cord-012010-5h2ox3hu	2020	take issue with our interpretation of the respiratory physiology of COVID-19, arguing that it is based merely on "small cohort studies," instead arguing that "a high proportion of mechanically ventilated COVID-19 patients exhibit near-normal lung compliance." [1] Yet the low respiratory compliance of COVID19 patients has now been extensively demonstrated by studies totaling more than 800 COVID-19 patients [2] [3] [4] [5] [6] [7] [8] , including a direct comparison with non-COVID ARDS patients that revealed no difference in respiratory compliance. In his response to our Editorial, Dr. Rajendram reveals a curious misinterpretation of our Editorial: "Thus, whilst the net effect of the ARDSNet protocol is beneficial at the level of the study population, theoretically, it may harm select patients… contrary to the opinions of the Surviving Sepsis Campaign, and Bos and colleagues, the ARDSNet protocol is not a panacea." Putting aside the wishful thinking of a supportive intervention functioning as a "panacea" for a condition with persistent mortality of 30-40%, the correspondent (along with Drs. Cherian et al.) seems to think that we dispute the heterogeneity of ARDS, and advocate for a "one-size-fits-all" approach to its clinical management.
cord-259453-1njd0c0x	2020	In the discussion of their findings, the authors cite previous studies describing follow-up of severe acute respiratory syndrome (SARS) patients having impaired D LCO as the most common abnormality, with affected proportion of patients ranging from 15.5% to 43.6%. The conclusion which can be obtained from this study is that low D LCO is caused mainly by reduced alveolar volume, and not residual interstitial abnormalities or pulmonary vascular abnormalities caused by COVID-19. Besides, in order for an easier and direct comparison with some previous studies on pulmonary function in patients with severe acute respiratory syndrome (SARS) [4, 5] , D LCO /V A was kept in our report. In follow-up studies of rehabilitating SARS patients ranging from 0.5 to 2 years, the impaired D LCO was the most common abnormality, accounting for 15.5% to 43.6% [11] [12] [13] . Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge
cord-274282-hvx5m2bx	2020	This study showed that clinical features and prognosis of the disease vary among patients of different ages and a thorough assessment of age may help clinicians worldwide to establish risk stratification for all COVID-19 patients. However, the ages related clinical characteristics, diseases courses and outcomes other than death in COVID-19 patients remain unclear. A unified observation endpoint date was set (March 7, 2020) in our study, primary outcome of the disease course and second outcome of respiratory failure rate for all COVID-19 patients in both groups were compared. In this study, we demonstrated that the clinical characteristics and outcomes of 221 COVID-19 patients were closely related to the different ages. In conclusion, the clinical features and prognosis of the disease vary among patients of different ages and a thorough assessment of age may help clinicians worldwide to establish risk stratification for all COVID-19 patients. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China
cord-275858-46jzw94p	2020	Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study Clinical characteristics and co-infections of 354 hospitalized patients with COVID-19 in Wuhan, China: a retrospective cohort study Risk factors associated with clinical outcomes in 323 COVID-19 hospitalized patients in Wuhan, China Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan Clinical characteristics of laboratory confirmed positive cases of SARS-CoV-2 infection in Wuhan, China: a retrospective single center analysis A preliminary study on serological assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 238 admitted hospital patients Epidemiological, clinical, and virological characteristics of 465 hospitalized cases of coronavirus disease 2019 (COVID-19) from Zhejiang province in China. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China
cord-277603-hpn1ovgo	2020	Some clinicians have found the clinical features of COVID-19 pneumonia to be similar to high-altitude pulmonary oedema (HAPE) [1] , and such theory has been amplified via social media. The assumption that the clinical features of COVID-19 pneumonia are similar to HAPE [1] may rely on the initial clinical presentation of COVID-19 patients, showing profound hypoxaemia with no respiratory distress, similar to patients with acute high-altitude disease that have a chemoreceptor dysfunction. The pathogenesis of the two diseases (HAPE and COVID-19 pneumonia) is clearly different, despite similarities in clinical features, chest imaging and bronchoalveolar lavage findings in later stages, as has recently been emphasised by LUKS et al. The use @ERSpublications COVID-19 pneumonia is a viral infection; high-altitude pulmonary oedema is a non-cardiogenic oedema. Clinicians should focus on the development of therapeutic strategies based on the pathogenesis of the disease, and should remember that COVID-19 pneumonia is a viral infection primarily leading to diffuse alveolar damage and airway inflammation.
cord-281193-sb7kgu24	2020	key: cord-281193-sb7kgu24 title: Re: Predictors of mortality for patients with COVID-19 pneumonia caused by SARSCoV-2: a prospective cohort study cord_uid: sb7kgu24 H. et al.''s paper published in the European Respiratory Journal. with COVID-19 pneumonia were associated with increased risk of death from this disease [1] . They further identified that CD3+CD8+ T-cells ⩽75 cells·μL −1 and cardiac troponin I especially ⩾0.05 ng·mL −1 could be used as predictors for mortality of patients with COVID-19 pneumonia using matched case-control study [1] . With great interest, we have read the full text of the paper and found that there are several issues which are worth to clarifying. We hope our comments will be helpful to improve the expression and increase the quality of the paper published by Du R et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study
cord-285897-ahysay2l	2020	OBJECTIVE: To develop and validate machine-learning model based on clinical features for severity risk assessment and triage for COVID-19 patients at hospital admission. CONCLUSION: The machine-learning model, nomogram, and online-calculator might be useful to access the onset of severe and critical illness among COVID-19 patients and triage at hospital admission. Therefore, our objective is to develop and validate a prognostic machine-learning model based on clinical, laboratory, and radiological variables of COVID-19 patients at hospital admission for severity risk assessment during hospitalization, and compare the performance with that of PSI as a representative clinical assessment method. This international multicenter study analyzed individually and in combination, clinical, laboratory and radiological characteristics for COVID-19 patients at hospital admission, to retrospectively develop and prospectively validate a prognostic model and tool to assess the severity of the illness, and its progression, and to compare these with PSI scoring.
cord-290080-hxte1gc1	2020	In their correspondence, the Authors raised two important issues, namely the possible association between tuberculosis (TB) and COVID-19 (can infection by SARS-CoV-2 reactivate TB?) and the effects of TB on early mortality in co-infected patients. Our research letter reported the first cohort of patients with diagnosis of TB (including posttreatment sequelae) and COVID-19. At the time the article was submitted several countries in Africa, Europe and Latin America represented in the Global Tuberculosis Network (GTN) had no TB/COVID-19 patients to report. The Authors [1] also raised the important question whether TB has a real effect or ''weight'' in increasing the probability of death in COVID-19 patients. It is important to emphasise that the cohort of young migrants without co-morbidities reported elsewhere [3, 4] experienced a milder form of COVID-19 with no deaths. Active tuberculosis, sequelae and COVID-19 co-infection: first cohort of 49 cases Pulmonary rehabilitation is effective in patients with tuberculosis pulmonary sequelae
cord-290378-h4cof32m	2020	SARS-CoV2 infected patients with non-hypercapnic acute hypoxemic respiratory failure can benefit from HFNO outside an ICU. Patients infected with SARS-CoV-2 can develop severe pneumonia and respiratory failure, which often require treatment in intensive care units (ICU) in Western European countries (2) . This report describes the use of HFNO to manage SARS-CoV-2 infected patients with respiratory failure on the pulmonology ward rather than in an ICU. The theoretical risk of virus aerosolization resulted in early published reports of critically ill SARS-CoV-2-infected patients in China not recommending the use of HFNO or non-invasive ventilation until the patient had been cleared of COVID-19 (4). While these results should be confirmed in larger studies, we believe that our data strongly suggest that SARS-CoV2 infected patients with non-hypercapnic acute hypoxemic respiratory failure can benefit from HFNO outside an ICU.
cord-290490-u3mkfvxw	2020	Cases of COVID-19 associated pulmonary aspergillosis (CAPA) are being increasingly reported and physicians treating patients with COVID-19-related lung disease need to actively consider these fungal co-infections. Influenza-associated pulmonary aspergillosis (IAPA) presents a known risk to critically unwell patients with influenza (12) (13) (14) and the clinical course of COVID-19 shows many features that are shared with severe influenza infection. Although the host risk factors and clinical characteristics of CAPA are not yet understood, those individuals fulfilling the criteria for proven or probable aspergillosis (13, 14) should then be treated according to current guidelines (31, 32) . Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study A clinical algorithm to diagnose invasive pulmonary aspergillosis in critically ill patients Beta-Dglucan detection as a diagnostic test for invasive aspergillosis in immunocompromised critically ill patients with symptoms of respiratory infection: an autopsy-based study Invasive pulmonary aspergillosis complicating COVID-19 in the ICU -A case report
cord-290712-flj352ql	2020	title: Does Chemotherapy Reactivate SARS-CoV-2 in Cancer Patients Recovered from Prior COVID-19 Infection? Those studies mainly addressed whether chemotherapy could predict for hospitalization, severe disease, and mortality in cancer patients with COVID-19 infection. To address this knowledge gap, this study''s findings suggest that administering chemotherapy to this population is associated with a very low short-term risk of SARS-CoV-2 reactivation. Third, the duration of follow-up in this study was relatively short and it may take a longer period of time to determine immune-related alterations caused by chemotherapy in cancer patients who have recovered from COVID-19 infection. Nevertheless, when conservatively interpreted, our study indicates no overt short-term increase in the risk for SARS-CoV-2 reactivation following immunosuppressive chemotherapy in this uniquely vulnerable population. To our knowledge, this is the first study reporting that recovered COVID-19 cancer patients remain negative in the short-term for SARS-CoV-2 after delivery of chemotherapy.
cord-293500-z28bws23	2020	Comorbid hypertension correlates with poorer outcomes in patients with Covid-19. We truly appreciate the comments from Sisnieguez et al., who have performed a further analysis on the potential association between cardiovascular comorbidities and the clinical outcomes of Covid-19 (in particular, the mortality) [1] . We also applaud the suggestion to thoroughly adjust for the potential confounding factors when interpreting the association between specific categories of cardiovascular comorbidities (e.g., hypertension) and the clinical outcomes of Covid-19. Our findings could have also been attributed to the relatively low proportion of patients with co-existing hypertension and coronary heart disease in our study. The causes for the association between cardiovascular diseases and the poor clinical outcomes of Covid-19 might be multifaceted, including but not limited to the interaction with the age, and the cardiac dysfunction due to viral infections. Prevalence of comorbidities in cases of Middle East respiratory syndrome coronavirus: a retrospective study
cord-293691-ewerquin	2020	RATIONALE: While severe coronavirus infections, including Middle East respiratory syndrome coronavirus (MERS-CoV) cause lung injury with high mortality rates, protective treatment strategies are not approved for clinical use. METHODS: Calu-3 cells and primary human alveolar epithelial cells (hAEC) were infected with MERS-CoV and treated with CsA or ALV or inhibitors targeting cyclophilin inhibitor-regulated molecules including Calcineurin, NFAT, or MAP kinases. To address the previously proposed antiviral activity of CsA in clinically relevant cells, we infected the human bronchial epithelial cell line Calu-3 and primary human alveolar epithelial cells (hAEC) with MERS-CoV and analyzed intracellular viral RNA and infectious particle release in presence of DMSO or CsA ( Figure 1 ). Our data demonstrated that silencing of IRF1 but not treatment by control siRNA lead to a significant increase in MERS-CoV released viral particles in CsA-treated cells ( Figure 6A , B).
cord-296440-18vpg419	2020	The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France. As the world faces the coronavirus disease 2019 (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, concerns have arisen about a possible increased risk of asthma exacerbations. In Wuhan, authors pointed out a rate of 0.9% [3] , markedly lower than that in the local population; in another study investigating the clinical characteristics and allergy status of 140 patients infected by SARS-CoV-2 in Wuhan, no patient were reported as being asthmatic [3] . All adult patients hospitalized from March 15, 2020 to April 15, 2020 with a diagnosis of SARS-CoV-2 infection and reporting a history of asthma were included. Moreover, obesity, hypertension and diabetes were the most common comorbidities observed in our cohort of hospitalized asthmatics with COVID-19, which is consistent with earlier research in other patient groups [4] [23] .
cord-296694-2js639bk	2020	The true prevalence of thrombosis associated with COVID-19 infection is unknown, as most studies to date do not include systematic and comprehensive investigation protocols. Two recent Dutch studies have reported cumulative incidences of thrombotic events between 48 and 49% respectively in their ICUs in patients with COVID-19 pneumonia [10, 11] . refine this further by describing a 50% cumulative incidence of pulmonary embolism (PE), diagnosed by CT-pulmonary angiogram (PA), in COVID-19 patients admitted to ICU in two hospitals of the University of Paris (ERJ ref Bompard). In addition to ACE2 mediated SARS-CoV-2 viral entry, recent reports of affinity of the SARS-CoV-2 spike protein and CD147, a membrane glycoprotein and extracellular matrix metalloproteinase inducer expressed on a variety of haematopoietic cell lines, suggest another potentially novel mechanism of thrombosis and inflammation in the arterial and venous circulations [27] . High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients
cord-299679-6z9e5gi6	2020	Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxaemia with "normal" (>40 mL·cmH(2)O(−1)) lung compliance and likely representing pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin and has low pulmonary compliance, Which is a result of co-infection or acute lung injury after noninvasive ventilation. The clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is broad, ranging from asymptomatic infection to flu-like illness (sometimes with digestive disturbances) to viral pneumonia. Phenotype 2 represents 80% of hospitalisations and is characterised by the presence of hypoxaemia or small opacities on chest radiographs and these patients should be referred for close respiratory monitoring ( particularly respiratory rate and oxygen saturation measure by pulse oximetry) because they are at risk of rapid deterioration progressing to death if intubation is not timely instituted.
cord-301318-9g547s2n	2020	Little is known about features, outcomes and intrauterine transmission potential in newborn babies aged 28 days or less. We identified all infected newborn babies in China by March 13 and described the clinical features, treatment, outcomes and intrauterine transmission potential. To analyze the intrauterine transmission potential, mother''s disease onset (symptoms, timing of symptoms onset relative to delivery), diagnosis, Wuhan linkage (living in or visited Wuhan, or directly contacting visitors from Wuhan), delivery (delivery methods, hospital level, protection level, gestational age at delivery), mother-child contact (separation, breastfeeding) were collected. Based on the data sources we used in this retrospective study, 4 nucleic acid-confirmed neonatal infections were identified through systematic and comprehensive searching among the 81,026 confirmed cases in China as of March 13 (Table) . First, although a systematic and comprehensive searching was made for SARS-CoV-2 infection in newborn babies <28 days of age, incomplete identification of cases is possible.
cord-307279-1yei5ifs	2020	title: Covid-19: Opacification score is higher in the right lung and right lung involvement is a better predictor of ICU admission In COVID-19 the right lung has higher degree of opacification on plain radiograph than the left lung. Right lung opacificiation is a stronger predictor for critical care admission and death. We extracted data from our EHR to build a risk score that predicted critical care admission or death. The extent of CXR abnormality was scored using an adapted radiographic assessment of lung oedema for COVID-19, as proposed by Wong et al (4) . In addition, opacification of the right lung was a stronger predictor of admission to critical care or die (see figure) . A clinical risk score to identify patients with COVID-19 at high risk of critical care admission or death: An observational cohort study
cord-307732-sdstnm9i	2020	Early identification of imported cases, prevention of family clustering transmission, preventive measures in the public area and strict infection control procedure in hospitals were crucial for successful prevention of COVID-19 in Shenzhen, China. Therefore, the purpose of this study was to analyze the epidemiology and preventive strategies in Shenzhen in order to understand the main transmission route and effective preventive strategies in cities with risk of imported cases, which may provide clue for better preventing outbreak of potential respiratory infectious disease, such as COVID-19 in cities with heavy population density and high proportion of external population. As early as January 19, when the National Health Commission announced the first imported case in Shenzhen, Shenzhen began to take temperature for people in main city entrances to screen imported cases, which was also widely used in the prevention of other respiratory infectious diseases, such as influenza in United States and SARS in China [11, 12] .
cord-316058-eh4m5jqz	2020	With a median follow-up time of 24.0 (17.5–30.0) days, progression occurred in 19.6% moderate, 27.8% severe, 66.7% critical COVID-19. This study aimed to investigate short-term outcomes of patients rated as different severities on admission, and to identify risk factors for progression, thereby, help the management of COVID-19 in clinical practice. On admission, the median disease duration was 6.0 (4.0-9.0) days, and the proportion of mild, moderate, severe, critical cases was 8 (2.6%), 245 (81.4%), 36 (12.0%), 12 (4.0%), respectively. 48 (19.6%) out of the 245 moderate patients experienced progression during hospitalization, among them, 14 (5.7%) turned moderate, 6 (2.5%) were discharged, while 21 (8.6%) were severe, 2 (0.8%) were critical, 5 (2.0%) died at the endpoint. A neutrophil-to-lymphocyte ratio ≥ 2.973 (hazard ratio *95% CI+: 2.641 *1.421-4.908], p = 0.002), age ≥ 50 years (2.504 *1.202-5.215], p = 0.014), male gender (2.004 [1.101-3.647], p = 0.023), and with comorbidity (1.969 [1.085-3.571], p = 0.026) were identified as risk factors for progression by multivariate Cox regression analyses.
cord-322075-e6whegrf	2020	The COVID-19 epidemic in Italy has shown many shortcomings of the national health care system but it also represents a historic opportunity to reinforce the central health care governance and reduce inequalities across the country [1, 2] In a recent editorial, Nava and co-authors pay a well-deserved tribute to the almost 200 health care workers who succumbed to COVID-19 in the country in less than 3 months since the first case was reported. [3] An obvious reason for Italy''s inadequate outbreak response can be found in years of neglect for the public sector, increased private expenditure, and health care budget cuts by governments of all political affiliations. Most patient transfers to relieve overwhelmed intensive care units were indeed performed inside the same region, or towards foreign countries. What Other Countries Can Learn From Italy During the COVID-19 Pandemic
cord-322580-7ohso8hl	2020	Patients with active TB admitted to the hospital were analysed to assess the impact of COVID-19 on their clinical course as well as radiologic and laboratory consequences of the co-infection. $ at COVID-19 diagnosis compared to the last available CXR result; ^ isoniazid-resistance was detected only through genotypic drugsusceptibility test; * lung pattern at chest radiography; ** lung pattern at chest computed tomography scan; £ ferritin was n ot routinely assessed but was part of a set of exams to perform only in patients affected by COVID-19, however, due to the lag obtaining the swab results for SARS-CoV-2 it was not included; & Frequent blood transfusions to treat severe anaemia due to sickle cell disease; ‡ O2 supply ex novo; § O2 supply at admission ad then stopped; # oxygen supply was required temporarily due to pleural blebs rupture and consequent pneumothorax.
cord-323480-h6z3vim0	2020	Clinical Application on the safety and effectiveness of Intelligent Oropharyngeal-swab Robot for the Implication for COVID-19 Pandemic [5] Remote controlled OPswab robot has the potential to avoid close contact between healthcare workers with patients, and thus reduce the risk of SARS-CoV-2 infection during sampling. Clinical application study was performed in 20 consecutive suspected COVID-19 patients from a fever clinic to compare the pathogen test results of the two methods. The Ct values showed 97% specimens as qualified, and no significant difference in the quality of the specimens was found in the four sampling force groups based on the sample GADPH Ct value. No differences in the success rate, swab quality, and pathogen discovery results were found between the oropharyngeal-swab robot and manual sampling methods. Though this was a preliminary, single-center study in limited COVID-19 patients, the sampling process of the intelligent oropharyngeal-swab robot is safe, with a high success rate of sampling.
cord-325565-cz9f65ca	2020	The second study used European data and, based on simple correlation analyses, associated long term (Jan-Feb 2020) exposure to nitrogen oxides (NOx) in the troposphere (resolution ~7*3.5km), assessed using satellite data, and absolute numbers of COVID-19-related deaths. [5] Positive associations were seen between levels of nitrogen dioxide and nitrogen oxide and increased COVID-19 mortality and reported number of cases, without adjustment for population size, age distribution or other confounding variables. In particular the two ecological studies which crudely correlate reported numbers of COVID-19 cases or mortality to regional air pollution levels ignored the time of introduction of COVID-19 in the different areas, did not take into account disease dynamics in any way, and ignored basic epidemiologic principles by using inadequate measures of disease frequency. The effect of air pollution on disease prognosis can be studied using more conventional approaches after COVID-19 infection.
cord-327169-sz4ildnd	2020	The primary aim of the present study was to describe the diagnostic yield of bronchoscopy in patients with negative nasopharyngeal swab(s) and a clinical and radiological suspicion of COVID-19 pneumonia. The indications of bronchoscopy were: -diagnosis of SARS-CoV-2 pneumonia in patients with previously negative nasopharyngeal swab (clinical and radiological suspicion of pneumonia); -need for undelayable procedures in COVID-19 patients (e.g., massive hemoptysis, post-obstructive atelectasis). The diagnostic yield of bronchoscopy was calculated dividing the number of patients with a molecular diagnosis of SARS-CoV-2 infection following the collection of bronchoscopic specimens by the number of patients with a suspected diagnosis of COVID-19 pneumonia. This is to our knowledge the largest study on the diagnostic yield of bronchoscopy in patients with negative nasopharyngeal swabs and a clinical/radiological suspicion of SARS-CoV-2 infection. Urgent/life-saving bronchoscopies were performed in 31 patients with a confirmed COVID-19 diagnosis for obstructive atelectasis, suspected concomitant lower respiratory tract infections, severe hemoptysis, suspected tracheal lacerations in patients mechanically ventilated, tracheostomy complications, and suspected concomitant pulmonary tuberculosis.
cord-330093-asba80bi	2020	Both research teams are reporting increased angiotensin-converting enzyme 2 (ACE-2) expression in airways of current smokers and those with COPD, with important implications for coronavirus disease 2019 (COVID-19) patients. Since ACE-2 has been shown to be the main receptor utilised by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter the host cells [2] , the authors conclude that nicotine is a risk factor for COVID-19. Here, we bring to the discussion whether the increased susceptibility and virulence of SARS-CoV-2 via α7-nAChR and the upregulation of small airway ACE-2 expression may also be relevant for those who vape using nicotine-based e-cigarettes. While smoking may not necessarily increase one''s risk for contracting COVID-19, the biological and inflammatory cascade that occurs upon severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may be particularly devastating for a smoker.
cord-331497-mipg4mg7	2020	We used a mathematical model of TB with an age-specific contact matrix calibrated to data from China, India and South Africa, [9] key high TB burden countries accounting for approximately 40% of global TB cases, [1] to estimate the relative impact of reductions in social contacts and health services due to COVID-19 on TB burden. In our worst case scenario, where COVID-19 interventions to reduce social contacts are minimal, but TB health services are badly affected, results suggest an increase in TB deaths of 23,516 (range 18,560-27,940), 149,448 (85,000-233,602) and 28,631 (19,963-40,011) in China, India and South Africa, respectively between 2020-2024, totalling 201,595 (123,523-301,553) additional TB deaths in these three countries alone. However, if these countries are able to minimise the impact on TB health service delivery, major reductions in social contacts could keep the number of additional TB deaths comparatively low. The potential impact of the COVID-19 response on tuberculosis in high-burden countries: a modelling analysis
cord-333131-affb4yln	2020	The National COVID-19 Chest Imaging Database (NCCID) is a repository of chest X-Ray, CT and MRI images and clinical data from COVID-19 patients across the UK, to support research and development of AI technology that may proffer insights into the disease. NCCID has put in place mechanisms to collate all chest imaging and prespecified clinical data from every UK hospital where patients undergo a RT-PCR test for COVID-19. The NCCID data and image transfer solutions are robust and secure, including those having been adapted from techniques tried and tested on numerous research studies involving large-scale medical image collection (9) . NCCID will collect chest radiographs in all RT-PCR COVID-19 positive patients in hospitals throughout the UK. 2) Computed tomography chest imaging: NCCID will collect all chest CT imaging in RT-PCR COVID-19 positive patients. 3) For all RT-PCR COVID-19 positive patients NCCID will acquire all chest imaging performed in the previous 3 years.
cord-335198-qp964238	2020	Given the stated extremes above, there is a clear trade-off between "doing all that one can for individual patients with currently available information in a timely manner and despite significant uncertainty" and "group treatment of individuals to be enrolled in properly conducted but costly (effort, time and money) clinical trials for specific therapeutic approaches that will help inform the evidence-base for future patients". And how do we quickly establish and conduct difficult and costly randomized, controlled clinical trials for the most promising old and new therapies where there is a clear equipoise between possible benefits and potential risks? Paradoxically, the almost immediate establishment of a well-designed RCT to test the combination antiviral treatment lopinavir-ritonavir in Wuhan, China during the beginning of the pandemic exemplified this tension in a most unusual way when trial recruitment ceased early due to falling COVID19 case numbers (7).
cord-335465-sckfkciz	2020	We aimed to address this knowledge gap by systematically evaluating the performance of proposed prognostic models, among consecutive patients hospitalised with a final diagnosis of COVID-19 at a single centre, when using predictors measured at the point of hospital admission. We also assessed the discrimination of each candidate model for standardised outcomes of: (a) our composite endpoint of clinical deterioration; and (b) mortality, across a range of pre-specified time horizons from admission (7 days, 14 days, 30 days and any time during hospital admission), by calculating time-dependent AUROCs (with cumulative sensitivity and dynamic specificity) [18] . In order to further benchmark the performance of candidate prognostic models, we then computed AUROCs for a limited number of univariable predictors considered to be of highest importance a priori, based on clinical knowledge and existing data, for prediction of our composite endpoints of clinical deterioration and mortality (7 days, 14 days, 30 days and any time during hospital admission).
cord-337889-90q4py0j	2020	After adjusting for age and smoking status, COPD [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424–5.048], diabetes (HR 1.59, 95%CI 1.03–2.45), hypertension (HR 1.58, 95%CI 1.07–2.32) and malignancy (HR 3.50, 95%CI 1.60–7.64) were risk factors of reaching to the composite endpoints. Studies that address these limitations is needed to explore for the factors underlying the adverse impact of Our objective was to evaluate the risk of serious adverse outcomes in patients with Covid-19 by stratification according to the number and type of comorbidities, thus unraveling the sub-populations with poorer prognosis. These findings have provided further objective evidence, with a large sample size and extensive coverage of the geographic regions across China, to take into account baseline comorbid diseases in the comprehensive risk assessment of prognosis among patients with Covid-19 on hospital admission. Our findings suggested that, similar with other severe acute respiratory outbreaks, comorbidities such as COPD, diabetes, hypertension and malignancy predisposed to adverse clinical outcomes in patients with Covid-19.
cord-338351-y1t9emu1	2020	The diagnosis of COVID-19 is mainly based on typical symptoms, history of exposure to an infected person and bilateral involvement on chest radiographs, and it is confirmed by a positive nucleic acid test for SARS-CoV-2 from numerous types of specimens including Oropharyngeal (OP) and nasopharyngeal (NP) swabs, anal swabs, stool, urine and bronchoalveoalr lavage fluid (BALF) 1,2 . Here we report our experience from a COVID-19 hospital in Rome, Italy, where patients with typical symptoms of the disease, suggestive CT scans and three NP/OP negative swabs performed on consecutive days and IgG and IgM serology negative for SARS-CoV-2 underwent bronchoscopy with BAL to define the diagnostic issue. In conclusion, our findings demonstrate that three negative swabs along with negative antibodies, despite a suggestive CT scan, can safely rule out the SARS-CoV-2 infection in suspected patients, hence to proceed in alternative diagnosis process.
cord-339934-g6ufz29l	2020	In the case of respiratory infection, while IgM and IgG isotypes have been the primary emphasis in characterizing immunity, mucosal and systemic IgA responses that may play a critical role in the disease pathogenesis, have received much less attention. This pattern of humoral immune response is different in case of SARS-CoV infection, in which IgM and IgA showed similar chronological profiles in terms of both seroconversion time and antibody titres [5] , in line with the knowledge that viremia is common in SARS. Upregulated IgA production may be the result of increased levels of TGF-β and IL-10 that promote antibody switching in SARS-CoV-2 infection. Considering the roles of mucosal and systemic IgA in COVID-19, inducing IgA production, e.g. using Lactoferrin to activate canonical TGF-β signaling [13] , or retinoic acid to enhance lactoferrin-induced IgA responses [14] , has been proposed as novel therapies for severe COVID-19.
cord-344641-rog2h4g7	2020	INTRODUCTION: The Coronavirus 2(SARS-CoV-2) outbreak spread rapidly in Italy and the lack of intensive care unit(ICU) beds soon became evident, forcing the application of noninvasive respiratory support(NRS) outside the ICU, raising concerns over staff contamination. Data were collected including medication, mode and usage of the NRS (i.e. high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), noninvasive ventilation(NIV)), length of stay in hospital, endotracheal intubation(ETI) and deaths. Variables recorded for each patient were obtained for the period from March 1 st until May 10 th 2020 and included the following: demographics (age, sex), comorbidities (type and number), respiratory condition at admission (respiratory rate (RR), PaO 2 /FiO 2 ratio), medications (type of drugs prescribed), mode and usage of the NRS (ventilatory settings for NIV and CPAP, and flow rate for HFNC), and stay in hospital (days).
cord-347046-u764muk6	2020	They use the trajectory of deaths from COVID-19 from around the world to estimate the consequences of easing lockdown measures. They assume the current fall in the rate of COVID-19 related mortality is a consequence of lockdown; but is it? The pitfalls of using such tools in COVID-19 research have been highlighted recently [5] The results from the models used to predict the initial onslaught of the virus differed hugely leading to panic buying of ventilators and the creation of overflow (Nightingale in the UK) hospitals which were never used. The belief that we know the contribution that social measure have made to the evolution of the pandemic is wrong and so advising "[our] estimates are incompatible with a return to previous activities post "lockdown." is hubris which may have greater socio-economic and thus clinical consequences than the virus itself. Estimates of the ongoing need for social distancing and control measures post-"lockdown" from trajectories of COVID-19 cases and mortality Wrong but Useful -What Covid-19 Epidemiologic Models Can and Cannot Tell Us
cord-349440-jxigsdzh	2020	Comment to an Editorial where we invite the authors to express with clarity the risks they are referring to and how their argument is furthering the cause of patients and clinicians. After reading sentences such as "…by needlessly clouding the clinical picture, false phenotypes … upon inspection of patient data, simply do not exist" , It is not clear to us -and without a doubt to most readers -what sort of clear, and self-evident truth we (and other authors) have been trying to cloud. We note also with concern the conclusions of the editorial: "by prematurely phenotyping patients with COVID-19, we expose ourselves and our patients to considerable and preventable risk" and we invite the authors to express with clarity the risks they are referring to and how their argument is furthering the cause of patients and clinicians.
cord-349958-126yb5se	2020	 Standard of care in most patients is chemoradiotherapy with 4 cycles of cisplatin/etoposide as preferred chemotherapy regimen.  Replacing intravenous with oral etoposide to reduce time-in-hospital should be weighed against its lower biological availability and variable pharmacodynamics in a curative setting [6]  In patients with stage I SCLC surgical resection of the tumour, followed by adjuvant chemotherapy (4 cycles of cisplatin/etoposide) is indicated.  Consider giving cisplatin/pemetrexed instead of cisplatin/etoposide, or weekly carboplatin/paclitaxel in non-squamous NSCLC to limit time-in-hospital [9] .  Evaluate the indication for palliative chemotherapy, immunotherapy or both with extra care in elderly patients or patients with significant comorbidity, decreased performance (PS ≥2), social isolation, decubitus, urinary catheters, … especially in second or further lines [3] .  Consider limiting palliative chemotherapy to 4 cycles and omitting pemetrexed maintenance therapy [3] .  Palliative chemotherapy with 4 cycles of platinum/pemetrexed is recommended in all other cases of PS 0-1 patients.
cord-350166-loxe11d6	2020	Our aim was to design and test an affordable and easy-to-build non-invasive bilevel pressure ventilator to allow reducing the serious shortage of ventilators in LMICs. METHODS: The ventilator was built using off-the-shelf materials available via e-commerce and was based on a high-pressure blower, two pressure transducers and an Arduino Nano controller with a digital display (total retail cost <75 US$), with construction details open source provided for free replication. CONCLUSION: The low-cost, easy-to-build non-invasive ventilator performs similarly as a high-quality commercial device, with its open-source hardware description, will allow for free replication and use in LMICs, facilitating application of this life-saving therapy to patients who otherwise could not be treated. To assess the performance of the novel bilevel pressure ventilator under wellcontrolled conditions, the prototype was evaluated in a bench test using an active patient simulator modelling the respiratory mechanics of patients with different levels of obstructive/restrictive diseases ( Figure 2 ).
cord-351349-ypaevb8b	2020	Rare disease patients may suffer delayed access to new drugs as SARS-CoV-2 is disrupting clinical trials. Here we present the results of several surveys performed within the European CF Society Clinical Trials Network (ECFS-CTN) that aimed to assess how the pandemic disrupted CF clinical trials and to rapidly share useful information about operational mitigation measures by clinical trial teams across Europe. Licensing and reimbursement of CFTR modulators varies by country and around 450 CF patients across ECFS-CTN sites currently access CFTR modulators via clinical trials. Four surveys were answered by clinical trial investigators and research coordinators in the 58 ECFS-CTN sites between March-May 2020 (Weeks 1, 2, 4 and 6). The Week 1 survey was performed just before initial FDA and EMA guidance in mid-March 2020 [3, 4] and showed that many sites had already prohibited new enrolment into trials and onsite monitoring visits ( Table 1) .
cord-351407-7vx9lzi0	2020	recently reported a cohort study of 137 patients with COVID-19 pneumonia, in which retrospective review of computed tomography pulmonary angiography (CTPA) scans demonstrated a cumulative incidence of pulmonary emboli (PE) of 24% overall and 50% in intensive care [2]. We recommend vigilance to the potentially increased thrombotic risk associated with JAKi, given the hypercoagulability of COVID-19 and our recent thromboprophylaxis recommendations for all hospitalised patients with COVID-19 [7]. Bompard et al recently reported a cohort study of 137 patients with COVID-19 pneumonia, in which retrospective review of computed tomography pulmonary angiography (CTPA) scans demonstrated a cumulative incidence of pulmonary emboli (PE) of 24% overall and 50% in intensive care 2 . Impact of Janus kinase inhibitors on risk of cardiovascular events in patients with rheumatoid arthritis: systematic review and meta-analysis of randomised controlled trials
cord-352502-vdm55zvq	2020	Francesco Salton 1 , Pietro Geri 1 Deepak and Colleague misreported that BAL was negative for SARS-CoV-2 rRT-PCR in majority of cases, including 38 patients with "strong clinical and radiological suspicion for COVID-19". On the contrary, in the only 2 cases of our series in which CT scan showed typical signs of COVID-19 infection according to a recently published international consensus statement [2] , BAL was positive for SARS-CoV-2 despite previous negative upper respiratory tract swabs. Moreover, we reported that, when chest CT scan was normal, then both upper respiratory tract swabs and BAL were rRT-PCR-negative for SARS-CoV-2. These findings support our main observation that BAL is likely to be negative if one or more upper respiratory tract specimens and thoracic imaging are concordantly negative, therefore it should be only reserved for those cases in which a high clinical and radiological suspicion for COVID-19 stands despite negative upper respiratory tract swabs.
cord-354290-o5i4a7nl	2020	We appreciate the comments of Elshof et al"s on our article "High-flow nasal cannula for COVID-19 patients: low risk of bio-aerosol dispersion" 1 and agree that further research is warranted to reduce risk of virus transmission from infected patients. The presented in vitro data 2 from a light detection of smoke dispersion distance and velocity model suggesting that high-flow nasal cannula (HFNC) generates larger dispersion distance than nonbreather mask and venturi mask is in contrast to reports from Hui et al, using a similar model 3 . The presented in vitro data 2 from a light detection of smoke dispersion distance and velocity model suggesting that high-flow nasal cannula (HFNC) generates larger dispersion distance than nonbreather mask and venturi mask is in contrast to reports from Hui et al, using a similar model 3 .
cord-355753-muefay2n	2020	Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a newly identified agent foisted upon humanity and responsible for the contagious affliction, coronavirus disease 2019 (COVID-19) [1] that has rapidly evolved into a pandemic testing to their limits, and sometimes beyond, the capacity to respond of healthcare systems across the world [2]. To the editor, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a newly identified agent foisted upon humanity and responsible for the contagious affliction, coronavirus disease 2019 (COVID-19)(1)that has rapidly evolved into a pandemic testing to their limits, and sometimes beyond, the capacity to respond of healthcare systems across the world (2) . A promising alternative approach to evaluating lung function is that of quantitative computed tomography (qCT) imaging (13) , and whilst currently a research tool has the potential for transforming clinical practice.