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18 | id2btkse | what are the best masks for preventing infection by Covid-19? | Lessons Learned During the COVID-19 Virus Pandemic |
11 | x74mcdah | what are the guidelines for triaging patients infected with coronavirus? | Síndrome respiratorio agudo grave. Una nueva enfermedad infecciosa emergente |
35 | es7h7wlk | What new public datasets are available related to COVID-19? | Is Working From Home The New Norm? An Observational Study Based on a Large Geo-tagged COVID-19 Twitter Dataset As the COVID-19 pandemic swept over the world, people discussed facts, expressed opinions, and shared sentiments on social media. Since the reaction to COVID-19 in different locations may be tied to local cases, government regulations, healthcare resources and socioeconomic factors, we curated a large geo-tagged Twitter dataset and performed exploratory analysis by location. Specifically, we collected 650,563 unique geo-tagged tweets across the United States (50 states and Washington, D.C.) covering the date range from January 25 to May 10, 2020. Tweet locations enabled us to conduct region-specific studies such as tweeting volumes and sentiment, sometimes in response to local regulations and reported COVID-19 cases. During this period, many people started working from home. The gap between workdays and weekends in hourly tweet volumes inspired us to propose algorithms to estimate work engagement during the COVID-19 crisis. This paper also summarizes themes and topics of tweets in our dataset using both social media exclusive tools (i.e., #hashtags, @mentions) and the latent Dirichlet allocation model. We welcome requests for data sharing and conversations for more insights. Dataset link: http://covid19research.site/geo-tagged_twitter_datasets/ |
1 | gu2mt6zp | what is the origin of COVID-19 | Emergence of Novel Coronavirus 2019-nCoV: Need for Rapid Vaccine and Biologics Development Novel Coronavirus (2019-nCoV) is an emerging pathogen that was first identified in Wuhan, China in late December 2019. This virus is responsible for the ongoing outbreak that causes severe respiratory illness and pneumonia-like infection in humans. Due to the increasing number of cases in China and outside China, the WHO declared coronavirus as a global health emergency. Nearly 35,000 cases were reported and at least 24 other countries or territories have reported coronavirus cases as early on as February. Inter-human transmission was reported in a few countries, including the United States. Neither an effective anti-viral nor a vaccine is currently available to treat this infection. As the virus is a newly emerging pathogen, many questions remain unanswered regarding the virus's reservoirs, pathogenesis, transmissibility, and much more is unknown. The collaborative efforts of researchers are needed to fill the knowledge gaps about this new virus, to develop the proper diagnostic tools, and effective treatment to combat this infection. Recent advancements in plant biotechnology proved that plants have the ability to produce vaccines or biopharmaceuticals rapidly in a short time. In this review, the outbreak of 2019-nCoV in China, the need for rapid vaccine development, and the potential of a plant system for biopharmaceutical development are discussed. |
24 | 3txvx2sk | what kinds of complications related to COVID-19 are associated with diabetes | A potential protective role of losartan against coronavirus-induced lung damage |
44 | 6tod4abn | How much impact do masks have on preventing the spread of the COVID-19? | Mask use during COVID-19: A risk adjusted strategy In the context of Coronavirus Disease (2019) (COVID-19) cases globally, there is a lack of consensus across cultures on whether wearing face masks is an effective physical intervention against disease transmission. This study 1) illustrates transmission routes of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2); 2) addresses controversies surrounding the mask from perspectives of attitude, effectiveness, and necessity of wearing the mask with evidence that the use of mask would effectively interrupt the transmission of infectious diseases in both hospital settings and community settings; and 3) provides suggestion that the public should wear the mask during COVID-19 pandemic according to local context. To achieve this goal, government should establish a risk adjusted strategy of mask use to scientifically publicize the use of masks, guarantee sufficient supply of masks, and cooperate for reducing health resources inequities. |
32 | p7ifetgw | Does SARS-CoV-2 have any subtypes, and if so what are they? | Does SARS‐CoV‐2 has a longer incubation period than SARS and MERS? The outbreak of a novel coronavirus (SARS‐CoV‐2) since December 2019 in Wuhan, the major transportation hub in central China, became an emergency of major international concern. While several etiological studies have begun to reveal the specific biological features of this virus, the epidemic characteristics need to be elucidated. Notably, a long incubation time was reported to be associated with SARS‐CoV‐2 infection, leading to adjustments in screening and control policies. To avoid the risk of virus spread, all potentially exposed subjects are required to be isolated for 14 days, which is the longest predicted incubation time. However, based on our analysis of a larger dataset available so far, we find there is no observable difference between the incubation time for SARS‐CoV‐2, severe acute respiratory syndrome coronavirus (SARS‐CoV), and middle east respiratory syndrome coronavirus (MERS‐CoV), highlighting the need for larger and well‐annotated datasets. |
31 | wjb7ltjx | How does the coronavirus differ from seasonal flu? | COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia OBJECTIVES: To investigate the clinical and chest CT characteristics of COVID-19 pneumonia and explore the radiological differences between COVID-19 and influenza. MATERIALS AND METHODS: A total of 122 patients (61 men and 61 women, 48 ± 15 years) confirmed with COVID-19 and 48 patients (23 men and 25 women, 47 ± 19 years) confirmed with influenza were enrolled in the study. Thin-section CT was performed. The clinical data and the chest CT findings were recorded. RESULTS: The most common symptoms of COVID-19 were fever (74%) and cough (63%), and 102 patients (83%) had Wuhan contact. Pneumonia in 50 patients with COVID-19 (45%) distributed in the peripheral regions of the lung, while it showed mixed distribution in 26 patients (74%) with influenza (p = 0.022). The most common CT features of the COVID-19 group were pure ground-glass opacities (GGO, 36%), GGO with consolidation (51%), rounded opacities (35%), linear opacities (64%), bronchiolar wall thickening (49%), and interlobular septal thickening (66%). Compared with the influenza group, the COVID-19 group was more likely to have rounded opacities (35% vs. 17%, p = 0.048) and interlobular septal thickening (66% vs. 43%, p = 0.014), but less likely to have nodules (28% vs. 71%, p < 0.001), tree-in-bud sign (9% vs. 40%, p < 0.001), and pleural effusion (6% vs. 31%, p < 0.001). CONCLUSIONS: There are significant differences in the CT manifestations of patients with COVID-19 and influenza. Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza. KEY POINTS: • Typical CT features of COVID-19 include pure ground-glass opacities (GGO), GGO with consolidation, rounded opacities, bronchiolar wall thickening, interlobular septal thickening, and a peripheral distribution. • Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza. |
37 | 0razl9qf | What is the result of phylogenetic analysis of SARS-CoV-2 genome sequence? | A candidate multi-epitope vaccine against SARS-CoV-2 In the past two decades, 7 coronaviruses have infected the human population, with two major outbreaks caused by SARS-CoV and MERS-CoV in the year 2002 and 2012, respectively. Currently, the entire world is facing a pandemic of another coronavirus, SARS-CoV-2, with a high fatality rate. The spike glycoprotein of SARS-CoV-2 mediates entry of virus into the host cell and is one of the most important antigenic determinants, making it a potential candidate for a vaccine. In this study, we have computationally designed a multi-epitope vaccine using spike glycoprotein of SARS-CoV-2. The overall quality of the candidate vaccine was validated in silico and Molecular Dynamics Simulation confirmed the stability of the designed vaccine. Docking studies revealed stable interactions of the vaccine with Toll-Like Receptors and MHC Receptors. The in silico cloning and codon optimization supported the proficient expression of the designed vaccine in E. coli expression system. The efficiency of the candidate vaccine to trigger an effective immune response was assessed by an in silico immune simulation. The computational analyses suggest that the designed multi-epitope vaccine is structurally stable which can induce specific immune responses and thus, can be a potential vaccine candidate against SARS-CoV-2. |
20 | ylr2b8ck | are patients taking Angiotensin-converting enzyme inhibitors (ACE) at increased risk for COVID-19? | COVID-19 and intracerebral haemorrhage: causative or coincidental? Pneumonia appears to be the most common manifestation of coronavirus disease 2019 (COVID-19), but some extrapulmonary involvement, such as gastrointestinal, cardiac and renal, has been reported. The limited clinical data about the virus's behavior to date, especially extrapulmonary symptoms, suggest that we should be aware of the possibility of initial cerebrovascular manifestations of COVID-19. |
17 | njkh20sv | are there any clinical trials available for the coronavirus | Rheumatologists' perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets The ongoing pandemic coronavirus disease 19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a matter of global concern. Environmental factors such as air pollution and smoking and comorbid conditions (hypertension, diabetes mellitus and underlying cardio-respiratory illness) likely increase the severity of COVID-19. Rheumatic manifestations such as arthralgias and arthritis may be prevalent in about a seventh of individuals. COVID-19 can result in acute interstitial pneumonia, myocarditis, leucopenia (with lymphopenia) and thrombocytopenia, also seen in rheumatic diseases like lupus and Sjogren's syndrome. Severe disease in a subset of patients may be driven by cytokine storm, possibly due to secondary hemophagocytic lymphohistiocytosis (HLH), akin to that in systemic onset juvenile idiopathic arthritis or adult-onset Still's disease. In the absence of high-quality evidence in this emerging disease, understanding of pathogenesis may help postulate potential therapies. Angiotensin converting enzyme 2 (ACE2) appears important for viral entry into pneumocytes; dysbalance in ACE2 as caused by ACE inhibitors or ibuprofen may predispose to severe disease. Preliminary evidence suggests potential benefit with chloroquine or hydroxychloroquine. Antiviral drugs like lopinavir/ritonavir, favipiravir and remdesivir are also being explored. Cytokine storm and secondary HLH might require heightened immunosuppressive regimens. Current international society recommendations suggest that patients with rheumatic diseases on immunosuppressive therapy should not stop glucocorticoids during COVID-19 infection, although minimum possible doses may be used. Disease-modifying drugs should be continued; cessation may be considered during infection episodes as per standard practices. Development of a vaccine may be the only effective long-term protection against this disease. |
2 | 11pcdnlw | how does the coronavirus respond to changes in the weather | The effect of ambient temperature on worldwide COVID-19 cases and deaths - an epidemiological study Background The role of ambient temperature in the spread of SARS-CoV-2 infections and subsequent deaths due to COVID-19 remains contentious. Coronaviruses such as the 2003 SARS-CoV showed an increased risk of transmission during cooler days. We sought to analyse the effects of ambient temperature on SARS-COV-2 transmission and deaths related to the virus. Methods The world population of COVID-19 cases and attributable deaths from the 23rd January 2020 to 11th April 2020 were analysed. Temperature 5 days before cases and 23 days prior to deaths (to account for the time lag of incubation period and time from symptoms to death) was compared to the average temperature experienced by the world population. Results The total number of cases during this period was 1,605,788 and total number of deaths was 103,471. The median temperature at the time of COVID-19 infection was 9.12C (10-90th percentile 4.29-17.97C) whilst the median temperature of the world population for the same period was 9.61C warmer at 18.73C (10-90th percentile 4.09-28.49C) with a notional p-value = 5.1 x10-11. The median temperature at the time of a COVID-19 death was 9.72C (10-90th percentile 5.39-14.11C) whilst the median temperature of the world population was 7.55C warmer at 17.27C (10-90th percentile 2.57C-27.76C) with a notional p-value = 1.1 x10-10. 80% of all COVID-19 related cases and deaths occurred between 4.29C and 17.97C. Conclusion A definitive association between infection rate and death from COVID-19 and ambient temperature exists, with the highest risk occurring around 9C. Governments should maintain vigilance with containment strategies when the ambient temperatures correspond to this highest risk. |
20 | cwfujgya | are patients taking Angiotensin-converting enzyme inhibitors (ACE) at increased risk for COVID-19? | Pathogenesis of severe acute respiratory syndrome Severe acute respiratory syndrome (SARS) is a zoonotic infectious disease caused by a novel coronavirus (CoV). The tissue tropism of SARS-CoV includes not only the lung, but also the gastrointestinal tract, kidney and liver. Angiotensin-converting enzyme 2 (ACE2), the C-type lectin CD209L (also known L-SIGN), and DC-SIGN bind SARS-CoV, but ACE2 appears to be the key functional receptor for the virus. There is a prominent innate immune response to SARS-CoV infection, including acute-phase proteins, chemokines, inflammatory cytokines and C-type lectins such as mannose-binding lectin, which plays a protective role against SARS. By contrast there may be a lack of type 1 interferon response. Moreover, lymphopenia with decreased numbers of CD4+ and CD8+ T cells is common during the acute phase. Convalescent patients have IgG-class neutralizing antibodies that recognize amino acids 441–700 of the spike protein (S protein) as the major epitope. |
50 | de5bchsb | what is known about an mRNA vaccine for the SARS-CoV-2 virus? | Presence of Subgenomic mRNAs in Virions of Coronavirus IBV Abstract The presence of subgenomic mRNAs in virions of IBV was examined by probing Northern blots of RNA extracted from virions using as a probe a cDNA of the 3′-terminal nucleocapsid protein (N) gene. This detects all five mRNAs because of the 3′-coterminal, nested-set arrangement of coronavirus mRNAs. The mRNAs were readily detected even after extensive purification of virions and after RNase A treatment of virions. In sucrose gradients the peaks of virus particles, genomic RNA (gRNA), and mRNAs were coincident. Cellular mRNA was not detected in virions. The molar ratio of gRNA to each mRNA ranged from about 10 to 30 for IBV-Beaudette and 25 to 800 for IBV-M41. The molar ratio of genomic to intracellular viral mRNAs was also determined. From this it was estimated that the efficiency of incorporation of gRNA into virions was at least 20- to 100-fold greater, depending on the mRNA species, for IBV-Beaudette and 100- to 500-fold for IBV-M41. It is concluded that most virions contain only gRNA or contain only one species of mRNA on average in addition to gRNA. |
15 | 6ffif8fc | how long can the coronavirus live outside the body | Repurposing Antiviral Protease Inhibitors Using Extracellular Vesicles for Potential Therapy of COVID-19 In January 2020, Chinese health agencies reported an outbreak of a novel coronavirus-2 (CoV-2) which can lead to severe acute respiratory syndrome (SARS). The virus, which belongs to the coronavirus family (SARS-CoV-2), was named coronavirus disease 2019 (COVID-19) and declared a pandemic by the World Health Organization (WHO). Full-length genome sequences of SARS-CoV-2 showed 79.6% sequence identity to SARS-CoV, with 96% identity to a bat coronavirus at the whole-genome level. COVID-19 has caused over 133,000 deaths and there are over 2 million total confirmed cases as of 15 April 2020. Current treatment plans are still under investigation due to a lack of understanding of COVID-19. One potential mechanism to slow disease progression is the use of antiviral drugs to either block the entry of the virus or interfere with viral replication and maturation. Currently, antiviral drugs, including chloroquine/hydroxychloroquine, remdesivir, and lopinavir/ritonavir, have shown effective inhibition of SARS-CoV-2 in vitro. Due to the high dose needed and narrow therapeutic window, many patients are experiencing severe side effects with the above drugs. Hence, repurposing these drugs with a proper formulation is needed to improve the safety and efficacy for COVID-19 treatment. Extracellular vesicles (EVs) are a family of natural carriers in the human body. They play a critical role in cell-to-cell communications. EVs can be used as unique drug carriers to deliver protease inhibitors to treat COVID-19. EVs may provide targeted delivery of protease inhibitors, with fewer systemic side effects. More importantly, EVs are eligible for major aseptic processing and can be upscaled for mass production. Currently, the FDA is facilitating applications to treat COVID-19, which provides a very good chance to use EVs to contribute in this combat. |
15 | awitk3se | how long can the coronavirus live outside the body | COVID-19 (Novel Coronavirus 2019) - recent trends. The World Health Organization (WHO) has issued a warning that, although the 2019 novel coronavirus (COVID-19) from Wuhan City (China), is not pandemic, it should be contained to prevent the global spread. The COVID-19 virus was known earlier as 2019-nCoV. As of 12 February 2020, WHO reported 45,171 cases and 1115 deaths related to COVID-19. COVID-19 is similar to Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) virus in its pathogenicity, clinical spectrum, and epidemiology. Comparison of the genome sequences of COVID-19, SARS-CoV, and Middle East Respiratory Syndrome coronavirus (MERS-CoV) showed that COVID-19 has a better sequence identity with SARS-CoV compared to MERS CoV. However, the amino acid sequence of COVID-19 differs from other coronaviruses specifically in the regions of 1ab polyprotein and surface glycoprotein or S-protein. Although several animals have been speculated to be a reservoir for COVID-19, no animal reservoir has been already confirmed. COVID-19 causes COVID-19 disease that has similar symptoms as SARS-CoV. Studies suggest that the human receptor for COVID-19 may be angiotensin-converting enzyme 2 (ACE2) receptor similar to that of SARS-CoV. The nucleocapsid (N) protein of COVID-19 has nearly 90% amino acid sequence identity with SARS-CoV. The N protein antibodies of SARS-CoV may cross react with COVID-19 but may not provide cross-immunity. In a similar fashion to SARS-CoV, the N protein of COVID-19 may play an important role in suppressing the RNA interference (RNAi) to overcome the host defense. This mini-review aims at investigating the most recent trend of COVID-19. |
36 | f418nsl8 | What is the protein structure of the SARS-CoV-2 spike? | What's Old is New! Similarities Between SARS-CoV-2 and HIV |
28 | l6l24pco | what evidence is there for the value of hydroxychloroquine in treating Covid-19? | The possible mechanisms of action of 4-aminoquinolines (chloroquine/hydroxychloroquine) against Sars-Cov-2 infection (COVID-19): A role for iron homeostasis? The anti-malarial drugs chloroquine (CQ) and primarily the less toxic hydroxychloroquine (HCQ) are currently used to treat autoimmune diseases for their immunomodulatory and anti-thrombotic properties. They have also been proposed for the treatment of several viral infections, due to their anti-viral effects in cell cultures and animal models, and, currently, for the treatment of coronavirus disease 2019 (COVID-19), the pandemic severe acute respiratory syndrome caused by coronavirus 2 (Sars-Cov-2) infection that is spreading all over the world. Although in some recent studies a clinical improvement in COVID-19 patients has been observed, the clinical efficacy of CQ and HCQ in COVID-19 has yet to be proven with randomized controlled studies, many of which are currently ongoing, also considering pharmacokinetics, optimal dosing regimen, therapeutic level and duration of treatment and taking into account patients with different severity degrees of disease. Here we review what is currently known on the mechanisms of action of CQ and HCQ as anti-viral, anti-inflammatory and anti-thrombotic drugs and discuss the up-to-date experimental evidence on the potential mechanisms of action of CQ/HCQ in Sars-Cov2 infection and the current clinical knowledge on their efficacy in the treatment of COVID-19 patients. Given the role of iron in several human viral infections, we also propose a different insight into a number of CQ and HCQ pharmacological effects, suggesting a potential involvement of iron homeostasis in Sars-Cov-2 infection and COVID-19 clinical course. |
4 | nmolo7rt | what causes death from Covid-19? | Baseline characteristics and risk factors for short-term outcomes in 132 COVID-19 patients with diabetes in Wuhan China: a retrospective study AIMS: To investigate the clinical characteristics, laboratory findings and high- resolution CT (HRCT) features and to explore the risk factors for in-hospital death and complications of coronavirus disease 2019 (COVID-19) patients with diabetes. METHODS: From Dec 31, 2019, to Apr 5, 2020, a total of 132 laboratory-confirmed COVID-19 patients with diabetes from two hospitals were retrospectively included in our study. Clinical, laboratory and chest CT data were analyzed and compared between the two groups with an admission glucose level of ≤11mmol/L (group 1) and >11mmol/L (group 2). Logistic regression analyses were used to identify the risk factors associated with in-hospital death and complications. RESULTS: Of 132 patients, 15 died in hospital and 113 were discharged. Patients in group 2 were more likely to require intensive care unit care (21.4% vs. 9.2%), to develop acute respiratory distress syndrome (ARDS) (23.2% vs. 9.25%) and acute cardiac injury (12.5% vs. 1.3%), and had a higher death rate (19.6% vs. 5.3%) than group 1. In the multivariable analysis, patients with admission glucose of >11 mmol/l had an increased risk of death (OR: 7.629, 95%CI: 1.391-37.984) and in-hospital complications (OR: 3.232, 95%CI: 1.393-7.498). Admission d-dimer of ≥1.5 µg/mL (OR: 6.645, 95%CI: 1.212-36.444) and HRCT score of ≥10 (OR: 7.792, 95%CI: 2.195-28.958) were associated with increased odds of in-hospital death and complications, respectively. CONCLUSIONS: In COVID-19 patients with diabetes, poorly-controlled blood glucose (>11mmol/L) may be associated with poor outcomes. Admission hyperglycemia, elevated d-dimer and high HRCT score are potential risk factors for adverse outcomes and death. |
45 | csgnet13 | How has the COVID-19 pandemic impacted mental health? | What does COVID mean for UK mental health care? |
3 | mhfu0e9r | will SARS-CoV2 infected people develop immunity? Is cross protection possible? | Improving Cross-Protection against Influenza Virus Using Recombinant Vaccinia Vaccine Expressing NP and M2 Ectodomain Tandem Repeats Conventional influenza vaccines need to be designed and manufactured yearly. However, they occasionally provide poor protection owing to antigenic mismatch. Hence, there is an urgent need to develop universal vaccines against influenza virus. Using nucleoprotein (NP) and extracellular domain of matrix protein 2 (M2e) genes from the influenza A virus A/Beijing/30/95 (H3N2), we constructed four recombinant vaccinia virus-based influenza vaccines carrying NP fused with one or four copies of M2e genes in different orders. The recombinant vaccinia viruses were used to immunize BALB/C mice. Humoral and cellular responses were measured, and then the immunized mice were challenged with the influenza A virus A/Puerto Rico/8/34 (PR8). NP-specific humoral response was elicited in mice immunized with recombinant vaccinia viruses carrying full-length NP, while robust M2e-specific humoral response was elicited only in the mice immunized with recombinant vaccinia viruses carrying multiple copies of M2e. All recombinant viruses elicited NP- and M2e-specific cellular immune responses in mice. Only immunization with RVJ-4M2eNP induced remarkably higher levels of IL-2 and IL-10 cytokines specific to M2e. Furthermore, RVJ-4M2eNP immunization provided the highest cross-protection in mice challenged with 20 MLD(50) of PR8. Therefore, the cross-protection potentially correlates with both NP and M2e-specific humoral and cellular immune responses induced by RVJ-4M2eNP, which expresses a fusion antigen of full-length NP preceded by four M2e repeats. These results suggest that the rational fusion of NP and multiple M2e antigens is critical toward inducing protective immune responses, and the 4M2eNP fusion antigen may be employed to develop a universal influenza vaccine. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12250-019-00138-9) contains supplementary material, which is available to authorized users. |
48 | l705no5s | what are the benefits and risks of re-opening schools in the midst of the COVID-19 pandemic? | Academic Coaching of Medical Students During COVID-19 Social distancing measures due to the COVID-19 pandemic has required many medical schools to adapt existing on-site medical education activities to delivery via online platforms. The sudden switch to a new, unfamiliar model of learning led to additional challenges for students. We observed that students requiring academic support often had ineffective learning strategies, poor motivation, and suboptimal communication skills, all of which were magnified by home-based learning. We therefore established a virtual academic coaching programme to engage these students and to address specific challenges that arose from an adapted educational programme. |
34 | b4wxcz49 | What are the longer-term complications of those who recover from COVID-19? | COVID-19: towards controlling of a pandemic |
36 | dxikgdmn | What is the protein structure of the SARS-CoV-2 spike? | The MERS-CoV Receptor DPP4 as a Candidate Binding Target of the SARS-CoV-2 Spike The ongoing outbreak of the novel coronavirus pneumonia COVID-19 has caused great number of cases and deaths, but our understanding about the pathogen SARS-CoV-2 remains largely unclear. The attachment of the virus with the cell-surface receptor and a cofactor is the first step for the infection. Here, bioinformatics approaches combining human-virus protein interaction prediction and protein docking based on crystal structures have revealed the high affinity between human dipeptidylpeptidase 4 (DPP4) and the spike (S) receptor-binding domain of SARS-CoV-2. Intriguingly, the crucial binding residues of DPP4 are identical to those that are bound to the MERS-CoV-S. Moreover, E484 insertion and adjacent substitutions should be most essential for this DPP4-binding ability acquirement of SARS-CoV-2-S compared with SARS-CoV-S. This potential utilization of DPP4 as a binding target for SARS-CoV-2 may offer novel insight into the viral pathogenesis and help the surveillance and therapeutics strategy for meeting the challenge of COVID-19. |
14 | rla49fx0 | what evidence is there related to COVID-19 super spreaders | Estimating and modelling the transmissibility of Middle East Respiratory Syndrome CoronaVirus during the 2015 outbreak in the Republic of Korea BACKGROUND: Emerging respiratory infections represent a significant public health threat. Because of their novelty, there are limited measures available to control their early spread. Learning from past outbreaks is important for future preparation. The Middle Eastern Respiratory Syndrome CoronaVirus (MERS‐CoV ) 2015 outbreak in the Republic of Korea (ROK) provides one such opportunity. OBJECTIVES: We demonstrated through quantitative methodologies how to estimate MERS‐CoV's transmissibility and identified the effective countermeasures that stopped its spread. METHODS: Using the outbreak data, statistical methods were employed to estimate the basic reproductive number R (0), the average number of secondary cases produced by a typical primary case during its entire infectious period in a fully susceptible population. A transmission dynamics model was also proposed to estimate R (0) and to identify the most effective countermeasures. The consistency between results will provide cross‐validation of the approaches. RESULTS: R (0) ranged from 2.5 with 95% confidence interval (CI): [1.7, 3.1] (using the sequential Bayesian method) to 7.2 with 95% CI: [5.3, 9.4] (using the Nowcasting method). Estimates from transmission model were higher but overlapped with these. Personal protection and rapid confirmation of cases were identified as the most important countermeasures. CONCLUSIONS: Our estimates were in agreement with others from the ROK outbreak, albeit significantly higher than estimates based on other small outbreaks and sporadic cases of MERS‐CoV. The large‐scale outbreak in the ROK was jointly due to the high transmissibility in the healthcare‐associated setting and the Korean culture‐associated contact behaviour. Limiting such behaviour by rapidly identifying and isolating cases and avoiding high‐risk contacts effectively stopped further transmission. |
9 | xzoleks8 | how has COVID-19 affected Canada | Laboratory-confirmed COVID-19 in children and youth in Canada, January 15-April 27, 2020. Understanding the epidemiology of COVID-19 among children and youth in Canada will help to inform public health measures in settings where children gather. As of April 27, 2020, provinces and territories provided the Public Health Agency of Canada with detailed information on 24,079 cases, of which 3.9% (n=938) were younger than 20 years of age. The detection rate per 100,000 population was lower in this age group (11.9 per 100,000), compared with those aged 20-59 years (72.4 per 100,000) and 60 and older (113.6 per 100,000). The median age among those younger than 20 years of age was 13 years, and cases were distributed equally across male and female genders. Among provinces and territories with more than 100 cases, 1.6% to 9.8% of cases were younger than 20 years of age. Cases in this age group were more likely to be asymptomatic: 10.7% compared with 2.4% in those aged 20-59 years and 4.1% in those aged 60 and older. Children and youth experienced severe outcomes less often, but 2.2% (n=15/672) of cases within this age group were severe enough to require hospitalization. Based on available exposure information, 11.3% (n=59/520) of cases aged younger than 20 years had no known contact with a case. Canadian findings align with those of other countries. |
41 | 2gb9pzy0 | What are the impacts of COVID-19 among African-Americans that differ from the rest of the U.S. population? | Characteristics and Outcomes of COVID-19 Patients in New York City's Public Hospital System Background New York City (NYC) has borne the greatest burden of COVID-19 in the United States, but information about characteristics and outcomes of racially/ethnically diverse individuals tested and hospitalized for COVID-19 remains limited. In this case series, we describe characteristics and outcomes of patients tested for and hospitalized with COVID-19 in New York City's public hospital system. Methods We reviewed the electronic health records of all patients who received a SARS-CoV-2 test between March 5 and April 9, 2020, with follow up through April 16, 2020. The primary outcomes were a positive test, hospitalization, and death. Demographics and comorbidities were also assessed. Results 22254 patients were tested for SARS-CoV-2. 13442 (61%) were positive; among those, the median age was 52.7 years (interquartile range [IQR] 39.5-64.5), 7481 (56%) were male, 3518 (26%) were Black, and 4593 (34%) were Hispanic. Nearly half (4669, 46%) had at least one chronic disease (27% diabetes, 30% hypertension, and 21% cardiovascular disease). Of those testing positive, 6248 (46%) were hospitalized. The median age was 61.6 years (IQR 49.7-72.9); 3851 (62%) were male, 1950 (31%) were Black, and 2102 (34%) were Hispanic. More than half (3269, 53%) had at least one chronic disease (33% diabetes, 37% hypertension, 24% cardiovascular disease, 11% chronic kidney disease). 1724 (28%) hospitalized patients died. The median age was 71.0 years (IQR 60.0, 80.9); 1087 (63%) were male, 506 (29%) were Black, and 528 (31%) were Hispanic. Chronic diseases were common (35% diabetes, 37% hypertension, 28% cardiovascular disease, 15% chronic kidney disease). Male sex, older age, diabetes, cardiac history, and chronic kidney disease were significantly associated with testing positive, hospitalization, and death. Racial/ethnic disparities were observed across all outcomes. Conclusions and Relevance This is the largest and most racially/ethnically diverse case series of patients tested and hospitalized for COVID-19 in the United States to date. Our findings highlight disparities in outcomes that can inform prevention and testing recommendations. |
8 | 9q4gvjrs | how has lack of testing availability led to underreporting of true incidence of Covid-19? | Bayesian analysis of tests with unknown specificity and sensitivity When testing for a rare disease, prevalence estimates can be highly sensitive to uncertainty in the specificity and sensitivity of the test. Bayesian inference is a natural way to propagate these uncertainties, with hierarchical modeling capturing variation in these parameters across experiments. Another concern is the people in the sample not being representative of the general population. Statistical adjustment cannot without strong assumptions correct for selection bias in an opt-in sample, but multilevel regression and poststratification can at least adjust for known differences between sample and population. We demonstrate these models with code in R and Stan and discuss their application to a controversial recent study of COVID-19 antibodies in a sample of people from the Stanford University area. Wide posterior intervals make it impossible to evaluate the quantitative claims of that study regarding the number of unreported infections. For future studies, the methods described here should facilitate more accurate estimates of disease prevalence from imperfect tests performed on non-representative samples. |
34 | l18vhymh | What are the longer-term complications of those who recover from COVID-19? | A Follow-up Study of Recovered Patients with COVID-19 in Wuhan, China |
34 | 1z6l12ks | What are the longer-term complications of those who recover from COVID-19? | Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review Importance: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019, causing human coronavirus disease 2019 (COVID-19), which has now spread into a worldwide pandemic. The pulmonary manifestations of COVID-19 have been well described in the literature. Two similar human coronaviruses that cause Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV-1) are known to cause disease in the central and peripheral nervous systems. Emerging evidence suggests COVID-19 has neurologic consequences as well. Observations: This review serves to summarize available information regarding coronaviruses in the nervous system, identify the potential tissue targets and routes of entry of SARS-CoV-2 into the central nervous system, and describe the range of clinical neurological complications that have been reported thus far in COVID-19 and their potential pathogenesis. Viral neuroinvasion may be achieved by several routes, including transsynaptic transfer across infected neurons, entry via the olfactory nerve, infection of vascular endothelium, or leukocyte migration across the blood-brain barrier. The most common neurologic complaints in COVID-19 are anosmia, ageusia, and headache, but other diseases, such as stroke, impairment of consciousness, seizure, and encephalopathy, have also been reported. Conclusions and Relevance: Recognition and understanding of the range of neurological disorders associated with COVID-19 may lead to improved clinical outcomes and better treatment algorithms. Further neuropathological studies will be crucial to understanding the pathogenesis of the disease in the central nervous system, and longitudinal neurologic and cognitive assessment of individuals after recovery from COVID-19 will be crucial to understand the natural history of COVID-19 in the central nervous system and monitor for any long-term neurologic sequelae. |
15 | hht23dh0 | how long can the coronavirus live outside the body | Coronavirus just caused the American Physical Society to cancel its biggest meeting of the year ;Science ;AAAS Citing the growing threat of the coronavirus, the American Physical Society (APS), the 55,000 member professional society for physicists and researchers in associated fields, cancelled its largest meeting of the year just 34 hours before it was supposed to begin APS's March Meeting was to be held this week at the Colorado Convention Center in Denver, and the society anticipated more than 10,000 people from all over the world would attend However, late yesterday, APS issued a statement abruptly calling off the meeting "The decision to cancel was based on the latest scientific data being reported, and the fact that a large number of attendees at this meeting are coming from outside the U S ," including countries where the virus is circulating and for which the U S Centers for Disease Control and Prevention have advised people to avoid non-essential travel, the APS statement says "[T]his decision was made out of deep concern for the health and well-being of our registrants, staff, vendors, and the Denver community " |
38 | hhvmsn5b | What is the mechanism of inflammatory response and pathogenesis of COVID-19 cases? | Pattern of Cytokine Responses to Gram‐Positive and Gram‐Negative Commensal Bacteria is Profoundly Changed when Monocytes Differentiate into Dendritic Cells The normal gastrointestinal flora is crucial for the maturation of the acquired immunity via effects on antigen‐presenting cells (APCs). Here, we have investigated how two types of APCs, monocytes and dendritic cells (DCs), react to different bacterial strains typical of the commensal intestinal flora. Purified monocytes and monocyte‐derived DCs were stimulated with UV‐inactivated gram‐positive (Lactobacillus plantarum and Bifidobacterium adolescentis) and gram‐negative (Escherichia coli and Veillonella parvula) bacterial strains. Monocytes produced higher levels of IL‐12p70 and TNF, as detected by ELISA, in response to L. plantarum than to E. coli and V. parvula. In contrast, DCs secreted high amounts of IL‐12p70, TNF, IL‐6 and IL‐10 in response to E. coli and V. parvula but were practically unresponsive to L. plantarum and B. adolescentis. The lack of response to the gram‐positive strains correlated with a lower surface expression of Toll‐like reseptor 2 (TLR2) on DCs compared to monocytes. The surface expression of TLR4 on DCs was undetectable when analysed by flow cytometry, but blocking this receptor decreased the TNF production in response to V. parvula, indicating that low TLR4 expression on DCs is sufficient to mount an inflammatory response to gram‐negative bacteria. IFN‐γ increased the expression of TLR4 on DCs and also potentiated the cytokine response to gram‐negative bacteria. Our results indicate that, when monocytes differentiate into DCs, their ability to respond to different commensal bacteria dramatically changes, thereby becoming unresponsive to probiotic gram‐positive bacteria. These results may have important implications for the capacity of different groups of commensal bacteria to regulate mucosal and systemic immunity. |
37 | niq3hosc | What is the result of phylogenetic analysis of SARS-CoV-2 genome sequence? | Climatic-niche evolution of SARS CoV-2 Adaptation of species to new environments is governed by natural selection that discriminates among genetic variations and favors survival of the fittest. Here, we propose climate plays an important role in the evolution of SARS CoV-2 and the spread of COVID-19 all over the world which was previously not known. To understand the climatic factors responsible for shaping the molecular determinants of the novel coronavirus, genotyping SARS CoV-2 across different latitudes and Koppen's climate is imperative. It seems this virus follows inverse latitudinal biodiversity gradient due to its preference towards Koppen's temperate (C) and cold climate (D). Our molecular phylogenetic analysis revealed division of 176 SARS CoV-2 strains into two variant groups, G1 and G2, well defined by four mutations. Initially, SARS CoV-2 was restricted to a "humid-subtropical" (Cfa) climate of southeast China, which soon spread all over the world having C climate. Genomic information superimposed on global Koppen's climate map elucidates that the gradation "humid-subtropical" (Cfa) and "marine-temperate" (Cfb) to "humid-continental" (Dfa-Dfb) climate drives the evolution of G1 into G2 variant group. It seems an early infection in Europe and USA is due to the dominance of C climate. Russia and North America were infected through linkage of C to D climate and South America from C to A climate. Our study elucidates viruses are sensitive to climate and combined genomic and climatic studies provide crucial information about the pathogenesis and natural spreading pathways during a pandemic which will enable us to take pre-emptive precautionary measures in such outbreaks. Graphical Abstract In Brief The authors elucidate adaptation of SARS CoV-2 to different climates by studying phylogenetics and the distribution of strains on Koppen's climate map. Highlights SARS CoV-2 follows inverse latitudinal gradient. Phylogenetic network divides SARS CoV-2 strains into two variant groups, G1 and G2. G1 strains is restricted to Koppen's "temperate" climate (mainly Cfa-Cfb). G2 strains has evolved from G1 to sustain in "humid-continental" (Dfa-Dfb) and "tropical-savannah" (Aw) climate. |
21 | urk7fe34 | what are the mortality rates overall and in specific populations | CLINICAL VIGNETTES |
47 | 5gio6ruj | what are the health outcomes for children who contract COVID-19? | Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise In this commentary, we focus our attention on what is known about SARS-CoV-2 infection in the pediatric population. We report literature and National data. The possible and different explanations for understanding why the infection seems to be more benign and less frequent in children are discussed. The possible role of children in the COVID-19 viral disease pandemic is also commented. Finally, our work suggests to search for future evidence and containment strategies to manage virus spread. |
4 | 1446jzbw | what causes death from Covid-19? | Epidemiological trends of COVID-19 epidemic in Italy over March 2020: From 1000 to 100 000 cases The coronavirus disease 2019 epidemic started in Italy by the end of January 2020 and, after 1 month, it affected 1049 persons. Based on the Italian Ministry of Health data, we reconstructed the daily course of virus-positive cases and deaths over March 2020 for the whole of Italy, 19 regions and 2 provinces. From 29 February to 31 March, there was a 100.9-fold increase in the cumulative number of cases and a 428.6-fold increase in the number of deaths in Italy. When plotted on a semilogarithmic scale, the curves tended to diverge from linearity with 23%, 16%, and 7% average daily increases during the three decades of March. Similarly, the number of deaths decreased from an average daily growth of 19% over the second decade to 10% over the third decade. The correlation coefficients relating the days to cases or deaths over each one of the three decades approached unity. As inferred from the equations of the regression lines relative to the three decades, the doubling times of cases were 3.4, 5.1, and 9.6 days, respectively. The doubling times of deaths over the second and third decades were 4.9 and 7.0 days, respectively. There was a broad geographic variability, with a striking gradient from the North, where 40.8% of cases and 57.9% of deaths occurred in Lombardy, to the South. On the whole, over March there was a trend to epidemic growth decline but the time for the end of the epidemic will depend on a variety of factors and, at present, it is unpredictable. |
36 | eermgk02 | What is the protein structure of the SARS-CoV-2 spike? | Docetaxel induces moderate ovarian toxicity in mice, primarily affecting granulosa cells of early growing follicles Advances in cancer therapy have focused attention on the quality of life of cancer survivors. Since infertility is a major concern following chemotherapy, it is important to characterize the drug-specific damage to the reproductive system to help find appropriate protective strategies. This study investigates the damage on neonatal mouse ovary maintained in vitro for 6 days, and exposed for 24 h (on Day 2) to clinically relevant doses of Docetaxel (DOC; low: 0.1 µM, mid: 1 µM, high: 10 µM). Furthermore, the study explores the putative protective action exerted by Tri-iodothyronine (T3; 10(−7) M). At the end of culture, morphological analyses and follicle counts showed that DOC negatively impacts on early growing follicles, decreasing primary follicle number and severely affecting health at the transitional and primary stages. Poor follicle health was mainly due to effects on granulosa cells, indicating that the effects of DOC on oocytes were likely to be secondary to granulosa cell damage. DOC damages growing follicles specifically, with no direct effect on the primordial follicle reserve. Immunostaining and western blotting showed that DOC induces activation of intrinsic, type II apoptosis in ovarian somatic cells; increasing the levels of cleaved caspase 3, cleaved caspase 8, Bax and cleaved poly(ADP-ribose) polymerase, while also inducing movement of cytochrome C from mitochondria into the cytosol. T3 did not prevent the damage induced by the low dose of DOC. These results demonstrated that DOC induces a gonadotoxic effect on the mouse ovary through induction of somatic cell apoptosis, with no evidence of direct effects on the oocyte, and that the damaging effect is not mitigated by T3. |
50 | vozji3so | what is known about an mRNA vaccine for the SARS-CoV-2 virus? | Severe acute respiratory syndrome coronaviruses with mutations in the E protein are attenuated and promising vaccine candidates. UNLABELLED Severe acute respiratory syndrome coronavirus (SARS-CoV) causes a respiratory disease with a mortality rate of 10%. A mouse-adapted SARS-CoV (SARS-CoV-MA15) lacking the envelope (E) protein (rSARS-CoV-MA15-ΔE) is attenuated in vivo. To identify E protein regions and host responses that contribute to rSARS-CoV-MA15-ΔE attenuation, several mutants (rSARS-CoV-MA15-E*) containing point mutations or deletions in the amino-terminal or the carboxy-terminal regions of the E protein were generated. Amino acid substitutions in the amino terminus, or deletion of regions in the internal carboxy-terminal region of E protein, led to virus attenuation. Attenuated viruses induced minimal lung injury, diminished limited neutrophil influx, and increased CD4(+) and CD8(+) T cell counts in the lungs of BALB/c mice, compared to mice infected with the wild-type virus. To analyze the host responses leading to rSARS-CoV-MA15-E* attenuation, differences in gene expression elicited by the native and mutant viruses in the lungs of infected mice were determined. Expression levels of a large number of proinflammatory cytokines associated with lung injury were reduced in the lungs of rSARS-CoV-MA15-E*-infected mice, whereas the levels of anti-inflammatory cytokines were increased, both at the mRNA and protein levels. These results suggested that the reduction in lung inflammation together with a more robust antiviral T cell response contributed to rSARS-CoV-MA15-E* attenuation. The attenuated viruses completely protected mice against challenge with the lethal parental virus, indicating that these viruses are promising vaccine candidates. IMPORTANCE Human coronaviruses are important zoonotic pathogens. SARS-CoV caused a worldwide epidemic infecting more than 8,000 people with a mortality of around 10%. Therefore, understanding the virulence mechanisms of this pathogen and developing efficacious vaccines are of high importance to prevent epidemics from this and other human coronaviruses. Previously, we demonstrated that a SARS-CoV lacking the E protein was attenuated in vivo. Here, we show that small deletions and modifications within the E protein led to virus attenuation, manifested by minimal lung injury, limited neutrophil influx to the lungs, reduced expression of proinflammatory cytokines, increased anti-inflammatory cytokine levels, and enhanced CD4(+) and CD8(+) T cell counts in vivo, suggesting that these phenomena contribute to virus attenuation. The attenuated mutants fully protected mice from challenge with virulent virus. These studies show that mutations in the E protein are not well tolerated and indicate that this protein is an excellent target for vaccine development. |
49 | yhdj5m0e | do individuals who recover from COVID-19 show sufficient immune response, including antibody levels and T-cell mediated immunity, to prevent re-infection? | Long-lived effector/central memory T-cell responses to severe acute respiratory syndrome coronavirus (SARS-CoV) S antigen in recovered SARS patients Abstract The role of cell-mediated immunity in human SARS-CoV infection is still not well understood. In this study, we found that memory T-cell responses against the spike (S) protein were persistent for more than 1 year after SARS-CoV infection by detecting the production of IFN-γ using ELISA and ELISpot assays. Flow cytometric analysis showed that both CD4+ and CD8+ T cells were involved in cellular responses against SARS-CoV infection. Interestingly, most of SARS-CoV S-specific memory CD4+ T cells were central memory cells expressing CD45RO+ CCR7+ CD62L−. However, the majority of memory CD8+ T cells revealed effector memory phenotype expressing CD45RO− CCR7− CD62L−. Thus, our study provides the evidence that SARS-CoV infection in humans can induce cellular immune response that is persistent for a long period of time. These data may have an important implication in the possibility of designing effective vaccine against SARS-CoV infection, specifically in defining T-cell populations that are implicated in protective immunity. |
25 | z0vup2lr | which biomarkers predict the severe clinical course of 2019-nCOV infection? | Early prediction of mortality risk among severe COVID-19 patients using machine learning Abstract Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been spreading globally. The number of deaths has increased with the increase in the number of infected patients. We aimed to develop a clinical model to predict the outcome of severe COVID-19 patients early. Methods Epidemiological, clinical, and first laboratory findings after admission of 183 severe COVID-19 patients (115 survivors and 68 nonsurvivors) from the Sino-French New City Branch of Tongji Hospital were used to develop the predictive models. Five machine learning approaches (logistic regression, partial least squares regression, elastic net, random forest, and bagged flexible discriminant analysis) were used to select the features and predict the patients' outcomes. The area under the receiver operating characteristic curve (AUROC) was applied to compare the models' performance. Sixty-four severe COVID-19 patients from the Optical Valley Branch of Tongji Hospital were used to externally validate the final predictive model. Results The baseline characteristics and laboratory tests were significantly different between the survivors and nonsurvivors. Four variables (age, high-sensitivity C-reactive protein level, lymphocyte count, and d-dimer level) were selected by all five models. Given the similar performance among the models, the logistic regression model was selected as the final predictive model because of its simplicity and interpretability. The AUROCs of the derivation and external validation sets were 0.895 and 0.881, respectively. The sensitivity and specificity were 0.892 and 0.687 for the derivation set and 0.839 and 0.794 for the validation set, respectively, when using a probability of death of 50% as the cutoff. The individual risk score based on the four selected variables and the corresponding probability of death can serve as indexes to assess the mortality risk of COVID-19 patients. The predictive model is freely available at https://phenomics.fudan.edu.cn/risk_scores/. Conclusions Age, high-sensitivity C-reactive protein level, lymphocyte count, and d-dimer level of COVID-19 patients at admission are informative for the patients' outcomes. |
27 | k2q9ziks | what is known about those infected with Covid-19 but are asymptomatic? | A COVID-19 case report from asymptomatic contact: implication for contact isolation and incubation management BACKGROUND: As of 2 March, 2020, at least 80 151 coronavirus disease 2019 (COVID-19) cases were reported in China. Most of the patients had a history of visiting Hubei Province or contacting with people who had ever stayed in or passed by Hubei Province or were exposed to symptoms. Some patients got infected through only asymptomatic contact. This study aimed to report the epidemic features and lab identification of a patient confirmed with COVID-19 infection through only asymptomatic contact. CASE PRESENTATION: A 44-year-old man, who lived in Nanchang, Jiangxi Province, China until 6 March 2020, suffered from cough on 27 January 2020. Fever symptoms appeared on 28 January, with a maximum temperature of 38.8 °C, accompanied by cough, sore throat, headache, fatigue, muscle ache, joint ache, and other symptoms. The symptoms continued until he was hospitalized on 30 January. Coronavirus conventional polymerase chain reaction assay was positive for the throat swab sample. The patient, along with his wife and son, drove from Nanchang to back to Honghu City, Hubei Province, on 23 January 2020. After staying with his parents and brother's family for 3 days, the patient drove back to Nanchang and arrived on 25 January. On the way back home, they stopped by Tongshan service area, Hubei Province, without any close contact with other people. After arriving home in Nanchang City, Jiangxi Province, none of them left their residence. In addition, his parents stayed at home for 20 days with his younger brother's family before they got back. His younger brother and one of his brother's children visited Wuhan on 5 January and came home on 6 January 2020. CONCLUSIONS: This report suggested that, in the early phase of COVID-19 pneumonia, routine screening could miss patients who were virus carriers. Highlighting travel history is of paramount importance for the early detection and isolation of severe acute respiratory syndrome coronavirus 2 cases. |
16 | r71g2e9y | how long does coronavirus remain stable on surfaces? | Bats, Civets and the Emergence of SARS Severe acute respiratory syndrome (SARS) was the first pandemic transmissible disease of previously unknown aetiology in the twenty-first century. Early epidemiologic investigations suggested an animal origin for SARS-CoV. Virological and serological studies indicated that masked palm civets ( Paguma larvata ), together with two other wildlife animals, sampled from a live animal market were infected with SARS-CoV or a closely related virus. Recently, horseshoe bats in the genus Rhinolophus have been identified as natural reservoir of SARS-like coronaviruses. Here, we review studies by different groups demonstrating that SARS-CoV succeeded in spillover from a wildlife reservoir (probably bats) to human population via an intermediate host(s) and that rapid virus evolution played a key role in the adaptation of SARS-CoVs in at least two nonreservoir species within a short period. |
39 | 4lcstrf1 | What is the mechanism of cytokine storm syndrome on the COVID-19? | Therapeutic blockade of granulocyte macrophage colony-stimulating factor in COVID-19-associated hyperinflammation: challenges and opportunities The COVID-19 pandemic is a global public health crisis, with considerable mortality and morbidity exerting pressure on health-care resources, including critical care. An excessive host inflammatory response in a subgroup of patients with severe COVID-19 might contribute to the development of acute respiratory distress syndrome (ARDS) and multiorgan failure. Timely therapeutic intervention with immunomodulation in patients with hyperinflammation could prevent disease progression to ARDS and obviate the need for invasive ventilation. Granulocyte macrophage colony-stimulating factor (GM-CSF) is an immunoregulatory cytokine with a pivotal role in initiation and perpetuation of inflammatory diseases. GM-CSF could link T-cell-driven acute pulmonary inflammation with an autocrine, self-amplifying cytokine loop leading to monocyte and macrophage activation. This axis has been targeted in cytokine storm syndromes and chronic inflammatory disorders. Here, we consider the scientific rationale for therapeutic targeting of GM-CSF in COVID-19-associated hyperinflammation. Since GM-CSF also has a key role in homoeostasis and host defence, we discuss potential risks associated with inhibition of GM-CSF in the context of viral infection and the challenges of doing clinical trials in this setting, highlighting in particular the need for a patient risk-stratification algorithm. |
50 | akqpdv7f | what is known about an mRNA vaccine for the SARS-CoV-2 virus? | Demystifying the myths about COVID-19 infection and its societal importance |
31 | 0lyxvex0 | How does the coronavirus differ from seasonal flu? | Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic Abstract Novel Corona Virus Disease (COVID-19) originating from China has rapidly crossed borders, infecting people throughout the whole world. This phenomenon has led to a massive public reaction; the media has been reporting continuously across borders to keep all informed about the pandemic situation. All these things are creating a lot of concern for people leading to heightened levels of anxiety. Pandemics can lead to heightened levels of stress; Anxiety is a common response to any stressful situation. This study attempted to assess the knowledge, attitude, anxiety experience, and perceived mental healthcare need among adult Indian population during the COVID-19 pandemic. An online survey was conducted using a semi-structured questionnaire using a non-probability snowball sampling technique. A total of 662 responses were received. The responders had a moderate level of knowledge about the COVID-19 infection and adequate knowledge about its preventive aspects. The attitude towards COVID-19 showed peoples' willingness to follow government guidelines on quarantine and social distancing. The anxiety levels identified in the study were high. More than 80 % of the people were preoccupied with the thoughts of COVID-19 and 72 % reported the need to use gloves, and sanitizers. In this study, sleep difficulties, paranoia about acquiring COVID-19 infection and distress related social media were reported in 12.5 %, 37.8 %, and 36.4 % participants respectively. The perceived mental healthcare need was seen in more than 80 % of participants. There is a need to intensify the awareness and address the mental health issues of people during this COVID-19 pandemic. |
11 | ailr08y5 | what are the guidelines for triaging patients infected with coronavirus? | COVID-19, una emergencia de salud pública mundial Resumen Un nuevo brote de coronavirus surgió el pasado 31 de diciembre de 2019 en Wuhan, China, causando conmoción entre la comunidad médica y el resto del mundo. Esta nueva especie de coronavirus fue denominada como 2019-nCoV, causante de un gran número de casos y fallecimientos en China y en cantidad creciente fuera de ella, convirtiéndose en una emergencia de salud pública a nivel mundial. 2019-nCoV es un virus con alta homología con otros coronavirus patogénicos, como los originados por zoonosis con murciélagos (SARS-CoV) causantes de aproximadamente 646 muertes en China a principios de la década. Su tasa de mortalidad no es tan elevada (aproximadamente del 2-3%), pero su rápida propagación ha propiciado la activación de protocolos para detener su diseminación. Este patógeno tiene el potencial para convertirse en pandemia, por lo que es vital seguir las recomendaciones de cuidado personal dictadas por la Organización Mundial de la Salud. Abstract A new coronavirus outbreak emerged on the 31st of December 2019 in Wuhan, China, causing commotion among the medical community and the rest of the world. This new species of coronavirus has been termed 2019-nCoV and has caused a considerable number of cases of infection and deaths in China and, to a growing degree, beyond China, becoming a worldwide public health emergency. 2019-nCoV has high homology to other pathogenic coronaviruses, such as those originating from bat-related zoonosis (SARS-CoV), which caused approximately 646 deaths in China at the start of the decade. The mortality rate for 2019-nCoV is not as high (approximately 2-3%), but its rapid propagation has resulted in the activation of protocols to stop its spread. This pathogen has the potential to become a pandemic. It is therefore vital to follow the personal care recommendations issued by the World Health Organisation. |
26 | xza5tufk | what are the initial symptoms of Covid-19? | Pneumonia in the Non–HIV-Infected Immunocompromised Patient |
16 | f9qcabcx | how long does coronavirus remain stable on surfaces? | Computational Design of ACE2-Based Peptide Inhibitors of SARS-CoV-2 [Image: see text] Peptide inhibitors against the SARS-CoV-2 coronavirus, currently causing a worldwide pandemic, are designed and simulated. The inhibitors are mostly formed by two sequential self-supporting α-helices (bundle) extracted from the protease domain (PD) of angiotensin-converting enzyme 2 (ACE2), which bind to the SARS-CoV-2 receptor binding domains. Molecular dynamics simulations revealed that the α-helical peptides maintain their secondary structure and provide a highly specific and stable binding (blocking) to SARS-CoV-2. To provide a multivalent binding to the SARS-CoV-2 receptors, many such peptides could be attached to the surfaces of nanoparticle carriers. The proposed peptide inhibitors could provide simple and efficient therapeutics against the COVID-19 disease. |
9 | zxudiyj4 | how has COVID-19 affected Canada | Genetic evolution analysis of 2019 novel coronavirus and coronavirus from other species The Corona Virus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a Public Health Emergency of International Concern. However, so far, there are still controversies about the source of the virus and its intermediate host. Here, we found the novel coronavirus was closely related to coronaviruses derived from five wild animals, including Paguma larvata, Paradoxurus hermaphroditus, Civet, Aselliscus stoliczkanus and Rhinolophus sinicus, and was in the same branch of the phylogenetic tree. However, genome and ORF1a homology show that the virus is not the same coronavirus as the coronavirus derived from these five animals, whereas the virus has the highest homology with Bat coronavirus isolate RaTG13. |
38 | muyj3t2p | What is the mechanism of inflammatory response and pathogenesis of COVID-19 cases? | SARS-CoV-2, which induces COVID-19, causes kawasaki-like disease in children: role of pro-inflammatory and anti-inflammatory cytokines. Acute severe respiratory syndrome coronavirus-2 (SARS-CoV-2) caused a global pandemic coronavirus disease 2019 (COVID-19). In humans, SARS-CoV-2 infection leads to acute respiratory distress syndrome which presents edema, hemorrhage, intra-alveolar fibrin deposition, and vascular changes characterized by thrombus formation, micro-angiopathy and thrombosis. These clinical signs are mediated by pro-inflammatory cytokines. In recent studies it has been noted that COVID-19 pandemic can affect patients of all ages, including children (even if less severely) who were initially thought to be immune. Kawasaki disease is an autoimmune acute febrile inflammatory condition, which primarily affects young children. The disease can present immunodeficiency with the inability of the immune system to fight inflammatory pathogens and leads to fever, rash, alterations of the mucous membranes, conjunctiva infection, pharyngeal erythema, adenopathy, and inflammation. In the COVID-19 period, virus infection aggravates the condition of Kawasaki disease, but it has also been noted that children affected by SARS-V-2 may develop a disease similar to Kawasaki's illness. However, it is uncertain whether the virus alone can give Kawasaki disease-like forms. As in COVID-19, Kawasaki disease and its similar forms are mediated by pro-inflammatory cytokines produced by innate immunity cells such as macrophages and mast cells (MCs). In light of the above, it is therefore pertinent to think that by blocking pro-inflammatory cytokines with new anti-inflammatory cytokines, such as IL-37 and IL-38, it is possible to alleviate the symptoms of the disease and have a new available therapeutic tool. However, since Kawasaki and Kawasaki-like diseases present immunodeficiency, treatment with anti-inflammatory/immunosuppressant molecules must be applied very carefully. |
3 | 00qk10im | will SARS-CoV2 infected people develop immunity? Is cross protection possible? | Prevention and treatment of COVID-19 disease by controlled modulation of innate immunity The recent outbreak of coronavirus disease 2019 (COVID-19), triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses an enormous threat to global public health and economies. Human coronaviruses normally cause no or mild respiratory disease but in the past two decades, potentially fatal coronavirus infections have emerged, causing respiratory tract illnesses such as pneumonia and bronchitis. These include severe acute respiratory syndrome coronavirus (SARS-CoV), followed by the Middle East respiratory syndrome coronavirus (MERS-CoV), and recently the SARS-CoV-2 coronavirus outbreak that emerged in Wuhan, China, in December 2019. Currently, most COVID-19 patients receive traditional supportive care including breathing assistance. To halt the ongoing spread of the pandemic SARS-CoV-2 coronavirus and rescue individual patients, established drugs and new therapies are under evaluation. Since it will be some time until a safe and effective vaccine will be available, the immediate priority is to harness innate immunity to accelerate early antiviral immune responses. Second, since excessive inflammation is a major cause of pathology, targeted anti-inflammatory responses are being evaluated to reduce inflammation-induced damage to the respiratory tract and cytokine storms. Here, we highlight prominent immunotherapies at various stages of development that aim for augmented anti-coronavirus immunity and reduction of pathological inflammation. |
26 | egzztatj | what are the initial symptoms of Covid-19? | The spread of the COVID‐19 coronavirus: Health agencies worldwide prepare for the seemingly inevitability of the COVID‐19 coronavirus becoming endemic While it is too late to confine the COVID‐19 coronovirus outbreak to China, a wealth of data spurs epidemiological and vaccine research. [Image: see text] |
44 | 8m7n5r85 | How much impact do masks have on preventing the spread of the COVID-19? | Importance of Interaction Structure and Stochasticity for Epidemic Spreading: A COVID-19 Case Study In the recent COVID-19 pandemic, computer simulations are used to predict the evolution of the virus propagation and to evaluate the prospective effectiveness of non-pharmaceutical interventions. As such, the corresponding mathematical models and their simulations are central tools to guide political decision-making. Typically, ODE-based models are considered, in which fractions of infected and healthy individuals change deterministically and continuously over time. In this work, we translate an ODE-based COVID-19 spreading model from literature to a stochastic multi-agent system and use a contact network to mimic complex interaction structures. We observe a large dependency of the epidemic's dynamics on the structure of the underlying contact graph, which is not adequately captured by existing ODE-models. For instance, existence of super-spreaders leads to a higher infection peak but a lower death toll compared to interaction structures without super-spreaders. Overall, we observe that the interaction structure has a crucial impact on the spreading dynamics, which exceeds the effects of other parameters such as the basic reproduction number R0. We conclude that deterministic models fitted to COVID-19 outbreak data have limited predictive power or may even lead to wrong conclusions while stochastic models taking interaction structure into account offer different and probably more realistic epidemiological insights. |
19 | jnp2ldcj | what type of hand sanitizer is needed to destroy Covid-19? | Angiotensin receptor blockers and COVID-19 Abstract Angiotensin Receptor Blockers (ARBs) exhibit major pleiotropic protecting effects beyond their antihypertensive properties, including reduction of inflammation. ARBs directly protect the lung from the severe acute respiratory syndrome as a result of viral infections, including those from coronavirus. The protective effect of ACE2 is enhanced by ARB administration. For these reasons ARB therapy must be continued for patients affected by hypertension, diabetes and renal disease, comorbidities of the current COVID-19 pandemic. Controlled clinical studies should be conducted to determine whether ARBs may be included as additional therapy for COVID-19 patients. |
20 | t3odwr3n | are patients taking Angiotensin-converting enzyme inhibitors (ACE) at increased risk for COVID-19? | Assessing ACE2 expression patterns in lung tissues in the pathogenesis of COVID-19 It has been reported that SARS-CoV-2 may use ACE2 as a receptor to gain entry into human cells, in a way similar to that of SARS-CoV. Analyzing the distribution and expression level of ACE2 may therefore help reveal underlying mechanisms of viral susceptibility and post-infection modulation. In this study, we utilized previously uploaded information on ACE2 expression in various conditions including SARS-CoA to evaluate the role of ACE2 in SARS-CoV and extrapolate that to COVID-19. We found that the expression of ACE2 in healthy populations and patients with underlying diseases was not significantly different. However, based on the elevated expression of ACE2 in cigarette smokers, we speculate that long-term smoking may be a risk factor for COVID-19. Analysis of ACE2 in SARS-CoV infected cells suggests that ACE2 is not only a receptor but is also involved in post-infection regulation, including immune response, cytokine secretion, and viral genome replication. Moreover, we constructed Protein-protein interaction (PPI) networks and identified hub genes in viral activity and cytokine secretion. Our findings may help clinicians and researchers gain more insight into the pathogenesis of SARS-CoV-2 and design therapeutic strategies for COVID-19. |
32 | b6qts3n0 | Does SARS-CoV-2 have any subtypes, and if so what are they? | Neurological Insights of COVID-19 Pandemic The novel coronavirus SARS-CoV-2, which was identified after a recent outbreak in Wuhan, China, in December 2019, has kept the whole world in tenterhooks due to its severe life-threatening nature of the infection. The virus is unlike its previous counterparts, SARS-CoV and MERS-CoV, or anything the world has encountered before both in terms of virulence and severity of the infection. If scientific reports relevant to the SARS-CoV-2 virus are noted, it can be seen that the virus owes much of its killer properties to its unique structure that has a stronger binding affinity with the human angiotensin-converting enzyme 2 (hACE2) protein, which the viruses utilize as an entry point to gain accesses to its hosts. Recent reports suggest that it is not just the lung that the virus may be targeting; the human brain may soon emerge as the new abode of the virus. Already instances of patients with COVID-19 have been reported with mild (anosmia and ageusia) to severe (encephalopathy) neurological manifestations, and if that is so, then it gives us more reasons to be frightened of this killer virus. Keeping in mind that the situation does not worsen from here, immediate awareness and more thorough research regarding the neuroinvasive nature of the virus is the immediate need of the hour. Scientists globally also need to up their game to design more specific therapeutic strategies with the available information to counteract the pandemic. In this Viewpoint, we provide a brief outline of the currently known neurological manifestations of COVID-19 and discuss some probable ways to design therapeutic strategies to overcome the present global crisis. |
21 | 1spd7jwz | what are the mortality rates overall and in specific populations | A deeper look at COVID-19 CFR: health care impact and roots of discrepancy Intensive care capacity and proper testing play a paramount role in the COVID-19 Case Fatality Rate (CFR). Nevertheless, the real impact of such important measures has not been appreciated due to the lack of proper metrics. In this work, we have proposed a method for estimating a lower bound for the number of positive cases by using the reported data on the oldest age group and the regions' population distributions. The proposed estimation method improved the expected similarity between the age-distribution of positive cases and regions' population. Further, we have provided a quantitative measure for the impact of intensive care on the critical cases by comparing the CFR among those who did and did not receive intensive care. Our findings showed that the chance of living among non-ICU receivers is less than half of ICU receivers (~24% vs ~60%). |
49 | i1mu2fmt | do individuals who recover from COVID-19 show sufficient immune response, including antibody levels and T-cell mediated immunity, to prevent re-infection? | Unraveling the mystery of Covid‐19 Cytokine storm: From skin to organ systems. COVID‐19 is a global pandemic that emerged from Wuhan, China. Besides pneumonia and acute respiratory distress syndrome, the disease leads to multisystem involvement in the form of myocarditis, arrhythmias, cardiac arrest, gastrointestinal symptoms, hypoxemic brain injury, acute liver and renal function impairment. There are also reports of cutaneous lesions in form of urticarial and maculopapular rashes, chilblain like fingers and toes (covid feet), livedoid vasculopathy and chicken‐pox like or varicelliform vesicles. Clinically, many of these skin lesions are likely secondary to occlusion of small to medium blood vessels due to microthrombi formation or due to viral laden antigen‐antibody immune complexes; and same explanation may hold true for possible hypoxemic injury simultaneously occurring in other vital organs like lungs, heart, brain and kidneys. The histopathology, immunoflorescence and RT‐PCR analysis of skin biopsies can provide useful insights for ascertaining the pathogenesis of this complex viral syndrome. Apparently, it is interplay of disarmed cellular immunity and over‐activated humoral immunity that culminates in end‐organ changes. The morbidity and mortality can be significantly reduced by upgrading the cellular immunity and downgrading the humoral response; along with prevention of hypoxemic and reperfusion injuries by using antivirals, immunomodulators, antioxidants, anti‐platelets and anticoagulants in judicious and phased manner. This article is protected by copyright. All rights reserved. |
40 | xnamt7q4 | What are the observed mutations in the SARS-CoV-2 genome and how often do the mutations occur? | Unsupervised cluster analysis of SARS-CoV-2 genomes reflects its geographic progression and identifies distinct genetic subgroups of SARS-CoV-2 virus Over 10,000 viral genome sequences of the SARS-CoV-2 virus have been made readily available during the ongoing coronavirus pandemic since the initial genome sequence of the virus was released on the open access Virological website (http://virological.org/) early on January 11. We utilize the published data on the single stranded RNAs of 11, 132 SARS-CoV-2 patients in the GISAID (Elbe and Buckland-Merrett, 2017; Shu and McCauley, 2017) database, which contains fully or partially sequenced SARS-CoV-2 samples from laboratories around the world. Among many important research questions which are currently being investigated, one aspect pertains to the genetic characterization/classification of the virus. We analyze data on the nucleotide sequencing of the virus and geographic information of a subset of 7, 640 SARS-CoV-2 patients without missing entries that are available in the GISAID database. Instead of modelling the mutation rate, applying phylogenetic tree approaches, etc., we here utilize a model-free clustering approach that compares the viruses at a genome-wide level. We apply principal component analysis to a similarity matrix that compares all pairs of these SARS-CoV-2 nucleotide sequences at all loci simultaneously, using the Jaccard index (Jaccard, 1901; Tan et al., 2005; Prokopenko et al., 2016; Schlauch et al., 2017). Our analysis results of the SARS-CoV-2 genome data illustrates the geographic and chronological progression of the virus, starting from the first cases that were observed in China to the current wave of cases in Europe and North America. We also observe that, based on their sequence data, the SARS-CoV-2 viruses cluster in distinct genetic subgroups. It is the subject of ongoing research to examine whether the genetic subgroup could be related to diseases outcome and its potential implications for vaccine development. |
19 | txtrbqxj | what type of hand sanitizer is needed to destroy Covid-19? | Environmental Contamination of SARS-CoV-2 in Healthcare Premises Abstract Objectives A large number of healthcare workers (HCWs) were infected by SARS-CoV-2 during the ongoing outbreak of COVID-19 in Wuhan, China. Hospitals are significant epicenters for the human-to-human transmission of the SARS-CoV-2 for HCWs, patients, and visitors. No data has been reported on the details of hospital environmental contamination status in the epicenter of Wuhan. Methods We collected 626 surface swabs within the Zhongnan Medical Center in Wuhan in the mist of the COVID-19 outbreak between February 7 - February 27, 2020. Dacron swabs were aseptically collected from the surfaces of 13 hospital function zones, five major objects, and three major PPE. The SARS-CoV-2 RNAs were detected by reverse transcription-PCR. Results The most contaminated zones were the intensive care unit specialized for taking care of novel coronavirus pneumonia (NCP) (31.9%), Obstetric Isolation Ward specialized for pregnant women with NCP (28.1%), and Isolation Ward for NCP (19.6%). We classified the 13 zones into four contamination levels. The most contaminated objects were self-service printers (20.0%), desktop/keyboard (16.8%), and doorknob (16.0%). Both hand sanitizer dispensers (20.3%) and gloves (15.4%) were the most contaminated PPE. Conclusion Our findings emphasize the urgent need to ensure adequate environmental cleaning, strengthen infection prevention training, and improve infection prevention among HCWs during the outbreak of COVID-19. |
3 | l0asrcn5 | will SARS-CoV2 infected people develop immunity? Is cross protection possible? | Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis INTRODUCTION: In the beginning of 2020, an unexpected outbreak due to a new corona virus made the headlines all over the world. Exponential growth in the number of those affected makes this virus such a threat. The current meta-analysis aimed to estimate the prevalence of underlying disorders in hospitalized COVID-19 patients. METHODS: A comprehensive systematic search was performed on PubMed, Scopus, Web of science, and Google scholar, to find articles published until 15 February 2020. All relevant articles that reported clinical characteristics and epidemiological information of hospitalized COVID-19 patients were included in the analysis. RESULTS: The data of 76993 patients presented in 10 articles were included in this study. According to the meta-analysis, the pooled prevalence of hypertension, cardiovascular disease, smoking history and diabetes in people infected with SARS-CoV-2 were estimated as 16.37% (95%CI: 10.15%-23.65%), 12.11% (95%CI 4.40%-22.75%), 7.63% (95%CI 3.83%-12.43%) and 7.87% (95%CI 6.57%-9.28%), respectively. CONCLUSION: According to the findings of the present study, hypertension, cardiovascular diseases, diabetes mellitus, smoking, chronic obstructive pulmonary disease (COPD), malignancy, and chronic kidney disease were among the most prevalent underlying diseases among hospitalized COVID-19 patients, respectively. |
39 | 4lm663f1 | What is the mechanism of cytokine storm syndrome on the COVID-19? | SARS-CoV-2-A Tough Opponent for the Immune System Coronaviruses recently returned with a new one, SARS-CoV-2, related to a potentially severe respiratory disease-called the coronavirus disease (COVID-19). Research shows that the SARS-CoV-2 can be clustered with the Bat SARS-like coronavirus. Bats possess an additional, innate ability for antiviral defense, and, on the other hand, the potential to go hand-in-hand with the virus to generate variability. Besides the high potential of the novel coronavirus in compromising the respiratory system, its rapid transmission and ability to engage many hosts in severe forms of infections or immunopathological complications make it a tough opponent for the immune system. The interactions between SARS-CoV2 and the host immune system result in unleashing tremendous amounts of cytokines, and these cytokines make a storm that would determine the outcome (recovery or death) of the lungs of the patient. |
19 | cmaaa5j6 | what type of hand sanitizer is needed to destroy Covid-19? | An evaluation of the effectiveness of nursing students' hand hygiene compliance: A cross-sectional study • There is a need to improve nursing students' compliance with hand hygiene. • Increasing the use of AHR may improve compliance with hand hygiene. • New techniques that prevent the frequently omitted areas of the hands should be integrated into the training programs. |
35 | 5s10b9zy | What new public datasets are available related to COVID-19? | Relative antioxidant activities of quercetin and its structurally related substances and their effects on NF-κB/CRE/AP-1 signaling in murine macrophages Reactive oxygen species (ROS) and reactive nitrogen species (RNS) produced by the oxidative burst in activated macrophages and neutrophils cause oxidative stressimplicated diseases. Quercetin is flavonoid that occurs naturally in plants and is widely used as a nutritional supplement due to its antioxidant and anti-inflammatory properties. In this study, we investigated antioxidant activities and mechanisms of action in zymosan-induced macrophages of quercetin and quercetin-related flavonoids such as quercitrin, isoquercitrin, quercetin 3-O-β-(2″-galloyl)-rhamnopyranoside (QGR) and quercetin 3-O-β-(2″-galloyl)-glucopyranoside (QGG) as well as gallic acid, a building moiety of QGR and QGG. QGR and QGG exhibited stronger antioxidant activities compared with quercetin, whereas quercitrin, isoquercitrin and gallic acid exhibited weak-tono antioxidant activities, assessed by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, superoxide production, superoxide scavenging, nitric oxide (NO) production, peroxynitrite (ONOO(−)) scavenging and myeloperoxidase (MPO) activity. Regarding mechanisms, the quercetincontaining flavonoids QGR and QGG differentially targeted compared with quercetin in the NF-κB signaling pathway that inhibited the DNA binding activity of the NF-κB complex without affecting the degradation and phosphorylation of IκBα and NF-κB phosphorylation. In addition, QGR and QGG inhibited CRE and activator protein (AP-1) transcriptional activity and JNK phosphorylation by inhibiting the cAMP/protein kinase A (PKA) and protein kinase C (PKC) signaling in a different manner than quercetin. Our results showed that although QGR and QGG exhibited stronger antioxidant activities than querce-tin in macrophages, their mechanisms of action in terms of the NF-κB, PKA and PKC signaling pathways were different. |
1 | k3bkgf1g | what is the origin of COVID-19 | Novel Coronavirus disease (COVID-19) in newborns and infants: what we know so far Recently, an outbreak of viral pneumonitis in Wuhan, Hubei, China successively spread as a global pandemia, led to the identification of a novel betacoronavirus species, the 2019 novel coronavirus, successively designated 2019-nCoV then SARS-CoV-2). The SARS-CoV-2 causes a clinical syndrome designated coronavirus disease 2019 (COVID19) with a spectrum of manifestations ranging from mild upper respiratory tract infection to severe pneumonitis, acute respiratory distress syndrome (ARDS) and death. Few cases have been observed in children and adolescents who seem to have a more favorable clinical course than other age groups, and even fewer in newborn babies. This review provides an overview of the knowledge on SARS-CoV-2 epidemiology, transmission, the associated clinical presentation and outcomes in newborns and infants up to 6 months of life. |
3 | ax9btc74 | will SARS-CoV2 infected people develop immunity? Is cross protection possible? | Analysis of SARS-CoV-2 Antibodies in COVID-19 Convalescent Plasma using a Coronavirus Antigen Microarray The current practice for diagnosis of COVID-19, based on SARS-CoV-2 PCR testing of pharyngeal or respiratory specimens in a symptomatic patient at high epidemiologic risk, likely underestimates the true prevalence of infection. Serologic methods can more accurately estimate the disease burden by detecting infections missed by the limited testing performed to date. Here, we describe the validation of a coronavirus antigen microarray containing immunologically significant antigens from SARS-CoV-2, in addition to SARS-CoV, MERS-CoV, common human coronavirus strains, and other common respiratory viruses. A comparison of antibody profiles detected on the array from control sera collected prior to the SARS-CoV-2 pandemic versus convalescent blood specimens from virologically confirmed COVID-19 cases demonstrates complete discrimination of these two groups. This array can be used as a diagnostic tool, as an epidemiologic tool to more accurately estimate the disease burden of COVID-19, and as a research tool to correlate antibody responses with clinical outcomes. |
3 | 26py5jyu | will SARS-CoV2 infected people develop immunity? Is cross protection possible? | Pathogenicity and Viral Shedding of MERS-CoV in Immunocompromised Rhesus Macaques Middle East respiratory syndrome coronavirus (MERS-CoV) has recently emerged in the Middle East. Since 2012, there have been approximately 2,100 confirmed cases, with a 35% case fatality rate. Disease severity has been linked to patient health status, as people with chronic diseases or an immunocompromised status fare worse, although the mechanisms of disease have yet to be elucidated. We used the rhesus macaque model of mild MERS to investigate whether the immune response plays a role in the pathogenicity in relation to MERS-CoV shedding. Immunosuppressed macaques were inoculated with MERS-CoV and sampled daily for 6 days to assess their immune statues and to measure viral shedding and replication. Immunosuppressed macaques supported significantly higher levels of MERS-CoV replication in respiratory tissues and shed more virus, and virus disseminated to tissues outside of the respiratory tract, whereas viral RNA was confined to respiratory tissues in non-immunosuppressed animals. Despite increased viral replication, pathology in the lungs was significantly lower in immunosuppressed animals. The observation that the virus was less pathogenic in these animals suggests that disease has an immunopathogenic component and shows that inflammatory responses elicited by the virus contribute to disease. |
3 | plh92ifi | will SARS-CoV2 infected people develop immunity? Is cross protection possible? | LY6E impairs coronavirus fusion and confers immune control of viral disease Zoonotic coronaviruses (CoVs) are significant threats to global health, as exemplified by the recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. Host immune responses to CoV are complex and regulated in part through antiviral interferons. However, the interferon-stimulated gene products that inhibit CoV are not well characterized2. Here, we show that interferon-inducible lymphocyte antigen 6 complex, locus E (LY6E) potently restricts cellular infection by multiple CoVs, including SARS-CoV, SARS-CoV-2, and Middle East respiratory syndrome coronavirus (MERS-CoV). Mechanistic studies revealed that LY6E inhibits CoV entry into cells by interfering with spike protein-mediated membrane fusion. Importantly, mice lacking Ly6e in hematopoietic cells were highly susceptible to murine CoV infection. Exacerbated viral pathogenesis in Ly6e knockout mice was accompanied by loss of hepatic and splenic immune cells and reduction in global antiviral gene pathways. Accordingly, we found that Ly6e directly protects primary B cells and dendritic cells from murine CoV infection. Our results demonstrate that LY6E is a critical antiviral immune effector that controls CoV infection and pathogenesis. These findings advance our understanding of immune-mediated control of CoV in vitro and in vivo, knowledge that could help inform strategies to combat infection by emerging CoV. |
29 | 679qfp2s | which SARS-CoV-2 proteins-human proteins interactions indicate potential for drug targets. Are there approved drugs that can be repurposed based on this information? | Lack of Antiviral Activity of Darunavir against SARS-CoV-2 Given the high need and the absence of specific antivirals for treatment of COVID-19 (the disease caused by severe acute respiratory syndrome-associated coronavirus-2 [SARS-CoV-2]), human immunodeficiency virus (HIV) protease inhibitors are being considered as therapeutic alternatives. Prezcobix/Rezolsta is a fixed-dose combination of 800 mg of the HIV protease inhibitor darunavir (DRV) and 150 mg cobicistat, a CYP3A4 inhibitor, which is indicated in combination with other antiretroviral agents for the treatment of HIV infection. There are currently no definitive data on the safety and efficacy of DRV/cobicistat for treatment of COVID-19. The in vitro antiviral activity of darunavir against a clinical isolate from a patient infected with SARS-CoV-2 was assessed. DRV showed no activity against SARS-CoV-2 at clinically relevant concentrations (EC50 >100 μM). Remdesivir, used as a positive control, showed potent antiviral activity (EC50 = 0.38 μM). Overall, the data do not support the use of DRV for treatment of COVID-19. |
9 | gt21ix2r | how has COVID-19 affected Canada | 2019 novel coronavirus disease (COVID-19) in patients with inflammatory bowel diseases BACKGROUND: Data on patients with inflammatory bowel diseases (IBD) who have had 2019 novel coronavirus (SARS-CoV-2) disease (COVID-19) are needed. AIMS: To report the clinical characteristics, including gastrointestinal symptoms, of COVID-19 in IBD patients, and to assess the risk of COVID-19 in IBD. METHODS: This case series included consecutive IBD patients with laboratory-confirmed COVID-19. Age-adjusted cumulative incidences were compared with the general population in the Madrid region. RESULTS: Through April 8, 12 of 1918 IBD patients were diagnosed with COVID-19. The average age was 52 years, 75% of the patients were female and 58.3% had Crohn's disease. Seven patients (58%) were on maintenance treatment with immunomodulators/biologics, of these four with combined therapy (33%). Eight patients (66%) required hospitalisation (one intensive care unit admission, and two deaths), and four patients were isolated at home. Nine patients had diarrhoea ranging between 4 and 10 loose stools per day (mean 5.4, SD 1.6). In five patients (42%) diarrhoea was a presenting symptom. In two patients, diarrhoea was the only symptom at debut. Cumulative incidence of COVID-19 was 6.2 per 1000 IBD patients. IBD patients had a lower adjusted incidence ratio of COVID-19 (OR 0.74, 95% CI 0.70-0.77; P < 0.001), and a similar associated mortality ratio (OR 0.95, 95% CI: 0.84-1.06; P = 0.36), compared with the general population. CONCLUSIONS: IBD patients do not have an increased risk of COVID-19 and associated mortality compared with the general population. In many IBD patients, diarrhoea was a presenting symptom, and sometimes, was the only symptom at onset of COVID-19. |
20 | kimyvw4w | are patients taking Angiotensin-converting enzyme inhibitors (ACE) at increased risk for COVID-19? | Role and mechanism of angiotensin-converting enzyme 2 in acute lung injury in coronavirus disease 2019 Coronavirus disease 2019 is a major threat to public health globally. Though its pathogenesis has not been fully elucidated, angiotensin-converting enzyme 2 (ACE2) has been recently identified as a receptor for the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the cell. Here, we aimed to clarify the potential role of ACE2 in SARS-CoV-2-induced acute lung injury and its underlying mechanism. As a receptor for coronavirus, ACE2 mediates the entry of SARS-CoV-2 into cells in a similar way as for severe acute respiratory syndrome coronavirus (SARS-CoV). The high binding affinity of SARS-CoV-2 to ACE2 correlates with its efficient spread among humans. On the other hand, ACE2 negatively regulates the renin-angiotensin-aldosterone system (RAAS) primarily by converting angiotensin II to angiotensin 1–7, which exerts a beneficial effect on coronavirus-induced acute lung injury. Human recombinant ACE2 has been considered as a potential therapy for SARS-CoV-2 by blocking virus entry and redressing the imbalance of RAAS in SARS-CoV-2 infection. The level of ACE2 expression can be upregulated by treatment with an ACE inhibitor (ACEI) or angiotensin Ⅱ type 1 receptor blocker (ARB). To date, no evidence shows that ACEIs or ARBs increase the susceptibility and mortality of patients infected with SARS-CoV-2, and hence, it is not advisable to discontinue such drugs in patients with cardiovascular disease. |
24 | al6v3b9x | what kinds of complications related to COVID-19 are associated with diabetes | Impact of antibacterials on subsequent resistance and clinical outcomes in adult patients with viral pneumonia: an opportunity for stewardship INTRODUCTION: Respiratory viruses are increasingly recognized as significant etiologies of pneumonia among hospitalized patients. Advanced technologies using multiplex molecular assays and polymerase-chain reaction increase the ability to identify viral pathogens and may ultimately impact antibacterial use. METHOD: This was a single-center retrospective cohort study to evaluate the impact of antibacterials in viral pneumonia on clinical outcomes and subsequent multidrug-resistant organism (MDRO) infections/colonization. Patients admitted from March 2013 to November 2014 with positive respiratory viral panels (RVP) and radiographic findings of pneumonia were included. Patients transferred from an outside hospital or not still hospitalized 72 hours after the RVP report date were excluded. Patients were categorized based on exposure to systemic antibacterials: less than 3 days representing short-course therapy and 3 to 10 days being long-course therapy. RESULTS: A total of 174 patients (long-course, n = 67; short-course, n = 28; mixed bacterial-viral infection, n = 79) were included with most being immunocompromised (56.3 %) with active malignancy the primary etiology (69.4 %). Rhinovirus/Enterovirus (23 %), Influenza (19 %), and Parainfluenza (15.5 %) were the viruses most commonly identified. A total of 13 different systemic antibacterials were used as empiric therapy in the 95 patients with pure viral infection for a total of 466 days-of-therapy. Vancomycin (50.7 %), cefepime (40.3 %), azithromycin (40.3 %), meropenem (23.9 %), and linezolid (20.9 %) were most frequently used. In-hospital mortality did not differ between patients with viral pneumonia in the short-course and long-course groups. Subsequent infection/colonization with a MDRO was more frequent in the long-course group compared to the short-course group (53.2 vs 21.1 %; P = 0.027). CONCLUSION: This study found that long-course antibacterial use in the setting of viral pneumonia had no impact on clinical outcomes but increased the incidence of subsequent MDRO infection/colonization. |
41 | xo1f35jg | What are the impacts of COVID-19 among African-Americans that differ from the rest of the U.S. population? | Black Lives in a Pandemic: Implications of Systemic Injustice for End‐of‐Life Care In recent months, Covid‐19 has devastated African American communities across the nation, and a Minneapolis police officer murdered George Floyd. The agents of death may be novel, but the phenomena of long‐standing epidemics of premature black death and of police violence are not. This essay argues that racial health and health care disparities, rooted as they are in systemic injustice, ought to carry far more weight in clinical ethics than they generally do. In particular, this essay examines palliative and end‐of‐life care for African Americans, highlighting the ways in which American medicine, like American society, has breached trust. In the experience of many African American patients struggling against terminal illness, health care providers have denied them a say in their own medical decision‐making. In the midst of the Covid‐19 pandemic, African Americans have once again been denied a say with regard to the rationing of scarce medical resources such as ventilators, in that dominant and ostensibly race‐neutral algorithms sacrifice black lives. Is there such thing as a "good" or "dignified" death when African Americans are dying not merely of Covid‐19 but of structural racism? |
1 | d677ef8l | what is the origin of COVID-19 | Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series OBJECTIVE: To study the clinical characteristics of patients in Zhejiang province, China, infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) responsible for coronavirus disease 2019 (covid-2019). DESIGN: Retrospective case series. SETTING: Seven hospitals in Zhejiang province, China. PARTICIPANTS: 62 patients admitted to hospital with laboratory confirmed SARS-Cov-2 infection. Data were collected from 10 January 2020 to 26 January 2020. MAIN OUTCOME MEASURES: Clinical data, collected using a standardised case report form, such as temperature, history of exposure, incubation period. If information was not clear, the working group in Hangzhou contacted the doctor responsible for treating the patient for clarification. RESULTS: Of the 62 patients studied (median age 41 years), only one was admitted to an intensive care unit, and no patients died during the study. According to research, none of the infected patients in Zhejiang province were ever exposed to the Huanan seafood market, the original source of the virus; all studied cases were infected by human to human transmission. The most common symptoms at onset of illness were fever in 48 (77%) patients, cough in 50 (81%), expectoration in 35 (56%), headache in 21 (34%), myalgia or fatigue in 32 (52%), diarrhoea in 3 (8%), and haemoptysis in 2 (3%). Only two patients (3%) developed shortness of breath on admission. The median time from exposure to onset of illness was 4 days (interquartile range 3-5 days), and from onset of symptoms to first hospital admission was 2 (1-4) days. CONCLUSION: As of early February 2020, compared with patients initially infected with SARS-Cov-2 in Wuhan, the symptoms of patients in Zhejiang province are relatively mild. |
40 | bkr4ndl2 | What are the observed mutations in the SARS-CoV-2 genome and how often do the mutations occur? | Accurate prediction of functional, structural, and stability changes in PITX2 mutations using in silico bioinformatics algorithms Mutations in PITX2 have been implicated in several genetic disorders, particularly Axenfeld-Rieger syndrome. In order to determine the most reliable bioinformatics tools to assess the likely pathogenicity of PITX2 variants, the results of bioinformatics predictions were compared to the impact of variants on PITX2 structure and function. The MutPred, Provean, and PMUT bioinformatic tools were found to have the highest performance in predicting the pathogenicity effects of all 18 characterized missense variants in PITX2, all with sensitivity and specificity >93%. Applying these three programs to assess the likely pathogenicity of 13 previously uncharacterized PITX2 missense variants predicted 12/13 variants as deleterious, except A30V which was predicted as benign variant for all programs. Molecular modeling of the PITX2 homoedomain predicts that of the 31 known PITX2 variants, L54Q, F58L, V83F, V83L, W86C, W86S, and R91P alter PITX2's structure. In contrast, the remaining 24 variants are not predicted to change PITX2's structure. The results of molecular modeling, performed on all the PITX2 missense mutations located in the homeodomain, were compared with the findings of eight protein stability programs. CUPSAT was found to be the most reliable in predicting the effect of missense mutations on PITX2 stability. Our results showed that for PITX2, and likely other members of this homeodomain transcription factor family, MutPred, Provean, PMUT, molecular modeling, and CUPSAT can reliably be used to predict PITX2 missense variants pathogenicity. |
36 | 0d8hf8qv | What is the protein structure of the SARS-CoV-2 spike? | Applications of isothermal titration calorimetry in protein folding and molecular recognition During the past decade, isothermal titration calorimetry (ITC) has developed from a specialist method to a major, commercially available tool in the arsenal directed at understanding molecular interactions. At present, ITC is used to study all types of binding reactions, including protein-protein, protein-ligand, DNA-drug, DNA-protein, receptor-target, and enzyme kinetics, and it is becoming the method of choice for the determination of the thermodynamic parameters associated with the structure transformation of one molecule or non-covalent interaction of two (or more) molecules. Here, the new applications of ITC in protein folding/unfolding and misfolding, as well as its traditional application in molecular interaction/recognition are reviewed, providing an overview of what can be achieved in these fields using this method and what developments are likely to occur in the near future. |
3 | j0pfz0pd | will SARS-CoV2 infected people develop immunity? Is cross protection possible? | A consideration of publication-derived immune-related associations in Coronavirus and related lung damaging diseases The severe acute respiratory syndrome virus SARS-CoV-2, a close relative of the SARS-CoV virus, is the cause of recent COVID-19 pandemic affecting, to date, over a 2 million individuals across the globe and demonstrating relatively high rates of infection and mortality. A third virus, the H5N1, responsible for avian influenza, has caused infection with some clinical similarities to those in COVID-19 infections. Cytokines, small proteins that modulate immune responses, have been directly implicated in some of the severe responses seen in COVID-19 patients, e.g. cytokine storms. Understanding the immune processes related to COVID-19, and other similar infections, could help identify diagnostic markers and therapeutic targets. Here we examine data of cytokine, immune cell types, and disease associations captured from biomedical literature associated with coronavirus, SARS, and H5N1 influenza, with the objective of identifying potentially useful relationships and areas for future research. Cytokine and cell-type associations captured from MeSH terms linked to thousands of PubMed abstracts, has identified differing patterns of associations between the three corpuses of abstracts (coronavirus, SARS, or H5N1 influenza). Clustering of cytokine-disease co-occurrences in the context of coronavirus has identified compelling clusters of co-morbidities and symptoms, some of which already known to be linked to COVID-19. Finally, network analysis identified sub-networks of cytokines and immune cell types associated with different manifestations, co-morbidities and symptoms of coronavirus, SARS, and H5N1. Systematic review of research in medicine is essential to facilitate evidence-based choices about health interventions. In a fast moving pandemic the approach taken here will identify trends and enable rapid comparison to the literature of related diseases. |
48 | 7eksp1sj | what are the benefits and risks of re-opening schools in the midst of the COVID-19 pandemic? | Crime, Justice & the COVID-19 Pandemic: Toward a National Research Agenda The novel corona virus COVID-19 has become a worldwide public health pandemic that has induced anomic conditions impacting daily routines. COVID-19 response measures specifically alter regular schedules and both restrict and expand opportunities for various types of crime while presenting unprecedented challenges for the criminal justice system. For criminologists and criminal justice scientists, the virus also presents natural experiment conditions allowing for real-world theory tests and observation of the relative effectiveness of practice and policy options under weighty conditions. Toward synthesizing scientific discourse and forthcoming empirical work, we suggest the benefits of a COVID-19 crime and justice research program and offer some anchoring concepts. Contagion, containment measures (social distancing, facemasks, shelter-in-place, economic shutdown, virtual work and schooling, banned group gatherings), and social ordinance compliance (voluntary or enforced) posture a conceptual framework from which to align research on crime, justice, and victimization during the virus. After observing crime trends and justice system challenges, we suggest how the pandemic presents opportunities for review of various criminal justice, especially incarceration, policies. System change is a recurring theme across this special issue of the American Journal of Criminal Justice that features twenty additional contributions from a wide range of authoritative crime and justice scholars. These articles on traditional crime during the virus, virus specific hate crime and domestic violence, and the challenges posed by COVID-19 to law enforcement, the courts, and corrections will hopefully provide initial commentary toward deeper inquiry. |
8 | t20huil6 | how has lack of testing availability led to underreporting of true incidence of Covid-19? | Tabagisme et maladie à coronavirus 2019 (COVID-19) |
18 | qeyw5my5 | what are the best masks for preventing infection by Covid-19? | Effect of preventive actions and health care factors in controlling the outbreaks of COVID-19 pandemic With the insurgence of the COVID-19 pandemic, a large number of people died in the past several months, and the situation is ongoing with increasing panic and vulnerability. Due to the lack of drugs and prophylaxis against COVID-19, most of the countries are now relying on preventive measures focusing on maintaining social distance. However, this social distancing can create global socio-economic threats and psychological disorders. Therefore, these control measures need to have an assessment to evaluate their potential in containing the situation. In this study, we analyzed the outcome of COVID-19 in response to control measures, health care facilities, and prevalent diseases. Based on our findings, the number of COVID-19 deaths found to reduce with increased medical personnel and hospital beds. We found 0.23, 0.16, and 0.21 as the measurement of non-linear relationship between COVID-19 case fatality and number of physicians, nurses and midwives, and hospital beds and these relationships are highly significant with p-value of 0.000007, 0.0046, and 0.0196, respectively. Importantly, we observed a significant correlation between the reduction of COVID-19 cases and the earliness of preventive initiation. As a result, enhancing health care facilities as well as imposing those control measures in a short time could be valuable to prevent the currently raging COVID-19 pandemic. The apathy of taking immediate health care action from the nations has identified as one of the critical reasons to make the circumstances worst. Gambia, Nicaragua, Burundi, Namibia, and Nepal have marked in a state of danger based on the comparative study towards the health care action for the top twenty burdening and least affected countries. Interestingly, no association in most diseases except for few cases has found between the comorbidities and severity of COVID-19, which warranted further investigation at the pathobiological level. We believe that this study could provide a guide for future COVID-19 research. |
34 | hlbjrkqp | What are the longer-term complications of those who recover from COVID-19? | Psychological impact of anti-Asian stigma due to the COVID-19 pandemic: A call for research, practice, and policy responses The COVID-19 pandemic is linked to a rise in stigma and discrimination against Chinese and other Asians, which is likely to have a negative impact on mental health, especially when combined with additional outbreak-related stressors. We discuss the need to consider the potential harms of these anti-Asian sentiments during both the height of the pandemic and longer-term recovery through (a) research-examining how it affects mental health and recovery; (b) practice-implementing evidence-based stigma reduction initiatives; and (c) policy-coordinating federal response to anti-Asian racism including investment in mental health services and community-based efforts. (PsycInfo Database Record (c) 2020 APA, all rights reserved). |
45 | qauaqwhl | How has the COVID-19 pandemic impacted mental health? | COVID-19 Impact on Well-Being and Education in Radiology Residencies: a survey of the Association of Program Directors in Radiology RATIONALE AND OBJECTIVES: The COVID-19 pandemic has forced rapid evolution of the healthcare environment. Efforts to mitigate the spread of the virus through social distancing and shelter-at-home edicts have unintended consequences upon clinical and educational missions and mental well-being of radiology departments. We sought to understand the impact of the COVID-19 pandemic on radiology residencies with respect to the educational mission and perceptions of impact on well-being. MATERIALS AND METHODS: This study was IRB exempt. An anonymous 22 question survey regarding the impact of COVID-19 pandemic on educational and clinical missions of residencies, its perceived impact upon morale of radiologists and trainees and a query of innovative solutions devised in response, was emailed to the APDR membership. Survey data were collected using SurveyMonkey® (San Mateo, California). RESULTS: Respondents felt the COVID-19 pandemic has negatively impacted their residency programs. Regarding the educational mission impact, 70.1% (75/107) report moderate/marked negative impact and 2.8% (3/107) that educational activities have ceased. Regarding the pandemic's impact on resident morale, 44.8% (48/107) perceive moderate/marked negative effect; perceived resident morale in programs with redeployment is significantly worse with 57.1% (12/21) reporting moderate/marked decrease. Respondents overwhelmingly report adequate resident access to mental health resources during the acute phase of the pandemic (88.8%, 95/107). Regarding morale of program directors, 61% (65/106) report either mild or marked decreased morale. Program innovations reported by program directors were catalogued and shared. CONCLUSION: The COVID-19 pandemic has markedly impacted the perceived well-being and educational missions of radiology residency programs across the United States. |
42 | mk2c1maf | Does Vitamin D impact COVID-19 prevention and treatment? | COVID-19: hemoglobin, iron, and hypoxia beyond inflammation. A narrative review Coronavirus disease-19 (COVID-19) has been regarded as an infective-inflammatory disease, which affects mainly lungs. More recently, a multi-organ involvement has been highlighted, with different pathways of injury. A hemoglobinopathy, hypoxia and cell iron overload might have a possible additional role. Scientific literature has pointed out two potential pathophysiological mechanisms: i) severe acute respiratory syndrome-coronavirus-2 (SARS-CoV- 2) interaction with hemoglobin molecule, through CD147, CD26 and other receptors located on erythrocyte and/or blood cell precursors; ii) hepcidin-mimetic action of a viral spike protein, inducing ferroportin blockage. In this translational medicinebased narrative review, the following pathologic metabolic pathways, deriving from hemoglobin denaturation and iron metabolism dysregulation, are highlighted: i) decrease of functioning hemoglobin quote; ii) iron overload in cell/tissue (hyperferritinemia); iii) release of free toxic circulating heme; iv) hypoxemia and systemic hypoxia; v) reduction of nitric oxide; vi) coagulation activation; vii) ferroptosis with oxidative stress and lipoperoxidation; viii) mitochondrial degeneration and apoptosis. A few clinical syndromes may follow, such as pulmonary edema based on arterial vasoconstriction and altered alveolo-capillary barrier, sideroblastic-like anemia, endotheliitis, vasospastic acrosyndrome, and arterio- venous thromboembolism. We speculated that in COVID-19, beyond the classical pulmonary immune-inflammation view, the occurrence of an oxygen-deprived blood disease, with iron metabolism dysregulation, should be taken in consideration. A more comprehensive diagnostic/therapeutic approach to COVID-19 is proposed, including potential adjuvant interventions aimed at improving hemoglobin dysfunction, iron over-deposit and generalized hypoxic state. |
49 | g6ufz29l | do individuals who recover from COVID-19 show sufficient immune response, including antibody levels and T-cell mediated immunity, to prevent re-infection? | Distinct features of SARS-CoV-2-specific IgA response in COVID-19 patients Humoral immune response to SARS-CoV-2 showed an early response of IgA, instead of IgM, in COVID-19 patients. As highlighted by our study, enhanced IgA responses observed in severe COVID-19 might confer damaging effects in severe COVID-19. |
11 | 2h3kz82b | what are the guidelines for triaging patients infected with coronavirus? | Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19 Abstract Background Several studies have described the clinical characteristics of patients with novel coronavirus (SARS-CoV-2) infected pneumonia (COVID-19), indicating severe patients tended to have higher neutrophil to lymphocyte ratio (NLR). Whether baseline NLR could be an independent predictor of in-hospital death in Chinese COVID-19 patients remains to be investigated. Methods A cohort of patients with COVID-19 admitted to the Zhongnan Hospital of Wuhan University from January 1 to February 29 was retrospectively analyzed. The baseline data of laboratory examinations, including NLR, were collected. Univariate and multivariate logistic regression models were developed to assess the independent relationship between the baseline NLR and in-hospital all-cause death. A sensitivity analysis was performed by converting NLR from a continuous variable to a categorical variable according to tertile. Interaction and stratified analyses were conducted as well. Results 245 COVID-19 patients were included in the final analyses, and the in-hospital mortality was 13.47%. Multivariate analysis demonstrated that there was 8% higher risk of in-hospital mortality for each unit increase in NLR (Odds ratio [OR] = 1.08; 95% confidence interval [95% CI], 1.01 to 1.14; P = 0.0147). Compared with patients in the lowest tertile, the NLR of patients in the highest tertile had a 15.04-fold higher risk of death (OR = 16.04; 95% CI, 1.14 to 224.95; P = 0.0395) after adjustment for potential confounders. Notably, the fully adjusted OR for mortality was 1.10 in males for each unit increase of NLR (OR = 1.10; 95% CI, 1.02 to 1.19; P = 0.016). Conclusions NLR is an independent risk factor of the in-hospital mortality for COVID-19 patients especially for male. Assessment of NLR may help identify high risk individuals with COVID-19. |
23 | 3ngfv96u | what kinds of complications related to COVID-19 are associated with hypertension? | Risks and Epidemiology of Infections After Hematopoietic Stem Cell Transplantation Infections following HCT are frequently related to risk factors caused by the procedure itself. Neutropenia and mucositis predispose to bacterial infections. Prolonged neutropenia increases the likelihood of invasive fungal infection. GVHD and its treatment create the most important easily identifiable risk period for a variety of infectious complications, particularly mold infections. Profound, prolonged T cell immunodeficiency, present after T cell-depleted or cord blood transplants, is the main risk factor for viral problems like disseminated adenovirus disease or EBV-related posttransplant lymphoproliferative disorder. |
6 | 8vfxwpai | what types of rapid testing for Covid-19 have been developed? | Residual Attention U-Net for Automated Multi-Class Segmentation of COVID-19 Chest CT Images The novel coronavirus disease 2019 (COVID-19) has been spreading rapidly around the world and caused significant impact on the public health and economy. However, there is still lack of studies on effectively quantifying the lung infection caused by COVID-19. As a basic but challenging task of the diagnostic framework, segmentation plays a crucial role in accurate quantification of COVID-19 infection measured by computed tomography (CT) images. To this end, we proposed a novel deep learning algorithm for automated segmentation of multiple COVID-19 infection regions. Specifically, we use the Aggregated Residual Transformations to learn a robust and expressive feature representation and apply the soft attention mechanism to improve the capability of the model to distinguish a variety of symptoms of the COVID-19. With a public CT image dataset, we validate the efficacy of the proposed algorithm in comparison with other competing methods. Experimental results demonstrate the outstanding performance of our algorithm for automated segmentation of COVID-19 Chest CT images. Our study provides a promising deep leaning-based segmentation tool to lay a foundation to quantitative diagnosis of COVID-19 lung infection in CT images. |
12 | c0c4rjfa | what are best practices in hospitals and at home in maintaining quarantine? | Infection control practices among hospital health and support workers in Hong Kong Summary A report by the Hong Kong government noted that hospital infection control standards were inadequate, requiring audit, development and implementation. In addition, hospital staff needed training in infection control measures. We investigated infection control practices among 162 hospital health workers (109 nurses, 45 doctors and 8 therapists) and 44 support workers in one acute hospital and two rehabilitation hospitals using a non-blinded, observational design. We examined compliance with isolation precautions and infection control guidelines, including proper wearing of a mask, goggles/face shield, or gown; handling patient care equipment, linen, and laundry; routine and terminal cleaning; and terminal cleaning of an isolation room. One major breakdown in compliance was use of sleeveless disposable plastic aprons instead of long-sleeved gowns during procedures likely to generate splashes or sprays of blood and body fluids. In more than half of the observed episodes, participants failed to disinfect medical devices, such as stethoscopes, before re-use. Thorough cleansing of commodes between patients was also lacking. Overall compliance with local and international infection control guidelines was satisfactory, but several aspects required improvement. |
23 | e21a5084-2019-04-18T12:37:53Z-00002-000 | Should euthanasia or physician-assisted suicide be legal? | Euthanasia should be legal First I will make my argument against euthanasia and secondly I will respond to your original questions. My argument will be based on 3 points: Mixed Messages Further Implications Alternative Options *************************************************************************************************************** Mixed Messages The first point to my argument is that euthanasia sends mixed messages to society about the value of our own lives and the tragedy of suicide. This is because in its essence euthanasia (or doctor assisted suicide) is by its nature suicide. Now put aside the factors that lead people to this decision and ask yourself, is suicide a good thing? I think the answer for most of us is no, as it should be. Since killing ourselves goes against human nature objectively speaking suicide is morally wrong. Now when considering those with serious illness does the morality of the act change? But before one answers this question I think a prior question needs to be answered. Is deep depression a serious illness? I think the answer is yes, and many psychologists and those who study the brain would agree, depression is an illness that can sometimes be incurable [1]. Now take into account how society responds to teenage, middle age, or any depression related suicide. We mourn, and we mourn because we all know that what has happened is a tragedy. We know that regardless of the individual's illness their life was worth preserving and that this is a tragedy. So what message does this send to people with suicidal thoughts that if your illness is visible it's okay to kill yourself? But if you who are arguably just as sick with deep depression, killing yourself is a failure and a tragedy. As a society we spend millions of dollars (and rightly so) to prevent suicide in our culture. Why then is it okay to also spend millions of dollars to publicly subsides and praise the suicide of others. Who gets to say to the 31 year old with deep depression that he isn't just as sick as the 91 year old with a tumor? Instead let's promote one unified message to all people, your live if worth living until its natural end, and we will do whatever it takes to make it as liveable as possible. Further Implications In countries that have legalized euthanasia predictable trends have emerged. As I mentioned in my first point, questions start to be raised as to who gets to decide who dies? How can the government tell one person it's okay and another it's not? Well in the Netherlands they are learning the hard way that once you deny that suicide is objectively wrong, no one has the right to tell anyone else that suicide isn't a good option for them. Take the Dutch woman, who was allowed to die because of PTSD from sexual abuse. "A woman in her 20s who suffered sexual abuse as a child has been permitted to undergo euthanasia in the Netherlands. She was given a lethal injection after doctors and psychiatrists determined that her post-traumatic stress disorder (PTSD) and continuing conditions including chronic depression and suicidal mood swings could not be cured." [2] Or the Swiss woman, who was euthanized because she was "tired of life". "She was not terminally ill, nor was she particularly severely disabled, yet she could not find much enjoyment in living anymore and felt the time was right to say goodbye." [3] The logical ramifications of saying suicide is not objectively wrong is that no one can say it's wrong. And going back to my pervious point, if we can't say to young people it's okay to kill yourself then we can't say it to anyone. Alternative Options My last point doesn't address why euthanasia is objectively wrong but rather why it's not needed as much as we think. Currently there exist options for those in incredible (physical) suffering to be given what is called palliative care. Palliative care doctors concentrate on preventing and alleviating suffering, improving your quality of life, and helping you and your loved ones cope with the stress and burden of your illness [4]. This kind of care can relive many of the symptoms of the terminally ill and provide them and their families with support through the process. This kind of option should it be properly funded would replace the need for euthanasia in our societies. The last point on this is that studies have shown that terminally ill patients have chosen death mostly because of a loss of dignity. "The primary reason given (in The Netherlands) for choosing euthanasia is "a loss of dignity". [5] If we can show terminally ill patients that their lives and their comfort do matter through the use of palliative care then we eliminate the desire for euthanasia. Conclusion Euthanasia is wrong because of the mixed messages it sends, the implications it has on society, and the alternatives that make it unnecessary Sources: 1. http://news.nationalpost.com... 2. http://www.huffingtonpost.co.uk... 3. http://www.express.co.uk... 4. http://palliativedoctors.org... 5. https://www.ncbi.nlm.nih.gov...; Response In response to you original questions, I think I have answered, that just as we shouldn't allow young people with serious depressing to end their life we also shouldn't let people who have lost their dignity to do so. As far as the personal freedom argument goes we should not be free to do whatever we please but rather only what is right. Do the laws that say you can't chop your own arm off mean you aren't free? No, because we should only have the freedom to do what is right not whatever we please. |
29 | 2025b712-2019-04-18T17:48:41Z-00003-000 | Should the government allow illegal immigrants to become citizens? | Issues of Immigrations I have proven that there are no issues with immigration by stating the following, " America is defined by immigrants." "Immigrants are a good source of people for America because they strengthen our economy thus making out work force young." "They helped us start businesses like Google, Yahoo, they have created industries in which had created jobs for Americans." I absolutely have given reasons to why it's not an issue to the immigrants that are already here. You're right about the national security and the statistics of those that come to the country by crossing the borderline. But the numbers have gone down dramatically over the years by the strength of our national security.http://www.rita.dot.gov... ---- this link indicates that the numbers on border crossing has declined overtime. And again you're right for the drug deals immigrants bring in and out the country but don't forget that there are deeply consequences for those that break the U.S. LAW. Such as deporting those that are not legally here in the U.S. and arresting those that legally here in the U.S. http://www.invw.org... But my focus is clearly on the benefits that immigrants have provided for America which I had already provided in my other round. |
3 | 41e8d87f-2019-04-17T11:47:37Z-00019-000 | Should insider trading be allowed? | Carbon emissions trading Complicated cap-and-trade system requires costly administration. |
31 | b5b096db-2019-04-18T18:54:54Z-00001-000 | Is obesity a disease? | Obesity is a disease. Majority of the population will loose weight if they eat healthy and exercise as i stated originally. There will always be people with issues such as imbalanced hormones that will cause different results. The hormone imbalance would be considered a disease leading to obesity. Obesity is not a disease. Obesity can cause illness and be a result of other conditions but being overweight in itself is not a disease. The genetics that cause diseases such as diabetes and heart disease is absolutely real. Being healthy and good lifestyle choices only helps reduce your risk of being subjected to these diseases. In many cases no matter what you do you will become diabetic because it is in your family but it will always help to be healthy when trying to fight a disease. Overall, eating fatty foods and lack of exercise will result in obesity. You decide what to put into your body and how active your life is. While there are genetic disease that can result in obesity, obesity in itself is not an illness but rather a choice. |
33 | 7eabc63c-2019-04-18T12:18:12Z-00003-000 | Should people become vegetarian? | Should People Become Vegetarian Many people disagree over the topic of Should People Become Vegetarian as it is controversial issue. My opinion on the issue of Should People Become Vegetarian is that people do not have to become vegetarian. This claim is justified by the fact that raising beef is one of the most efficient way to produce food and access to get protein for humans. This is a good thing, because with the rapidly increasing population, we need as much food as we can provide that also provides us with the nutrition we need. Inevitably, we must agree that not everyone should be vegetarian, because we need to provide everyone food and this is one of the most efficient way. |
47 | 81d5454b-2019-04-18T13:19:41Z-00004-000 | Is homework beneficial? | Homework Is Unnecessary [ Arguments ] There are several reasons that people support homework:1. To reinforce what is being taught in the classroom2. To enable parents to engage in their child's education3. To help children prepare for tests and state exams4. To teach fundamental skills such as time managementHowever I will be arguing that1. Homework does not fuel academic success2. Homework inhibits family time and burdens parents3. Homework infringes on playtime and recreation time4. Homework fosters resentment that is detrimental and unnecessaryPoint 1 Let's begin with the supposition that homework is vital to one's education. In fact, there is almost no evidence that homework helps elementary school students achieve academic success, and little more that it helps older students. A study led by an Indiana University School of Education faculty member finds little correlation between time spent on homework and better course grades [1].Using databases like the Trends in Mathematics and Science Study (TIMSS) we can see how homework impacts academic achievement around the world. According to TIMSS data, homework is not associated with high national or international levels of academic achievement [2].Adam Maltese and his colleagues analyzed the amount of time students spent on homework to their academic success. Research showed there was no relationship whatsoever between time spent on homework and course grade, and "no substantive difference in grades between students who complete homework and those who do not" [3]. Whereas the research showed a slight improvement in standardized test scores for students who did more homework, this improvement is described as being "very modest." The fact is, you can't "reinforce" understanding the way you can reinforce a behavior. If you had a hard time understanding the lesson in class, chances are you won't have an easier time understanding it (if you can understand it at all) through the assignment of homework. I will be glad to expand on the research if my opponent challenges this contention.Point 2Homework places a burden on parents. After working all day, parents are required to go home and not only take care of their household, but help their child complete additional work. This is stressful and can often cause family conflict. Indeed many parents have rebelled against homework [4] and some have even taken legal action (and won) to not have to suffer the burden of this homework obligation [5]. Parents should be able to choose what the best way to teach their children is outside of the classroom, which may or may not be reviewing their day's lesson. Homework can cut into important personal and family time [6]. Rather than bonding by spending quality time with their loved ones, homework requires students continue working rather than strengthening their personal relationships. A Stanford researcher found that too much homework can negatively affect kids away from school, where family, friends and activities matter [7]. It can also emphasize the mentality that work is more important than family. Researcher Alfie Kohn notes, "We parents, meanwhile, turn into nags. After being away from our children all day, the first words out of our mouths, sadly, may be: 'So, did you finish your homework?' One mother told me it permanently damaged her relationship with her son because it forced her to be an enforcer rather than a mom" [8]. Moreover, each child has a different home environment. Whereas some parents have the time and resources to dedicate to homework monitoring and assistance, other parents do not have the opportunity to be as involved. Thus a shoddy homework response might reflect poorly on the child unfairly. Further, homework arguably places an unnecessary burden on teachers in addition to parents. Rather than spending time planning their lessons, grading classwork or working on their own self-improvement, teachers have to spend time grading "busy work" that they can't be sure the child has even completed on their own. While some suggest that homework teaches kids about responsibility, most of the time it needs asssistance from parents. In the early years especially, it often cannot be done without parental guidance (so much for teaching independence!).Point 3 After spending all day in school, children are forced to begin a "second shift" of work which can include hours of additional assignments. This deprives children of time for other physical and creative activities, or even time to rest. Homework leads kids to be frustrated and tired to the point of inhibiting their learning. For one thing they might become bored or impatient with the perpetual tasks; for another they might be too drained to focus on them. Homework consistently builds a hateful relationship with learning [9]. While we don't give slow-working children a longer school day, we consistently give them a longer homework day. Kids who take longer to read, grasp the work or work more slowly in general have less time for non-academic education compared to their peers. Learning an instrument, playing sports, working on the arts, and even general playtime has significant benefits to a child's health, wellness and intellectual development [10]. Recreational activities can teach all kinds of useful life lessons and skills that pertain to schoolwork and beyond. Point 4 Homework is known for "causing a loss of sleep, of self esteem, of cheer, and of childhood" [11]. "It extinguishes the flame of curiosity." A child is not engaged through homework but rather disengaged through "drill and kill" methods that provide little to no utility. Homework also widens the gap between high and low achievers, and can increase pressure to do well. This in turn can encourage cheating and may disproportionately punish low-income or minority students in disadvantages situations. As for proposed alternatives, "The best teachers know that children learn how to make good decisions by making decisions, not by following directions... At least two investigators have found that the most impressive teachers (as defined by various criteria) tend to involve students in decisions about assignments rather than simply telling them what they'll have to do at home" [12]. As such, we can improve the status quo by asking students the best way to reinforce what they have learned in class. While this might include some work from home, it probably won't look like the standard version of homework that is uniform, repetitive and monotonous. Perhaps teachers and parents can work with each student individually to figure out their goals and best methods of learning based on their habits, skill set and home environment. [ Sources ] [1] http://research.indiana.edu...[2] https://www.washingtonpost.com...[3] Adam V. Maltese, Robert H. Tai, and Xitao Fan, "When Is Homework Worth the Time? Evaluating the Association Between Homework and Achievement in High School Science and Math," The High School Journal, October/November 2012: 52-72. [4] http://www.nationalpost.com...[5] http://www.theguardian.com...[6] Cooper, H., Robinson, J. C., & Patall, E. A. (2006). Does homework improve academic achievement? A synthesis of research, 1987–2003. Review of Educational Research, 76(1), 1-62.[7] https://news.stanford.edu...[8] http://www.familycircle.com...[9] http://www.salon.com...[10] http://www.parks.ca.gov...[11] http://www.21learn.org...[12] http://www.alfiekohn.org... |
6 | 4a9c9344-2019-04-18T13:30:56Z-00002-000 | Is a college education worth it? | Abortion should be legal up through the second trimester, regardless of circumstance Rebuttal 1A: This case was more of a defense; just in case you claimed that death by abortion was lesened by Roe V. Wade.Rebuttal 1B:My opponent tries to debunk my statsitcal evidence by quoting from his ownn source. He claims they are "one of the most pretigious medical journals on Earth". However, this study does not reflect his claim. Let me give you information about a woman's eligibility for the study from his own source excludes many women.In a study regarding egtopic pregnancy and early birth, they exclude women who had an egtopic pregnancy that originally was in their study. They excluded women who had more than one abortion. They exclude large groups of women to where only 1.1% remain. This allows for the study's data to be easily manipulated. They excluded women, as I have shown, that would contradict their study. I would like voters to disregard this source; as it is obviously manipulated. My source is a compilation of over 59 studies; while his study is faulty and only has one. I urge voters to hold this point in my favor.Rebuttal 1C:The site itself is not the problem. If the study itself is credible, there is no need to deny it. The study itself is from the Journel of Reproductive Medicine. This study is a compliation of 59 studies. This proves its validity. He ignores the 2007 study as he claims that other studies I quoted were irrelevant since some of them were in the past. The studies covered the times from the 70's to recent years. that is what makes that study so reliable. Thank you for that. Rebuttal 1D:My opponent quote a study that seems to be flawed. As my other study explains:" Abortion increases a woman's overall risk of breast cancer by 30 per cent. The risk is likely much higher in women who have a first abortion at a young age, or who have a family history of breast cancer. Since 1957, 23 of 37 worldwide studies show an increased breast cancer risk with abortion, a risk as high as 310 per cent. Ten of fifteen U.S. studies confirm the abortion-breast cancer link. The biological rationale for breast cancer development is related to the woman's unprotected internal exposure to estrogen when a pregnancy is abruptly terminated early in gestation. The magnitude of the risk has, until recently, been hidden by studies of poor quality, many of which have failed to separate induced abortion from low-risk spontaneous miscarriage. The medical establishment is often slow to accept and respond to emerging data, slowed further, in this case, by the conflicting politics of abortion. A history of previous induced abortion(s) may play a role in cancers of the reproductive system and rectal cancers. Inconsistencies between studies and countries where the studies are done, in addition to the fact that in the literature, spontaneous and induced abortions are often not separated, make it difficult to draw definitive conclusions. Recent studies have connected a higher risk of cervical and ovarian cancers to previous abortions, though the degree of risk varies from study to study. A consistent finding has been the protective effect of full-term pregnancies against the onset of cancers of the reproductive system. Researchers have found a connection between abortion and rectal cancer. With reproductive and rectal cancers on the increase in women, more studies are needed, specifically to examine the connection between abortion and cancer. Subsequent pregnancies are negatively affected by induced abortion. The main complications are: cervical incompetence leading to future miscarriages; uterine perforations and placenta previa with serious implications to the health of the woman and her child(ren) in later pregnancies; and ectopic pregnancies which, if undiagnosed and not treated, can lead to a woman's death. Forty-nine studies of preterm or premature births from Europe and North America found increased risks ranging from 30 per cent to 510 per cent. The consequence of this significantly increased risk of prematurity after abortion is that the rate of cerebral palsy among premature infants weighing less than 1500 grams at birth is 38 times greater than among the general population. Induced abortion, in other words, is directly responsible for many thousands of cases of cerebral palsy - in North America alone - that otherwise would not have occurred. Despite the data which point to the link between induced abortion and future serious health risks, many North-American research studies fail to point these out. Numerical data should be carefully compared to research abstracts and conclusions because they often do not correlate; in other words, where data clearly indicate increased health risks, they are often minimized in the abstracts and conclusions of medical articles. In light of the growing knowledge of the impact of abortion on the rate of prematurity, abortion providers soon incur greatly increased liability for obtaining informed consent for women contemplating abortion. Women die from abortion-related problems but, owing to irregular and biased reporting, it is difficult to know how many. Reasons for maternal mortality related to abortion are many, including hemorrhage, infection, embolism, ectopic pregnancy, and cardiomyopathy. Coding deaths in hospitals and reasons for death on death certificates frequently record only the presenting problem as the cause of death, which results in many abortion-related deaths going unreported. The American Medical Association (AMA) relies on the Centers for Disease Control (CDC) for its statistics concerning abortion-related deaths and, given that the CDC uses hospital and clinic records (which underreport maternal deaths from abortion) for its data, the AMA does not recognize the full extent of abortion-related deaths. At most risk of abortion-related deaths are African-American and other minority women. A large-scale, authoritative Scandinavian study establishes post-pregnancy death rates within one year that are nearly four times greater among women who abort their pregnancies than among women who bear their babies. The suicide rate is nearly six times greater among aborting women than among women who give birth. These findings refute the oft-heard claim that induced abortion is safer than childbirth. There is an urgent need for independent studies of maternal mortality related to abortion, and medical facilities should be required to keep more accurate and informative records so that women may be better served in this area." (1) Obviously, Pro's sources are not correct.Mental Health Rebuttal:I will let my source do the talking:" Women who have abortions are at risk of emotional difficulties after the procedure, especially those with pre-existing factors such as relationship problems, ambivalence about their abortion, adolescence, previous psychiatric or emotional problems, pressure by others into making a decision to abort, or religious or philosophical values that are at odds with aborting a pregnancy. The prevailing interpretation of post-abortion grief, depression, guilt, anger, and anxiety in abortion clinics and research studies in North America is that they are due, not to the procedure, but to a woman's pre-existing disposition to psychological problems. Where support through counseling is offered (for example, in Sweden) to pregnant women who are not sure if they should or can carry their pregnancy to term, they are more likely not to abort. Given the evidence that women in certain risk groups are more emotionally vulnerable after an abortion, should abortion clinics and medical facilities consider recommending against abortion in their cases? This question has become crucial given recent findings that women who abort are much likelier to commit suicide. Informed consent for the psychological well-being of women, post-abortion, is an issue which health care professionals should address. After an abortion, women are more likely to display self-destructive behaviors including suicide and attempts at suicide; mutilation and various forms of punishment (including repeat abortions and sterilization); drug, alcohol and tobacco abuse; and eating disorders as a way of denying or minimizing the guilt, pain and numbness they feel. Women who abort often have trouble bonding with the children of future pregnancies and have a higher chance of eventually abusing them, which leads to a cyclical pattern of abuse-abortion- abuse. It seems clear, given the frequency of negative behavioral outcomes for women after abortion, that more thought needs to be given to appropriate therapy for women (and their children) who are at risk. Many women seek support in recovering from post-abortion distress, often years after the abortion. Project Rachel, The Healing Choice, and The National Office for Reconciliation and Healing are among the many therapeutic options that have evolved in the wake of widely- practised abortion. Women's marital or partner or family relationships can be significantly affected by abortion. After abortion, many relationships come to an end, and if the woman stays with her partner or husband, sexual dysfunction often results as does difficulty bonding with children born later on. When a woman or adolescent girl has been coerced into having an abortion, typical reactions include feelings of betrayal (by partners or family members), anger, depression, sadness, and breakdown of trust and intimacy in relationships. Some men are negatively affected and sense a loss of control and pride, especially when their partner has had an abortion without their being consulted "Suppressed mourning" has very negative outcomes, often leading to feelings of numbness and/or hostility and anger, and to difficulties in forming future relationships and in bonding with later-born children; in some instances, post-abortion trauma can lead to actual abuse of later children. (1) It is clear my case has a better logical, ethical, and moral basis than Pro's. Vote Con.Anime OP:http://tinyurl.com...;1. http://tinyurl.com... |
18 | 308d42d9-2019-04-18T15:44:36Z-00005-000 | Should churches remain tax-exempt? | Why Should Tony Abott Remain Prime Minister Tony Abott should remain P.M, because first of all he has helped 62% of charaties in Australia... and BTW (BY THE WAY) HE HAS HELPED ABOUT 625 AUSTRALIAN STRUGGLING CHILDREN!!!!!! OMG.. YOU MIGHT NOT KNOW THIS BUT I DO WANT HIM TO BE SACKED IT IS JUST THAT I HAVE TO DO THIS DEBATE |
4 | 21d6875b-2019-04-18T16:29:45Z-00002-000 | Should corporal punishment be used in schools? | Corporal punishment in the families!!! Today striking a child over the head is classed as abusive because it can lead to detrimental physical, psychological and congestive impacts which can be lifelong. I should have presented this point more clearly This point wasn't supposed to sound as if I thought abuse was the same as corporal punishment. It was meant to read that definitions of 'corporal punishment' in the past contrast with our modern views of what acceptable methods of punishment were (e.g. hitting your wife for 'disobeying you'. Okay in the eighteen hundreds, illegal today). The definition of corporal punishment is "… a means of discipline that relies on fear and submissiveness." or more broadly as '… a wide range of parenting practices intended to cause physical pain. These include such acts as pinching, shaking, slapping, punching and kicking children, and, with or without the use of objects like belts, cords and brushes, spanking, hitting and beating children…' these definitions mention nothing about the perpetration's emotions at the time of the corporal punishment, or them having to 'back it with love'. Your point goes against corporal punishment, not for it because some people use it while they are angry or frustrated at a child for the child's actions so feel they should be disciplined. This definition doesn't include anything saying that parents can't be angry when they physically discipline children. Child abuse isn't always deliberate or taken out of anger, passive emotion child abuse being a prominent example of this. I know this because I've spoken with child councillors from a national child abuse charity in person (as part of a project on child abuse). In my experience, parents who do use corporal punishment do so out of anger, not love. Besides, loving someone doesn't stop it from being abuse; perpetrators of domestic abuse sometimes believe they love their victims so are a prime example of this. The link between corporal punishments in children and an improvement their long term behaviour has never been made. In fact, a recent study has shown the opposite. While all children can act out in public, my parents never used any form of corporal punishment on me, this hasn't made me a bad person. It also never made us act out in public. In my childhood, I knew children whose parents used corporal punishment on them but behaved worse than me in public. The negative impacts of corporal punishment overweight the potential benefits of corporal punishment in children. There have been many studies which show that the negative effects of corporal punishment on children which disagree with your views. Notably, children who experienced parental corporal punishment are more likely to have antisocial behaviour and anxiety/depression than other children. The results of these studies are robust. Additionally, they have showed that children who experienced corporal punishment, similarly to those expeienced by child abuse victims.This impacts were outlined by Gershoff (sources in comments). |
3 | 3e3209b7-2019-04-18T16:43:01Z-00005-000 | Should insider trading be allowed? | Novice Tournament R2: Military aid ought to be prioritized over development assistance in Africa. Thank you, Josh.I affirm the resolve, "Military Aid should be Prioritized over Development Assistance in the Sahel region of Africa."ContentionsIt is pointless to invest Development Assistance in a region which is politically corrupt.The vast majority of Sahel governments suffer from immense political corruption. Throughout all levels of government, from federal to local, Sahelian officials are infamous for their unique persistence in draining public treasuries and acting against the public good. Out of 182 countries profiled in Transparency International's 2011 Corruption Perceptions Index, Sahelian nations occupied some of the worst spots. On a list where the number one country, New Zealand, was the least corrupt, Sahelian countries ranked 112 (Senegal), 118 (Mali), 134 (Eritrea and Niger, tied), 143 (Mauritania and Nigeria, tied), 168 (Chad), and 177 (Sudan) [1]. This deep rooted and chronic misconduct by officials has tremendous social and economic repercussions on Sahelian society.When Nigerian dictator Sani Abacha died in 1998, he was revealed to have stolen over $1 billion from Nigerian treasuries. The systematic and deliberate corruption existed throughout his entire cabinet. According to Forbes, "While he ruled Nigeria from a fortified presidential villa in Nigeria's capital… he and a circle of aides and business partners tapped virtually every stage of the oil business, Nigeria's most important industry and the source of 80 percent of its government revenue. They took kickbacks from foreign companies for licenses to search for oil in the basin and delta of the Niger River and offshore. They got bribes and pocketed the money." [1]. Abacha is just one example of a problem that persists throughout Sahelian governments. The rampant corruption prevents Sahelian citizens from using public infrastructure, ultimately depriving them of the food, clean water, and medicine that comes from foreign development assistance. According to a report by Global Financial Integrity, Nearly $1 trillion was sapped from the developing [Sahel] world in 2011 through bribery and corruption, a dramatic increase from past years, and more than 10 times the total official development assistance that went in." [2]. Until Sahelian governments are free of corruption, it is ridiculous to waste money on development assistance.Military Aid would improve stability.In addition to governmental corruption, violent local conflicts and extreme jihadism take a toll on the stability and overall security of the Sahel region. Terrorist groups are effectively opposing western presence in the Sahel and are attempting to discourage regional development. As long as this violence continues to target western interests, building infrastructure and developing local resources is ineffective and wasteful. According to an article published in the New York Times, "Before any longer-term focus on economic development, political inclusion and government accountability can be achieved in the [Sahel] region the immediate concern is restoring security. Without security there can be no sustainable political and economic development – but security will depend on international cooperation and training of local forces." [3]. A comparable example would be the highway development program in Afghanistan, another politically unstable region. Local terrorist groups have attacked contractors and hijacked development aid. The cost of the project is expected to over-run by nearly 300%, is months behind schedule, and has been hindered by over 300 attacks and road-side bombs [3].Furthermore, instability in the Sahel region is perpetuated by an inadequate criminal justice system and an uncontrollable drug trade. Cooperation between powerful terrorist groups and organized criminals has created a situation in which local resources are being sapped, and citizens live in fear. At a recent conference between representatives from from Algeria, Burkina Faso, Chad, Libya, Mali, and Mauritania, delegates listed the drug trade and crime as the two most plaguing issues to Sahelian society, and called for increased security in localities and international support [4].Fortunately, instability is a solvable problem. "The desire of the Sahel countries to improve their military arsenal comes from their situation," security expert Abdallahi Ould Mohamed said, "which forces them to confront security challenges, particularly terrorism and smuggling operations." "It also must be taken into account that these countries, especially Mauritania, Mali and Niger, have poor militaries, leading al-Qaeda to exploit that vulnerability and implement its operations with ease. Thus, they cannot address those risks unless their military capacities are developed." Strategic expert Ibrahim Ould Vall explained, "It is known that military cooperation between the countries of the Sahel and countries with high military experience is very important, and the Sahel countries realized this recently and so focused on strengthening the capacity of their armies." "The threat of terrorism in these countries has become an incentive to strengthen military cooperation between these countries and other countries like the United States… training their armies to track terrorist elements, benefiting from some military equipment in order to protect and monitor the borders, and combating smuggling of all kinds, especially the smuggling of light weapons," he added [4]. Clearly, through prioritization of military aid, Sahel nations can improve their stability and security, which will ultimately allow for utilization of resources, education, and other forms of development assistance later on.Military Aid would save lives.Unlike Development Assistance, Military Aid directly addresses and prevents human rights violations and unnecessary violence through Peace Keeping Organizations (PKOs). Primarily, Military Aid assists in counter-terror and counter-insurgency. Through fighting jihad groups head-on, PKOs drive extremist influence out of the Sahel region and protect local towns. According to Alexis Arieff, Analyst in African Affairs at the Congressional Research Service, "Prior to French intervention, regional and Western leaders had warned of a rising threat to international security associated with an expansion of jihadist influence and scope of operations in Mali, a possible spread of violent extremist ideology, and state fragmentation. The main threat from armed Islamist groups in the north, who appeared to coordinate their actions and share personnel... has been reduced." [5].Military Aid is also necessary to prevent the recruitment of child soldiers. Hundreds of children have been recruited by all of the armed groups active in the Sahel, including Al-Qaida in the Islamic Maghreb, Ansar Dine, the Movement for Unity and Jihad in West Africa and the National Movement for the Liberation of Azawad [6]. Through direct confrontation and eventual destruction of these armed groups, the use of child soldiers and other violations of international law can be prevented.The resolve is affirmed.Sources[1]http://www.theglobalobservatory.org...[2]http://csis.org...[3]http://aidwatchers.com...[4]http://magharebia.com...[5]http://www.cna.org...[6]Ban Ki-Moon, (UN Secretary General), REPORT OF THE SECRETARY-GENERAL ON THE SITUATION IN MALI, Mar. 24, 2013. |
1 | 1b03f390-2019-04-18T18:42:36Z-00004-000 | Should teachers get tenure? | The collective bargaining rights of teachers should be removed Thanks to Darkkermit for his argument. I'm now going to pick up where I left off in refutation. My opponent speaks of increasing efficiency in education by removing collective bargaining. He hasn't shown though, that bargaining itself, is responsible for the inefficiencies. I've seen no fix so far that warrants an intrusion on the rights of teachers to make choices about their representation. Finances are a consideration, but school districts are NOT able to raise taxes. They can ask for an increase in the budget, but are unlikely to see any change, other than negative, when times are bad. A union can not "raise the price of it's labor", it can only ask for that raise in negotiations. One of the biggest expenses in any industry is labor costs. That will not change by removing bargaining. Common sense dictates that making a profession less financially secure, and denying rights based on public sentiment will dissuade people from joining the profession. This will lead to having to keep bad teachers, not because of the union, but out of necessity. We're going to get what we pay for. My opponent talks about differences between public and private sector bargaining, and percentage of union workers. Those things are largely irrelevant to the resolution. It should be noted that the decrease in private sector union members coincides with the loss of middle-class manufacturing jobs, and also an increase in worker protection mandated by law. Many things workers enjoy today, OSHA safety regulations, 40-hour work week, overtime pay, vacations, FMLA and military leave, etc., can be attributed to the struggles of unions. Those benefits aren't only given to union workers though, thus my contention that unions affect ALL workers in a good way. Unions act as a check and balance system, the only options are to keep them, or depend on increased governmental regulation. Below is an excerpt from a very interesting, and relevant article that all should read.(4) "Legislated labor protections are sometimes considered alternatives to collective bargaining in the workplace, but the fact of the matter is that a top-down strategy of legislating protections may not be influential unless there is also an effective voice and intermediary for workers at the workplace—unions. In all of the research surveyed, no institutional factor appears as capable as unions of acting in workers' interests (Weil 2003). Labor legislation and unionization are best thought of as complements, not substitutes."He argues against education being a public service, but it is what it is. He is free to fight for change, but in the meantime, his disagreement with the system does not warrant punishing teachers. They have a right to fight against that change, just as he does to fight for it. Teacher strikes are becoming a thing of the past. Many states are passing no-strike laws. Though pro-union, I agree with this trend, and so do many teachers(1). I do not defend teacher's strikes, and refer back to my argument about finding a middle ground and not allowing the hard-liners, on either side, to be in complete control. There is a middle ground, and many states are finding it, where strikes are concerned. My opponent keeps alluding to difficulty in firing teachers. I've shown that tenure and dismissal is set by the states, not the collective bargaining process, and should not be part of this debate. These videos and articles do nothing but attempt to prejudice the reader, and distract from the issues. They are highly prejudicial, and should not be given weight in the decision. They are evidence of the highly political nature of my opponents position.Introduction Sorry that my opponent resents my statement. Perhaps if the status quo were being challenged for the right reasons, and teachers weren't scapegoats for the anti-union movement, I might be more receptive to his cause. With due respect, having a financial stake in something does not make us experts in what the real problems are in that system. Teachers are there everyday, in the classroom, they know what the problems are, they are the experts, not us. If my opponent valued teachers, as he claimed, he would respect that fact. He would also respect their ability to know what they need, and allow them to make choices for themselves, rather than protest against them under the guise of protecting them. The only "hijacking" being done, is that of their individual rights and freedom of association. Protection My opponent's argument seems to me to be a clear impact turn. First he argues that it's too hard to fire a teacher, but here he has presented evidence as to why it SHOULD be hard. This argument shows why it is not in the best interest of education, or the public, to fire teachers except in clearly egregious cases. Also, I restate that tenure is usually a matter of law, not bargaining. What if the bottom 6-10% of teachers are those in the most difficult schools, with the most difficult students?? Does that mean that they should be fired just to make room for unproven college grads?? Of course not, that's absurd and unless they can be shown to be deserving of termination, my opponent's above argument is why it's in no one's best interest. My opponent has yet to address the issue of teachers being at the mercy of the quality of students.I'll say again that teachers are the only ones who know what protections they need. For someone who isn't a teacher to claim to know what workplace issues they face, and need help with is absurd. Unions provide many protections for the rights of teachers, not just disciplinary issues. Past Practice There is no pre-set framework that I must abide by in this debate. My opponent is free to make whatever arguments he wishes, as am I. We could not do justice to a debate on this subject if we did not consider legal issues. Past practice means that if an employer gives a right to workers, and it is clearly understood by both parties, they cannot just arbitrarily remove that right without due process. Creating a mob mentality and attacking the rights of a group without due process is immoral. As I said this is a case-by-case issue, applicable in some, not so in others, depending on laws in that state. When laws are passed banning the right, then we have a different discussion. Until then legal issues must be considered. Other Legal Issues My opponent seems to be injecting his morals here, but what makes his morals the authority that all should be bound by?? He doesn't like unions, that's fine, he has the right not to join one. Yet he's in favor of taking away another's right to decide for themself. Why is that the correct moral position?? I maintain that if one group of public employees has a right, it is discriminatory to remove the right from another group. The strike issue has been addressed. The same checks exist in the public sector. ALL employees are bound by budgets, whether they're public or private sector.Specialization It is not the job of unions to create jobs, to use that as an argument them is misleading. Doctors and lawyers usually work for themselves, under their own license. There are many organizations that represent the interests of these professions. The AMA (2), APA, the Bar Association (3), to name a few. Are they politically active?? Yes. Do doctors and lawyers have a right to have a voice in our political system, where it affects their profession?? Yes, and so do teachers. "Society should not bare the risks of an individul's choice"- Society demands specialized degrees for this service to the public, those who comply should be rewarded, not penalized and raked over the coals just because there are a few bad teachers.1. http://www.nysdeputy.org...2. http://www.ama-assn.org...?3. http://www.americanbar.org...4. http://www.epi.org... |
40 | 75f8acc8-2019-04-18T14:13:25Z-00002-000 | Should the death penalty be allowed? | death penalty Alright, thanks to my opponent, and let's get into this. As Pro's opening round didn't really present an argument, so I'll just move into his R2. 1) Deterrent of capital crimes He starts off by arguing for retributive justice. I've already argued that Pro is supporting institutionalized vengeance, and that he'd have to apply this principle of a crime befitting an equal punishment across the board, something he's so far failed to support. But the principle itself is nonsense. What "equilibrium of justice" ends with more lives lost? That's not balance, that's just more imbalance. More death doesn't benefit anyone. Equal intensity of punishment doesn't bear any benefit either. If we truly wish to create some sort of balance, then we should force the convict to give back to society, something they cannot do if they are dead. Pro continues by arguing deterrence. He doesn't explain how the DP is a greater deterrent than life imprisonment, which ends in the same general outcome. Moreover, he doesn't explain how murders, which are often committed in the heat of the moment and without rational thought, In fact, there's very little to no effect of the threat of the DP on actual murder rates.[9] The Ted Bundy example utterly fails him. First, he tells us that Bundy waited 9 years. This case was incredibly straightforward, and yet it took 9 years to reach his execution date, and as Pro points out, he "exhausted every single legal point he and his lawyers could think of", which means they went through numerous, expensive appeals. But despite knowing that the DP was a likely outcome for him, despite clearly being afraid of it, he still engaged in the murder of so many women. In fact, this man represents the perfect example of an individual who a) wasn't deterred, b) exploited the DP system to bilk money out of the state and waste precious resources, and c) took an excessively long time to be executed anyway. All Pro can really garner from this is that he feared the DP more than life imprisonment, but Pro has to prove a broad deterrent effect exists, not just a fear. Pro is speculative on this, claiming that the fear prevents murders without any support, and ignoring any and all deterrent effect for LWOP. Lastly, Pro argues that there's some form of human dignity inherent to the DP. He spends all of a single sentence here, and doesn't explain how the death penalty and no other form of punishment is capable of accomplishing this. Any punishment treats a defendant as a free moral actor. Killing them deprives them of their free moral actor status, and thus removes any possibility for rehabilitation and redemption. 2) Closure I've covered this under the vengeance contention. The justice system does not exist as a means for doling out the pain of the victims' family. Even if they do receive some feelings of closure, the justice system is debased by becoming a vehicle for vengeance on the part of the family rather than acting as a fair, impartial means of achieving just outcomes. But there is no closure. There have been multiple studies on this, showing that there's no benefit to physical, psychological or behavioral health, and no increase in the level of satisfaction with the cirminal justice system. In fact, it's quite the opposite.[10] This holds up with other studies, which show that feelings of exacted revenge actually made individuals "feel worse, apparently because meting out a punishment caused htem to think about the offender more and dwell on the negative incident."[11]. Even if some people might feel closure, there's no reason to believe that they wouldn't feel the same closure in LWOP sentences. In fact, I would argue that faster sentencing increases closure, and the elongated trials that accompany repeated appeals drag on these cases for far longer than with LWOP. 3) Less expensive Pro doesn't source any of his arguments here, so voters should prefer mine, which clearly show that the appeals system and the process of killing someone requires higher costs than imprisoning someone over the remainder of their lives. Pro does provide one source that's just a number without any data. It's a nice bumper sticker, but not a good argument. So turn all of Pro's benefits of preventing hunger to my side. 4) Save lives So now we're back to deterrence. Pro never actually challenges the reality that LWOP ends in the eventual death of the inmate (multiple life sentences actually have more to do with preventing overturned or reduced sentences from releasing an inmate [http://bit.ly...]). As for the ability to kill while in prison or escape, both of those are possible for death row inmates, as those prisoners still languish for years or even decades. Why are LWOP prisoners more prone to either of these behaviors? Pro's example of Betty Beets is another bad one for him. The DP is not required to prevent recidivism. If she had initially received LWOP, there would have been no recidivism. The idea that a criminal is "a rotten apple among good ones... like a virus to the society" is interesting. On that basis, why shouldn't all criminals be executed? What makes murderers special? We don't want pervasive theivery or rape, either. It's because we recognize that not all criminals are going to remain terrors on society who have nothing of worth to contribute. We recognize that ending all of these lives will only exacerbate the harms on society, and produce little to no benefit in return. Allowing for rehabilitation and some form of redemption through their acts, something they're only allowed to do if they're not dead, is important. 5) Less possibility of error All Pro does here is mitigate the level of harm. I pointed out in the previous round just how common these are. Pro doesn't contest those statistics, merely asserting that no innocent persons have been executed since 1976. Of course, that's wrong " there have been at least 4, and these are the publicized cases.[http://bit.ly...] Pro doesn't respond to my point about "innocent until proven guilty" being ingrained in our sense of justice. It's upheld by our Bill of Rights and the Universal Declaration of Human Rights, and yet it clearly happens. It's one thing to take away someone's freedom while their case is further assessed, it's another to end their lives and remove any possibility of redemption. Lastly, this point about preventing more murders than we lose in innocent deaths is absurd. First, Pro hasn't proven that he's preventing any loss of life. Second, even if he gave some credible evidence, his argument presumes that we know the mindsets of murderers and can predict what they will do in the absence of a death penalty. It's Minority Report without the precogs, an effort to see into possible futures and make a determination based on nothing more than weak statistical correlation. Third, there's a difference between society killing an individual and individual murder. The injustice is much greater on the former. Society has an obligation to its citizens established through the social contract, and killing them without sufficient proof destroys the trust that citizens place in their government. Meanwhile, the government is not directly responsible for every individual who goes out and murders someone. Conclusion: Note that Pro drops all of my arguments. He's unresponsive to the need for rehabilitation, drops that the DP is cruel and unusual punishment, and that it is unfairly and unjustly applied wholesale. Since decisions regarding the DP are inherently questions of justice, these are very important, because even if Pro manages to prove that there's some utilitarian benefit to its continued existence, the lack of justice makes it untenable by itself, warping our legal system at its very core. Back over to you, Pro. 9. http://bit.ly... 10. http://cbsloc.al... 11. http://cnn.it... 12. http://bit.ly... |
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