Analysis of the Atypical Pneumonia Outbreak in Wuhan, China, 2019–2020

abstract:
  Virological tests have now shown conclusively that a novel coronavirus is causing the 2019–2020 atypical pneumonia outbreak in Wuhan, China. We demonstrate that non-virological descriptive characteristics could have determined that the outbreak is caused by a novel pathogen in advance of virological testing. Characteristics of the ongoing outbreak were collected in real time from two medical social media sites. These were compared against characteristics of eleven pathogens that have previously caused cases of atypical pneumonia. The probability that the current outbreak is due to “Disease X” (i.e., previously unknown etiology) as opposed to one of the known pathogens was inferred, and this estimate was updated as the outbreak continued. The probability (expressed as a percentage) that Disease X is driving the outbreak was assessed as over 29% on 31 December 2019, one week before virus identification. After some specific pathogens were ruled out by laboratory tests on 5 January 2020, the inferred probability of Disease X was over 49%. We showed quantitatively that the emerging outbreak of atypical pneumonia cases is consistent with causation by a novel pathogen. The proposed approach, which uses only routinely observed non-virological data, can aid ongoing risk assessments in advance of virological test results becoming available.


id: cord-264616-l8bv5t3o
author: Zhao, Shi
date: 2020-02-01
txt: ./txt/cord-264616-l8bv5t3o.txt
cache: ./cache/cord-264616-l8bv5t3o.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32024089/
doi: 10.3390/jcm9020388
summary:
  title: Estimating the Unreported Number of Novel Coronavirus (2019-nCoV) Cases in China in the First Half of January 2020: A Data-Driven Modelling Analysis of the Early Outbreak Background: In December 2019, an outbreak of respiratory illness caused by a novel coronavirus (2019-nCoV) emerged in Wuhan, China and has swiftly spread to other parts of China and a number of foreign countries. We used the serial intervals (SI) of infection caused by two other well-known coronaviruses (CoV), Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) CoVs, as approximations of the unknown SI for 2019-nCoV to estimate R(0). In this study, we estimated the number of unreported cases and the basic reproduction number, R 0 , of 2019-nCoV in Wuhan from 1 to 15 January 2020 based on the limited data in the early outbreak. Estimating the Potential Total Number of Novel Coronavirus (2019-nCoV) Cases in Wuhan City

title:
  Estimating the Unreported Number of Novel Coronavirus (2019-nCoV) Cases in China in the First Half of January 2020: A Data-Driven Modelling Analysis of the Early Outbreak

abstract:
  Background: In December 2019, an outbreak of respiratory illness caused by a novel coronavirus (2019-nCoV) emerged in Wuhan, China and has swiftly spread to other parts of China and a number of foreign countries. The 2019-nCoV cases might have been under-reported roughly from 1 to 15 January 2020, and thus we estimated the number of unreported cases and the basic reproduction number, R(0), of 2019-nCoV. Methods: We modelled the epidemic curve of 2019-nCoV cases, in mainland China from 1 December 2019 to 24 January 2020 through the exponential growth. The number of unreported cases was determined by the maximum likelihood estimation. We used the serial intervals (SI) of infection caused by two other well-known coronaviruses (CoV), Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) CoVs, as approximations of the unknown SI for 2019-nCoV to estimate R(0). Results: We confirmed that the initial growth phase followed an exponential growth pattern. The under-reporting was likely to have resulted in 469 (95% CI: 403–540) unreported cases from 1 to 15 January 2020. The reporting rate after 17 January 2020 was likely to have increased 21-fold (95% CI: 18–25) in comparison to the situation from 1 to 17 January 2020 on average. We estimated the R(0) of 2019-nCoV at 2.56 (95% CI: 2.49–2.63). Conclusion: The under-reporting was likely to have occurred during the first half of January 2020 and should be considered in future investigation.


id: cord-267933-rg1yus8g
author: Sbeit, Wisam
date: 2020-09-12
txt: ./txt/cord-267933-rg1yus8g.txt
cache: ./cache/cord-267933-rg1yus8g.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9092953
doi: 10.3390/jcm9092953
summary:
  Methods: a multi-center, retrospective case-control study conducted at two Israeli medical centers from January 2013 to December 2018 including all patients 18 years of age or older who underwent ERCP and biliary stent insertion for the treatment of acute cholangitis due to choledocholithiasis. Eighty-three patients who underwent urgent ERCP for acute cholangitis complicating choledocholithiasis with biliary stent insertion mostly without papillotomy or with papillotomy when stone extraction was attempted, had retained long-term biliary stents of more than 6 months from insertion (group A) vs. On the other hand, a recent retrospective study comparing the outcome in 3 groups of patients with choledocholithiasis unfit for definitive endoscopic stone removal or surgery using plastic biliary stenting (7 Fr, 7 cm), showed cholangitis rate of 2.9% and 8.6% in 6-and 12-month replacement groups, respectively, and 35.3% in the third group in whom stent replacement was carried out due to developing acute cholangitis with a median time for replacement of 16.3 months [20] .

title:
  Long-Term Safety of Endoscopic Biliary Stents for Cholangitis Complicating Choledocholithiasis: A Multi-Center Study

abstract:
  Background: Treatment of cholangitis complicating choledocholithiasis includes biliary sphincterotomy and stone extraction. In certain cases of elderly comorbid patients with high risk for definitive endoscopic treatment, biliary stenting is the only measure for relieving biliary obstruction. Aim: We aimed to report the safety of retained biliary stone. Methods: a multi-center, retrospective case-control study conducted at two Israeli medical centers from January 2013 to December 2018 including all patients 18 years of age or older who underwent ERCP and biliary stent insertion for the treatment of acute cholangitis due to choledocholithiasis. Results: Three-hundred and eight patients were identified. Eighty-three patients had retained long-term biliary stents of more than 6 months (group A) from insertion compared to 225 patients whose biliary stents were removed within a 6-month period (group B). The mean follow-up in group A was 66.1± 16.3 vs. 11.1 ± 2.7 weeks in group B. Overall complications during the follow-up were similar between groups A and B (6% vs. 4.9%, OR 1.24, Chi square 0.69). Similarly, the rate of each complication alone was not different when comparing group A to group B (3.6%, 1.2% and 1.2% vs. 2.7%, 0.44% and 1.8%) for cholangitis, stent related pancreatitis and biliary colic, respectively (Chi square 0.85). Even after 12 months, the rates of overall complications and each complication alone were not higher compared to less than 12 months (Chi square 0.72 and 0.8, respectively). Conclusion: endoscopic biliary stenting for cholangitis complicating choledocholithiasis is safe for the long-term period without increase in stent related complications.


id: cord-273351-vq3budip
title: Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis
author: Farré, Núria
date: 2020-08-21
txt: ./txt/cord-273351-vq3budip.txt
cache: ./cache/cord-273351-vq3budip.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9092712
doi: 10.3390/jcm9092712
summary:
  A prolonged QTc was independently associated with a higher mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin. QTc prolongation was defined as an increase of at least one millisecond in QTc compared to baseline QTc. According to the protocol at our center at the time of the study, treatment with hydroxychloroquine and azithromycin was recommended to all patients. The variables included in the model were age, baseline QTc > 480 ms, chronic kidney disease, treatment with azithromycin and hydroxychloroquine, ischemic chronic disease, atrial fibrillation or flutter, heart failure, and the presence of any cardiovascular risk factor. Although these differences could be due to a more severe presentation in a group of elderly comorbid patients, SARS-CoV-2 infection could be the cause of this prolonged QTc interval, either as a direct effect of the virus or through systemic inflammation. A prolonged QTc was independently associated with a higher risk of mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin.

abstract:
  Background: The prognostic value of a prolonged QT interval in SARS-Cov2 infection is not well known. Objective: To determine whether the presence of a prolonged QT on admission is an independent factor for mortality in SARS-Cov2 hospitalized patients. Methods: Single-center cohort of 623 consecutive patients with positive polymerase-chain-reaction test (PCR) to SARS Cov2, recruited from 27 February to 7 April 2020. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval. A prolonged QT interval was defined as a corrected QT (QTc) interval >480 milliseconds. Patients were followed up with until 10 May 2020. Results: Sixty-one patients (9.8%) had prolonged QTc and only 3.2% had a baseline QTc > 500 milliseconds. Patients with prolonged QTc were older, had more comorbidities, and higher levels of immune-inflammatory markers. There were no episodes of ventricular tachycardia or ventricular fibrillation during hospitalization. All-cause death was higher in patients with prolonged QTc (41.0% vs. 8.7%, p < 0.001, multivariable HR 2.68 (1.58–4.55), p < 0.001). Conclusions: Almost 10% of patients with COVID-19 infection have a prolonged QTc interval on admission. A prolonged QTc was independently associated with a higher mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin. An electrocardiogram should be included on admission to identify high-risk SARS-CoV-2 patients.


id: cord-273567-8fp3a9h8
author: Zipprich, Hannah M.
date: 2020-05-29
txt: ./txt/cord-273567-8fp3a9h8.txt
cache: ./cache/cord-273567-8fp3a9h8.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32486074/
doi: 10.3390/jcm9061643
summary:
  Methods: Semi-structured telephone interviews were performed with 99 patients with Parkinson''s disease (PD) and 21 controls to explore knowledge, attitudes, practices, and burden in order to elucidate nonadherence to preventive measures. Since then, local and national governments have taken unprecedented measures in response to the outbreak of SARS-CoV-2-induced coronavirus disease in 2019 (COVID-19), including quarantining infected individuals and their family members, canceling public transportation, exit controls, travel restrictions, contact restrictions, curfews, school closures, and requiring people to wear mouth and nose masks [4, 5] . The semi-structured questionnaire consisted of 22 questions to assess the patient''s current situation and adherence to the ongoing regulations, with four of these questions examining the patient''s knowledge of preventive measures (questions 4, 5, 6, and 7), three capturing their attitude toward the virus (questions 8, 9, and 16) , and six exploring practices and behavioral changes regarding COVID-19 (questions 10, 11, 12, 13, 14, and 15 ).

title:
  Knowledge, Attitudes, Practices, and Burden During the COVID-19 Pandemic in People with Parkinson’s Disease in Germany

abstract:
  Background: Adherence to measures that have been adopted during the COVID-19 pandemic is crucial to control the spread of the coronavirus. Methods: Semi-structured telephone interviews were performed with 99 patients with Parkinson’s disease (PD) and 21 controls to explore knowledge, attitudes, practices, and burden in order to elucidate nonadherence to preventive measures. Results: The majority of patients understood the preventive measures and felt sufficiently informed. Analysis of qualitative answers, however, showed that about 30% of patients had an insufficient level of knowledge, which was not associated with educational level, cognitive disorders, or depression. Changes in behaviour were reported by 73 patients (99% performed at least one specific preventive behavior, and 86.9% have reduced social contacts and stayed home). A closer analysis of qualitative answers showed that 27.3% of patients continued to meet relatives face-to-face almost daily. Anxiety and worries about the current situation were reported by 58.6% of patients; 31.3% complained about a decrease in their mobility since the beginning of the restrictions, mainly because of worsening of PD and because regular therapies (e.g., physiotherapy) were canceled. Conclusions: About 30% of PD patients are nonadherent to preventive measures. Use of simple dichotomous questions overestimates adherence to preventive measures in patients with PD.


id: cord-274563-jimw6skv
title: COVID-19 Pandemic Outbreak and its Psychological Impact on Patients with Rare Lysosomal Diseases
author: Fiumara, Agata
date: 2020-08-22
txt: ./txt/cord-274563-jimw6skv.txt
cache: ./cache/cord-274563-jimw6skv.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9092716
doi: 10.3390/jcm9092716
summary:
  During the COVID-19 (Corona Virus Disease 2019) pandemic lockdown, patients with LSDs on enzyme replacement therapy (ERT) missed their scheduled access to the Day Hospital to get their treatment. Methods: Based on the feeling that our patients were experiencing profound distress, we designed a structured telephone interview with the aim to evaluate how, and to which extent, the pandemic outbreak was changing their behavior and feelings about their chronic disease, the impact on therapies, and future expectations. Moreover, a striking similarity emerged between the groups regarding forced home reclusion and the profound feeling to be excluded by normal life, well-known to those affected by a chronic rare disease. Based on the feeling that our patients were experiencing profound distress, we designed a structured interview [3, 4] with the aim to evaluate how, and to which extent, the COVID-19 pandemic was changing our patients'' behavior and feelings about their chronic disease, the impact on therapies, and their future expectations.

abstract:
  Background: Lysosomal storage disorders (LSDs) are rare, chronic, progressive multisystem diseases implying severe medical issues and psychological burden. Some of these disorders are susceptible to a treatment, which is administered weekly or every other week, in a hospital. During the COVID-19 (Corona Virus Disease 2019) pandemic lockdown, patients with LSDs on enzyme replacement therapy (ERT) missed their scheduled access to the Day Hospital to get their treatment. Methods: Based on the feeling that our patients were experiencing profound distress, we designed a structured telephone interview with the aim to evaluate how, and to which extent, the pandemic outbreak was changing their behavior and feelings about their chronic disease, the impact on therapies, and future expectations. The same interview was administered to an age-matched control group. Results: All interviewed people experienced an increase of anxiety, worries, and uncertainty fostered by incessant media updates. Moreover, a striking similarity emerged between the groups regarding forced home reclusion and the profound feeling to be excluded by normal life, well-known to those affected by a chronic rare disease. Conclusions: Although no statistically significant difference was found compared to controls, we felt that the reactions were qualitatively different, underlining the fragility and isolation of such patients.


id: cord-280111-6hiuzkvz
author: Maspero, Cinzia
date: 2020-06-17
txt: ./txt/cord-280111-6hiuzkvz.txt
cache: ./cache/cord-280111-6hiuzkvz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32560322/
doi: 10.3390/jcm9061891
summary:
  This literature review aims at reducing in-office appointments by providing an overview of the technologies available and their reliability in the long-distance monitoring of patients, i.e., teledentistry. As no reviews have yet been carried out on the efficacy of teleassistance in orthodontics as a way to manage patients at a distance, we would like to report on the evidence available as to the possibility of implementing new technologies in teleassistance, generally known by teleorthodontics to help during the COVID-19 pandemic to remotely monitor patients'' conditions. The attitudes toward teleassistance in orthodontics, and in general, dentistry by respective dental care professionals, was investigated in several studies which confirmed it was as an effective alternative to in-office visits for several routine procedures and to make consultations more accessible to dentists and patients [23, 38] .

title:
  Available Technologies, Applications and Benefits of Teleorthodontics. A Literature Review and Possible Applications during the COVID-19 Pandemic

abstract:
  Background: COVID-2019 spread rapidly throughout the world from China. This infection is highly contagiousness, has a high morbidity, and is capable of evolving into a potentially lethal form of interstitial pneumonia. Numerous countries shut-down various activities that were considered “not essential.” Dental treatment was in this category and, at the time of writing, only non-deferrable emergencies are still allowed in many countries. Therefore, follow-up visits of ongoing active therapies (e.g., orthodontic treatment) must be handled taking special precautions. This literature review aims at reducing in-office appointments by providing an overview of the technologies available and their reliability in the long-distance monitoring of patients, i.e., teledentistry. Methods: A literature review was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Randomized clinical trials, cross sectional, observational, and case-control studies were evaluated with the Mixed Methods Appraisal Tool for quality assessment and study limitations. Results: A primary search found 80 articles, 69/80 were excluded as non-relevant on the basis of: the abstract, title, study design, bias, and/or lack of relevance. Twelve articles were included in the qualitative analysis. Conclusions: Teleorthodontics can manage most emergencies, reassuring and following patients remotely. The aim set by dental teleassistance was met as it reduced patients’ office visits whilst maintaining regular monitoring, without compromising the results. Although our preliminary findings should be further investigated to objectively evaluate the efficacy, cost-effectiveness, and long-term results, we are confident that teleassistance in orthodontics will have a role to play in the near future.


id: cord-281039-a7q5nzwn
title: Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19
author: Rodilla, Enrique
date: 2020-09-28
txt: ./txt/cord-281039-a7q5nzwn.txt
cache: ./cache/cord-281039-a7q5nzwn.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32998337/
doi: 10.3390/jcm9103136
summary:
  Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). First, a previous diagnosis of HT increased the risk of all-cause death in COVID-19 patients who required hospitalization on the order of approximately 20% and independently of age and other cardiovascular comorbidities, such as HF and atrial fibrillation. Second, previous treatment with ACEIs/ARBs in hypertensive patients was not associated with a higher risk of all-cause mortality in hypertensive hospitalized COVID-19 patients compared to other antihypertensive drugs.

abstract:
  It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to specific mechanisms. Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors. The mean age of the study population was 67.5 ± 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization. ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.


id: cord-282384-qbcqbhk4
title: Peripapillary Retinal Vascular Involvement in Early Post-COVID-19 Patients
author: Savastano, Alfonso
date: 2020-09-08
txt: ./txt/cord-282384-qbcqbhk4.txt
cache: ./cache/cord-282384-qbcqbhk4.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9092895
doi: 10.3390/jcm9092895
summary:
  Furthermore, we performed an additional analysis within the post-COVID-19 group correlating the primary outcome measures with the other examined variables to detect potential risk factors for RPCP impairment in post SARS-CoV-2 patients. Spearman''s Test revealed a statistically significant linear correlation between RNFL average thickness and both RPCP perfusion density (p < 0.001) ( Figure 3 ) and RPCP flow index (p < 0.001) (Figure 4) within the post-COVID-19 group. Our study examined this aspect outlining the correlation of the RPCP perfusion density and RPCP flow index with the RNFL average thickness also in early post-COVID-19 patients. In this regard, it is interesting to notice that patients in the post-COVID-19 group showed a lower mean age, a lower prevalence of diabetes and systemic arterial hypertension, and a higher prevalence of females (typically affected by milder manifestations of the disease) compared to the reported SARS-CoV-2 epidemiologic data [38] .

abstract:
  The ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2′s) to cause multi-organ ischemia and coronavirus-induced posterior segment eye diseases in mammals gave concern about potential sight-threatening ischemia in post coronavirus disease 2019 patients. The radial peripapillary capillary plexus (RPCP) is a sensitive target due to the important role in the vascular supply of the peripapillary retinal nerve fiber layer (RNFL). Eighty patients one month after SARS-CoV-2 infection and 30 healthy patients were selected to undergo structural OCT (optical coherence tomography) and OCTA (optical coherence tomography angiography) exams. Primary outcome was a difference in RPCP perfusion density (RPCP-PD) and RPCP flow index (RPCP-FI). No significant difference was observed in age, sex, intraocular pressure (IOP) and prevalence of myopia. RPCP-PD was lower in post SARS-CoV-2 patients compared to controls. Within the post-COVID-19 group, patients with systemic arterial hypertension had lower RPCP-FI and age was inversely correlated to both RPCP-FI and RPCP-PD. Patients treated with lopinavir + ritonavir or antiplatelet therapy during admission had lower RPCP-FI and RPCP-PD. RNFL average thickness was linearly correlated to RPCP-FI and RPCP-PD within post-COVID-19 group. Future studies will be needed to address the hypothesis of a microvascular retinal impairment in individuals who recovered from SARS-CoV-2 infection.


id: cord-283407-3zb6ufum
title: Frontiers of Robotic Colonoscopy: A Comprehensive Review of Robotic Colonoscopes and Technologies
author: Ciuti, Gastone
date: 2020-05-31
txt: ./txt/cord-283407-3zb6ufum.txt
cache: ./cache/cord-283407-3zb6ufum.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32486374/
doi: 10.3390/jcm9061648
summary:
  The Endotics System (ERA Endoscopy Srl, Pisa, Italy) is a CE mark pneumatically-driven robotic disposable colonoscope able to crawl through the colon by using two mucosal clamping devices, located at the proximal and distal ends of the probe, and a soft extension/retraction central mechanism, mimicking an inchworm-like locomotion ( Figure 3E ). Computer-assisted single-use colonoscope propelled, forward or backward, by an inverted-sleeve mechanism composed of eight drive wheels; robotically-driven tip with LEDs and a CMOS 114 • camera, electro-hydraulically flexed through a hand-held control unit to 180 • in any direction with full retroflection; diameter of 18 mm and working length of 2000 mm with standard functions including: (1) suction, (2) irrigation, and (3) insufflation with a 3.2 mm working channel, also used for conventional therapeutic procedures.

abstract:
  Flexible colonoscopy remains the prime mean of screening for colorectal cancer (CRC) and the gold standard of all population-based screening pathways around the world. Almost 60% of CRC deaths could be prevented with screening. However, colonoscopy attendance rates are affected by discomfort, fear of pain and embarrassment or loss of control during the procedure. Moreover, the emergence and global thread of new communicable diseases might seriously affect the functioning of contemporary centres performing gastrointestinal endoscopy. Innovative solutions are needed: artificial intelligence (AI) and physical robotics will drastically contribute for the future of the healthcare services. The translation of robotic technologies from traditional surgery to minimally invasive endoscopic interventions is an emerging field, mainly challenged by the tough requirements for miniaturization. Pioneering approaches for robotic colonoscopy have been reported in the nineties, with the appearance of inchworm-like devices. Since then, robotic colonoscopes with assistive functionalities have become commercially available. Research prototypes promise enhanced accessibility and flexibility for future therapeutic interventions, even via autonomous or robotic-assisted agents, such as robotic capsules. Furthermore, the pairing of such endoscopic systems with AI-enabled image analysis and recognition methods promises enhanced diagnostic yield. By assembling a multidisciplinary team of engineers and endoscopists, the paper aims to provide a contemporary and highly-pictorial critical review for robotic colonoscopes, hence providing clinicians and researchers with a glimpse of the major changes and challenges that lie ahead.


id: cord-284301-fg3hk94b
author: Umemura, Yutaka
date: 2020-09-05
txt: ./txt/cord-284301-fg3hk94b.txt
cache: ./cache/cord-284301-fg3hk94b.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32899532/
doi: 10.3390/jcm9092875
summary:
  Methods: To elucidate the specific pattern of coagulopathy induced by COVID-19 pneumonia, this retrospective, observational study targeted consecutive adult patients with COVID-19-induced acute respiratory distress syndrome (ARDS) and compared hemostatic biomarkers with non-COVID-19-induced septic ARDS. The aim of this study was to reveal the specific pattern of coagulopathy induced by severe COVID-19 pneumonia by comparing the hemostatic parameters chronologically with those in patients with ARDS induced by non-COVID-19 pneumonia. We also performed multilevel mixed-effects regression analysis to evaluate the time series differences during the first seven days in other organ dysfunction parameters, including P/F ratio, serum creatinine level, serum bilirubin level, Glasgow Coma Scale, and SOFA subscore for the cardiovascular component between the COVID-19 and non-COVID-19 groups. Second, we enrolled patients with different pathophysiology (bacterial ARDS) as the control group for the study purpose of evaluating the specific phenotype of severe COVID-19-induced coagulopathy by comparing it to other types of sepsis.

title:
  Hematological Phenotype of COVID-19-Induced Coagulopathy: Far from Typical Sepsis-Induced Coagulopathy

abstract:
  Background: Blood coagulation disorders commonly occur with severe coronavirus disease 2019 (COVID-19). However, there is only limited evidence on differentiating the pattern of the hemostatic parameters from those of typical sepsis-induced coagulopathy (SIC). Methods: To elucidate the specific pattern of coagulopathy induced by COVID-19 pneumonia, this retrospective, observational study targeted consecutive adult patients with COVID-19-induced acute respiratory distress syndrome (ARDS) and compared hemostatic biomarkers with non-COVID-19-induced septic ARDS. Multilevel mixed-effects regression analysis was performed and Kaplan–Meier failure curves were constructed. Results: We enrolled 24 patients with COVID-19-induced ARDS and 200 patients with non-COVID-19-induced ARDS. Platelet count, antithrombin activity, and prothrombin time in the COVID-19 group were almost within normal range and time series alterations of these markers were significantly milder than the non-COVID-19 group (p = 0.052, 0.037, and 0.005, respectively). However, fibrin/fibrinogen degradation product and D-dimer were significantly higher in the COVID-19 group (p = 0.001, 0.002, respectively). COVID-19 patients had moderately high levels of thrombin–antithrombin complex and plasmin-alpha2-plasmin inhibitor complex but normal plasminogen activator inhibitor-1 level. Conclusions: The hematological phenotype of COVID-19-induced coagulopathy is quite different from that in typical SIC characterized by systemic hypercoagulation and suppressed fibrinolysis. Instead, local thrombus formation might be promoted in severe COVID-19.


id: cord-286298-pn9nwl64
author: Helmy, Yosra A.
date: 2020-04-24
txt: ./txt/cord-286298-pn9nwl64.txt
cache: ./cache/cord-286298-pn9nwl64.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32344679/
doi: 10.3390/jcm9041225
summary:
  Another group of researchers reported that the virus originated from bats based on the genome sequence of SARS-CoV-2, which is 96% identical to bat coronavirus RaTG13. These factors include, but are not limited to: (1) travel to or contact with individuals who have recently visited Wuhan, China, or other places experiencing an outbreak; (2) close contact with persons who are diagnosed positive for the disease, such as healthcare workers caring for patients with SARS-CoV-2; (3) contact with droplets and secretions (produced by sneezing or coughing) from an infected person and eating or handling wild animals native to China such as bats. These factors include, but are not limited to: (1) travel to or contact with individuals who have recently visited Wuhan, China, or other places experiencing an outbreak; (2) close contact with persons who are diagnosed positive for the disease, such as healthcare workers caring for patients with SARS-CoV-2; (3) contact with droplets and secretions (produced by sneezing or coughing) from an infected person and eating or handling wild animals native to China such as bats.

title:
  The COVID-19 Pandemic: A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control

abstract:
  A pneumonia outbreak with unknown etiology was reported in Wuhan, Hubei province, China, in December 2019, associated with the Huanan Seafood Wholesale Market. The causative agent of the outbreak was identified by the WHO as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), producing the disease named coronavirus disease-2019 (COVID-19). The virus is closely related (96.3%) to bat coronavirus RaTG13, based on phylogenetic analysis. Human-to-human transmission has been confirmed even from asymptomatic carriers. The virus has spread to at least 200 countries, and more than 1,700,000 confirmed cases and 111,600 deaths have been recorded, with massive global increases in the number of cases daily. Therefore, the WHO has declared COVID-19 a pandemic. The disease is characterized by fever, dry cough, and chest pain with pneumonia in severe cases. In the beginning, the world public health authorities tried to eradicate the disease in China through quarantine but are now transitioning to prevention strategies worldwide to delay its spread. To date, there are no available vaccines or specific therapeutic drugs to treat the virus. There are many knowledge gaps about the newly emerged SARS-CoV-2, leading to misinformation. Therefore, in this review, we provide recent information about the COVID-19 pandemic. This review also provides insights for the control of pathogenic infections in humans such as SARS-CoV-2 infection and future spillovers.


id: cord-287102-o19uwryp
title: Clinical Course and Outcomes of Severe Covid-19: A National Scale Study
author: Amit, Moran
date: 2020-07-18
txt: ./txt/cord-287102-o19uwryp.txt
cache: ./cache/cord-287102-o19uwryp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32708357/
doi: 10.3390/jcm9072282
summary:
  The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined. The recorded data included the following: age, sex, medical comorbidities (i.e., smoking status, hypertension, diabetes, ischemic heart disease, chronic heart failure, cancer, chronic kidney disease, immunosuppression, cirrhosis, and dementia), medication history, vital signs, chest X-rays, laboratory studies on admission to the ICU, anti-Covid-19 pharmacological therapy in the ICU (antimalarials, antivirals, anti-inflammatories, and plasma from recovered patients), respiratory support method (invasive or noninvasive mechanical ventilation and oxygen mask), renal replacement therapy, nutrition methods (enteral and total parenteral nutrition), the use of extracorporeal membrane oxygenation (ECMO), complications, and outcome. In this nation-based registry study of critically ill patients with Covid-19 who were admitted to ICUs in Israel, the majority of patients were 55 years and older men, and a large proportion required mechanical ventilation.

abstract:
  Knowledge of the outcomes of critically ill patients is crucial for health and government officials who are planning how to address local outbreaks. The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined. Methods: This was a retrospective registry-based case series of patients with laboratory-confirmed SARS-CoV-2 who were referred for ICU admission and treated in the ICUs of the 13 participating centers in Israel between 5 March and 27 April 2020. Demographic and clinical data including clinical management were collected and subjected to a multivariable analysis; primary outcome was mortality. Results: This study included 156 patients (median age = 72 years (range = 22–97 years)); 69% (108 of 156) were male. Eighty-nine percent (139 of 156) of patients had at least one comorbidity. One hundred three patients (66%) required invasive mechanical ventilation. As of 8 May 2020, the median length of stay in the ICU was 10 days (range = 0–37 days). The overall mortality rate was 56%; a multivariable regression model revealed that increasing age (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), the presence of sepsis (OR = 1.08 for each year of age, 95%CI = 1.03–1.13), and a shorter ICU stay(OR = 0.90 for each day, 95% CI = 0.84–0.96) were independent prognostic factors. Conclusions: In our case series, we found lower mortality rates than those in exhausted health systems. The results of our multivariable model suggest that further evaluation is needed of antiviral and antibacterial agents in the treatment of sepsis and secondary infection.


id: cord-289034-yl3emjef
title: Mitochondria at the Crossroads of Physiology and Pathology
author: Moro, Loredana
date: 2020-06-24
txt: ./txt/cord-289034-yl3emjef.txt
cache: ./cache/cord-289034-yl3emjef.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9061971
doi: 10.3390/jcm9061971
summary:
  Two mitochondria quality control mechanisms are in place to meet the functional needs of any given cell under different physiological and pathological conditions: (a) mitochondrial biogenesis, fusion and fission [4] [5] [6] ; (b) mitophagy [7, 8] . The second mechanism, mitophagy, is a specific form of autophagy that removes damaged mitochondria and reduces the mitochondrial mass upon microenvironmental stresses, such as hypoxia and nutrient starvation, promoting cell survival [11] . In this context, mutations in three TCA cycle enzymes, namely succinate dehydrogenase, fumarate hydratase and isocitrate dehydrogenase, have been shown to play a causal role in carcinogenesis [54, 55] , thus providing compelling evidence for the involvement of mitochondrial metabolic alterations as cancer drivers. Mitochondrial dysfunction is implicated in several pathological conditions, ranging from neurodegenerative and cardiovascular diseases, to aging, cancer and inflammation.

abstract:
  Mitochondria play a crucial role in cell life and death by regulating bioenergetic and biosynthetic pathways. They are able to adapt rapidly to different microenvironmental stressors by accommodating the metabolic and biosynthetic needs of the cell. Mounting evidence places mitochondrial dysfunction at the core of several diseases, notably in the context of pathologies of the cardiovascular and central nervous system. In addition, mutations in some mitochondrial proteins are bona fide cancer drivers. Better understanding of the functions of these multifaceted organelles and their components may finetune our knowledge on the molecular bases of certain diseases and suggest new therapeutic avenues.


id: cord-289219-qjxdggz3
title: Pulmonary Rehabilitation: Time for an Upgrade
author: Sebio-García, Raquel
date: 2020-08-25
txt: ./txt/cord-289219-qjxdggz3.txt
cache: ./cache/cord-289219-qjxdggz3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32854317/
doi: 10.3390/jcm9092742
summary:
  Pulmonary rehabilitation is a notoriously known but highly underused intervention aimed to restore or improve functional capacity, symptom management and health-related quality of life among patients with chronic respiratory diseases. Since early 1980s, pulmonary rehabilitation has been acknowledged as a comprehensive intervention with hundreds of studies being performed over the past thirty years demonstrating its benefits on multiple outcomes; nevertheless, there are still multiple unresolved challenges, and new ones are currently emerging, with the COVID-19 outbreak now in the spotlight. PR stems from a comprehensive evaluation of the patient aimed to design an individually-tailored, multi-component intervention to optimise symptom control, pulmonary function, exercise capacity and health-related quality of life [1] . The effectiveness of PR on different outcomes such as exercise capacity, muscle function, dyspnoea and symptom control, is quite robust, so it is currently recommended in the management of different chronic respiratory conditions, especially for patients with chronic obstructive pulmonary disease (COPD).

abstract:
  Pulmonary rehabilitation is a notoriously known but highly underused intervention aimed to restore or improve functional capacity, symptom management and health-related quality of life among patients with chronic respiratory diseases. Since early 1980s, pulmonary rehabilitation has been acknowledged as a comprehensive intervention with hundreds of studies being performed over the past thirty years demonstrating its benefits on multiple outcomes; nevertheless, there are still multiple unresolved challenges, and new ones are currently emerging, with the COVID-19 outbreak now in the spotlight. In this editorial, these issues are summarized and discussed, while presenting some of the latest findings in research and clinical practice, with the ultimate goal of raising awareness of the future of pulmonary rehabilitation in the post COVID-19 era.


id: cord-289422-5z012sr6
title: Prediction of the Epidemic Peak of Coronavirus Disease in Japan, 2020
author: Kuniya, Toshikazu
date: 2020-03-13
txt: ./txt/cord-289422-5z012sr6.txt
cache: ./cache/cord-289422-5z012sr6.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32183172/
doi: 10.3390/jcm9030789
summary:
  The purpose of this study is to give a prediction of the epidemic peak for COVID-19 in Japan by using the real-time data from 15 January to 29 February 2020. In addition, we obtain the following epidemiological insights: (1) the essential epidemic size is less likely to be affected by the rate of identification of the actual infective population; (2) the intervention has a positive effect on the delay of the epidemic peak; (3) intervention over a relatively long period is needed to effectively reduce the final epidemic size. In this study, by applying the SEIR compartmental model to the daily reported cases of COVID-19 in Japan from 15 January to 29 February, we have estimated that the basic reproduction number R 0 is 2.6 (95%CI, 2.4-2.8) and the epidemic peak could possibly reach the early-middle summer.

abstract:
  The first case of coronavirus disease 2019 (COVID-19) in Japan was reported on 15 January 2020 and the number of reported cases has increased day by day. The purpose of this study is to give a prediction of the epidemic peak for COVID-19 in Japan by using the real-time data from 15 January to 29 February 2020. Taking into account the uncertainty due to the incomplete identification of infective population, we apply the well-known SEIR compartmental model for the prediction. By using a least-square-based method with Poisson noise, we estimate that the basic reproduction number for the epidemic in Japan is [Formula: see text] ([Formula: see text] CI, [Formula: see text] – [Formula: see text]) and the epidemic peak could possibly reach the early-middle summer. In addition, we obtain the following epidemiological insights: (1) the essential epidemic size is less likely to be affected by the rate of identification of the actual infective population; (2) the intervention has a positive effect on the delay of the epidemic peak; (3) intervention over a relatively long period is needed to effectively reduce the final epidemic size.


id: cord-289832-092dtzrd
author: Villard, Orianne
date: 2020-07-21
txt: ./txt/cord-289832-092dtzrd.txt
cache: ./cache/cord-289832-092dtzrd.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32708205/
doi: 10.3390/jcm9072315
summary:
  The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). Moreover, aldosterone levels were also gradually and significantly increased when we compared clinical status of patients in the three following categories: mild (OS ≤ 3), moderate (OS = 4) and severe (OS ≥ 5) on Day 2 and at OS max (analysis of variance, p = 0.001 and p = 0.006, respectively) ( Figure 2B) . In the present study, higher plasmatic aldosterone and CRP levels at inclusion are associated with severe clinical course of Covid-19 in hospitalized patients, and both parameters appear to be correlated.

title:
  The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study

abstract:
  Background. The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. Since the RAAS can induce and modulate pro-inflammatory responses, it could play a key role in the pathophysiology of Covid-19. Thus, we aimed to determine the levels of plasma renin and aldosterone as indicators of RAAS activation in a series of consecutively admitted patients for Covid-19 in our clinic. Methods. Plasma renin and aldosterone levels were measured, among the miscellaneous investigations needed for Covid-19 management, early after admission in our clinic. Disease severity was assessed using a seven-category ordinal scale. Primary outcome of interest was the severity of patients’ clinical courses. Results. Forty-four patients were included. At inclusion, 12 patients had mild clinical status, 25 moderate clinical status and 7 severe clinical status. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). In multivariate analyses, only aldosterone and CRP levels remained positively associated with severity. We also observed a positive significant correlation between aldosterone and CRP levels among patients with an aldosterone level greater than 102.5 pmol/L. Conclusions. Both plasmatic aldosterone and CRP levels at inclusion are associated with the clinical course of Covid-19. Our findings may open new perspectives in the understanding of the possible role of RAAS for Covid-19 outcome.


id: cord-290135-ax5ck4qw
author: Urbano, Nicoletta
date: 2020-07-13
txt: ./txt/cord-290135-ax5ck4qw.txt
cache: ./cache/cord-290135-ax5ck4qw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32668651/
doi: 10.3390/jcm9072213
summary:
  The aim of this study was to evaluate the possible association among sestamibi uptake and the main histopathological characteristics of parathyroid lesions related to aggressiveness such as the proliferation index (Ki67 expression and mitosis), angiogenesis (number of vessels), and vascular invasion in hyperparathyroidism patients. In conclusion, data obtained on patients with positive or negative scintigraphy support the hypothesis that sestamibi can be a tracer that is capable of predicting some biological characteristics of parathyroid tumors such as angiogenesis, proliferation indexes, and the invasion of surrounding tissues or vessels. Starting from these considerations, the aim of this study was to evaluate the possible association among sestamibi uptake and the main histopathological characteristics of parathyroid lesions related to aggressiveness such as proliferation index (Ki67 expression and mitosis), angiogenesis (number of vessels), and vascular invasion in PHP patients.

title:
  [(99)mTc]Sestamibi SPECT Can Predict Proliferation Index, Angiogenesis, and Vascular Invasion in Parathyroid Patients: A Retrospective Study

abstract:
  The aim of this study was to evaluate the possible association among sestamibi uptake and the main histopathological characteristics of parathyroid lesions related to aggressiveness such as the proliferation index (Ki67 expression and mitosis), angiogenesis (number of vessels), and vascular invasion in hyperparathyroidism patients. To this end, 26 patients affected by primary hyperparathyroidism subjected to both scintigraphy with [(99)mTc]Sestamibi and surgery/bioptic procedure were retrospectively enrolled. Hyperfunctioning of the parathyroid was detected in 19 patients. Our data showed a significant positive association among the sestamibi uptake and the proliferation index histologically evaluated both in terms of the number of Ki67 positive cells and mitosis. According to these data, lesions with a higher valuer of L/N (lesion to nonlesion ratio) frequently showed several vessels in tumor areas and histological evidence of vascular invasion. It is noteworthy that among patients with negative scintigraphy, 2 patients showed a neoplastic lesion after surgery (histological analysis). However, it is important to highlight that these lesions displayed very low proliferation indexes, which was evaluated in terms of number of both mitosis and Ki67-positive cells, some/rare vessels in the main lesion, and no evidence of vascular invasion. In conclusion, data obtained on patients with positive or negative scintigraphy support the hypothesis that sestamibi can be a tracer that is capable of predicting some biological characteristics of parathyroid tumors such as angiogenesis, proliferation indexes, and the invasion of surrounding tissues or vessels.


id: cord-290286-3t0roikx
author: Arango-Lasprilla, Juan Carlos
date: 2020-06-26
txt: ./txt/cord-290286-3t0roikx.txt
cache: ./cache/cord-290286-3t0roikx.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9062007
doi: 10.3390/jcm9062007
summary:
  Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe. The backward predictor selection revealed a simplified model which included the following sociodemographic, premorbid, and injury-related factors significantly influencing the probability of employment one year after TBI: age (2) , employment status at baseline (5), premorbid psychological/psychiatric problems (6), ISS (9), GCS score (10) , and LOS at the hospital (12).

title:
  Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

abstract:
  Sustaining a traumatic brain injury (TBI) often affects the individual’s ability to work, reducing employment rates post-injury across all severities of TBI. The objective of this multi-country study was to assess the most relevant early predictors of employment status in individuals after TBI at one-year post-injury in European countries. Using a prospective longitudinal non-randomized observational cohort (The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project), data was collected between December 2014–2019 from 63 trauma centers in 18 European countries. The 1015 individuals who took part in this study were potential labor market participants, admitted to a hospital and enrolled within 24 h of injury with a clinical TBI diagnosis and indication for a computed tomography (CT) scan, and followed up at one year. Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe.


id: cord-292341-uo54ghf3
title: Clinical Features and Chest Imaging as Predictors of Intensity of Care in Patients with COVID-19
author: Cocconcelli, Elisabetta
date: 2020-09-16
txt: ./txt/cord-292341-uo54ghf3.txt
cache: ./cache/cord-292341-uo54ghf3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32947904/
doi: 10.3390/jcm9092990
summary:
  Univariate logistic regression analysis of factors associated with level of care revealed that sex, age, smoking history, FiO2, pO2 in room air at admission, bacterial co-infections developed during hospitalization, CVDs, metabolic and oncologic diseases and chest X-ray global score had significant positive association with a higher level of care in the entire study population (Table 3) . Univariate logistic regression analysis of factors associated with level of care revealed that sex, age, smoking history, FiO2, pO2 in room air at admission, bacterial co-infections developed during hospitalization, CVDs, metabolic and oncologic diseases and chest X-ray global score had significant positive association with a higher level of care in the entire study population (Table 3) . This is a retrospective analysis of clinical features and radiographic severity scores in patients with COVID-19 and how these parameters on hospital admission correlate with different levels of medical care (i.e., HIMC vs.

abstract:
  Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with lung disease representing the main cause of morbidity and mortality. Conventional chest-X ray (CXR) and ultrasound (US) are valuable instruments to assess the extent of lung involvement. We investigated the relationship between CXR scores on admission and the level of medical care required in patients with COVID-19. Further, we assessed the CXR-US correlation to explore the role of ultrasound in monitoring the course of COVID-19 pneumonia. Clinical features and CXR scores were obtained at admission and correlated with the level of intensity of care required [high- (HIMC) versus low-intensity medical care (LIMC)]. In a subgroup of patients, US findings were correlated with clinical and radiographic parameters. On hospital admission, CXR global score was higher in HIMCs compared to LIMC. Smoking history, pO(2) on admission, cardiovascular and oncologic diseases were independent predictors of HIMC. The US score was positively correlated with FiO(2) while the correlation with CXR global score only trended towards significance. Our study identifies clinical and radiographic features that strongly correlate with higher levels of medical care. The role of lung ultrasound in this setting remains undetermined and needs to be explored in larger prospective studies.


id: cord-294910-gnc04ax1
author: Nogueira, Paulo Jorge
date: 2020-07-24
txt: ./txt/cord-294910-gnc04ax1.txt
cache: ./cache/cord-294910-gnc04ax1.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9082368
doi: 10.3390/jcm9082368
summary:
  The risk factors for increased odds of death by COVID-19 were: sex (male: OR = 1.47, ref = female), age ((56–60) years, OR = 6.01; (61–65) years, OR = 10.5; (66–70) years, OR = 20.4; (71–75) years, OR = 34; (76–80) years, OR = 50.9; (81–85) years, OR = 70.7; (86–90) years, OR = 83.2; (91–95) years, OR = 91.8; (96–104) years, OR = 140.2, ref = (0–55)), Cardiac disease (OR = 2.86), Kidney disorder (OR = 2.95), and Neuromuscular disorder (OR = 1.58), while condition (None (absence of precondition); OR = 0.49) was associated with a reduced chance of dying after adjusting for other variables of interest. The data retrieved include individuals'' demographic characteristics (age, sex, region), COVID-19 disease information (death, recovery, still in treatment, hospitalization, intensive care, respiratory support), and preconditions (Asthma, Cancer, Cardiac disease, Hematological disorder, Diabetes, HIV and other immune deficiency, Kidney disorder, Liver disorder, Neuromuscular disorder, Other precondition and None (absence of precondition)).

title:
  The Role of Health Preconditions on COVID-19 Deaths in Portugal: Evidence from Surveillance Data of the First 20293 Infection Cases

abstract:
  Background: It is essential to study the effect of potential co-factors on the risk of death in patients infected by COVID-19. The identification of risk factors is important to allow more efficient public health and health services strategic interventions with a significant impact on deaths by COVID-19. This study aimed to identify factors associated with COVID-19 deaths in Portugal. Methods: A national dataset with the first 20,293 patients infected with COVID-19 between 1 January and 21 April 2020 was analyzed. The primary outcome measure was mortality by COVID-19, measured (registered and confirmed) by Medical Doctors serving as health delegates on the daily death registry. A logistic regression model using a generalized linear model was used for estimating Odds Ratio (OR) with 95% confidence intervals (95% CI) for each potential risk indicator. Results: A total of 502 infected patients died of COVID-19. The risk factors for increased odds of death by COVID-19 were: sex (male: OR = 1.47, ref = female), age ((56–60) years, OR = 6.01; (61–65) years, OR = 10.5; (66–70) years, OR = 20.4; (71–75) years, OR = 34; (76–80) years, OR = 50.9; (81–85) years, OR = 70.7; (86–90) years, OR = 83.2; (91–95) years, OR = 91.8; (96–104) years, OR = 140.2, ref = (0–55)), Cardiac disease (OR = 2.86), Kidney disorder (OR = 2.95), and Neuromuscular disorder (OR = 1.58), while condition (None (absence of precondition); OR = 0.49) was associated with a reduced chance of dying after adjusting for other variables of interest. Conclusions: Besides age and sex, preconditions justify the risk difference in mortality by COVID-19.


id: cord-300991-ipy24zxp
title: Obesity and COVID-19: Oro-Naso-Sensory Perception
author: Khan, Amira Sayed
date: 2020-07-08
txt: ./txt/cord-300991-ipy24zxp.txt
cache: ./cache/cord-300991-ipy24zxp.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9072158
doi: 10.3390/jcm9072158
summary:
  Through a recent upsurge of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, the clinical assessment of most of the coronavirus disease 19 (COVID-19) patients clearly presents a health condition with the loss of oro-naso-sensory (ONS) perception, responsible for the detection of flavor and savor. Hence, obesity represents a great risk factor for SARS-CoV-2 infection, as it may hide the viral-associated altered ONS symptoms, thus leading to a high mortality rate in these subjects. Moreover, the number of immunosuppressive T-regulatory, Treg (CD4 + CD25 + Foxp3 + ) cells and concentrations of IL-6, IL-10, and C-reactive protein (CRP) were upregulated in patients with severe COVID-19 [18] , suggesting that SARS-CoV-2 infection may lead to "over-immunosuppression" in the case of obesity ( Figure 1 ). SARS-CoV-2 infection may further aggravate the ONS functions; mask the obesity-induced inflammation, including loss of taste and smell; and render the obese subjects more vulnerable and prone to severe pathophysiological consequences such as RTI, leading to death.

abstract:
  Through a recent upsurge of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, the clinical assessment of most of the coronavirus disease 19 (COVID-19) patients clearly presents a health condition with the loss of oro-naso-sensory (ONS) perception, responsible for the detection of flavor and savor. These changes include anosmia and dysgeusia. In some cases, these clinical manifestations appear even before the general flu-like symptoms, e.g., sore throat, thoracic oppression and fever. There is no direct report available on the loss of these chemical senses in obese COVID-19 patients. Interestingly, obesity has been shown to be associated with low ONS cues. These alterations in obese subjects are due to obesity-induced altered expression of olfacto-taste receptors. Besides, obesity may further aggravate the SARS-CoV-2 infection, as this pathology is associated with a high degree of inflammation/immunosuppression and reduced protection against viral infections. Hence, obesity represents a great risk factor for SARS-CoV-2 infection, as it may hide the viral-associated altered ONS symptoms, thus leading to a high mortality rate in these subjects.


id: cord-301157-tu3iig9o
author: Felsenstein, Susanna
date: 2020-10-14
txt: ./txt/cord-301157-tu3iig9o.txt
cache: ./cache/cord-301157-tu3iig9o.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33066459/
doi: 10.3390/jcm9103293
summary:
  Whilst most children and young people develop mild symptoms, recent reports suggest a novel paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Since the advent of the Coronavirus Disease 2019 (COVID-19) pandemic, dominated by respiratory disease and evolution of acute respiratory distress syndrome (ARDS), cardiovascular compromise, excessive systemic inflammation and coagulopathy in adults [1] [2] [3] , several countries affected by the coronavirus disease [4] pandemic have reported an unusually high number of cases of children hospitalized due to a multisystem inflammatory condition, at times requiring intensive care (Table S1) . Temporal distribution of paediatric inflammatory multisystem syndrome temporally associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (PIMS-TS) cases of this cohort, in relation to COVID-19 like presentations to hospitals in England. The peak of presentations of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 followed the peak of presentations of patients, adult and paediatric, to English Emergency Departments, with a lag of 4-6 weeks (Figure adapted from https://www.gov.uk/government/news/weekly-covid-19-surveillance-report-published; week 30).

title:
  Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS)

abstract:
  The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the pathogen responsible for Coronavirus Disease 2019 (COVID-19). Whilst most children and young people develop mild symptoms, recent reports suggest a novel paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Case definition and classification are preliminary, treatment is empiric and disease-associated outcomes are unclear. Here, we report 29 patients with PIMS-TS who were diagnosed, admitted and treated in the English North West between March and June 2020. Consistent with patterns observed internationally, cases peaked approximately 4 weeks after the initial surge of COVID-19-like symptoms in the UK population. Clinical symptoms included fever (100%), skin rashes (72%), cardiovascular involvement (86%), conjunctivitis (62%) and respiratory involvement (21%). Some patients had clinical features partially resembling Kawasaki disease (KD), toxic shock syndrome and cytokine storm syndrome. Male gender (69%), black, Asian and other minority ethnicities (BAME, 59%) were over-represented. Immune modulating treatment was used in all, including intravenous immunoglobulin (IVIG), corticosteroids and cytokine blockers. Notably, 32% of patients treated with IVIG alone went into remission. The rest required additional treatment, usually corticosteroids, with the exception of two patients who were treated with TNF inhibition and IL-1 blockade, respectively. Another patient received IL-1 inhibition as primary therapy, with associated rapid and sustained remission. Randomized and prospective studies are needed to investigate efficacy and safety of treatment, especially as resources of IVIG may be depleted secondary to high demand during future waves of COVID-19.


id: cord-306438-db2rqz4d
author: Kalathiya, Umesh
date: 2020-05-14
txt: ./txt/cord-306438-db2rqz4d.txt
cache: ./cache/cord-306438-db2rqz4d.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32422996/
doi: 10.3390/jcm9051473
summary:
  An important stage in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) life cycle is the binding of the spike (S) protein to the angiotensin converting enzyme-2 (ACE2) host cell receptor. These findings identify a novel small molecule binding-site formed by the spike protein oligomer, that might assist in future drug discovery programs aimed at targeting the coronavirus (CoV) family of viruses. Our current study focuses on understanding the variability of the trimer spike glycoprotein in SARS-CoV-2 with respect to the genomes from other coronavirus strains, and identifying the changes in the molecular properties due to conformational flexibility in the spike protein. Our data suggest a mechanism whereby Chitosan (and possibly its derivatives), as well as macrolide type molecules, might bind to a pocket formed by the spike protein trimer and provide a novel domain to focus on for future drug discovery projects.

title:
  Highly Conserved Homotrimer Cavity Formed by the SARS-CoV-2 Spike Glycoprotein: A Novel Binding Site

abstract:
  An important stage in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) life cycle is the binding of the spike (S) protein to the angiotensin converting enzyme-2 (ACE2) host cell receptor. Therefore, to explore conserved features in spike protein dynamics and to identify potentially novel regions for drugging, we measured spike protein variability derived from 791 viral genomes and studied its properties by molecular dynamics (MD) simulation. The findings indicated that S2 subunit (heptad-repeat 1 (HR1), central helix (CH), and connector domain (CD) domains) showed low variability, low fluctuations in MD, and displayed a trimer cavity. By contrast, the receptor binding domain (RBD) domain, which is typically targeted in drug discovery programs, exhibits more sequence variability and flexibility. Interpretations from MD simulations suggest that the monomer form of spike protein is in constant motion showing transitions between an “up” and “down” state. In addition, the trimer cavity may function as a “bouncing spring” that may facilitate the homotrimer spike protein interactions with the ACE2 receptor. The feasibility of the trimer cavity as a potential drug target was examined by structure based virtual screening. Several hits were identified that have already been validated or suggested to inhibit the SARS-CoV-2 virus in published cell models. In particular, the data suggest an action mechanism for molecules including Chitosan and macrolides such as the mTOR (mammalian target of Rapamycin) pathway inhibitor Rapamycin. These findings identify a novel small molecule binding-site formed by the spike protein oligomer, that might assist in future drug discovery programs aimed at targeting the coronavirus (CoV) family of viruses.


id: cord-309273-gtvi37gh
author: Flesia, Luca
date: 2020-10-19
txt: ./txt/cord-309273-gtvi37gh.txt
cache: ./cache/cord-309273-gtvi37gh.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9103350
doi: 10.3390/jcm9103350
summary:
  Finally, with the goal of anticipating persons in need of treatment and improving the targeting and overall effectiveness of preventive programs, we aimed at developing machine learning models to predict individual psychological responses to the COVID-19 pandemic, based on sociodemographic and psychological variables with maximal sensitivity in classifying subjects with high versus low levels of perceived stress. To better understand the role of stable psychological traits in predicting the level of perceived stress (PSS-10 score), a second multiple linear regression was run, adding to the previous model the scores of the five coping styles measured by the COPE-NVI-25 (COPE positive, COPE problem, COPE avoidance, COPE religion and COPE support), the BSCS total score, the internal LOC score, and the scores for the five personality traits measured by the BFI-10 (BFI-10 agreeableness, BFI-10 conscientiousness, BFI-10 emotional stability, BFI-10 extraversion and BFI-10 openness).

title:
  Predicting Perceived Stress Related to the Covid-19 Outbreak through Stable Psychological Traits and Machine Learning Models

abstract:
  The global SARS-CoV-2 outbreak and subsequent lockdown had a significant impact on people’s daily lives, with strong implications for stress levels due to the threat of contagion and restrictions to freedom. Given the link between high stress levels and adverse physical and mental consequences, the COVID-19 pandemic is certainly a global public health issue. In the present study, we assessed the effect of the pandemic on stress levels in N = 2053 Italian adults, and characterized more vulnerable individuals on the basis of sociodemographic features and stable psychological traits. A set of 18 psycho-social variables, generalized regressions, and predictive machine learning approaches were leveraged. We identified higher levels of perceived stress in the study sample relative to Italian normative values. Higher levels of distress were found in women, participants with lower income, and participants living with others. Higher rates of emotional stability and self-control, as well as a positive coping style and internal locus of control, emerged as protective factors. Predictive learning models identified participants with high perceived stress, with a sensitivity greater than 76%. The results suggest a characterization of people who are more vulnerable to experiencing high levels of stress during the COVID-19 pandemic. This characterization may contribute to early and targeted intervention strategies.


id: cord-309876-l0xginsa
title: Prevalence of Antibodies to SARS-CoV-2 in Italian Adults and Associated Risk Factors
author: Vena, Antonio
date: 2020-08-27
txt: ./txt/cord-309876-l0xginsa.txt
cache: ./cache/cord-309876-l0xginsa.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32867328/
doi: 10.3390/jcm9092780
summary:
  A generalized estimating equations model showed that the main risk factors associated with SARS-CoV-2 seroprevalence were the following: an occupational exposure to the virus [Odd ratio (OR) = 2.36; 95% CI 1.59–3.50, p = 0.001], being a long-term care facility resident (OR = 4.53; 95% CI 3.19–6.45, p = 0.001), and reporting previous symptoms of influenza-like illness (OR = 4.86; 95% CI 3.75–6.30, p = 0.001) or loss of sense of smell or taste (OR = 41.00; 95% CI 18.94–88.71, p = 0.001). In the present observational study performed on a large sample of subject in northern Italy, we found the following: (1) the overall seroprevalence of anti-SARS-CoV-2 antibodies (IgG and/or IgM) was 11.0%; (2) occupational exposure to the virus, long-term care facility residency, as well as previous symptoms of influenza-like illness or loss of sense of smell or taste were independently associated with anti-SARS-CoV-2 positivity.

abstract:
  We aimed to assess the prevalence of and factors associated with anti- severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positivity in a large population of adult volunteers from five administrative departments of the Liguria and Lombardia regions. A total of 3609 individuals were included in this analysis. Participants were tested for anti-SARS-CoV-2 antibodies [Immunoglobulin G (IgG) and M (IgM) class antibodies] at three private laboratories (Istituto Diganostico Varelli, Medical Center, and Casa della Salute di Genova). Demographic data, occupational or private exposure to SARS-CoV-2-infected patients, and prior medical history consistent with SARS-CoV-2 infection were collected according to a preplanned analysis. The overall seroprevalence of anti-SARS-CoV-2 antibodies (IgG and/or IgM) was 11.0% [398/3609; confidence interval (CI) 10.0%–12.1%]. Seroprevalence was higher in female inmates than in male inmates (12.5% vs. 9.2%, respectively, p = 0.002), with the highest rate observed among adults aged >55 years (13.2%). A generalized estimating equations model showed that the main risk factors associated with SARS-CoV-2 seroprevalence were the following: an occupational exposure to the virus [Odd ratio (OR) = 2.36; 95% CI 1.59–3.50, p = 0.001], being a long-term care facility resident (OR = 4.53; 95% CI 3.19–6.45, p = 0.001), and reporting previous symptoms of influenza-like illness (OR = 4.86; 95% CI 3.75–6.30, p = 0.001) or loss of sense of smell or taste (OR = 41.00; 95% CI 18.94–88.71, p = 0.001). In conclusion, we found a high prevalence (11.0%) of SARS-CoV-2 infection that is significantly associated with residing in long-term care facilities or occupational exposure to the virus. These findings warrant further investigation into SARS-CoV-2 antibody prevalence among the Italian population.


id: cord-310304-f28tjmi8
title: Racial Disparities-Associated COVID-19 Mortality among Minority Populations in the US
author: Alcendor, Donald J.
date: 2020-07-30
txt: ./txt/cord-310304-f28tjmi8.txt
cache: ./cache/cord-310304-f28tjmi8.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32751633/
doi: 10.3390/jcm9082442
summary:
  Maintaining glycemic control in COVID-19 patients is essential, as hyperglycemia could affect pulmonary function, the immune response to infection, and the development of the pro-inflammatory cytokine storm associated with more severe clinical disease ( Figure 1 ). Patients who clinically present with normal or high blood pressure may be subject to undue complications related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients who clinically present with normal or high blood pressure may be subject to undue complications related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, upon infection with SARS-CoV-2 the ACE2 protein serves as the entry receptor for the virus and is internalized in the endosome with SARS-CoV-2 during membrane fusion and uptake by Hypothetical model of uncontrolled blood pressure in patients with hypertension and increased risk for complications due to COVID-19. Longstanding health disparities such as diabetes, hypertension, CVD, and pulmonary disease among minority populations in the US may serve to predispose these communities to SARS-CoV-2 infection and increased risk for clinically severe COVID-19.

abstract:
  Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a betacoronavirus that causes the novel coronavirus disease 2019 (COVID-19), is highly transmissible and pathogenic for humans and may cause life-threatening disease and mortality, especially in individuals with underlying comorbidities. First identified in an outbreak in Wuhan, China, COVID-19 is affecting more than 185 countries and territories around the world, with more than 15,754,651 confirmed cases and more than 640,029 deaths. Since December 2019, SARS-CoV-2 transmission has become a global threat, which includes confirmed cases in all 50 states within the United States (US). As of 25 July 2020, the Johns Hopkins Whiting School of Engineering Center for Systems Science and Engineering reports more than 4,112,651 cases and 145,546 deaths. To date, health disparities are associated with COVID-19 mortality among underserved populations. Here, the author explores potential underlying reasons for reported disproportionate, increased risks of mortality among African Americans and Hispanics/Latinos with COVID-19 compared with non-Hispanic Whites. The author examines the underlying clinical implications that may predispose minority populations and the adverse clinical outcomes that may contribute to increased risk of mortality. Government and community-based strategies to safeguard minority populations at risk for increased morbidity and mortality are essential. Underserved populations living in poverty with limited access to social services across the US are more likely to have underlying medical conditions and are among the most vulnerable. Societal and cultural barriers for ethnic minorities to achieve health equity are systemic issues that may be addressed only through shifts in governmental policies, producing long-overdue, substantive changes to end health care inequities.


id: cord-315188-a9pvugjt
title: Clinical Characteristics and Disease Progression in Early-Stage COVID-19 Patients in South Korea
author: Choi, Min Hyuk
date: 2020-06-23
txt: ./txt/cord-315188-a9pvugjt.txt
cache: ./cache/cord-315188-a9pvugjt.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9061959
doi: 10.3390/jcm9061959
summary:
  The following clinical data were collected using electronic medical records: age at diagnosis, sex, signs and symptoms, date of symptom onset, date of hospital admission, date of discharge or transfer, Charlson comorbidity index [16] , Eastern Cooperative Oncology Group (ECOG) performance status [17] , Multilobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension and Age (MuLBSTA) score [18] , pneumonia severity index [19] , Confusion, Urea, Respiratory rate, Blood pressure plus age ≥ 65 years (CURB-65) [20] , respiratory support, and treatment agents administered before and during hospitalization. After PS matching, prior history of drug use, including ibuprofen, ARB, DPP4i, was not statistically different between patients in the progression and improvement/stabilization groups. Before matching, the proportion of patients reporting prior use of these drugs was significantly greater in the progression group; however, after adjusting for 10 confounding variables, including underlying comorbidities, there was no significant difference between patients with and without these medication histories.

abstract:
  A rapid increase in the number of patients with coronavirus disease 19 (COVID-19) may overwhelm the available medical resources. We aimed to evaluate risk factors for disease severity in the early stages of COVID-19. The cohort comprised 293 patients with COVID-19 from 5 March 2020, to 18 March 2020. The Korea Centers for Disease Control and Prevention (KCDC) classification system was used to triage patients. The clinical course was summarized, including the impact of drugs (angiotensin II receptor blockers [ARB], ibuprofen, and dipeptidyl peptidase-4 inhibitors [DPP4i]) and the therapeutic effect of lopinavir/ritonavir. After adjusting for confounding variables, prior history of drug use, including ARB, ibuprofen, and DPP4i was not a risk factor associated with disease progression. Patients treated with lopinavir/ritonavir had significantly shorter progression-free survival than those not receiving lopinavir/ritonavir. KCDC classification I clearly distinguished the improvement/stabilization group from the progression group of COVID-19 patients (AUC 0.817; 95% CI, 0.740–0.895).


id: cord-315634-fkm6slkc
title: Hypoxemia Index Associated with Prehospital Intubation in COVID-19 Patients
author: Jouffroy, Romain
date: 2020-09-20
txt: ./txt/cord-315634-fkm6slkc.txt
cache: ./cache/cord-315634-fkm6slkc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32962227/
doi: 10.3390/jcm9093025
summary:
  In the present study, we report the relationship between COVID-19 patients intubated in the prehospital setting by a Paris Fire Brigade advanced life support team and the Hypoxemia Index (HI), defined as the ratio between initial pulse oximetry and initial respiratory rate. From ALS prehospital medical reports, we retrieved the patients'' demographic characteristics (age and gender), medical history (previous hypertension, cardiopathy, coronaropathy, chronic renal failure, chronic obstructive pulmonary disease, diabetes mellitus, obesity, stroke, immunosuppression, asthma, and active smoking), initial (i.e., at the first medical contact) prehospital vital sign values (systolic blood pressure, heart rate (HR), pulse oximetry (SpO 2 ), respiratory rate (RR), temperature, and Glasgow coma scale (GCS)), and record of administered prehospital treatments (oxygen modality and catecholamine type and dose). Third, we assessed the relationship between HI and prehospital intubation using logistic regression-including the following potential confounders: age, hypertension, cardiopathy, coronaropathy, chronic renal failure, chronic obstructive pulmonary disease, diabetes mellitus, obesity, immunosuppression, asthma, active smoking, systolic blood pressure, and HR-based on previous studies and physiopathological knowledge [6, 9, 11, 19, 20] .

abstract:
  Background: There exists a need for prognostic tools for the early identification of COVID-19 patients requiring prehospital intubation. Here we investigated the association between a prehospital Hypoxemia Index (HI) and the need for intubation among COVID-19 patients in the prehospital setting. Methods: We retrospectively analyzed COVID-19 patients initially cared for by a Paris Fire Brigade advanced life support (ALS) team in the prehospital setting between 8th March and 18th April of 2020. We assessed the association between HI and prehospital intubation using receiver operating characteristic (ROC) curve analysis and logistic regression model analysis after propensity score matching. Results are expressed as odds ratio (OR) and 95% confidence interval (CI). Results: We analyzed 300 consecutive COVID-19 patients (166 males (55%); mean age, 64 ± 18 years). Among these patients, 45 (15%) were deceased on the scene, 34 (11%) had an active care restriction, and 18 (6%) were intubated in the prehospital setting. The mean HI value was 3.4 ± 1.9. HI was significantly associated with prehospital intubation (OR, 0.24; 95% CI: 0.12–0.41, p < 10(−3)) with a corresponding area under curve (AUC) of 0.91 (95% CI: 0.85–0.98). HI significantly differed between patients with and without prehospital intubation (1.0 ± 1.0 vs. 3.6 ± 1.8, respectively; p < 10(−3)). ROC curve analysis defined the optimal HI threshold as 1.3. Bivariate analysis revealed that HI <1.3 was significantly, positively associated with prehospital intubation (OR, 38.38; 95% CI: 11.57–146.54; p < 10(−3)). Multivariate logistic regression analysis demonstrated that prehospital intubation was significantly associated with HI (adjusted odds ratio (ORa), 0.20; 95% CI: 0.06–0.45; p < 10(−3)) and HI <3 (ORa, 51.08; 95% CI: 7.83–645.06; p < 10(−3)). After adjustment for confounders, the ORa between HI <1.3 and prehospital intubation was 3.6 (95% CI: 1.95–5.08; p < 10(−3)). Conclusion: An HI of <1.3 was associated with a 3-fold increase in prehospital intubation among COVID-19 patients. HI may be a useful tool to facilitate decision-making regarding prehospital intubation of COVID-19 patients initially cared for by a Paris Fire Brigade ALS team. Further prospective studies are needed to confirm these preliminary results.


id: cord-315696-43wmazxa
author: Marinaki, Smaragdi
date: 2020-09-16
txt: ./txt/cord-315696-43wmazxa.txt
cache: ./cache/cord-315696-43wmazxa.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32947798/
doi: 10.3390/jcm9092986
summary:
  title: A Systematic Review of COVID-19 Infection in Kidney Transplant Recipients: A Universal Effort to Preserve Patients'' Lives and Allografts Kidney transplant (KTx) recipients have been recently classified by the Center for Disease Control and Prevention (CDC) as a high-risk group for severe COVID-19 [2] . All major adverse outcomes (O) of COVID-19 infection, i.e., hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV), acute kidney injury (AKI), acute respiratory syndrome (ARDS), and death, were recorded as were recovery and discharge. All major adverse outcomes (O) of COVID-19 infection, i.e., hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV), acute kidney injury (AKI), acute respiratory syndrome (ARDS), and death, were recorded as were recovery and discharge. A Case Report of Oligosymptomatic Kidney Transplant Patients with COVID-19: Do They Pose a Risk to Other Recipients?

title:
  A Systematic Review of COVID-19 Infection in Kidney Transplant Recipients: A Universal Effort to Preserve Patients’ Lives and Allografts

abstract:
  The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to physicians and healthcare systems worldwide. Evidence about kidney transplant (KTx) recipients is still limited. A systematic literature review was performed. We included 63 articles published from 1 January until 7 July 2020, reporting on 420 adult KTx recipients with confirmed COVID-19. The mean age of patients was 55 ± 15 years. There was a male predominance (67%). The majority (74%) were deceased donor recipients, and 23% were recently transplanted (<1 year). Most patients (88%) had at least one comorbidity, 29% had two, and 18% three. Ninety-three percent of cases were hospitalized. Among them, 30% were admitted to the intensive care unit, 45% developed acute respiratory distress syndrome, and 44% had acute kidney injury with 23% needing renal replacement therapy. From the hospitalized patients a total of 22% died, 59% were discharged, and 19% were still in hospital at the time of publication. Immunosuppression was reduced in 27%, discontinued in 31%, and remained unchanged in 5%. Hydroxychloroquine was administered to 78% of patients, antibiotics to 73%, and antivirals to 30% while 25% received corticosteroid boluses, 28% received anti-interleukin agents, and 8% were given immunoglobulin. The main finding of our analysis was that the incidence of COVID-19 among kidney transplant patients is not particularly high, but when they do get infected, this is related to significant morbidity and mortality.


id: cord-318018-ybdkp398
author: Bruni, Margherita
date: 2020-10-01
txt: ./txt/cord-318018-ybdkp398.txt
cache: ./cache/cord-318018-ybdkp398.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9103188
doi: 10.3390/jcm9103188
summary:
  Sera from healthcare workers affected by non-severe COVID-19 were longitudinally collected over four weeks, and compared to sera from patients hospitalized in Intensive Care Units (ICU) and SARS-CoV-2-negative subjects for the presence of IgM, IgG and IgA antibodies as well as soluble pro-inflammatory mediators in the sera. Our data show that humoral immune responses against SARS-CoV-2 correlated with disease severity in terms of both antibody titers, persistence over time and serum levels of pro-inflammatory cytokines. Here we show that humoral immune responses against SARS-CoV-2 correlated with disease severity in terms of both antibody titers, persistence over time and serum levels of pro-inflammatory mediators. Moreover, we showed that the vast majority of COVID-19 mildly symptomatic patients analyzed in the study halved their anti-RBD antibody titers after 4 weeks from viral negativization, thus confirming the short lifespan of humoral immune responses against SARS-CoV-2.

title:
  Persistence of Anti-SARS-CoV-2 Antibodies in Non-Hospitalized COVID-19 Convalescent Health Care Workers

abstract:
  Although antibody response to SARS-CoV-2 can be detected early during the infection, several outstanding questions remain to be addressed regarding the magnitude and persistence of antibody titer against different viral proteins and their correlation with the strength of the immune response. An ELISA assay has been developed by expressing and purifying the recombinant SARS-CoV-2 Spike Receptor Binding Domain (RBD), Soluble Ectodomain (Spike), and full length Nucleocapsid protein (N). Sera from healthcare workers affected by non-severe COVID-19 were longitudinally collected over four weeks, and compared to sera from patients hospitalized in Intensive Care Units (ICU) and SARS-CoV-2-negative subjects for the presence of IgM, IgG and IgA antibodies as well as soluble pro-inflammatory mediators in the sera. Non-hospitalized subjects showed lower antibody titers and blood pro-inflammatory cytokine profiles as compared to patients in Intensive Care Units (ICU), irrespective of the antibodies tested. Noteworthy, in non-severe COVID-19 infections, antibody titers against RBD and Spike, but not against the N protein, as well as pro-inflammatory cytokines decreased within a month after viral clearance. Thus, rapid decline in antibody titers and in pro-inflammatory cytokines may be a common feature of non-severe SARS-CoV-2 infection, suggesting that antibody-mediated protection against re-infection with SARS-CoV-2 is of short duration. These results suggest caution in using serological testing to estimate the prevalence of SARS-CoV-2 infection in the general population.


id: cord-318211-hhp84ygq
title: Pregnancy-Related Complications in Women with Recurrent Pregnancy Loss: A Prospective Cohort Study
author: Ticconi, Carlo
date: 2020-09-01
txt: ./txt/cord-318211-hhp84ygq.txt
cache: ./cache/cord-318211-hhp84ygq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32882985/
doi: 10.3390/jcm9092833
summary:
  The aim of this prospective cohort study was to determine whether women with recurrent pregnancy loss (RPL) have an increased risk of pregnancy complications compared to normal pregnant women. This observation suggests that the number of miscarriages-a likely indicator of the gravity of the condition-is a major determinant of the reproductive success of women with RPL; in fact, it has been reported that the live birth rates in the successive pregnancy in women with two consecutive losses is around 75% [4, 5] . This prospective, observational, study has been carried out to investigate the occurrence rates of major gestational complications in a cohort of women with RPL compared to normal healthy women without RPL followed during their first subsequent pregnancy after referral.

abstract:
  The aim of this prospective cohort study was to determine whether women with recurrent pregnancy loss (RPL) have an increased risk of pregnancy complications compared to normal pregnant women. A total of 1092 singleton pregnancies were followed, 431 in women with RPL and 661 in normal healthy women. The prevalence of the following complications was observed: threatened miscarriage, miscarriage, cervical insufficiency, chromosomal/genetic abnormalities, fetal anomalies, oligohydramnios, polyhydramnios, fetal growth restriction, intrauterine fetal death, gestational diabetes mellitus (GDM), preeclampsia, placenta previa, abruptio placentae, pregnancy-related liver disorders, and preterm premature rupture of the membranes. The odds ratio and 95% CI for each pregnancy complication considered were determined by comparing women with RPL and normal healthy women. Women with RPL had an overall rate of pregnancy complications higher than normal women (OR = 4.37; 95% CI: 3.353–5.714; p < 0.0001). Their risk was increased for nearly all the conditions considered. They also had an increased risk of multiple concomitant pregnancy complications (OR = 4.64; 95% CI: 3.10–6.94, p < 0.0001). Considering only women with RPL, women with ≥3 losses had a higher risk of pregnancy complications than women with two losses (OR = 1.269; 95% CI: 1.112–2.386, p < 0.02). No differences were found in the overall risk of pregnancy complications according to the type, explained or unexplained, of RPL. Women with secondary RPL had an increased risk of GDM than women with primary RPL. Pregnancy in women with RPL should be considered at high risk.


id: cord-320823-a1fq6mno
author: Moula, Amalia Ioanna
date: 2020-08-19
txt: ./txt/cord-320823-a1fq6mno.txt
cache: ./cache/cord-320823-a1fq6mno.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9092685
doi: 10.3390/jcm9092685
summary:
  Patients with pre-existing cardiovascular disease (CVD) might be more susceptible to infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and have higher mortality rates. Sex, age, presence of CAD and/or other types of CVD, hypertension, cerebrovascular diseases and diabetes mellitus increase mortality in patients with COVID-19. Therefore, the present meta-analysis is aimed to quantify the risk of mortality in relation to sex, age and pre-existing CVD in COVID-19 patients, and attempt to identify the potential factors involved in such a causation. In our analysis, we quantified the risk of death in almost 8500 COVID-19 patients in relation to sex, age, pre-existing CVD and cardiovascular risk factors. The third finding of our meta-analysis is that the presence of cardiovascular diseases, is associated with a higher risk of mortality when compared to COVID-19 patients without pre-existing CVD. Our results demonstrate that sex, age, presence of CAD and/or other types of CVD, hypertension, cerebrovascular diseases and diabetes mellitus increase mortality in patients with COVID-19.

title:
  Quantification of Death Risk in Relation to Sex, Pre-Existing Cardiovascular Diseases and Risk Factors in COVID-19 Patients: Let’s Take Stock and See Where We Are

abstract:
  Patients with pre-existing cardiovascular disease (CVD) might be more susceptible to infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and have higher mortality rates. Nevertheless, the risk of mortality has not been previously quantified. The aim of this meta-analysis is to quantify the risk of mortality in coronavirus disease 2019 (COVID-19) patients. A meta-analysis was conducted analyzing the impact of (1) sex, (2) age, (3) CVD with coronary artery disease (CAD), (4) CAD alone, (5) CVD without CAD, (6) hypertension, (7) cerebrovascular diseases, and (8) diabetes on mortality. Relative risk was assessed for dichotomous variables, mean difference for continuous variables. Twenty-six studies were included, encompassing 8497 patients. Males had 16% higher risk of mortality than females (p < 0.05) and elderly patients had higher chance of dying than younger patients (p < 0.0001). Patients with overall CVD have a 1.96-fold higher mortality risk (p < 0.0001). CAD increases risk of mortality by 1.90-fold (p < 0.05). CVD-CAD were found to increase risk up to 2.03-fold (p < 0.05). Hypertension, cerebrovascular disease and diabetes increase the risk of death up to 1.73-fold, 1.76-fold and 1.59-fold, respectively (p < 0.0001, p < 0.0001, p < 0.05, respectively). Sex, age, presence of CAD and/or other types of CVD, hypertension, cerebrovascular diseases and diabetes mellitus increase mortality in patients with COVID-19.


id: cord-320882-cr0ccsnp
title: Smoking and SARS-CoV-2 Disease (COVID-19): Dangerous Liaisons or Confusing Relationships?
author: Li Volti, Giovanni
date: 2020-05-02
txt: ./txt/cord-320882-cr0ccsnp.txt
cache: ./cache/cord-320882-cr0ccsnp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32370269/
doi: 10.3390/jcm9051321
abstract: We read with great interest the article by Brake SJ and colleagues [...].
summary:
  Keywords: COVID-19; SARS-Cov-2; smoking; angiotensin-converting enzyme-2 We read with great interest the article by Brake SJ and colleagues [1] investigating the relationship between smoking and angiotensin-converting enzyme-2 (ACE-2) and the potential implication for COVID-19. The authors present findings linking ACE-2 expression to smoking in a variety of experimental models together with observations of their own; immunohistochemistry data showing an increased expression of ACE-2 in a series of biopsies from a group of current smokers with chronic obstructive pulmonary disease when compared to a control group. The authors then venture into reporting existing Chinese case reports to support their hypothesis that smoking could increase the risk of COVID-19 via upregulation of ACE-2 expression, a known cellular entry gateway for SARS-CoV-2 [2] . Smoking upregulates angiotensin-converting enzyme-2 receptor: A potential adhesion site for novel coronavirus SARS-CoV-2 (Covid-19) Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: Molecular mechanisms and potential therapeutic target


id: cord-322184-kgv9f58a
author: Sohn, Yujin
date: 2020-09-10
txt: ./txt/cord-322184-kgv9f58a.txt
cache: ./cache/cord-322184-kgv9f58a.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32927798/
doi: 10.3390/jcm9092924
summary:
  Conclusions: In conclusion, our study suggests that even if viral shedding is sustained in asymptomatic or mildly symptomatic patients with later phase of COVID-19, it can be expected that the transmission risk of the virus is low. In this study, we attempted to confirm the presence of viable virus by performing RT-PCR assay and culture using salivary and nasopharyngeal swabs of asymptomatic or mildly symptomatic COVID-19 patients who had been diagnosed with the disease and admitted to a CTC at least two weeks previously. Therefore, based on the evidence that the virus is rarely detected in respiratory specimens after 10 days following the onset of symptoms, especially in mild or asymptomatic cases of SARS-CoV-2 infection, even if viral shedding is sustained in the later phase of COVID-19, it can be expected that the transmission risk of the virus is low.

title:
  Assessing Viral Shedding and Infectivity of Asymptomatic or Mildly Symptomatic Patients with COVID-19 in a Later Phase

abstract:
  Background: The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a major global public health issue. SARS-CoV-2 infection is confirmed by the detection of viral RNA using reverse transcription polymerase chain reaction (RT-PCR). Prolonged viral shedding has been reported in patients with SARS-CoV-2 infection, but the presence of viral RNA does not always correlate with infectivity. Therefore, the present study aimed to confirm the presence of viable virus in asymptomatic or mildly symptomatic patients in the later phase of the disease, more than two weeks after diagnosis. Method: Asymptomatic or mildly symptomatic COVID-19 patients who had been diagnosed with the disease at least two weeks previously and admitted to a community treatment center (CTC) from 15 March to 10 April 2020 were enrolled in this study. Nasopharyngeal and salivary swab specimens were collected from each patient. Using these specimens, RT-PCR assay and viral culture were performed. Result: In total, 48 patients were enrolled in this study. There were no significant differences in baseline characteristics between the asymptomatic and mildly symptomatic patient groups. RT-PCR assay and viral culture of SARS-CoV-2 were performed using nasopharyngeal and salivary swabs. The results of RT-PCR performed using salivary swab specimens, in terms of cycle threshold (Ct) values, were similar to those of RT-PCR using nasopharyngeal swab specimens. In addition, no viable virus could be cultured from swab specimens collected from the late-phase COVID-19 patients with prolonged viral RNA shedding. Conclusions: In conclusion, our study suggests that even if viral shedding is sustained in asymptomatic or mildly symptomatic patients with later phase of COVID-19, it can be expected that the transmission risk of the virus is low. In addition, saliva can be used as a reliable specimen for the diagnosis of SARS-CoV-2 infection.


id: cord-325014-n7mnhk2v
author: Gujski, Mariusz
date: 2020-10-11
txt: ./txt/cord-325014-n7mnhk2v.txt
cache: ./cache/cord-325014-n7mnhk2v.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9103245
doi: 10.3390/jcm9103245
summary:
  As the time window for a positive RT-PCR result is short, serological testing, which provides information about whether a person has been exposed to SARS-CoV-2, may be useful for epidemiological purposes to detect the overall burden of previous infection in a given community. The aim of this study was to determine the prevalence of current and past SARS-CoV-2 infections among police employees, a high-risk population due to their professional duties, during the COVID-19 epidemic. Neither sex (p =0.155) nor other variables listed in Figure 2 were significantly associated with the IgG results ( Figure 2 A logistic regression model predicting a positive anti-SARS-CoV-2 IgM+IgA index was developed (Cox and Snell R Square at 0.015 andNagelkerke R Square at 0.033). After including all variables listed in Figures 1 and 2 along with the number of registered cases and deaths due to COVID-19 (per 10,000 inhabitants), only 4 variables showed a correlation with a positive anti-SARS-CoV-2 IgM+IgA index.

title:
  Prevalence of Current and Past SARS-CoV-2 Infections among Police Employees in Poland, June–July 2020

abstract:
  Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine the prevalence of current and past SARS-CoV-2 infections among police employees. Methods: This cross-sectional survey was undertaken among 5082 police employees from Mazowieckie Province, Poland. RT-PCR testing for current SARS-CoV-2 infection and serological tests (ELISA) for the presence of anti-SARS-CoV-2 IgM+IgA and IgG antibodies were performed. Results: All RT-PCR tests were negative. The anti-SARS-CoV-2 IgM+IgA index was positive (>8) in 8.9% of participants, including 11.2% women and 7.7% men (p < 0.001). Equivocal IgM+IgA index (6–8) was found in 9.8% of participants, including 11.9% women and 8.7% men (p < 0.001). The IgG index was positive (>6) in 4.3% and equivocal (4–6) in 13.2% of participants. A higher odds of positive IgM+IgA index was found in women vs. men (OR: 1.742) and police officers vs. civilian employees (OR: 1.411). Participants aged ≥60 years had a higher odds of positive IgG index vs. those aged 20–29 years (OR: 3.309). Daily vaping also increased the odds of positive IgG index (OR: 2.058). Conclusions: The majority of Polish police employees are seronegative for SARS-CoV-2 infection. Vaping and older age (≥60 years) were associated with a higher risk of SARS-CoV-2 infection.


id: cord-325093-g2llk2p0
title: COVID-19 Deaths: Are We Sure It Is Pneumonia? Please, Autopsy, Autopsy, Autopsy!
author: Pomara, Cristoforo
date: 2020-04-26
txt: ./txt/cord-325093-g2llk2p0.txt
cache: ./cache/cord-325093-g2llk2p0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32357503/
doi: 10.3390/jcm9051259
summary:
  The current outbreak of COVID-19 severe respiratory disease, which started in Wuhan, China, is an ongoing challenge, and a major threat to public health that requires surveillance, prompt diagnosis, and research efforts to understand this emergent pathogen and to develop an effective response. Due to the scientific community''s efforts, there is an increasing body of published studies describing the virus'' biology, its transmission and diagnosis, its clinical features, its radiological findings, and the development of candidate therapeutics and vaccines. Only by working with a complete set of histological samples obtained through autopsy can one ascertain the exact cause(s) of death, optimize clinical management, and assist clinicians in pointing out a timely and effective treatment to reduce mortality. Due to scientific community''s efforts, there is an increasing body of published studies describing the COVID-19''s biology, its transmission and diagnosis, its clinical features, its radiological findings, and the development of candidate therapeutics and vaccines.

abstract:
  The current outbreak of COVID-19 severe respiratory disease, which started in Wuhan, China, is an ongoing challenge, and a major threat to public health that requires surveillance, prompt diagnosis, and research efforts to understand this emergent pathogen and to develop an effective response. Due to the scientific community’s efforts, there is an increasing body of published studies describing the virus’ biology, its transmission and diagnosis, its clinical features, its radiological findings, and the development of candidate therapeutics and vaccines. Despite the decline in postmortem examination rate, autopsy remains the gold standard to determine why and how death happens. Defining the pathophysiology of death is not only limited to forensic considerations; it may also provide useful clinical and epidemiologic insights. Selective approaches to postmortem diagnosis, such as limited postmortem sampling over full autopsy, can also be useful in the control of disease outbreaks and provide valuable knowledge for managing appropriate control measures. In this scenario, we strongly recommend performing full autopsies on patients who died with suspected or confirmed COVID-19 infection, particularly in the presence of several comorbidities. Only by working with a complete set of histological samples obtained through autopsy can one ascertain the exact cause(s) of death, optimize clinical management, and assist clinicians in pointing out a timely and effective treatment to reduce mortality. Death can teach us not only about the disease, it might also help with its prevention and, above all, treatment.


id: cord-325307-agaau27o
title: Skin Manifestations in COVID-19: Prevalence and Relationship with Disease Severity
author: Giavedoni, Priscila
date: 2020-10-12
txt: ./txt/cord-325307-agaau27o.txt
cache: ./cache/cord-325307-agaau27o.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9103261
doi: 10.3390/jcm9103261
summary:
  Cutaneous lesions could be categorized into six patterns represented by the acronym "GROUCH": Generalized maculo-papular (20.7%), Grover''s disease and other papulo-vesicular eruptions (13.8%), livedo Reticularis (6.9%), Other eruptions (22.4%), Urticarial (6.9%), and CHilblain-like (29.3%). Patients with chilblain-like lesions exhibited a characteristic histology and were significantly younger and presented lower rates of systemic symptoms, radiological lung infiltrates and analytical abnormalities, and hospital and ICU admission compared to the rest of patients. These skin manifestations are represented by the acronym "GROUCH": Generalized maculo-papular; Grover''s disease and other papulo-vesicular; livedo Reticularis; Other eruptions; Urticarial; and CHilblain-like. Fourth, the detailed information on clinical manifestations other than cutaneous, radiological findings, analytical parameters, and particularly comprehensive histopathology data including immunofluorescence and IHC allowed us to better characterize the chilblain-like pattern as having largely specific features. Notably, patients with chilblain-like lesions have distinctive clinical and histological features and have less severe manifestations of the disease.

abstract:
  Background: Data on the clinical patterns and histopathology of SARS-CoV-2 related skin lesions, as well as on their relationship with the severity of COVID-19 are limited. Methods and Materials: Retrospective analysis of a prospectively collected cohort of patients with SARS-CoV-2 infection in a teaching hospital in Barcelona, Spain, from 1 April to 1 May 2020. Clinical, microbiological and therapeutic characteristics, clinicopathological patterns of skin lesions, and direct immunofluorescence and immunohistochemical findings in skin biopsies were analyzed. Results: Fifty-eight out of the 2761 patients (2.1%) either consulting to the emergency room or admitted to the hospital for COVID-19 suspicion during the study period presented COVID-19 related skin lesions. Cutaneous lesions could be categorized into six patterns represented by the acronym “GROUCH”: Generalized maculo-papular (20.7%), Grover’s disease and other papulo-vesicular eruptions (13.8%), livedo Reticularis (6.9%), Other eruptions (22.4%), Urticarial (6.9%), and CHilblain-like (29.3%). Skin biopsies were performed in 72.4%, including direct immunofluorescence in 71.4% and immunohistochemistry in 28.6%. Patients with chilblain-like lesions exhibited a characteristic histology and were significantly younger and presented lower rates of systemic symptoms, radiological lung infiltrates and analytical abnormalities, and hospital and ICU admission compared to the rest of patients. Conclusion: Cutaneous lesions in patients with COVID-19 appear to be relatively rare and varied. Patients with chilblain-like lesions have a characteristic clinicopathological pattern and a less severe presentation of COVID-19.


id: cord-325559-di8lljoi
title: Does SARS-CoV-2 Trigger Stress-Induced Autoimmunity by Molecular Mimicry? A Hypothesis
author: Cappello, Francesco
date: 2020-06-29
txt: ./txt/cord-325559-di8lljoi.txt
cache: ./cache/cord-325559-di8lljoi.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9072038
doi: 10.3390/jcm9072038
summary:
  Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced disease (COVID-19) is a planetary emergency that is urging many research groups to redirect their efforts and to channel their experience towards understanding its pathogenesis. These human epitopes, in turn, can be recognized by circulating antibodies made against crossreactive microbial antigens; these antibodies behave like autoantibodies, causing the destruction of the stressed cells, representing a typical example of pathology caused by molecular mimicry and manifested as autoimmunity [30] . We hypothesize that, at the basis of the generalized activation of the immune system, there are molecular mimicry phenomena: the antibodies produced against the virus could turn into autoantibodies against crossreactive proteins expressed on human cells, causing autoimmunity with cell destruction. We hypothesize that, at the basis of the generalized activation of the immune system, there are molecular mimicry phenomena: the antibodies produced against the virus could turn into autoantibodies against crossreactive proteins expressed on human cells, causing autoimmunity with cell destruction.

abstract:
  Viruses can generate molecular mimicry phenomena within their hosts. Why should severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) not be considered one of these? Information in this short review suggests that it might be so and, thus, encourages research aiming at testing this possibility. We propose, as a working hypothesis, that the virus induces antibodies and that some of them crossreact with host’s antigens, thus eliciting autoimmune phenomena with devasting consequences in various tissues and organs. If confirmed, by in vitro and in vivo tests, this could drive researchers to find effective treatments against the virus.


id: cord-326834-eeldyj2u
title: Characteristics and Prognosis of COVID-19 in Patients with COPD
author: Graziani, Desirée
date: 2020-10-12
txt: ./txt/cord-326834-eeldyj2u.txt
cache: ./cache/cord-326834-eeldyj2u.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9103259
doi: 10.3390/jcm9103259
summary:
  Patients with Chronic Obstructive Pulmonary Disease (COPD) have a higher prevalence of coronary ischemia and other factors that put them at risk for COVID-19-related complications. Several observational and case-control studies have confirmed a higher prevalence of cardiovascular diseases in COPD patients than in the general population, possibly due to the coexistence of common risk factors or an associated pathogenic mechanism [11] . Subsequently, a systematic review and meta-analysis showed that, although the prevalence of COPD in COVID-19 cases was low, SARS-CoV-2 infection was associated with high rates of severity and mortality in patients with COPD [20] . Most patients admitted for COVID-19 presented pulmonary infiltrates compatible with SARS-CoV-2 pneumonia and, in some cases, with associated heart failure; this finding markedly differed from patients with COPD exacerbation due to other viral causes.

abstract:
  Patients with Chronic Obstructive Pulmonary Disease (COPD) have a higher prevalence of coronary ischemia and other factors that put them at risk for COVID-19-related complications. We aimed to explore the impact of COVID-19 in a large population-based sample of patients with COPD in Castilla-La Mancha, Spain. We analyzed clinical data in electronic health records from 1 January to 10 May 2020 by using Natural Language Processing through the SAVANA Manager(®) clinical platform. Out of 31,633 COPD patients, 793 had a diagnosis of COVID-19. The proportion of patients with COVID-19 in the COPD population (2.51%; 95% CI 2.33–2.68) was significantly higher than in the general population aged >40 years (1.16%; 95% CI 1.14–1.18); p < 0.001. Compared with COPD-free individuals, COPD patients with COVID-19 showed significantly poorer disease prognosis, as evaluated by hospitalizations (31.1% vs. 39.8%: OR 1.57; 95% CI 1.14–1.18) and mortality (3.4% vs. 9.3%: OR 2.93; 95% CI 2.27–3.79). Patients with COPD and COVID-19 were significantly older (75 vs. 66 years), predominantly male (83% vs. 17%), smoked more frequently, and had more comorbidities than their non-COPD counterparts. Pneumonia was the most common diagnosis among COPD patients hospitalized due to COVID-19 (59%); 19% of patients showed pulmonary infiltrates suggestive of pneumonia and heart failure. Mortality in COPD patients with COVID-19 was associated with older age and prevalence of heart failure (p < 0.05). COPD patients with COVID-19 showed higher rates of hospitalization and mortality, mainly associated with pneumonia. This clinical profile is different from exacerbations caused by other respiratory viruses in the winter season.


id: cord-327610-cm3vkpcn
title: Virus-Induced Asthma Exacerbations: SIRT1 Targeted Approach
author: Fukuda, Yosuke
date: 2020-08-13
txt: ./txt/cord-327610-cm3vkpcn.txt
cache: ./cache/cord-327610-cm3vkpcn.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9082623
doi: 10.3390/jcm9082623
summary:
  The pathological role of cellular senescence, especially that involving the silent information regulator 2 homolog sirtuin (SIRT) protein family, has recently been demonstrated in stable and exacerbated chronic respiratory disease states. Thus, SIRT1 activators, including resveratrol, may be effective in targeting CXCL8-induced neutrophilic airway inflammation in virus-induced and steroid-resistant asthma exacerbations [58, 59] . These lines of evidence suggest that activation of SIRT1 may lead to suppression of neutrophilic inflammation, possibly through suppression of CXCL8 and may be an effective therapeutic strategy, especially for steroid-resistant virus-induced asthma exacerbations. These results indicated that SIRT1 activation could be a novel therapeutic strategy for virus-induced asthma exacerbations by regulating MMP-9 expression and suppressing airway neutrophilic inflammation and remodeling. These data suggested that SIRT1 activation may ameliorate IgE-mediated airway inflammation in viral-induced asthma exacerbations, whereas the detailed mechanism by which omalizumab blocks IgE is unclear and requires further study.

abstract:
  The prevalence of asthma has increased worldwide. Asthma exacerbations triggered by upper respiratory tract viral infections remain a major clinical problem and account for hospital admissions and time lost from work. Virus-induced asthma exacerbations cause airway inflammation, resulting in worsening asthma and deterioration in the patients’ quality of life, which may require systemic corticosteroid therapy. Despite recent advances in understanding the cellular and molecular mechanisms underlying asthma exacerbations, current therapeutic modalities are inadequate for complete prevention and treatment of these episodes. The pathological role of cellular senescence, especially that involving the silent information regulator 2 homolog sirtuin (SIRT) protein family, has recently been demonstrated in stable and exacerbated chronic respiratory disease states. This review discusses the role of SIRT1 in the pathogenesis of bronchial asthma. It also discusses the role of SIRT1 in inflammatory cells that play an important role in virus-induced asthma exacerbations. Recent studies have hypothesized that SIRT1 is one of major contributors to cellular senescence. SIRT1 levels decrease in Th2 and non-Th2-related airway inflammation, indicating the role of SIRT1 in several endotypes and phenotypes of asthma. Moreover, several models have demonstrated relationships between viral infection and SIRT1. Therefore, targeting SIRT1 is a novel strategy that may be effective for treating virus-induced asthma exacerbations in the future.


id: cord-331347-imexhlwn
author: Anzai, Asami
date: 2020-02-24
txt: ./txt/cord-331347-imexhlwn.txt
cache: ./cache/cord-331347-imexhlwn.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32102279/
doi: 10.3390/jcm9020601
summary:
  Data on confirmed cases diagnosed outside China were analyzed using statistical models to estimate the impact of travel reduction on three epidemiological outcome measures: (i) the number of exported cases, (ii) the probability of a major epidemic, and (iii) the time delay to a major epidemic. We aim to estimate reductions in the number of exported cases, probability of an outbreak occurring outside China, and any time delay to a major epidemic that may be gained with these policies. The present study explicitly quantified the epidemiological impact of reduced travel volume to and from China on the transmission dynamics of COVID-19 outside China using simple statistical The solid lines represent the probability of a major epidemic in the counterfactual scenario, i.e., based on the expected number of cases diagnosed in Japan.

title:
  Assessing the Impact of Reduced Travel on Exportation Dynamics of Novel Coronavirus Infection (COVID-19)

abstract:
  The impact of the drastic reduction in travel volume within mainland China in January and February 2020 was quantified with respect to reports of novel coronavirus (COVID-19) infections outside China. Data on confirmed cases diagnosed outside China were analyzed using statistical models to estimate the impact of travel reduction on three epidemiological outcome measures: (i) the number of exported cases, (ii) the probability of a major epidemic, and (iii) the time delay to a major epidemic. From 28 January to 7 February 2020, we estimated that 226 exported cases (95% confidence interval: 86,449) were prevented, corresponding to a 70.4% reduction in incidence compared to the counterfactual scenario. The reduced probability of a major epidemic ranged from 7% to 20% in Japan, which resulted in a median time delay to a major epidemic of two days. Depending on the scenario, the estimated delay may be less than one day. As the delay is small, the decision to control travel volume through restrictions on freedom of movement should be balanced between the resulting estimated epidemiological impact and predicted economic fallout.


id: cord-332180-dw4h69tp
title: Using Machine Learning to Predict ICU Transfer in Hospitalized COVID-19 Patients
author: Cheng, Fu-Yuan
date: 2020-06-01
txt: ./txt/cord-332180-dw4h69tp.txt
cache: ./cache/cord-332180-dw4h69tp.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9061668
doi: 10.3390/jcm9061668
summary:
  We developed a machine learning-based risk prioritization tool that predicts ICU transfer within 24 h, seeking to facilitate efficient use of care providers'' efforts and help hospitals plan their flow of operations. The primary aim of this study is to develop a novel supervised machine learning classifier for predicting the risk of ICU transfer within the next 24 h for COVID-19 patients using hospital EMR data. The following data were retrospectively collected from the Mount Sinai Health System COVID-19 registry, sourced from an EPIC EHR system: demographic information, time-series of the admission-discharge-transfer events, structured and semi-structured clinical assessments, vital signs from nursing flowsheets, and laboratory and electrocardiogram (ECG) results. Using machine learning, we developed a model for identifying deteriorating patients in need of ICU transfer by using data routinely collected during inpatient care. Using machine learning, we developed a model for identifying deteriorating patients in need of ICU transfer by using data routinely collected during inpatient care.

abstract:
  Objectives: Approximately 20–30% of patients with COVID-19 require hospitalization, and 5–12% may require critical care in an intensive care unit (ICU). A rapid surge in cases of severe COVID-19 will lead to a corresponding surge in demand for ICU care. Because of constraints on resources, frontline healthcare workers may be unable to provide the frequent monitoring and assessment required for all patients at high risk of clinical deterioration. We developed a machine learning-based risk prioritization tool that predicts ICU transfer within 24 h, seeking to facilitate efficient use of care providers’ efforts and help hospitals plan their flow of operations. Methods: A retrospective cohort was comprised of non-ICU COVID-19 admissions at a large acute care health system between 26 February and 18 April 2020. Time series data, including vital signs, nursing assessments, laboratory data, and electrocardiograms, were used as input variables for training a random forest (RF) model. The cohort was randomly split (70:30) into training and test sets. The RF model was trained using 10-fold cross-validation on the training set, and its predictive performance on the test set was then evaluated. Results: The cohort consisted of 1987 unique patients diagnosed with COVID-19 and admitted to non-ICU units of the hospital. The median time to ICU transfer was 2.45 days from the time of admission. Compared to actual admissions, the tool had 72.8% (95% CI: 63.2–81.1%) sensitivity, 76.3% (95% CI: 74.7–77.9%) specificity, 76.2% (95% CI: 74.6–77.7%) accuracy, and 79.9% (95% CI: 75.2–84.6%) area under the receiver operating characteristics curve. Conclusions: A ML-based prediction model can be used as a screening tool to identify patients at risk of imminent ICU transfer within 24 h. This tool could improve the management of hospital resources and patient-throughput planning, thus delivering more effective care to patients hospitalized with COVID-19.


id: cord-333520-v2sb90rc
author: Gardin, Chiara
date: 2020-08-26
txt: ./txt/cord-333520-v2sb90rc.txt
cache: ./cache/cord-333520-v2sb90rc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9092762
doi: 10.3390/jcm9092762
summary:
  Exosomes derived from mesenchymal stem cells (MSCs) are being explored for the management of a number of diseases that currently have limited or no therapeutic options, thanks to their anti-inflammatory, immunomodulatory, and pro-angiogenic properties. Next, we describe some of the most significant clinical evidence of the successful use of MSC-derived exosomes in animal models of lung and heart injuries, which might strengthen our hypothesis in terms of their utility for also treating critically ill COVID-19 patients. Recently, MSC-derived exosomes have been demonstrated to have comparable and even greater effects than cells themselves in improving inflammation and injury in a variety of pre-clinical lung disease models, including ALI/ARDS (Table 1) . From the studies discussed above, it emerged that the rationale for using MSC-derived exosomes, MVs, or EVs in ALI/ARDS is based on several processes, many of which are shared with those identified in the parent MSCs. These include immunomodulation and anti-inflammatory properties on host tissue, reduction of the permeability of alveolar epithelium and endothelium, improvement of alveolar fluid clearance, enhancement of macrophage phagocytosis, and tissue repair through direct mitochondrial transfer with host cells (Figure 2 ).

title:
  Could Mesenchymal Stem Cell-Derived Exosomes Be a Therapeutic Option for Critically Ill COVID-19 Patients?

abstract:
  Coronavirus disease 2019 (COVID-19) is a pandemic viral disease originated in Wuhan, China, in December 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severe form of the disease is often associated with acute respiratory distress syndrome (ARDS), and most critically ill patients require mechanical ventilation and support in intensive care units. A significant portion of COVID-19 patients also develop complications of the cardiovascular system, primarily acute myocardial injury, arrhythmia, or heart failure. To date, no specific antiviral therapy is available for patients with SARS-CoV-2 infection. Exosomes derived from mesenchymal stem cells (MSCs) are being explored for the management of a number of diseases that currently have limited or no therapeutic options, thanks to their anti-inflammatory, immunomodulatory, and pro-angiogenic properties. Here, we briefly introduce the pathogenesis of SARS-CoV-2 and its implications in the heart and lungs. Next, we describe some of the most significant clinical evidence of the successful use of MSC-derived exosomes in animal models of lung and heart injuries, which might strengthen our hypothesis in terms of their utility for also treating critically ill COVID-19 patients.


id: cord-333959-8ermzrmr
author: Gao, Zan
date: 2020-06-25
txt: ./txt/cord-333959-8ermzrmr.txt
cache: ./cache/cord-333959-8ermzrmr.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9061986
doi: 10.3390/jcm9061986
summary:
  Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, including declines in motor ability and physical activity (PA) participation, increased obesity, impaired cognition, and various psychological disorders. This generation has higher rates of chronic disease and disability compared to any other generation [8] , and studies have shown that the four most common poor health conditions seen in older adults are decreased motor ability, increased obesity, impaired cognition, and psychological disorders, which lead to a lower quality of life [9, 10] . For example, a home-based VR intervention, which used an Xbox 360 gaming console and Your Shape Fitness Evolved software and consisted of Tai Chi and Yoga exercise programs, indicated positive effects of VR exercise on older adults'' motor ability outcomes, such as hip muscle strength and balance control [22] .

title:
  Virtual Reality Exercise as a Coping Strategy for Health and Wellness Promotion in Older Adults during the COVID-19 Pandemic

abstract:
  The December 2019 COVID-19 outbreak in China has led to worldwide quarantine, as recommended by local governments and the World Health Organization. Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, including declines in motor ability and physical activity (PA) participation, increased obesity, impaired cognition, and various psychological disorders. Thus, given the secular increases in the older adult population, novel and effective intervention strategies are necessary to improve physical activity behaviors and health in this population. Virtual reality (VR)-integrated exercise is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. Therefore, the purpose of this editorial is to synthesize recent research examining the efficacy and effectiveness of VR exercise in the promotion of favorable health outcomes among the older adults. Results indicate the application of VR exercise to facilitate improved physical outcomes (e.g., enhanced motor ability, reduced obesity), cognition and psychological outcomes. VR exercise has also been observed to be an effective intervention strategy for fall prevention in this population. Future research should employ more rigorous research designs to allow for a more robust quantitative synthesis of the effect of VR exercise on the preceding outcomes to elucidate which type(s) of VR-based PA interventions are most effective in promoting improved health outcomes among older adults. Findings from this study will better inform the development of technology-savvy PA programs for wellness promotion in older adults who practice social distancing and exercise from home under the unprecedented global health crisis.


id: cord-336257-f6yglaz8
author: Forte, Giuseppe
date: 2020-06-10
txt: ./txt/cord-336257-f6yglaz8.txt
cache: ./cache/cord-336257-f6yglaz8.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9061802
doi: 10.3390/jcm9061802
summary:
  Although these results need to be considered with caution being based on self-reported data collected at the beginning of this emergency, they should be used as a starting point for further studies aimed to develop interventions to minimize both the brief and long-term psychological consequences of the COVID-19 pandemic. In both countries younger age, student status, female gender and direct contact with COVID-19 infection are associated with a greater psychological impact of the emergency, involving many psychopathological dimensions (e.g., anxiety, distress, sleep disturbance) [5] [6] [7] [8] [9] 26] . One of the aims of the study was to analyse the psychological impact of the COVID-19 outbreak in the different Italian territorial areas. Overall, the results highlighted high levels of anxiety, psychopathological symptoms and PTSD symptoms in Italian respondents during the first critical phase of the spread of the COVID-19 pandemic and of the Government measures taken to contain it.

title:
  The Enemy Which Sealed the World: Effects of COVID-19 Diffusion on the Psychological State of the Italian Population

abstract:
  Background: Starting from the first months of 2020, worldwide population has been facing the COVID-19 pandemic. Many nations, including Italy, took extreme actions to reduce the diffusion of the virus, profoundly changing lifestyles. The Italians have been faced with both the fear of contracting the infection and the consequences of enforcing social distancing. This study was aimed to understand the psychological impact of the COVID-19 outbreak and the psychopathological outcomes related to the first phase of this emergency. Methods: The study included 2291 respondents. An online survey collected information on socio-demographic variables, history of direct or indirect contact with COVID-19, and additional information concerning the COVID-19 emergency. Moreover, psychopathological symptoms such as anxiety, mood alterations and post-traumatic symptomatology were assessed. Results: The results revealed that respectively 31.38%, 37.19% and 27.72% of respondents reported levels of general psychopathological symptomatology, anxiety, and PTSD symptoms over the cut-off scores. Furthermore, a significant worsening of mood has emerged. Being a female or under the age of 50 years, having had direct contact with people infected by the COVID-19, and experiencing uncertainty about the risk of contagion represent risk factors for psychological distress. Conclusions: Our findings indicate that the first weeks of the COVID-19 pandemic appear to impact not only on physical health but also on psychological well-being. Although these results need to be considered with caution being based on self-reported data collected at the beginning of this emergency, they should be used as a starting point for further studies aimed to develop interventions to minimize both the brief and long-term psychological consequences of the COVID-19 pandemic.


id: cord-336810-77wq9laa
author: Klocperk, Adam
date: 2020-09-17
txt: ./txt/cord-336810-77wq9laa.txt
cache: ./cache/cord-336810-77wq9laa.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9093000
doi: 10.3390/jcm9093000
summary:
  Therefore, we observed a gradual increase of CRP, procalcitonin, ferritin, and serum IL-6 corresponding to the severity of the disease; however, these markers displayed a relative failure to upregulate in patients with a fatal course, who instead displayed high sIL2R and D-dimers ( Figure 1C ). Most markers of inflammation, the immune response, and liver damage presented in patients with a fatal course of COVID-19 so far seem mostly on par with those seen in patients with a moderate form of the disease, suggesting a weaker response to the infection compared to severely ill patients, which resulted in the patients'' deaths. In contrast, patients with fatal COVID-19 ( Figure 5B ) displayed a negative correlation between leukocytes and lymphocytes, and their inflammatory markers increased with markers of organ failure (liver enzymes, amylase, GGT, urea, and creatinine) and cytotoxic cellular immunity (activated CD38+ HLA-DR+ CD8 T cells) instead.

title:
  Complex Immunometabolic Profiling Reveals the Activation of Cellular Immunity and Biliary Lesions in Patients with Severe COVID-19

abstract:
  This study aimed to assess the key laboratory features displayed by coronavirus disease 2019 (COVID-19) inpatients that are associated with mild, moderate, severe, and fatal courses of the disease, and through a longitudinal follow-up, to understand the dynamics of the COVID-19 pathophysiology. All severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients admitted to the University Hospital in Motol between March and June 2020 were included in this study. A severe course of COVID-19 was associated with an elevation of proinflammatory markers; an efflux of immature granulocytes into peripheral blood; the activation of CD8 T cells, which infiltrated the lungs; transient liver disease. In particular, the elevation of serum gamma-glutamyl transferase (GGT) and histological signs of cholestasis were highly specific for patients with a severe form of the disease. In contrast, patients with a fatal course of COVID-19 failed to upregulate markers of inflammation, showed discoordination of the immune response, and progressed toward acute kidney failure. COVID-19 is a disease with a multi-organ affinity that is characterized by the activation of innate and cellular adaptive immunity. Biliary lesions with an elevation of GGT and the organ infiltration of interleukin 6 (IL-6)-producing cells are the defining characteristics for patients with the fulminant disease.


id: cord-345728-41k1bljo
author: Al’joboori, Yazi
date: 2020-08-26
txt: ./txt/cord-345728-41k1bljo.txt
cache: ./cache/cord-345728-41k1bljo.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9092765
doi: 10.3390/jcm9092765
summary:
  Non-patterned spinal cord stimulation (SCS), delivered by electrodes implanted in the epidural space of the spinal cord has been shown to elicit lower limb extensor movements in rats [3, 4] and humans [5] [6] [7] with motor complete SCI, via activation of large-to-medium diameter sensory International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI) before (pre) and after (post) the intervention for participants in transcutaneous spinal cord stimulation (tSCS) combined with sit-to-stand training (STIM (S)) and sit-to-stand training alone (NON-STIM (NS)) groups. The aim of this pilot study was to assess the feasibility of adding sub-threshold transcutaneous SCS to an 8-week sit-to-stand training intervention in individuals with chronic motor complete and incomplete SCI. The aim of this pilot study was to assess the feasibility of adding sub-threshold transcutaneous SCS to an 8-week sit-to-stand training intervention in individuals with chronic motor complete and incomplete SCI.

title:
  The Effects of Adding Transcutaneous Spinal Cord Stimulation (tSCS) to Sit-To-Stand Training in People with Spinal Cord Injury: A Pilot Study

abstract:
  Spinal cord stimulation may enable recovery of volitional motor control in people with chronic Spinal Cord Injury (SCI). In this study we explored the effects of adding SCS, applied transcutaneously (tSCS) at vertebral levels T10/11, to a sit-to-stand training intervention in people with motor complete and incomplete SCI. Nine people with chronic SCI (six motor complete; three motor incomplete) participated in an 8-week intervention, incorporating three training sessions per week. Participants received either tSCS combined with sit-to-stand training (STIM) or sit-to-stand training alone (NON-STIM). Outcome measures were carried out before and after the intervention. Seven participants completed the intervention (STIM N = 5; NON-STIM N = 2). Post training, improvements in International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) motor scores were noted in three STIM participants (range 1.0–7.0), with no change in NON-STIM participants. Recovery of volitional lower limb muscle activity and/or movement (with tSCS off) was noted in three STIM participants. Unassisted standing was not achieved in any participant, although standing with minimal assistance was achieved in one STIM participant. This pilot study has shown that the recruitment of participants, intervention and outcome measures were all feasible in this study design. However, some modifications are recommended for a larger trial.


id: cord-352668-qjlqsb2k
title: Consensus on Recommendations for Safe Sexual Activity during the COVID-19 Coronavirus Pandemic
author: Cabello, Francisco
date: 2020-07-20
txt: ./txt/cord-352668-qjlqsb2k.txt
cache: ./cache/cord-352668-qjlqsb2k.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32698369/
doi: 10.3390/jcm9072297
summary:
  Sexual activity offers numerous advantages for physical and mental health but maintains inherent risks in a pandemic situation, such as the current one caused by SARS-CoV-2. A group of experts from the Spanish Association of Sexuality and Mental Health (AESexSAME) has reached a consensus on recommendations to maintain lower-risk sexual activity, depending on one''s clinical and partner situations, based on the current knowledge of SARS-CoV-2. In all other cases (for those under quarantine, those with some clinical symptoms, health professionals in contact with COVID-19 patients, and during pregnancy), abstaining from coital/oral/anal sex, substituting it with masturbatory or virtual sexual activity to provide maximum protection from the contagion, and increasing the benefits inherent to sexual activity are recommended. Due to the ease of contagion and the lack of information about the possible transmission of SARS-CoV-2, a group of experts from the Spanish Association for Sexuality and Mental Health, covering the fields of sexology, psychiatry, psychology and medicine reached a consensus.

abstract:
  Sexual activity offers numerous advantages for physical and mental health but maintains inherent risks in a pandemic situation, such as the current one caused by SARS-CoV-2. A group of experts from the Spanish Association of Sexuality and Mental Health (AESexSAME) has reached a consensus on recommendations to maintain lower-risk sexual activity, depending on one’s clinical and partner situations, based on the current knowledge of SARS-CoV-2. Different situations are included in the recommendations: a sexual partner passing quarantine without any symptoms, a sexual partner that has not passed quarantine, a sexual partner with some suspicious symptoms of COVID-19, a positive sexual partner with COVID-19, a pregnant sexual partner, a health professional partner in contact with COVID-19 patients, and people without a sexual partner. The main recommendations include returning to engaging in safe sex after quarantine is over (28 days based on the duration one can carry SARS-CoV-2, or 33 days for those who are >60 years old) and all parties are asymptomatic. In all other cases (for those under quarantine, those with some clinical symptoms, health professionals in contact with COVID-19 patients, and during pregnancy), abstaining from coital/oral/anal sex, substituting it with masturbatory or virtual sexual activity to provide maximum protection from the contagion, and increasing the benefits inherent to sexual activity are recommended. For persons without a partner, not initiating sexual activity with a sporadic partner is strongly recommended.


id: cord-354717-4vrqzbof
author: Linton, Natalie M.
date: 2020-02-17
txt: ./txt/cord-354717-4vrqzbof.txt
cache: ./cache/cord-354717-4vrqzbof.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/jcm9020538
doi: 10.3390/jcm9020538
summary:
  title: Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data Using publicly available event-date data from the ongoing epidemic, the present study investigated the incubation period and other time intervals that govern the epidemiological dynamics of COVID-19 infections. The median time delay of 13 days from illness onset to death (17 days with right truncation) should be considered when estimating the COVID-19 case fatality risk. Using publicly available data from the ongoing epidemic with known case event dates, the present study aimed to estimate the incubation period and other time intervals that govern the interpretation of epidemiological dynamics of COVID-19 infections. The median time from illness onset to hospital admission was estimated at 3.3 days (95% CI: 2.7, 4.0) among living cases and 6.5 days (95% CI: 5.2, 8.0) among deceased cases using the gamma distribution, which provided the best fit for both sets of data.

title:
  Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data

abstract:
  The geographic spread of 2019 novel coronavirus (COVID-19) infections from the epicenter of Wuhan, China, has provided an opportunity to study the natural history of the recently emerged virus. Using publicly available event-date data from the ongoing epidemic, the present study investigated the incubation period and other time intervals that govern the epidemiological dynamics of COVID-19 infections. Our results show that the incubation period falls within the range of 2–14 days with 95% confidence and has a mean of around 5 days when approximated using the best-fit lognormal distribution. The mean time from illness onset to hospital admission (for treatment and/or isolation) was estimated at 3–4 days without truncation and at 5–9 days when right truncated. Based on the 95th percentile estimate of the incubation period, we recommend that the length of quarantine should be at least 14 days. The median time delay of 13 days from illness onset to death (17 days with right truncation) should be considered when estimating the COVID-19 case fatality risk.


