This version of BIP! Finder aims to ease the exploration of COVID-19-related literature by enabling ranking articles based on various impact metrics.
Last Update: 18 - 01 - 2023 (628506 entries)
Popularity: Citation-based measure reflecting the current impact.
Influence: Citation-based measure reflecting the total impact.
Reader Attention: The current number of Mendeley readers.
Social Media Attention: The number of recent tweets related to this article.
*More details on these impact measures can be found here.
Exceptional score (in top 0.01%).
Substantial score (in top 1%).
Average score (in bottom 99%).
Score not available.
CORD-19 dataset(1) (list of papers)
LitCovid hub(2) (list of papers)
PMC & PubMed (citations)
Mendeley (number of readers)
COVID-19-TweetIDs(3) (tweets)
| Title | Venue | Year | Impact | Source | |
|---|---|---|---|---|---|
| 6801 | RBD-Fc-based COVID-19 vaccine candidate induces highly potent SARS-CoV-2 neutralizing antibody response The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed serious threats to global health and economy, thus calling for the development of safe and effective vaccines. The receptor-binding domain (RBD) in the spike protein of SARS-CoV-2 is responsible for its binding to angiotensin-converting enzyme 2 (ACE2) receptor. It contains multiple dominant neutralizing epitopes and serves as an important antigen for the development of COVID-19 vaccines. Here, we showed that immunization of mice with a candidate subunit vaccine consisting of SARS-CoV-2 RBD and Fc fragment of human IgG, as an immunopotentiator, elicited high titer of RBD-specific antibodies with robust neutralizing activity against both pseudotyped and live SARS-CoV-2 infections. The mouse antisera could also effectively neutralize infection by pseudotyped SARS-CoV-2 with several natural mutations in RBD and the IgG extracted from the mouse antisera could also show neutralization against pseudotyped SARS-CoV and SARS-related coronavirus (SARSr-CoV). Vaccination of human ACE2 transgenic mice with RBD-Fc could effectively protect mice from the SARS-CoV-2 challenge. These results suggest that SARS-CoV-2 RBD-Fc has good potential to be further developed as an effective and broad-spectrum vaccine to prevent infection of the current SARS-CoV-2 and its mutants, as well as future emerging SARSr-CoVs and re-emerging SARS-CoV. | Signal Transduct Target Ther | 2020 | LitCov and CORD-19 | |
| 6802 | Mapping the situation of research on coronavirus disease-19: a preliminary bibliometric analysis during the early stage of the outbreak BACKGROUND: The novel coronavirus, named as 2019-nCoV or coronavirus disease 2019 (COVID-19), has recently appeared in China and has spread worldwide, presenting a health threat to the global community. Therefore, it is important to understand the global scientific output of COVID-19 research during the early stage of the outbreak. Thus, to track the current hotspots, and highlight future directions, we performed a bibliometric analysis to obtain an approximate scenario of COVID-19 to date. METHODS: Relevant studies to COVID-19 were obtained from the Scopus database during the early stage of the outbreak. We then analysed the data by using well-established bibliometric indices: document type, country, collaboration patterns, affiliation, journal name, and citation patterns. VOSviewer was applied to map and determine hot topics in this field. RESULTS: The bibliometric analysis indicated that there were 19,044 publications on Scopus published on COVID-19 during the early stage of the outbreak (December 2019 up until June 19, 2020). Of all these publications, 9140 (48.0%) were articles; 4192 (22.0%) were letters; 1797 (9.4%) were reviews; 1754 (9.2%) were editorials; 1728 (9.1%) were notes; and 433 (2.3%) were others. The USA published the largest number of publications on COVID-19 (4479; 23.4%), followed by China (3310; 17.4%), Italy, (2314; 12.2%), and the UK (1981; 10.4%). British Medical Journal was the most productive. The Huazhong University of Science and Technology, Tongji Medical, and Harvard Medical School were the institutions that published the largest number of COVID-19 research. The most prevalent topics of research in COVID-19 include “clinical features studies”, “pathological findings and therapeutic design”, “care facilities preparation and infection control”, and “maternal, perinatal and neonatal outcomes”. CONCLUSIONS: This bibliometric study may reflect rapidly emerging topics on COVID-19 research, where substantial research activity has already begun extensively during the early stage of the outbreak. The findings reported here shed new light on the major progress in the near future for hot topics on COVID-19 research including clinical features studies, pathological findings and therapeutic design, care facilities preparation and infection control, and maternal, perinatal and neonatal outcomes. | BMC Infect Dis | 2020 | LitCov and CORD-19 | |
| 6803 | SARS-CoV-2 immune repertoire in MIS-C and pediatric COVID-19 N/A | Nat Immunol | 2021 | LitCov and CORD-19 | |
| 6804 | Determinants of physical activity among adults in the United Kingdom during the COVID-19 pandemic: The DUK-COVID study N/A | Br J Health Psychol | 2021 | LitCov and CORD-19 | |
| 6805 | Early recovery following new onset anosmia during the COVID-19 pandemic-an observational cohort study BACKGROUND: A rapidly evolving evidence suggests that smell and taste disturbance are common symptoms in COVID-19 infection. As yet there are no reports on duration and recovery rates. We set out to characterise patients reporting new onset smell and taste disturbance during the COVID-19 pandemic and report on early recovery rates. METHODS: Online Survey of patients reporting self-diagnosed new onset smell and taste disturbance during the COVID-19 pandemic, with 1 week follow-up. RESULTS: Three hundred eighty-two patents completed bot an initial and follow-up survey. 86.4% reported complete anosmia and a further 11.5% a very severe loss of smell at the time of completing the first survey. At follow-up 1 week later, there is already significant improvement in self-rating of severity of olfactory loss. 80.1% report lower severity scores at follow-up, 17.6% are unchanged and 1.9% are worse. 11.5% already report compete resolution at follow up, while 17.3% report persistent complete loss of smell, with reported duration being 1 to over 4 weeks. This is reflected in the overall cumulative improvement rate of 79% patients overall in the interval between surveys. CONCLUSIONS: A review of the growing evidence base supports the likelihood that out cohort have suffered olfactory loss as part of COVID-19 infection. While early recovery rates are encouraging, long term rates will need to be further investigated and there may be an increase in patients with persistent post-viral loss as a result of the pandemic. We further call for loss of sense of smell to be formerly recognised as a marker of COVID-19 infection. | J Otolaryngol Head Neck Surg | 2020 | LitCov and CORD-19 | |
| 6806 | Social distancing during the COVID-19 pandemic: quantifying the practice in Michigan-a "hotspot state" early in the pandemic-using a volunteer-based online survey BACKGROUND: Public Health policies related to social distancing efforts during the COVID-19 pandemic helped slow the infection rate. However, individual-level factors associated with social distancing are largely unknown. We sought to examine social distancing during the COVID-19 pandemic in Michigan, an infection “hotspot” state in the United States early in the pandemic. METHODS: Two surveys were distributed to Michigan residents via email lists and social media following COVID-19 related state mandates in March; 45,691 adults responded to the first survey and 8512 to the second. Staying home ≥ 3 out of 5 previous days defined having more social distancing. Logistic regression models were used to examine potential factors associated with more social distancing. RESULTS: Most respondents were women (86% in Survey 1, 87% in Survey 2). In Survey 1, 63% reported more social distancing, increasing to 78% in Survey 2. Female sex and having someone (or self) sick in the home were consistently associated with higher social distancing, while increasing age was positively associated in Survey 1 but negatively associated in Survey 2. Most respondents felt social distancing policies were important (88% in Survey 1; 91% in Survey 2). CONCLUSIONS: Michiganders responding to the surveys were both practicing and supportive of social distancing. State-level executive orders positively impacted behaviors early in the COVID-19 pandemic in Michigan. Additional supports are needed to help vulnerable populations practice social distancing, including older individuals. | BMC Public Health | 2021 | LitCov and CORD-19 | |
| 6807 | Social distancing practice and associated factors in response to COVID-19 pandemic at West Guji Zone, Southern Ethiopia, 2021: A community based cross-sectional study BACKGROUND: Curtailing physical contact between individuals reduces transmission and spread of the disease. Social distancing is an accepted and effective strategy to delay the disease spread and reduce the magnitude of outbreaks of pandemic COVID-19. However, no study quantified social distancing practice and associated factors in the current study area. Therefore, the study aimed to assess social distancing practice and associated factors in response to COVID-19 pandemic in West Guji Zone, Southern Ethiopia, 2020. METHODS AND MATERIALS: A Community based cross-sectional study design was conducted among randomly selected 410 household members of Bule Hora Town, West Guji Zone. Data were collected by pre-tested interviewer administered structured questionnaire adapted from previous peer reviewed articles. The data were coded and entered in to Epi data version 3.5 and analyzed by SPSS version 23. The bivariate and multivariate logistic regressions analysis was done to identify factors associated with social distancing practice. Adjusted odds ratio with 95% confidence interval and p value <0.05 were used to declare statistical significance. RESULT: Out of 447 planned samples, 410 participants were successfully interviewed and included into final analysis; making the response rate of 91.7%. The median (±IQR) age of study participants was 28(±9) years. In this study, 38.3% [95% CI: 33.5%, 43.1%)] of the study participants have good social distancing practices for the prevention of COVID-19. Age group 26–30 years [AOR = 2.56(95% CI: 1.18–5.54)] and 31–35 years [AOR = 3.57(95%CI: 1.56–8.18)], employed [AOR = 6.10(95%CI: 3.46–10.74)],poor knowledge [AOR = 0.59 (95% CI:0.36–0.95)], negative attitude [AOR = 0.55 (95% CI:0.31–0.95)] and low perceived susceptibility [AOR = 0.33(95%CI: 0.20–0.54)] were significantly associated with good social distancing practice. CONCLUSION: Social distancing practice is relatively poor in the study area. The knowledge and attitude level of participants were identified to be the major factors for the observed poor social distancing practice. Sustained efforts to improve awareness and attitudes towards COVID-19 prevention might improve adherence to social distancing practices. | PLoS One | 2021 | LitCov and CORD-19 | |
| 6808 | Development of a Novel, Genome Subtraction-Derived, SARS-CoV-2-Specific COVID-19-nsp2 Real-Time RT-PCR Assay and Its Evaluation Using Clinical Specimens The pandemic novel coronavirus infection, Coronavirus Disease 2019 (COVID-19), has affected at least 190 countries or territories, with 465,915 confirmed cases and 21,031 deaths. In a containment-based strategy, rapid, sensitive and specific testing is important in epidemiological control and clinical management. Using 96 SARS-CoV-2 and 104 non-SARS-CoV-2 coronavirus genomes and our in-house program, GolayMetaMiner, four specific regions longer than 50 nucleotides in the SARS-CoV-2 genome were identified. Primers were designed to target the longest and previously untargeted nsp2 region and optimized as a probe-free real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. The new COVID-19-nsp2 assay had a limit of detection (LOD) of 1.8 TCID(50)/mL and did not amplify other human-pathogenic coronaviruses and respiratory viruses. Assay reproducibility in terms of cycle threshold (Cp) values was satisfactory, with the total imprecision (% CV) values well below 5%. Evaluation of the new assay using 59 clinical specimens from 14 confirmed cases showed 100% concordance with our previously developed COVID-19-RdRp/Hel reference assay. A rapid, sensitive, SARS-CoV-2-specific real-time RT-PCR assay, COVID-19-nsp2, was developed. | Int J Mol Sci | 2020 | LitCov and CORD-19 | |
| 6809 | Online teaching-learning in higher education during lockdown period of COVID-19 pandemic The whole educational system from elementary to tertiary level has been collapsed during the lockdown period of the novel coronavirus disease 2019 (COVID-19) not only in India but across the globe. This study is a portrayal of online teaching-learning modes adopted by the Mizoram University for the teaching-learning process and subsequent semester examinations. It looks forward to an intellectually enriched opportunity for further future academic decision-making during any adversity. The intended purpose of this paper seeks to address the required essentialities of online teaching-learning in education amid the COVID-19 pandemic and how can existing resources of educational institutions effectively transform formal education into online education with the help of virtual classes and other pivotal online tools in this continually shifting educational landscape. The paper employs both quantitative and qualitative approach to study the perceptions of teachers and students on online teaching-learning modes and also highlighted the implementation process of online teaching-learning modes. The value of this paper is to draw a holistic picture of ongoing online teaching-learning activities during the lockdown period including establishing the linkage between change management process and online teaching-learning process in education system amid the COVID-19 outbreak so as to overcome the persisting academic disturbance and consequently ensure the resumption of educational activities and discourses as a normal course of procedure in the education system. | Int J Educ Res Open | 2020 | LitCov and CORD-19 | |
| 6810 | Into the eye of the cytokine storm N/A | Microbiol Mol Biol Rev | 2012 | CORD-19 | |
| 6811 | State-of-the-art review of secondary pulmonary infections in patients with COVID-19 pneumonia BACKGROUND: The incidence of secondary pulmonary infections is not well described in hospitalized COVID-19 patients. Understanding the incidence of secondary pulmonary infections and the associated bacterial and fungal microorganisms identified can improve patient outcomes. OBJECTIVE: This narrative review aims to determine the incidence of secondary bacterial and fungal pulmonary infections in hospitalized COVID-19 patients, and describe the bacterial and fungal microorganisms identified. METHOD: We perform a literature search and select articles with confirmed diagnoses of secondary bacterial and fungal pulmonary infections that occur 48 h after admission, using respiratory tract cultures in hospitalized adult COVID-19 patients. We exclude articles involving co-infections defined as infections diagnosed at the time of admission by non-SARS-CoV-2 viruses, bacteria, and fungal microorganisms. RESULTS: The incidence of secondary pulmonary infections is low at 16% (4.8–42.8%) for bacterial infections and lower for fungal infections at 6.3% (0.9–33.3%) in hospitalized COVID-19 patients. Secondary pulmonary infections are predominantly seen in critically ill hospitalized COVID-19 patients. The most common bacterial microorganisms identified in the respiratory tract cultures are Pseudomonas aeruginosa, Klebsiella species, Staphylococcus aureus, Escherichia coli, and Stenotrophomonas maltophilia. Aspergillus fumigatus is the most common microorganism identified to cause secondary fungal pulmonary infections. Other rare opportunistic infection reported such as PJP is mostly confined to small case series and case reports. The overall time to diagnose secondary bacterial and fungal pulmonary infections is 10 days (2–21 days) from initial hospitalization and 9 days (4–18 days) after ICU admission. The use of antibiotics is high at 60–100% involving the studies included in our review. CONCLUSION: The widespread use of empirical antibiotics during the current pandemic may contribute to the development of multidrug-resistant microorganisms, and antimicrobial stewardship programs are required for minimizing and de-escalating antibiotics. Due to the variation in definition across most studies, a large, well-designed study is required to determine the incidence, risk factors, and outcomes of secondary pulmonary infections in hospitalized COVID-19 patients. | Infection | 2021 | LitCov and CORD-19 | |
| 6812 | Risk Factors Associated with COVID-19 Infected Healthcare Workers in Muscat Governorate, Oman INTRODUCTION: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, causing a global public health crisis. Healthcare workers (HCWs) are vulnerable due to their role in the management of COVID-19 infected patients. As of June 2020, a total of 847 HCWs in Oman had reportedly contracted COVID-19, with an incidence rate of 1.47%. This study therefore aimed to identify factors associated with COVID-19 infection among HCWs in Muscat Governorate, Oman, as well as to evaluate adherence to infection prevention and control (IPC) measures. METHODS: This cross-sectional study involved cases of laboratory-confirmed COVID-19 infection among HCWs working under the Directorate General of Health Services of Muscat Governorate, Ministry of Health, between February and June 2020. Data regarding the participants’ sociodemographic characteristics, risk factors, pre-existing medical conditions, and adherence to IPC measures were collected using a self-administered questionnaire distributed via a web-based mobile application. RESULTS: A total of 126 HCWs with confirmed COVID-19 infection participated in the study. Of these, 72.2% were female, 53.2% worked in primary care facilities, and 61.1% were medical doctors or nurses. Only 18.1% were over 45 years of age and 30.2% had pre-existing medical conditions. While 29.4% had never received IPC training, the majority followed recommended hand hygiene practice (96.8%) and social distancing protocols (93.7%) and wore protective facemasks for routine patient care (96.9%). CONCLUSION: While the majority of HCWs followed crucial IPC measures, one-third had never received specific IPC training or faced restrictions on PPE use. HCWs, including those in housekeeping and administrative functions are recommended to undergo rigorous IPC training. In addition, high-risk HCWs could be assigned duties away from active COVID 19 cases. It is recommended to restructure health facilities for better adherence to IPC standards. | J Prim Care Community Health | 2021 | LitCov and CORD-19 | |
| 6813 | COVID-19 Breakthrough Infection after Inactivated Vaccine Induced Robust Antibody Responses and Cross-Neutralization of SARS-CoV-2 Variants, but Less Immunity against Omicron The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and the waning of immunity in vaccinated individuals is resulting in increased numbers of SARS-CoV-2 breakthrough infections. This study investigated binding antibody responses and neutralizing activities against SARS-CoV-2 variants, in patients with COVID-19 who had been fully vaccinated with CoronaVac (n = 77), individuals who had been fully vaccinated with CoronaVac but had not contracted COVID-19 (n = 170), and individuals who had received AZD1222 as a third vaccination (n = 210). Breakthrough infection was generally detected approximately 88 days after the second CoronaVac vaccination (interquartile range 68–100 days). Blood samples were collected at a median of 34 days after infection. Binding antibody levels in sera from patients with breakthrough infection were significantly higher than those in individuals who had received AZD1222 as a third vaccination. However, neutralizing activities against wild-type and variants, including alpha (B.1.1.7), beta (B.1.351), and delta (B.1.617.2), were comparable in patients with breakthrough infections and individuals who received a third vaccination with AZD1222, which exceeds 90%. Omicron (B.1.1.529) was neutralized less effectively by serum from breakthrough infection patients, with a 6.3-fold reduction compared to delta variants. The study suggests that breakthrough infection after two doses of an inactivated vaccine can induce neutralizing antibodies against omicron. Further investigation is needed to assess the long-term persistence of antibodies against the omicron variant. | Vaccines (Basel) | 2022 | LitCov and CORD-19 | |
| 6814 | Discovery of M Protease Inhibitors Encoded by SARS-CoV-2 The coronavirus (CoV) disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome CoV-2 (SARS-CoV-2) is a health threat worldwide. Viral main protease (M(pro), also called 3C‐like protease [3CL(pro)]) is a therapeutic target for drug discovery. Herein, we report that GC376, a broad-spectrum inhibitor targeting M(pro) in the picornavirus-like supercluster, is a potent inhibitor for the M(pro) encoded by SARS-CoV-2, with a half-maximum inhibitory concentration (IC(50)) of 26.4 ± 1.1 nM. In this study, we also show that GC376 inhibits SARS-CoV-2 replication with a half-maximum effective concentration (EC(50)) of 0.91 ± 0.03 μM. Only a small portion of SARS-CoV-2 M(pro) was covalently modified in the excess of GC376 as evaluated by mass spectrometry analysis, indicating that improved inhibitors are needed. Subsequently, molecular docking analysis revealed that the recognition and binding groups of GC376 within the active site of SARS-CoV-2 M(pro) provide important new information for the optimization of GC376. Given that sufficient safety and efficacy data are available for GC376 as an investigational veterinary drug, expedited development of GC376, or its optimized analogues, for treatment of SARS-CoV-2 infection in human is recommended. | Antimicrob Agents Chemother | 2020 | LitCov and CORD-19 | |
| 6815 | Lessons from healthcare personnel screening and management during H1N1 pandemic in preparation for the impending COVID-19 pandemic in a tertiary care hospital in India BACKGROUND: In the wake of the COVID-19 pandemic caused by a novel corona virus, health care personnel are at increased risk of acquiring the infection. In preparation for the management of health care personnel that are likely to be infected, we looked in to the data collected during the Influenza pandemic in 2009, caused by a novel strain of H1N1 influenza called swine flu. The care of healthcare personnel in our institution, who had an acute febrile respiratory illness (AFRI) during that period was routed through a single channel using a uniform protocol. We retrospectively analysed the available data, during the initial four months of the pandemic, to draw lessons from it. OBJECTIVE: To study the prevalence, clinical profile and risk factors of swine flu among health care personnel during the pandemic of 2009 in a tertiary care hospital in South India. METHODOLOGY: This retrospective study enrolled all the health care personnel including students of a tertiary care institution in South India, who presented with an acute febrile respiratory illness (AFRI) between June to August, the initial four months of the swine flu pandemic of 2009. The clinical profile and risk factors were extracted. The results of the RT PCR for swine flu was obtained. Prevalence in each demographic group was calculated and compared. Characteristics of those with swine flu were compared with those who turned negative for the swine flu. RESULTS: The prevalence of all AFRI and only swine flu among health care personnel during the study period was 18 per thousand and 8.7 per thousand respectively. Highest prevalence of swine flu was found among students and office staff. After adjusting for confounding factors, hyperthermia at presentation was significantly higher {OR=1.97; 95% CI (1.01-3.76)} among those who tested positive for swine flu as compared with those with other AFRI’s. Only 2.5% of the entire AFRI group required admission and there was no mortality. CONCLUSION: Health care personnel are at increased risk of acquiring infection. Our study demonstrated that students and office staff were the most susceptible. Unprotected exposure to unknown infectious patients and relatives is likely to have been an important factor. Though the mode of transmission is similar, compared to H1N1, COVID-19 is associated with different comorbidities and has significantly higher mortality. Therefore, in preparation for the COVID-19 pandemic, the personal protective equipment of the healthcare personnel need to be escalated. | Indian J Tuberc | 2020 | LitCov and CORD-19 | |
| 6816 | A Comparison Between In-Person and Virtual Fellowship Interviews During the COVID-19 Pandemic IMPORTANCE: Traditional in-person fellowship interviews require great time and financial commitments. Here, we studied the response of PDs and applicants to virtual interviews. Virtual interviews could decrease both financial and time commitments. OBJECTIVE: To determine if most applicants and PDs believed that virtual interviews should be used more widely in the future. DESIGN: After the 2020 cardiothoracic fellowship match, an e-mail survey was sent to 66 program directors and 107 applicants using the Qualtrics platform. SETTING: During the 2020 cardiothoracic fellowship interview cycle, the COVID-19 pandemic shut down travel for in-person interviews. This forced a transition to virtual interviews. PARTICIPANTS: Of 107 applicants emailed, 46 (44%) participated with a completion rate of 87%. 66 PDs were contacted and of those, 36 (55%) participated with a 92% survey completion rate. EXPOSURE: All survey participants were participants in the 2020 cardiothoracic match. MAIN OUTCOME(S) AND MEASURE(S): 1) The percent of participants who agree that virtual interviews should be continued in the future and the percent of participants who agree that virtual interviews could be replacements for in person interviews. 2) Were virtual interviews perceived to have a negative impact on one's ultimate match? 3) What is the current cost of an in-person interview in travel and lodging for an applicant? RESULTS: 46 applicants (44% participation rate) and 36 PDs (55% participation rate) participated in the survey. 79% of program directors and 55% of applicants either agreed or strongly agreed that virtual interviews should be offered in the future. However, just 15% of PDs and 20% of applicants either agreed or strongly agreed that virtual interviews should be offered without the option of an in-person interview. 25% of PDs and applicants agreed or strongly agreed that virtual interviews negatively impacted their chance of matching one of their top applicants/programs. The median cost of an in-person interview was $600 (IQR 500-725). CONCLUSIONS AND RELEVANCE: Most applicants and PDs agree that virtual interviews should be offered in the future. 25% of participants reported that they believed virtual interviews negatively impacted their match. Given the overall acceptance of virtual interviews and the cost of in-person interviews, virtual interviews could be useful to incorporate into future interview seasons. | J Surg Educ | 2020 | LitCov and CORD-19 | |
| 6817 | Effect of non-pharmaceutical interventions to contain COVID-19 in China On March 11, 2020, the World Health Organization declared COVID-19 a pandemic(1). The outbreak containment strategies in China based on non-pharmaceutical interventions (NPIs) appear to be effective(2), but quantitative research is still needed to assess the efficacy of NPIs and their timings(3). Using epidemiological and anonymised human movement data(4,5), here we develop a modelling framework that uses daily travel networks to simulate different outbreak and intervention scenarios across China. We estimated that there were a total of 114,325 COVID-19 cases (interquartile range 76,776 -164,576) in mainland China as of February 29, 2020. Without NPIs, the COVID-19 cases would likely have shown a 67-fold increase (interquartile range 44 - 94) by February 29, 2020, with the effectiveness of different interventions varying. The early detection and isolation of cases was estimated to have prevented more infections than travel restrictions and contact reductions, but combined NPIs achieved the strongest and most rapid effect. The lifting of travel restrictions since February 17, 2020 does not appear to lead to an increase in cases across China if the social distancing interventions can be maintained, even at a limited level of 25% reduction on average through late April. Our findings contribute to an improved understanding of NPIs on COVID-19 and to inform response efforts across the World. | Nature | 2020 | LitCov and CORD-19 | |
| 6818 | Determinants of parental hesitancy to vaccinate their children against COVID-19 in China N/A | Expert Rev Vaccines | 2021 | LitCov and CORD-19 | |
| 6819 | Risk of persistent and new clinical sequelae among adults aged 65 years and older during the post-acute phase of SARS-CoV-2 infection: retrospective cohort study OBJECTIVE: To characterize the risk of persistent and new clinical sequelae in adults aged ≥65 years after the acute phase of SARS-CoV-2 infection. DESIGN: Retrospective cohort study. SETTING: UnitedHealth Group Clinical Research Database: deidentified administrative claims and outpatient laboratory test results. PARTICIPANTS: Individuals aged ≥65 years who were continuously enrolled in a Medicare Advantage plan with coverage of prescription drugs from January 2019 to the date of diagnosis of SARS-CoV-2 infection, matched by propensity score to three comparison groups that did not have covid-19: 2020 comparison group (n=87 337), historical 2019 comparison group (n=88 070), and historical comparison group with viral lower respiratory tract illness (n=73 490). MAIN OUTCOME MEASURES: The presence of persistent and new sequelae at 21 or more days after a diagnosis of covid-19 was determined with ICD-10 (international classification of diseases, 10(th) revision) codes. Excess risk for sequelae caused by infection with SARS-CoV-2 was estimated for the 120 days after the acute phase of the illness with risk difference and hazard ratios, calculated with 95% Bonferroni corrected confidence intervals. The incidence of sequelae after the acute infection was analyzed by age, race, sex, and whether patients were admitted to hospital for covid-19. RESULTS: Among individuals who were diagnosed with SARS-CoV-2, 32% (27 698 of 87 337) sought medical attention in the post-acute period for one or more new or persistent clinical sequelae, which was 11% higher than the 2020 comparison group. Respiratory failure (risk difference 7.55, 95% confidence interval 7.18 to 8.01), fatigue (5.66, 5.03 to 6.27), hypertension (4.43, 2.27 to 6.37), memory difficulties (2.63, 2.23 to 3.13), kidney injury (2.59, 2.03 to 3.12), mental health diagnoses (2.50, 2.04 to 3.04), hypercoagulability 1.47 (1.2 to 1.73), and cardiac rhythm disorders (2.19, 1.76 to 2.57) had the greatest risk differences compared with the 2020 comparison group, with similar findings to the 2019 comparison group. Compared with the group with viral lower respiratory tract illness, however, only respiratory failure, dementia, and post-viral fatigue had increased risk differences of 2.39 (95% confidence interval 1.79 to 2.94), 0.71 (0.3 to 1.08), and 0.18 (0.11 to 0.26) per 100 patients, respectively. Individuals with severe covid-19 disease requiring admission to hospital had a markedly increased risk for most but not all clinical sequelae. CONCLUSIONS: The results confirm an excess risk for persistent and new sequelae in adults aged ≥65 years after acute infection with SARS-CoV-2. Other than respiratory failure, dementia, and post-viral fatigue, the sequelae resembled those of viral lower respiratory tract illness in older adults. These findings further highlight the wide range of important sequelae after acute infection with the SARS-CoV-2 virus. | BMJ | 2022 | LitCov and CORD-19 | |
| 6820 | Cerebrospinal fluid cytokine, chemokine and SARS-CoV-2 antibody profiles in children with neuropsychiatric symptoms associated with COVID-19 BACKGROUND: Neuropsychiatric symptoms and CSF cytokine, chemokine, and SARS-COV-2 antibody profiles are unknown in pediatric patients with COVID-19 or multisystem inflammatory syndrome (MIS-C), (NP-COVID-19). METHODS: Children at a single pediatric institution quaternary referral center with laboratory-confirmed COVID-19 or MIS-C and neuropsychiatric symptoms were included in this retrospective case series. Clinical symptoms, ancillary testing data, treatments and outcomes are described. Multiplexed electrochemiluminescence assays for cytokines, chemokines and SARS-CoV-2 antibodies were tested in the CSF NP-COVID-19 patients compared to five controls and were analyzed using the Student's t-test. RESULTS: Three of five NP-COVID-19 patients had psychiatric symptoms, and two patients had encephalopathy and seizures. All patients had full or near resolution of neuropsychiatric symptoms by discharge. One patient received intravenous steroids for treatment for psychiatric symptoms; 3/5 other patients received immunotherapy for MIS-C, including IVIG, high-dose steroids, anakinra, and tocilizumab. Pro-inflammatory chemokines, including MIG, MPC, MIP-1β, and TARC were significantly elevated in NP-COVID-19 patients compared to controls. Two of five patients had elevated CSF neurofilament light chain. CSF SARS-CoV-2 antibody titers to the full-length spike, receptor binding domain and N-terminal domain were significantly elevated. SARS-CoV-2 antibody titers strongly correlated with pro-inflammatory chemokines/cytokines, including IL-1β, IL-2, IL-8, TNF-α, and IFN-γ (P≤0.05 for all). CONCLUSIONS: A spectrum of neuropsychiatric clinical manifestations can occur in children with SARS-CoV-2 infection. CSF pro-inflammatory chemokines and SARS-CoV-2 antibodies may serve as biomarkers of SARS-CoV-2 mediated NP-COVID-19. Additional study is required to understand the pathophysiologic mechanisms of neuroinflammation in children with COVID-19 and MIS-C. | Mult Scler Relat Disord | 2021 | LitCov and CORD-19 | |
| 6821 | "I Have a Cough": An Interactive Virtual Respiratory Case-Based Module INTRODUCTION: The COVID-19 pandemic has radically disrupted traditional models of medical education, forcing rapid evolution in the delivery of clinical training. As a result, clinical educators must quickly transition away from in-person sessions and develop effective virtual learning opportunities instead. This virtual resource was designed to replace a clinical simulation session for the physical examination course for medical students in the preclinical years. METHODS: We designed an online interactive module in three sections for preclinical (first- or second-year) medical students who had not yet learned the respiratory physical exam. The first section incorporated demonstration and practice of the components of the respiratory physical exam that could be effectively taught via videoconferencing software. Following this, students conducted a telemedicine encounter with a standardized patient and received patient-centered feedback evaluating their communication skills. The final segment involved a case discussion and clinical reasoning component. RESULTS: These sessions were implemented for 122 first-year medical students. The module was well received by the students. A majority felt that it helped improve their telemedicine communication skills (93%), interpretation of physical exam findings (84%), development of differential diagnosis (95%), and correlation of clinical and basic science content (93%). DISCUSSION: Our pilot educational session demonstrates that this virtual instruction method is an effective tool for teaching basic clinical skills during medical school. Virtual learning resources allow remote instruction to take place and can be a supplement when face-to-face clinical teaching is not possible. | MedEdPORTAL | 2020 | LitCov and CORD-19 | |
| 6822 | Real-world effectiveness of early molnupiravir or nirmatrelvir-ritonavir in hospitalised patients with COVID-19 without supplemental oxygen requirement on admission during Hong Kong's omicron BA.2 wave: a retrospective cohort study N/A | Lancet Infect Dis | 2022 | LitCov | |
| 6823 | Predictors of Intensive Care Unit admission in patients with COVID-19 N/A | Monaldi Arch Chest Dis | 2020 | LitCov and CORD-19 | |
| 6824 | Analysis of personal and national factors that influence depression in individuals during the COVID-19 pandemic: a web-based cross-sectional survey BACKGROUND: The World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic on March 11, 2020. Previous studies of infectious diseases showed that infectious diseases not only cause physical damage to infected individuals but also damage to the mental health of the public. Therefore this study aims to analyze the factors that affected depression in the public during the COVID-19 pandemic to provide evidence for COVID-19-related mental health policies and to emphasize the need to prepare for mental health issues related to potential infectious disease outbreaks in the future. RESULTS: This study performed the following statistical analyses to analyze the factors that influence depression in the public during the COVID-19 pandemic. First, to confirm the level of depression in the public in each country, the participants’ depression was plotted on a Boxplot graph for analysis. Second, to confirm personal and national factors that influence depression in individuals, a multi-level analysis was conducted. As a result, the median Patient Health Questionnaire-9 (PHQ-9) score for all participants was 6. The median was higher than the overall median for the Philippines, Indonesia, and Paraguay, suggesting a higher level of depression. In personal variables, depression was higher in females than in males, and higher in participants who had experienced discrimination due to COVID-19 than those who had not. In contrast, depression was lower in older participants, those with good subjective health, and those who practiced personal hygiene for prevention. In national variables, depression was higher when the Government Response Stringency Index score was higher, when life expectancy was higher, and when social capital was higher. In contrast, depression was lower when literacy rates were higher. CONCLUSIONS: Our study reveals that depression was higher in participants living in countries with higher stringency index scores than in participants living in other countries. Maintaining a high level of vigilance for safety cannot be criticized. However, in the current situation, where coexisting with COVID-19 has become inevitable, inflexible and stringent policies not only increase depression in the public, but may also decrease resilience to COVID-19 and compromise preparations for coexistence with COVID-19. Accordingly, when establishing policies such as social distancing and quarantine, each country should consider the context of their own country. | Global Health | 2021 | LitCov and CORD-19 | |
| 6825 | The Impact of COVID-19 on the Delivery of Educational Programs in Native American Communities: Qualitative Study BACKGROUND: Despite the availability of culturally responsive sexual health educational programs for American Indian and Alaska Native (AI/AN) youth, barriers to their uptake and utilization persist in tribal communities. These challenges were exacerbated by the COVID-19 pandemic, which required flexible program delivery using both in-person and virtual classrooms. OBJECTIVE: This exploratory study provides a preliminary understanding of the extent to which pre-existing challenges impact the delivery of culturally responsive sexual health education programs in Native communities and to what extent they were exacerbated by the COVID-19 pandemic. It also highlights the challenges faced by adolescent health advocates when adapting culturally responsive health curricula to online platforms. Finally, this study discloses major socioeconomic, health, and mental challenges experienced by AI/AN youth during the pandemic. METHODS: An exploratory, descriptive, qualitative design approach was adopted to carry out 5 individual and 1 collective in-depth key informant interviews. A total of 8 Native and non-Native sexual health educators served as key informants and shared their personal experiences with the delivery of sexual health education programs for youth during the COVID-19 pandemic. The interviews were conducted virtually from October to November 2020 using Zoom to reach participants dispersed across different regions of the United States. We followed the consolidated criteria for reporting qualitative research (COREQ) as a reference for the study methodology. We also used the Braun and Clarke framework (2006) to conduct a thematic analysis. RESULTS: Experts’ opinions were structured according to 5 main themes: (1) competing community priorities during COVID-19; (2) moving to web-based programming: skills, training, support; (3) recruiting youth; and (4) challenges for implementation in a household environment; and (5) recommendations to overcome implementation challenges. These themes are complementary, connected, and should be considered holistically for the development, dissemination, and implementation of online sexual health programs for AI/AN youth, specifically during the COVID-19 pandemic. The results raised the following points for discussion: (1) Building partnerships with schools and community organizations facilitates program adaptation and implementation, (2) there is a need to adopt a holistic approach when addressing youth sexual health in AI/AN communities, (3) a systematic and culturally responsive adaptation approach ensures effective virtual program delivery, and (4) community and youth engagement is essential for the success of virtual sexual health programs. CONCLUSIONS: Findings can provide recommendations on actions to be taken by sexual health educators and guidelines to follow to ensure cultural sensitivity, effective adaptation, and successful implementation when setting out to advocate for online sexual health programs for AI/AN youth. | JMIR Form Res | 2022 | LitCov and CORD-19 | |
| 6826 | Neutralizing antibody and T-cell responses against SARS-CoV-2 variants of concern following ChAdOx-1 or BNT162b2 boosting in the elderly previously immunized with CoronaVac vaccine BACKGROUND: The existence of SARS-CoV-2 variants of concern (VOCs) in association with evidence of breakthrough infections despite vaccination resulted in the need for vaccine boosting. In elderly individuals, information on the immunogenicity of booster vaccinations is limited. In countries where the CoronaVac inactivated vaccine is the primary vaccine, the appropriate boosting regimen is not clear. Immunologic studies of the effects of booster vaccination against VOCs, particularly Delta and Omicron, following CoronaVac in elderly individuals are helpful for policy makers. In this study, we determined the immune responses against VOCs following ChAdOx-1 or BNT162b2 boosting in elderly individuals previously immunized with CoronaVac. RESULTS: Before boosting, the median % inhibition of neutralizing antibodies (NAbs) against the wild-type (WT), Alpha, Beta, Delta and Omicron variants in the ChAdOx-1 and BNT162b2 groups was 52.8% vs. 53.4, 36.6% vs. 39.9, 5.2% vs. 13.7, 34.3% vs. 44.9, and 20.8% vs. 18.8%, respectively. After boosting with ChAdOx-1 or BNT162b2, the % inhibition of NAbs were increased to 97.3% vs. 97.4, 94.3% vs. 97.3%, 79.9 vs. 93.7, 95.5% vs. 97.5, and 26.9% vs. 31.9% for WT, Alpha, Beta, Delta and Omicron variants, respectively. Boosting with BNT162b2 induced significantly higher NAb levels than boosting with ChAdOx-1 against the Alpha, Beta and Delta variants but not the WT and Omicron variants. NAb levels against Omicron variant were not significantly different before and after boosting with ChAdOx-1 or BNT162b2. To evaluate T-cell responses, S peptides of the WT, Alpha, Beta and Delta variants were used to stimulate T cells. Upon stimulation, the expression of IL-17A in CD8 T cells was higher in the BNT162b2 group than in the ChAdOx-1 boosting group. However, IFN-γ production in CD4 and CD8 T cells did not significantly differ under all vaccination regimens. The expression of FasL in CD4 T cells, but not CD8 T cells, was higher in the BNT162b2-boosted group. CONCLUSION: Boosting with either ChAdOx-1 or BNT162b2 in CoronaVac-primed healthy elderly individuals induced high NAb production against all examined VOCs except Omicron. BNT162b2 stimulated higher NAb and some T-cell responses than ChAdOx-1. Vaccine boosting is, therefore, recommended for elderly individuals previously immunized with CoronaVac. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12979-022-00279-8. | Immun Ageing | 2022 | LitCov and CORD-19 | |
| 6827 | Priority-setting dilemmas, moral distress and support experienced by nurses and physicians in the early phase of the COVID-19 pandemic in Norway BACKGROUND: The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction. AIM: Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway. RESEARCH DESIGN: A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020. ETHICAL CONSIDERATIONS: Ethical approval granted by the Regional Research Ethics Committee in Western Norway (131421). FINDINGS: Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful. DISCUSSION: By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority. CONCLUSION: Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. | Nurs Ethics | 2021 | LitCov and CORD-19 | |
| 6828 | A Potential SARS-CoV-2 Variant of Interest (VOI) Harboring Mutation E484K in the Spike Protein Was Identified within Lineage B.1.1.33 Circulating in Brazil The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in Brazil was dominated by two lineages designated as B.1.1.28 and B.1.1.33. The two SARS-CoV-2 variants harboring mutations at the receptor-binding domain of the Spike (S) protein, designated as lineages P.1 and P.2, evolved from lineage B.1.1.28 and are rapidly spreading in Brazil. Lineage P.1 is considered a Variant of Concern (VOC) because of the presence of multiple mutations in the S protein (including K417T, E484K, N501Y), while lineage P.2 only harbors mutation S:E484K and is considered a Variant of Interest (VOI). On the other hand, epidemiologically relevant B.1.1.33 deriving lineages have not been described so far. Here we report the identification of a new SARS-CoV-2 VOI within lineage B.1.1.33 that also harbors mutation S:E484K and was detected in Brazil between November 2020 and February 2021. This VOI displayed four non-synonymous lineage-defining mutations (NSP3:A1711V, NSP6:F36L, S:E484K, and NS7b:E33A) and was designated as lineage N.9. The VOI N.9 probably emerged in August 2020 and has spread across different Brazilian states from the Southeast, South, North, and Northeast regions. | Viruses | 2021 | LitCov and CORD-19 | |
| 6829 | A guideline to limit indoor airborne transmission of COVID-19 The current revival of the American economy is being predicated on social distancing, specifically the Six-Foot Rule, a guideline that offers little protection from pathogen-bearing aerosol droplets sufficiently small to be continuously mixed through an indoor space. The importance of airborne transmission of COVID-19 is now widely recognized. While tools for risk assessment have recently been developed, no safety guideline has been proposed to protect against it. We here build on models of airborne disease transmission in order to derive an indoor safety guideline that would impose an upper bound on the “cumulative exposure time,” the product of the number of occupants and their time in an enclosed space. We demonstrate how this bound depends on the rates of ventilation and air filtration, dimensions of the room, breathing rate, respiratory activity and face mask use of its occupants, and infectiousness of the respiratory aerosols. By synthesizing available data from the best-characterized indoor spreading events with respiratory drop size distributions, we estimate an infectious dose on the order of 10 aerosol-borne virions. The new virus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) is thus inferred to be an order of magnitude more infectious than its forerunner (SARS-CoV), consistent with the pandemic status achieved by COVID-19. Case studies are presented for classrooms and nursing homes, and a spreadsheet and online app are provided to facilitate use of our guideline. Implications for contact tracing and quarantining are considered, and appropriate caveats enumerated. Particular consideration is given to respiratory jets, which may substantially elevate risk when face masks are not worn. | Proc Natl Acad Sci U S A | 2021 | LitCov and CORD-19 | |
| 6830 | Nonpharmaceutical Interventions Used to Control COVID-19 Reduced Seasonal Influenza Transmission in China To suppress the ongoing COVID-19 pandemic, the Chinese government has implemented a set of non-pharmaceutical interventions (NPIs). Because COVID-19 and influenza have similar means of transmission, it is hypothesized that NPIs targeting COVID-19 may also affect influenza transmission. In this study, the extent to which NPIs targeting COVID-19 have affected seasonal influenza transmission was explored. Indicators of seasonal influenza activity in the epidemiological year 2019/20 were compared with those in 2017/18 and 2018/19. Results show that the incidence rate of seasonal influenza reduced by 64% in 2019/20 (p&0.001). These findings suggest that NPIs aimed at controlling COVID-19 significantly reduced the seasonal influenza transmission in China. (105 words) | J Infect Dis | 2020 | LitCov and CORD-19 | |
| 6831 | COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore BACKGROUND: Factors affecting COVID-19 vaccine acceptance and hesitancy among primary healthcare workers (HCW) remain poorly understood. This study aims to identify factors associated with vaccine acceptance and hesitancy among HCW. METHODS: A multi-centre online cross-sectional survey was performed across 6 primary care clinics from May to June 2021, after completion of staff vaccination exercise. Demographics, profession, years working in healthcare, residential status, presence of chronic medical conditions, self-perceived risk of acquiring COVID-19 and previous influenza vaccination were collected. HCW who accepted vaccine were then asked to rank their top 5 reasons for vaccine acceptance; HCW who were vaccine hesitant had to complete the 15-item 5C scale on psychological antecedents of vaccination. RESULTS: Five hundred fifty seven out of 1182 eligible HCW responded (47.1%). Twenty nine were excluded due to contraindications. Among 528 respondents, vaccine acceptance rate was 94.9% (n = 501). There were no statistically significant differences in COVID-19 vaccine acceptance between sex, age, ethnicity, profession, number of years in healthcare, living alone, presence of chronic diseases, self-perceived risk or previous influenza vaccination. The top 3 reasons for COVID-19 vaccine acceptance ranked by 501 HCW were to protect their family and friends, protect themselves from COVID-19 and due to high risk of acquiring COVID-19 because of their jobs. HCW with suspected or confirmed COVID-19 exposure were 3.4 times more likely to rank ‘high risk at work’ as one of the top reasons for vaccine acceptance (χ(2) = 41.9, p < 0.001, OR = 3.38, 95%C.I. 2.32–4.93). High mean scores of ‘Calculation’ (5.79) and low scores for ‘Constraint’ (2.85) for 5C components among vaccine hesitant HCW (n = 27) highlighted that accessibility was not a concern; HCW took time to weigh vaccine benefits and consequences. CONCLUSION: COVID-19 vaccine hesitancy is a minute issue among Singapore primary HCW, having achieved close to 95% acceptance rate. COVID-19 exposure risk influences vaccine acceptance; time is required for HCW to weigh benefits against the risks. Future studies can focus on settings with higher hesitancy rates, and acceptance of booster vaccinations with the emergence of delta and omicron variants. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-022-01693-z. | BMC Prim Care | 2022 | LitCov and CORD-19 | |
| 6832 | Intentional and unintentional non-adherence to social distancing measures during COVID-19: A mixed-methods analysis Social distancing measures implemented by governments worldwide during the COVID-19 pandemic have proven an effective intervention to control the transmission of SARS-CoV-2. There is a growing literature on predictors of adherence behaviours to social distancing measures, however, there are no comprehensive insights into the nature and types of non-adherence behaviours. To address this gap in the literature, we studied non-adherence in terms of counts of infringements and people’s accounts on their behaviours in a sample of North London residents. We focused on the following social distancing rules: keeping 2 mts. distancing, meeting family and friends, and going out for non-essential reasons. A mixed-methods explanatory sequential design was used comprising an online survey (May 1–31, 2020) followed by semi-structured in-depth interviews held with a purposive sample of survey respondents (August 5 –September 21, 2020). A negative binomial regression model (quantitative) and Framework Analysis (qualitative) were undertaken.681 individuals completed the survey, and 30 individuals were interviewed. We integrated survey and interview findings following three levels of the Social Ecological model: individual, interpersonal and community levels. We identified non-adherence behaviours as unintentional (barriers beyond individual’s control) and intentional (deliberate decision). Unintentional adherence was reported by interviewees as, lack of controllability in keeping 2 mts. distancing, environmental constraints, social responsibility towards the community and feeling low risk. Intentional non-adherence was statistically associated with and reported as lack of trust in Government, support from friends, and lack of knowledge about rules. In addition, interviewees reported individual risk assessment and decision making on the extent to following the rules, and perceived lack of adherence in the local area. Our findings indicate that unintentional and intentional non-adherence should be improved by Government partnerships with local communities to build trust in social distancing measures; tailored messaging to young adults emphasising the need of protecting others whilst clarifying the risk of transmission; and ensuring COVID-secured environments by working with environmental health officers. | PLoS One | 2021 | LitCov and CORD-19 | |
| 6833 | Distribution of ACE2, CD147, CD26 and other SARS-CoV-2 associated molecules in tissues and immune cells in health and in asthma, COPD, obesity, hypertension and COVID-19 risk factors BACKGROUND: Morbidity and mortality from COVID‐19 caused by novel coronavirus SARS‐CoV‐2 is accelerating worldwide and novel clinical presentations of COVID‐19 are often reported. The range of human cells and tissues targeted by SARS‐CoV‐2, its potential receptors and associated regulating factors are still largely unknown. The aim of our study was to analyze the expression of known and potential SARS‐CoV‐2 receptors and related molecules in the extensive collection of primary human cells and tissues from healthy subjects of different age and from patients with risk factors and known comorbidities of COVID‐19. METHODS: We performed RNA sequencing and explored available RNA‐Seq databases to study gene expression and co‐expression of ACE2, CD147 (BSG), CD26 (DPP4) and their direct and indirect molecular partners in primary human bronchial epithelial cells, bronchial and skin biopsies, bronchoalveolar lavage fluid, whole blood, peripheral blood mononuclear cells (PBMCs), monocytes, neutrophils, DCs, NK cells, ILC1, ILC2, ILC3, CD4(+) and CD8(+) T cells, B cells and plasmablasts. We analyzed the material from healthy children and adults, and from adults in relation to their disease or COVID‐19 risk factor status. RESULTS: ACE2 and TMPRSS2 were coexpressed at the epithelial sites of the lung and skin, whereas CD147 (BSG), cyclophilins (PPIA and PPIB), CD26 (DPP4) and related molecules were expressed in both, epithelium and in immune cells. We also observed a distinct age‐related expression profile of these genes in the PBMCs and T cells from healthy children and adults. Asthma, COPD, hypertension, smoking, obesity, and male gender status generally led to the higher expression of ACE2‐ and CD147‐related genes in the bronchial biopsy, BAL or blood. Additionally, CD147‐related genes correlated positively with age and BMI. Interestingly, we also observed higher expression of ACE2‐ and CD147‐related genes in the lesional skin of patients with atopic dermatitis. CONCLUSIONS: Our data suggest different receptor repertoire potentially involved in the SARS‐CoV‐2 infection at the epithelial barriers and in the immune cells. Altered expression of these receptors related with age, gender, obesity and smoking, as well as with the disease status might contribute to COVID‐19 morbidity and severity patterns. | Allergy | 2020 | LitCov and CORD-19 | |
| 6834 | Development and validation of a model for individualized prediction of hospitalization risk in 4,536 patients with COVID-19 BACKGROUND: Coronavirus Disease 2019 is a pandemic that is straining healthcare resources, mainly hospital beds. Multiple risk factors of disease progression requiring hospitalization have been identified, but medical decision-making remains complex. OBJECTIVE: To characterize a large cohort of patients hospitalized with COVID-19, their outcomes, develop and validate a statistical model that allows individualized prediction of future hospitalization risk for a patient newly diagnosed with COVID-19. DESIGN: Retrospective cohort study of patients with COVID-19 applying a least absolute shrinkage and selection operator (LASSO) logistic regression algorithm to retain the most predictive features for hospitalization risk, followed by validation in a temporally distinct patient cohort. The final model was displayed as a nomogram and programmed into an online risk calculator. SETTING: One healthcare system in Ohio and Florida. PARTICIPANTS: All patients infected with SARS-CoV-2 between March 8, 2020 and June 5, 2020. Those tested before May 1 were included in the development cohort, while those tested May 1 and later comprised the validation cohort. MEASUREMENTS: Demographic, clinical, social influencers of health, exposure risk, medical co-morbidities, vaccination history, presenting symptoms, medications, and laboratory values were collected on all patients, and considered in our model development. RESULTS: 4,536 patients tested positive for SARS-CoV-2 during the study period. Of those, 958 (21.1%) required hospitalization. By day 3 of hospitalization, 24% of patients were transferred to the intensive care unit, and around half of the remaining patients were discharged home. Ten patients died. Hospitalization risk was increased with older age, black race, male sex, former smoking history, diabetes, hypertension, chronic lung disease, poor socioeconomic status, shortness of breath, diarrhea, and certain medications (NSAIDs, immunosuppressive treatment). Hospitalization risk was reduced with prior flu vaccination. Model discrimination was excellent with an area under the curve of 0.900 (95% confidence interval of 0.886–0.914) in the development cohort, and 0.813 (0.786, 0.839) in the validation cohort. The scaled Brier score was 42.6% (95% CI 37.8%, 47.4%) in the development cohort and 25.6% (19.9%, 31.3%) in the validation cohort. Calibration was very good. The online risk calculator is freely available and found at https://riskcalc.org/COVID19Hospitalization/. LIMITATION: Retrospective cohort design. CONCLUSION: Our study crystallizes published risk factors of COVID-19 progression, but also provides new data on the role of social influencers of health, race, and influenza vaccination. In a context of a pandemic and limited healthcare resources, individualized outcome prediction through this nomogram or online risk calculator can facilitate complex medical decision-making. | PLoS One | 2020 | LitCov and CORD-19 | |
| 6835 | Misinformation and the US Ebola communication crisis: analyzing the veracity and content of social media messages related to a fear-inducing infectious disease outbreak BACKGROUND: The Ebola communication crisis of 2014 generated widespread fear and attention among Western news media, social media users, and members of the United States (US) public. Health communicators need more information on misinformation and the social media environment during a fear-inducing disease outbreak to improve communication practices. The purpose of this study was to describe the content of Ebola-related tweets with a specific focus on misinformation, political content, health related content, risk framing, and rumors. METHODS: We examined tweets from a random 1% sample of all tweets published September 30th - October 30th, 2014, filtered for English-language tweets mentioning “Ebola” in the content or hashtag, that had at least 1 retweet (N = 72,775 tweets). A randomly selected subset of 3639 (5%) tweets were evaluated for inclusion. We analyzed the 3113 tweets that meet inclusion criteria using public health trained human coders to assess tweet characteristics (joke, opinion, discord), veracity (true, false, partially false), political context, risk frame, health context, Ebola specific messages, and rumors. We assessed the proportion of tweets with specific content using descriptive statistics and chi-squared tests. RESULTS: Of non-joke tweets, 10% of Ebola-related tweets contained false or partially false information. Twenty-five percent were related to politics, 28% contained content that provoked reader response or promoted discord, 42% contained risk elevating messages and 72% were related to health. The most frequent rumor mentioned focused on government conspiracy. When comparing tweets with true information to tweets with misinformation, a greater percentage of tweets with misinformation were political in nature (36% vs 15%) and contained discord-inducing statements (45% vs 10%). Discord-inducing statements and political messages were both significantly more common in tweets containing misinformation compared with those without(p < 0.001). CONCLUSIONS: Results highlight the importance of anticipating politicization of disease outbreaks, and the need for policy makers and social media companies to build partnerships and develop response frameworks in advance of an event. While each public health event is different, our findings provide insight into the possible social media environment during a future epidemic and could help optimize potential public health communication strategies. | BMC Public Health | 2020 | CORD-19 | |
| 6836 | Personal protective equipment and adverse dermatological reactions among healthcare workers: Survey observations from the COVID-19 pandemic The pandemic of the 2019 novel coronavirus disease (COVID-19) has caused an unprecedented mobilization of the United States’ healthcare workforce. In addition to working extended hours under increased duress, healthcare professionals (HCP) of all stations have been making use of various types of personal protective equipment (PPE) with greatly increased frequency and duration. Current data regarding adverse skin reactions as a possible consequence of PPE use are, particularly in the United States, largely insufficient for policy-makers to make informed decisions regarding daily PPE use among HCP. The research vehicle employed by this study is a cross-sectional 25-item survey distributed via email to workers currently employed by a five-hospital system in southcentral Kentucky. This survey was used to collect information from hospital workers of all professional roles about their experiences during the COVID-19 pandemic, focusing on reports of adverse dermatological reactions and associated risk factors. Out of 879 respondents, 54.4% reported some type of skin irritation reaction. Skin irritation was significantly more prevalent among medical and medical support staff than non-medical hospital workers, with the highest prevalence among Certified Nurse Assistant (CNAs). Among clinical workers, those in dedicated COVID-19 units reported the highest prevalence of adverse skin reaction. The most common complaint was dryness/scaling of the skin (306 out of 439, 69.7%), and the most common location was the facial cheeks (305 out of 516, 59.1%). Among those who reported skin irritation, the average self-reported severity of skin reaction (on a scale of 1–5) was 2.00 ± 0.05, and the mean total days of skin reaction per month was 11.70 ± 0.39 days. Total days of irritation per month was found to be significantly related to “total days of PPE use per month,” “hours of PPE use per day,” “frequency of hand washing,” and “use of disinfecting UV irradiation.” Severity of skin reaction was found to be significantly related to “hours per day of PPE use,” “consecutive days of PPE use,” and “female sex.” Clinical workers that put in the most face-to-face time with patients, and those in dedicated COVID-19 units, had the highest risk of adverse skin reaction. Overall, skin reactions were found to be mild, even in those hospital workers with the heaviest PPE use. Because the widespread and consistent use of facial masks in public settings has become a key tool in our protracted struggle with SARS-CoV-2, these findings may help to ameliorate concerns that everyday facial mask and/or other PPE usage contributes to significant dermatologic morbidity among both medical professionals and public citizens. | Medicine (Baltimore) | 2022 | LitCov and CORD-19 | |
| 6837 | SARS-CoV-2 immune evasion by the B.1.427/B.1.429 variant of concern N/A | Science | 2021 | LitCov and CORD-19 | |
| 6838 | CoVaccine HT™ Adjuvant Potentiates Robust Immune Responses to Recombinant SARS-CoV-2 Spike S1 Immunization The current COVID-19 pandemic has claimed hundreds of thousands of lives and its causative agent, SARS-CoV-2, has infected millions, globally. The highly contagious nature of this respiratory virus has spurred massive global efforts to develop vaccines at record speeds. In addition to enhanced immunogen delivery, adjuvants may greatly impact protective efficacy of a SARS-CoV-2 vaccine. To investigate adjuvant suitability, we formulated protein subunit vaccines consisting of the recombinant S1 domain of SARS-CoV-2 Spike protein alone or in combination with either CoVaccine HT™ or Alhydrogel. CoVaccine HT™ induced high titres of antigen-binding IgG after a single dose, facilitated affinity maturation and class switching to a greater extent than Alhydrogel and elicited potent cell-mediated immunity as well as virus neutralizing antibody titres. Data presented here suggests that adjuvantation with CoVaccine HT™ can rapidly induce a comprehensive and protective immune response to SARS-CoV-2. | Front Immunol | 2020 | LitCov and CORD-19 | |
| 6839 | Imbalance of Regulatory and Cytotoxic SARS-CoV-2-Reactive CD4+ T Cells in COVID-19 The contribution of CD4+ T cells to protective or pathogenic immune responses to SARS-CoV-2 infection remains unknown. Here, we present single-cell transcriptomic analysis of >100,000 viral antigen-reactive CD4+ T cells from 40 COVID-19 patients. In hospitalized patients compared to non-hospitalized patients, we found increased proportions of cytotoxic follicular helper (TFH) cells and cytotoxic T helper cells (CD4-CTLs) responding to SARS-CoV-2, and reduced proportion of SARS-CoV-2-reactive regulatory T cells (TREG). Importantly, in hospitalized COVID-19 patients, a strong cytotoxic TFH response was observed early in the illness which correlated negatively with antibody levels to SARS-CoV-2 spike protein. Polyfunctional T helper (TH)1 and TH17 cell subsets were underrepresented in the repertoire of SARS-CoV-2-reactive CD4+ T cells compared to influenza-reactive CD4+ T cells. Together, our analyses provide insights into the gene expression patterns of SARS-CoV-2-reactive CD4+ T cells in distinct disease severities. | Cell | 2020 | LitCov and CORD-19 | |
| 6840 | Public Health Interventions for the COVID-19 Pandemic Reduce Respiratory Tract Infection-Related Visits at Pediatric Emergency Departments in Taiwan Background and objective: Public health interventions such as social distancing, wearing surgical or N95 masks, and handwashing are effective in significantly reducing the risk of infection. The purpose of this article is to analyze the effect of public health interventions on respiratory tract infection-related visits to pediatric emergency departments during the COVID-19 pandemic in Taiwan. Method: Pediatric emergency department visits between January 1 2020 and April 30 2020 were included for trend analysis and compared to the same period during the past 3 years. The datasets were retrieved from Taiwan National Infectious Disease Statistics System and Kaohsiung Chang Gung Memorial Hospital. Respiratory tract infections with other diagnoses categories, including fever, asthma, and urinary tract infections, were included for subgroup analysis. Result: A significant decrease of more than 50% in respiratory tract infection-related visits was found from February to April 2020 in the national database. With regard to diagnosis category, the proportion of respiratory tract infections in Kaohsiung Chang Gung Hospital also became significantly lower in 2020 during the months of March (43.4 vs. 37.4%, p = 0.024) and April (40.1 vs. 32.2%, p < 0.001). On the other hand, the proportion of urinary tract infections was significantly higher in 2020 during March (3.7 vs. 5.2%, p = 0.033) and April (3.9 vs. 6.5%, p < 0.001), and that of asthma was also higher in April (1.6 vs. 2.6%, p = 0.025). Furthermore, the intensive care unit admission rate was relatively higher in 2020 from February, with significant differences noted in March (1.3 vs. 2.8%, p < 0.001). Conclusion: Due to public health interventions for the COVID-19 pandemic, the transmission of not only COVID-19 but also other air droplet transmitted diseases in children may have been effectively prevented. | Front Public Health | 2020 | LitCov and CORD-19 | |
| 6841 | Experiences and views of frontline healthcare workers' family members in the UK during the COVID-19 pandemic: a qualitative study BACKGROUND: The COVID-19 pandemic has had a well-documented negative impact on the mental health and wellbeing of frontline healthcare workers (HCWs). Whilst no research has to date been carried out to explore the challenges experienced by the families of HCWs, some previous research has been conducted with military families, demonstrating that family members of deployed military personnel may also be affected seriously and negatively. OBJECTIVES: This study aimed to explore the experiences, views, and mental health impact on frontline HCWs’ families during the COVID-19 pandemic in the UK and what support the families of frontline HCWs may need. METHOD: Close family members and friends of HCWs were interviewed. Transcripts were analysed in line with the principles of reflexive thematic analysis. RESULTS: We completed fourteen interviews with three siblings, one mother, one friend, and nine spouses of HCWs. Family members were highly motivated to support healthcare workers and felt an intense sense of pride in their work. However, they also experienced increased domestic responsibilities and emotional burden due to anxiety about their loved ones’ work. The fact that sacrifices made by family members were not noticed by society, the anxiety they felt about their family’s physical health, the impact of hearing about traumatic experiences, and the failure of healthcare organisations to meet the needs of the HCWs all negatively affected the family members. CONCLUSIONS: We have an ethical responsibility to attend to the experiences and needs of the families of healthcare professionals. This study emphasises the experiences and needs of family members of healthcare professionals, which have hitherto been missing from the literature. Further research is needed to hear from more parents, siblings and friends, partners in same sex relationships, as well as children of HCWs, to explore the variety of family members and supporters’ experiences more fully. HIGHLIGHTS: • COVID19 has impacted families of HCWs as well as workers themselves. They have experienced more anxiety, increased practical burden, significant physical health risks and been exposed vicariously to workers’ traumatic experiences. We must ensure HCW families are better supported | Eur J Psychotraumatol | 2022 | LitCov and CORD-19 | |
| 6842 | Smell and Taste Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis Abstract Objective To estimate the prevalence of olfactory and gustatory dysfunctions (OGDs) among patients infected with novel coronavirus disease 2019 (COVID-19). Patients and Methods A systematic review was conducted by searching MEDLINE, EMBASE, and the preprint server MedRxiv until 11 May 2020 using the terms ‘anosmia’ or ‘hyposmia’ or ‘dysosmia’ or ‘olfactory dysfunction’ or ‘olfaction disorder’ or ‘smell dysfunction’ or ‘ageusia’ or ‘hypogeusia’ or ‘dysgeusia’ or ‘taste dysfunction’ or ‘gustatory dysfunction’ or ‘neurological’ and ‘COVID-19’ or ‘2019 novel coronavirus’ or ‘2019-nCoV’ or ‘SARS-CoV-2’. References of included studies were also manually screened. Only studies involving diagnostic-confirmed patients with COVID-19 were included. Random-effects meta-analysis was performed. Results A total of twenty-four studies with data from 8438 test-confirmed COVID-19 patients from thirteen countries were included. The pooled proportion of patients presenting with olfactory and gustatory dysfunctions was 41.0% (95% confidence interval [CI] 28.5% to 53.9) and 38.2% (95% CI 24.0 to 53.6%), respectively. Increasing mean age correlated with lower prevalence of olfactory (coefficient = -0.076; p=.02) and gustatory (coefficient = -0.073; p=.03) dysfunctions. There was a higher prevalence of olfactory dysfunctions with the use of objective measurements compared to self-reports (coefficient = 2.33; p=.01). No significant moderation of the prevalence of OGDs by gender was observed. Conclusion There is a high prevalence of OGDs among patients infected with COVID-19. Routine screening for these conditions could contribute to improved case detection in the ongoing COVID-19 pandemic. However, to better inform population screening measures, further studies are needed to establish causality. | Mayo Clin Proc | 2020 | LitCov and CORD-19 | |
| 6843 | COVID-19-an opportunity to improve access to primary care through organizational innovations? A qualitative multiple case study in Quebec and Nova Scotia (Canada) N/A | BMC Health Serv Res | 2022 | LitCov | |
| 6844 | Finding potent inhibitors against SARS-CoV-2 main protease through virtual screening, ADMET and molecular dynamics simulation studies N/A | J Biomol Struct Dyn | 2022 | LitCov and CORD-19 | |
| 6845 | Computational design and modeling of nanobodies toward SARS-CoV-2 receptor binding domain The ongoing pandemic of coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has become a global health concern and pose a serious threat to humanity. There is an urgent need for developing therapeutic drugs and (or) biologics to prevent the spread of the virus. The life cycle of SARS‐CoV‐2 shows that the virus enters host cells by first binding to angiotensin‐converting enzyme 2 (ACE2) through its spike protein receptor‐binding domain (RBD). Therefore, blocking the binding between of ACE2 and SARS‐CoV‐2 RBD can inhibit the virus infection in the host cells. In this study, by grafting the complementarity‐determining regions (CDRs) of developed SARS‐CoV, MERS‐CoVs specific neutralizing antibodies (nAbs) include monoclonal antibodies (mAbs) as well as SARS‐CoV‐2 mAbs onto a known stable nanobody (Nb) scaffold, and a total of 16 Nbs sequences were designed. Five Nbs, namely CS01, CS02, CS03, CS10, and CS16, were selected based on the free energy landscape of protein docking verified by the recently reported Nb‐RBD cocrystal structures. CS01, CS02, and CS03 occupied the ACE2 binding site of RBD, while CS10 and CS16 were proposed to inhibit the interaction between RBD and ACE2 through an allosteric mechanism. Based on the structures of the five Nbs in complex with RBD, seven brand‐new Nbs with enhanced binding affinities (CS02_RD01, CS03_RD01, CS03_RD02, CS03_RD03, CS03_RD04, CS16_RD01, and CS16_RD02) were generated by redesign of residues on the interface of the five Nbs contact with SARS‐CoV‐2 RBD. In addition, the identified “hot spots” on the interface of each complex provide useful information to understand the binding mechanism of designed Nbs to SARS‐CoV‐2 RBD. In sum, the predicted stabilities and high binding affinities of the 11 (re)designed Nbs indicating the potential of the developed computational framework in this work to design effective agents to block the infection of SARS‐CoV‐2. | Chem Biol Drug Des | 2021 | LitCov and CORD-19 | |
| 6846 | Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19 patients from a tertiary center in India N/A | Monaldi Arch Chest Dis | 2020 | LitCov and CORD-19 | |
| 6847 | Engaging Third-Year Medical Students on Their Internal Medicine Clerkship in Telehealth During COVID-19 Purpose: Due to the coronavirus disease-19 (COVID-19) global pandemic, the Association of American Medical Colleges (AAMC) recommended that medical students be removed from contact with patients testing positive or patients under suspicion (PUIs) for COVID-19. As a result of Detroit being a highly affected area, the Wayne State University (WSU) medical students assigned to hospital clerkships during this time were essentially prevented from performing any direct patient care activities. A model for the Internal Medicine (IM) clerkship was developed incorporating a clinical telehealth component, in order to create a safe environment for students to continue to perform meaningful patient care. Objectives: To model a curriculum whereby students have a diverse patient care experience while increasing their skill and confidence in the performance of telehealth, as measured by self-report in a required pre- and post-clerkship assessment. Participant population: Twenty, third-year medical students at the end of their academic year, assigned to the IM clerkship at the Detroit Medical Center. Methods: Students were instructed to complete the American College of Physicians (ACP) module on telehealth, given an orientation via the Zoom online platform by clinical faculty, and placed on a weekly telehealth clinic schedule, precepted by residents and attendings in IM. Survey data was collected covering students’ knowledge, skills, and attitudes surrounding telehealth at the beginning of the rotation. A mid-clerkship feedback session was held with the clerkship director, and the resultant qualitative data was assessed for themes to be compared against the baseline assessment. Determination of incremental change between pre- and post-assessment reports will be evaluated at the completion of the clerkship, with that data forthcoming. Results: Baseline survey revealed that 90% of students believed the telemedicine experience would be a valuable addition to their IM clerkship. Most were confident that, with training, they could effectively complete a telemedicine visit and 80% felt that telehealth would play an important role in their future careers. Students were pleased with the telemedicine visit logistics and with their role in actively assisting patients with the Zoom online platform. Despite initial anxiety over effectively communicating with patients prior to beginning the telemedicine experience, students demonstrated a common trend towards comfort with that aspect of the visit. Students were impressed with the amount of guidance given by resident and attending physicians in expressing empathy via a virtual platform. Overall, students were pleased with the variety of cases seen and the prompt feedback they received from resident and attending physicians after the telemedicine encounters. At the midpoint assessment, students expressed satisfaction with the overall experience and appreciated the opportunity to continue interacting with patients despite the limitations the pandemic imposed. Conclusions: Little is formally taught about telehealth in either medical school or medical residency, and integration into a formal curriculum is rare. The AAMC is underway with the development of competencies for telehealth, and, once released, the teaching of this format will become an expectation. We successfully developed a robust model in which medical students not only actively participated in, but also actively delivered, telehealth care to our patients. | Cureus | 2020 | LitCov and CORD-19 | |
| 6848 | Serious complications in COVID-19 ARDS cases: pneumothorax, pneumomediastinum, subcutaneous emphysema and haemothorax The novel coronavirus identified as severe acute respiratory syndrome-coronavirus-2 causes acute respiratory distress syndrome (ARDS). Our aim in this study is to assess the incidence of life-threatening complications like pneumothorax, haemothorax, pneumomediastinum and subcutaneous emphysema, probable risk factors and effect on mortality in coronavirus disease-2019 (COVID-19) ARDS patients treated with mechanical ventilation (MV). Data from 96 adult patients admitted to the intensive care unit with COVID-19 ARDS diagnosis from 11 March to 31 July 2020 were retrospectively assessed. A total of 75 patients abiding by the study criteria were divided into two groups as the group developing ventilator-related barotrauma (BG) (N = 10) and the group not developing ventilator-related barotrauma (NBG) (N = 65). In 10 patients (13%), barotrauma findings occurred 22 ± 3.6 days after the onset of symptoms. The mortality rate was 40% in the BG-group, while it was 29% in the NBG-group with no statistical difference identified. The BG-group had longer intensive care admission duration, duration of time in prone position and total MV duration, with higher max positive end-expiratory pressure (PEEP) levels and lower min pO(2)/FiO(2) levels. The peak lactate dehydrogenase levels in blood were higher by statistically significant level in the BG-group (P < 0.05). The contribution of MV to alveolar injury caused by infection in COVID-19 ARDS patients may cause more frequent barotrauma compared to classic ARDS and this situation significantly increases the MV and intensive care admission durations of patients. In terms of reducing mortality and morbidity in these patients, MV treatment should be carefully maintained within the framework of lung-protective strategies and the studies researching barotrauma pathophysiology should be increased. | Epidemiol Infect | 2021 | LitCov and CORD-19 | |
| 6849 | Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic N/A | Acta Psychiatr Scand | 2020 | LitCov and CORD-19 | |
| 6850 | The Role of Telehealth in Reducing the Mental Health Burden from COVID-19 N/A | Telemed J E Health | 2020 | LitCov and CORD-19 |
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(3) Currently tweets of June 23rd to June 29th 2022 have been considered.