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 +===== COVID-19 Case Reports Abstracts - Page 2 =====
  
 +[[oa_db:​covid19_case_reports_abstracts|Back to Table of Contents]]
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 +<​b>​[56] Title: </​b>​First Mildly Ill, Non-Hospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States - Maricopa County, Arizona, 2020.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​106.33<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-02<​br>​
 +<​b>​Publisher:​ </​b>​Clinical Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Biological Sciences, covid-19, sars-cov-2, illness severity, serial testing, viral transmission,​ Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​http://​doi.org/​10.1093/​cid/​ciaa374">​http://​doi.org/​10.1093/​cid/​ciaa374</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, non-hospitalized COVID-19 case who traveled to China. METHODS: The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive specimens collected on January 22, 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (>/=10 minutes within 2 meters). Medium-risk contacts wore all U.S. Centers for Disease Control and Prevention (CDC)-recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2. RESULTS: Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), >/=1 specimen tested positive or indeterminate,​ and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative. CONCLUSIONS:​ This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[57] Title: </​b>​Preliminary case report on the SARS-CoV-2 cluster in the UK, France, and Spain<​br><​br>​
 +<​b>​Altmetric Score: </​b>​102.1<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-02-27<​br>​
 +<​b>​Publisher:​ </​b>​Swiss Medical Weekly<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​smw.ch/​article/​doi/​smw.2020.20212">​https://​smw.ch/​article/​doi/​smw.2020.20212</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Almost half of the confirmed COVID-19 cases detected so far in the United Kingdom are part of a large cluster of 13 British nationals who tested positive for SARS-CoV-2 in the UK, Spain, and France. Transmissions among this cluster occurred at a ski resort in France, and originated from a single infected traveller returning from a conference in Singapore where he acquired the virus. At least 21 individuals were exposed to the virus, tested, and quarantined,​ with 13 of those testing positive between the period of 6th February and 15th February. Here, all publicly available information about the primarily UK/France cluster is consolidated,​ providing a complete and accessible summary of the cases and their connections. Notable in this cluster are the number of individuals infected, the apparent absence of any severe illness among those infected, and a case of a "​delayed positive"​ test during isolation after initially testing negative, at least 7 days after last possible contact.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[58] Title: </​b>​Cerebrovascular Disease in COVID-19.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​101.75<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-14<​br>​
 +<​b>​Publisher:​ </​b>​American Journal of Neuroradiology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​http://​www.ajnr.org/​content/​early/​2020/​05/​14/​ajnr.A6588">​http://​www.ajnr.org/​content/​early/​2020/​05/​14/​ajnr.A6588</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Coronavirus disease 19 (COVID-19) is a pandemic originating in Wuhan, China, in December 2019. Early reports suggest that there are neurologic manifestations of COVID-19, including acute cerebrovascular disease. We report a case of COVID-19 with acute ischemic stroke. To our knowledge, this is the first reported case of COVID-19-related cerebral infarcts that includes brain imaging at multiple time points and CT angiography. There is a growing body of published evidence that complications of COVID-19 are not limited to the pulmonary system. Neuroradiologists should be aware of a wide range of neurologic manifestations,​ including cerebrovascular disease.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[59] Title: </​b>​Successful recovery of COVID-19 pneumonia in a renal transplant recipient with long-term immunosuppression.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​98.38<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-03-17<​br>​
 +<​b>​Publisher:​ </​b>​American Journal of Transplantation<​br>​
 +<​b>​Keywords:​ </​b>​Medical And Health Sciences, covid-19, coronavirus,​ immunosuppression,​ pneumonia, renal transplantation,​ Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1111/​ajt.15869">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1111/​ajt.15869</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +The current outbreak of Coronavirus Disease 2019 (COVID-19) has raised great concern worldwide, but its impact on transplant recipients is unknown. We report here the clinical features and therapeutic course of the first reported renal transplant recipient with confirmed COVID-19 pneumonia. This is a 52-year-old man who received kidney transplantation 12 years ago. His overall clinical characteristics (symptoms, laboratory examinations,​ and chest CT) were similar to those of non-transplanted COVID-19 patients. Following a treatment regimen consisting of reduced immunosuppressant use and low dose methylprednisolone-based therapy, the COVID-19 pneumonia in this long-term immunosuppressive patient was successfully recovered. This effectively treated case has reference value for the future treatment of other transplant patients with COVID-19 pneumonia.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[60] Title: </​b>​Diabetic Ketoacidosis in COVID-19: unique concerns and considerations.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​91.85<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-18<​br>​
 +<​b>​Publisher:​ </​b>​The Journal of Clinical Endocrinology & Metabolism<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Biochemistry,​ Genetics and Molecular Biology, Health Sciences, Life Sciences, Medicine<​br>​
 +<​b>​DOI:​ </​b><​a href="​http://​doi.org/​10.1210/​clinem/​dgaa360">​http://​doi.org/​10.1210/​clinem/​dgaa360</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +While individuals with diabetes appear to be at similar risk for SARS-CoV-2 infection than those without diabetes, they are more likely to suffer severe consequences,​ including death. Diabetic ketoacidosis (DKA) is a common and potentially lethal acute complication of diabetes arising from a relative insulin deficiency, which occurs more often in those with type 1 diabetes and in the setting of moderate to severe illness. Early reports indicate that among patients with preexisting diabetes, DKA may be a common complication of severe COVID-19 and a poor prognostic sign. This clinical perspective explores the key elements of caring for individuals with DKA during the COVID-19 pandemic through two cases. Topics addressed include diagnosis, triage, and the fundamental principles of treatment with a focus on the importance of characterizing DKA severity and medical complexity to determine the best approach. As discussed, some tenets of DKA management may require flexibility in the setting of COVID-19 due to important public health goals such as preventing transmission to highest risk individuals,​ reducing health care worker exposure to infected patients and preserving personal protective equipment (PPE). Evidence for alternative treatment strategies is explored with special attention placed on treatment options that may be more relevant during the pandemic including use of subcutaneous insulin therapy. Finally, DKA is often a preventable condition. We include evidence-based strategies and guidance designed to empower clinicians and patients to avoid this serious complication when possible.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[61] Title: </​b>​Detectable SARS-CoV-2 viral RNA in feces of three children during recovery period of COVID-19 pneumonia.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​89.03<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-15<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Medical Virology<​br>​
 +<​b>​Keywords:​ </​b>​Medical Microbiology,​ covid-19, sars-cov-2, children, clinical characteristics,​ Health Sciences, Life Sciences, Medicine, Immunology and Microbiology<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​jmv.25795">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​jmv.25795</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Coronavirus Disease 2019 (COVID-19) is a newly emerging infectious disease caused by a novel coronavirus,​ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After its first occurrence in Wuhan of China from December 2019, COVID-19 rapidly spread around the world. According to the World Health Organization statement on 13 March 2020, there had been over 132 500 confirmed cases globally. Nevertheless,​ the case reports of children are rare, which results in the lack of evidence for preventing and controlling of children'​s infection. Here, we report three cases of SARS-CoV-2 infected children diagnosed from 3 February to 17 February 2020 in Tianjin, China. All of these three cases experienced mild illness and recovered soon after the treatment, with the nucleic acid of throat swab turning negative within 14, 11, and 7 days after diagnosis, respectively. However, after been discharged, all three cases were tested SARS-CoV-2 positive in the stool samples within 10 days, in spite of their remained negative nucleic acid in throat swab specimens. Therefore, it is necessary to be aware of the possibility of fecal-oral transmission of SARS-CoV-2 infection, especially for children cases.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[62] Title: </​b>​Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​84.53<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-01<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Infection<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, covid-19, characteristics,​ cluster of youngsters, incubation period, infectivity,​ outside wuhan, prospective contact-tracing study, rapid transmission,​ Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0163445320301171">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0163445320301171</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: The outbreak of coronavirus-disease-2019 (COVID-19) has rapidly spread to many places outside Wuhan. Previous studies on COVID-19 mostly included older hospitalized-adults. Little information on infectivity among and characteristics of youngsters with COVID-19 is available. METHODS: A cluster of 22 close-contacts of a 22-year-old male (Patient-Index) including youngsters with laboratory-confirmed COVID-19 and hospitalized close-contacts testing negative for severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) in Anhui Province, China was prospectively-traced. RESULTS: Since January 23, 2020, we enrolled a cluster of eight youngsters with COVID-19 (median age [range], 22 [16-23] years; six males) originating from Patient-Index returning from Wuhan to Hefei on January 19. Patient-Index visited his 16-year-old female cousin in the evening on his return, and met 15 previous classmates in a get-together on January 21. He reported being totally asymptomatic and were described by all his contacts as healthy on January 19-21. His very first symptoms were itchy eyes and fever developed at noon and in the afternoon on January 22, respectively. Seven youngsters (his cousin and six classmates) became infected with COVID-19 after a-few-hour-contact with Patient-Index. None of the patients and contacts had visited Wuhan (except Patient-Index),​ or had any exposure to wet-markets,​ wild-animals,​ or medical-institutes within three months. For affected youngsters, the median incubation-period was 2 days (range, 1-4). The median serial-interval was 1 day (range, 0-4). Half or more of the eight COVID-19-infected youngsters had fever, cough, sputum production, nasal congestion, and fatigue on admission. All patients had mild conditions. Six patients developed pneumonia (all mild; one bilateral) on admission. As of February 20, four patients were discharged. CONCLUSIONS:​ SARS-CoV-2-infection presented strong infectivity during the incubation-period with rapid transmission in this cluster of youngsters outside Wuhan. COVID-19 developed in these youngsters had fast onset and various nonspecific atypical manifestations,​ and were much milder than in older patients as previously reported.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[63] Title: </​b>​Neuropathology of COVID-19: a spectrum of vascular and acute disseminated encephalomyelitis (ADEM)-like pathology.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​83.65<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-24<​br>​
 +<​b>​Publisher:​ </​b>​Acta Neuropathologica<​br>​
 +<​b>​Keywords:​ </​b>​Medicine & Public Health, covid-19, demyelinating,​ infarct, neuropathology,​ sars-cov-2, white matter, Health Sciences, Life Sciences, Medicine, Neuroscience<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​link.springer.com/​article/​10.1007/​s00401-020-02166-2">​https://​link.springer.com/​article/​10.1007/​s00401-020-02166-2</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We report the neuropathological findings of a patient who died from complications of COVID-19. The decedent was initially hospitalized for surgical management of underlying coronary artery disease. He developed post-operative complications and was evaluated with chest imaging studies. The chest computed tomography (CT) imaging results were indicative of COVID-19 and he was subsequently tested for SARS-CoV-2, which was positive. His condition worsened and he died after more than 2 weeks of hospitalization and aggressive treatment. The autopsy revealed a range of neuropathological lesions, with features resembling both vascular and demyelinating etiologies. Hemorrhagic white matter lesions were present throughout the cerebral hemispheres with surrounding axonal injury and macrophages. The subcortical white matter had scattered clusters of macrophages,​ a range of associated axonal injury, and a perivascular acute disseminated encephalomyelitis (ADEM)-like appearance. Additional white matter lesions included focal microscopic areas of necrosis with central loss of white matter and marked axonal injury. Rare neocortical organizing microscopic infarcts were also identified. Imaging and clinical reports have demonstrated central nervous system complications in patients'​ with COVID-19, but there is a gap in our understanding of the neuropathology. The lesions described in this case provide insight into the potential parainfectious processes affecting COVID-19 patients, which may direct clinical management and ongoing research into the disease. The clinical course of the patient also illustrates that during prolonged hospitalizations neurological complications of COVID may develop, which are particularly difficult to evaluate and appreciate in the critically ill.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[64] Title: </​b>​COVID-19 in teriflunomide-treated patients with multiple sclerosis.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​80.98<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-03<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Neurology<​br>​
 +<​b>​Keywords:​ </​b>​Medicine & Public Health, antiviral, covid-19, coronavirus,​ multiple sclerosis, teriflunomide,​ Health Sciences, Life Sciences, Medicine, Neuroscience<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​link.springer.com/​article/​10.1007/​s00415-020-09944-8">​https://​link.springer.com/​article/​10.1007/​s00415-020-09944-8</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +The outbreak of a severe acute respiratory syndrome caused by a novel coronavirus (COVID-19), has raised health concerns for patients with multiple sclerosis (MS) who are commonly on long-term immunotherapies. Managing MS during the pandemic remains challenging with little published experience and no evidence-based guidelines. We present five teriflunomide-treated patients with MS who subsequently developed active COVID-19 infection. The patients continued teriflunomide therapy and had self-limiting infection, without relapse of their MS. These observations have implications for the management of MS in the setting of the COVID-19 pandemic.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[65] Title: </​b>​Management of the first severe case of COVID-19 in the small islands of Maldives.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​78.85<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-01-01<​br>​
 +<​b>​Publisher:​ </​b>​Respiratory Medicine Case Reports<​br>​
 +<​b>​Keywords:​ </b>, <br>
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2213007120302082">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2213007120302082</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +The first cases of COVID19 in the Maldives was reported on 7th March 2020 with a total of 13 cases by 27th March from number of resort islands and were confined to the islands in which the cases were detected. This report describes the clinical course and management of the first severe case that required intensive care. Treatment strategy adopted was supportive and patient improved wit timely symptomatic management. This case highlights the importance of epidemiological surveillance and active case finding to detect and diagnose the case at an early stage for appropriate clinical management for positive outcomes in high risk groups.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[66] Title: </​b>​Gastrointestinal effects of an attempt to "​disinfect"​ from COVID-19.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​78.28<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-07<​br>​
 +<​b>​Publisher:​ </​b>​Histopathology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1111/​his.14137">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1111/​his.14137</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +In April 2020 during the COVID-19 pandemic, a 41-year-old female presented to the emergency department with recurrent vomiting and abdominal pain that had been ongoing on for two days and additional hematemesis for several hours. The past medical history was unremarkable,​ except for bariatric gastric bypass surgery performed in 2016. During detailed inquiry the patient reported, she had intentionally taken 10 ml of Ethanol-containing hand disinfectant orally per diem for a period of over three weeks in fear of being infected with COVID-19. The product had been obtained from a regular pharmacy and had been produced locally according to WHO standards for hand disinfectan. Upper gastrointestinal endoscopy was performed and showed superficial mucosal damage in the oesophagus (Figure 1A), slightly increased mucosal redness in the stomach and severely injured small bowel mucosa with extensive fibrinous exudates (Figure 2A).<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[67] Title: </​b>​Co-infection with SARS-CoV-2 and influenza A virus.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​77.09<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-01-01<​br>​
 +<​b>​Publisher:​ </​b>​IDCases<​br>​
 +<​b>​Keywords:​ </b>, covid-19, co-infection,​ influenza, sars-cov-2<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2214250920300834">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2214250920300834</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Coronavirus Disease 2019 (COVID-19) infection, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2),​ is spreading globally and poses a major public health threat. We reported a case of influenza A virus and SARS-CoV-2 co-infection. As the number of COVID-19 cases increase, it will be necessary to comprehensively evaluate imaging and other clinical findings as well as consider co-infection with other respiratory viruses.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[68] Title: </​b>​Guillain Barre syndrome associated with COVID-19 infection: A case report.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​76.55<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-01<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Clinical Neuroscience<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, covid-19, case report, guillain barre syndrome, neuropathy, novel coronavirus,​ Health Sciences, Life Sciences, Medicine, Neuroscience<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0967586820308821">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0967586820308821</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Novel outbreak with coronavirus 2019 began since 31 December 2019. Coronaviruses can cause multiple systemic infections that respiratory complications are the most obvious symptoms. In this report, we describe the symptoms of Guillain Barre syndrome (GBS) in one infected patient with COVID-19, for the first time. We reported a 65-years- old male patient with complaints of acute progressive symmetric ascending quadriparesis. Two weeks prior to hospitalization,​ the patient suffered from cough, fever, and RT-PCR was reported positive for COVID-19 infection. The electrodiagnostic test showed that the patient is an AMSAN variant of GBS. COVID-19 stimulates inflammatory cells and produces various inflammatory cytokines and as a result, it creates immune-mediated processes. GBS is an immune-mediated disorder and molecular mimicry as a mechanism of autoimmune disorder plays an important role in creating it. It is unclear whether COVID-19 induces the production of antibodies against specific gangliosides. Further investigations should be conducted about the mechanism of GBS in patients with COVID-19, in the future.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[69] Title: </​b>​Vitamin D: A simpler alternative to tocilizumab for trial in COVID-19?<​br><​br>​
 +<​b>​Altmetric Score: </​b>​75.9<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-07-01<​br>​
 +<​b>​Publisher:​ </​b>​Medical Hypotheses<​br>​
 +<​b>​Keywords:​ </​b>​Medical And Health Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0306987720305454">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0306987720305454</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +There is anecdotal evidence that tocilizumab,​ an immunosuppressant drug, may be a potential therapeutic option for patients with severe manifestations of coronavirus disease 2019 (COVID-19). Like tocilizumab,​ Vitamin D appears to modulate the activity of an interleukin (IL-6), which may explain the seasonal variation in prevalence of influenza. While most cases of COVID-19 have, thus far, occurred in the Northern Hemisphere winter, limiting the ability to assess seasonal variation, there remains substantial variation in the severity of this condition that has yet to be explained. A retrospective comparison of Vitamin D levels in previously obtained blood samples between survivors and confirmed fatalities could establish a rationale for implementation of widespread Vitamin D supplementation. This would be far cheaper and simpler than tocilizumab as a therapeutic option to trial.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[70] Title: </​b>​Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​74.65<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-01<​br>​
 +<​b>​Publisher:​ </​b>​International Journal of Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Microbiology,​ asymptomatic carrier, covid-19, incubation period, pneumonia, sars-cov-2, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1201971220301740">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1201971220301740</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +OBJECTIVES: With the ongoing outbreak of COVID-19 around the world, it has become a worldwide health concern. One previous study reported a family cluster with an asymptomatic transmission of COVID-19. Here, we report another series of cases and further demonstrate the repeatability of the transmission of COVID-19 by pre-symptomatic carriers. METHODS: A familial cluster of five patients associated with COVID-19 was enrolled in the hospital. We collected epidemiological and clinical characteristics,​ laboratory outcomes from electronic medical records, and also verified them with the patients and their families. RESULTS: Among them, three family members (Case 3/4/5) had returned from Wuhan. Additionally,​ two family members, those who had not traveled to Wuhan, also contracted COVID-19 after contacting with the other three family members. Case 1 developed severe pneumonia and was admitted to the ICU. Case 3 and Case 5 presented fever and cough on days two through three of hospitalization and had ground-glass opacity changes in their lungs. Case 4 presented with diarrhea and pharyngalgia after admission without radiographic abnormalities. Case 2 presented no clinical nor radiographic abnormalities. All five cases had an increasing level of C-reactive protein. CONCLUSIONS:​ Our findings indicate that COVID-19 can be transmitted by asymptomatic carriers during the incubation period.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[71] Title: </​b>​COVID-19 -associated Diffuse Leukoencephalopathy and Microhemorrhages.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​72.65<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-21<​br>​
 +<​b>​Publisher:​ </​b>​Radiological Society of North America<​br>​
 +<​b>​Keywords:​ </​b>​Medical And Health Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​pubs.rsna.org/​doi/​10.1148/​radiol.2020202040">​https://​pubs.rsna.org/​doi/​10.1148/​radiol.2020202040</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Coronavirus disease 2019 (COVID-19) has been reported in association with a variety of brain imaging findings such as ischemic infarct, hemorrhage, and acute hemorrhagic necrotizing encephalopathy. Here, we report brain imaging features in 11 critically ill COVID-19 patients with persistently depressed mental status who underwent MRI between April 5-25, 2020 at our institution. These features include, 1) Confluent T2 hyperintensity and mild restricted diffusion in bilateral supratentorial deep and subcortical white matter (in 10 of 11 patients), and 2) multiple punctate microhemorrhages in juxtacortical and callosal white matter (in 7 of 11 patients). We also discuss potential pathogeneses.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[72] Title: </b>A 55-Day-Old Female Infant Infected With 2019 Novel Coronavirus Disease: Presenting With Pneumonia, Liver Injury, and Heart Damage.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​69.1<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-03-17<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Medical And Health Sciences, covid-19 pneumonia, heart damage, liver injury, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​http://​doi.org/​10.1093/​infdis/​jiaa113">​http://​doi.org/​10.1093/​infdis/​jiaa113</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were mainly based on information from adult populations. Limited data are available for children with COVID-19, especially for infected infants. METHODS: We report a 55-day-old case with COVID-19 confirmed in China and describe the identification,​ diagnosis, clinical course, and treatment of the patient, including the disease progression from day 7 to day 11 of illness. RESULTS: This case highlights that children with COVID-19 can also present with multiple organ damage and rapid disease changes. CONCLUSIONS:​ When managing such infant patients with COVID-19, frequent and careful clinical monitoring is essential.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[73] Title: </​b>​Implications for Online Management: Two Cases with COVID-19.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​66.93<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-01<​br>​
 +<​b>​Publisher:​ </​b>​Telemedicine Journal (now called Telemedicine Journal and e-Health)<​br>​
 +<​b>​Keywords:​ </​b>​Biomedical Engineering,​ e-health, multidisciplinary collaboration,​ novel coronavirus pneumonia, online management, quarantine, self-management,​ telemedicine,​ Medicine, Health Professions,​ Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​www.liebertpub.com/​doi/​10.1089/​tmj.2020.0066">​https://​www.liebertpub.com/​doi/​10.1089/​tmj.2020.0066</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Satisfactory outcome was observed in one mild case and one severe case of COVID-19 pneumonia after the use of the online/​offline multidisciplinary quarantine observation form, online monitoring, and classified diagnosis and treatment, as well as strict compliance with quarantine measures. Conditions of both patients were improved, and cross-infection and disease onset clustering were not observed. The multidisciplinary self-quarantine model provides early judgment, identification,​ and treatment of disease, improves compliance with early rehabilitation,​ increases confidence in recovery, and enhances self-management capabilities. This model is applicable to the current novel coronavirus pneumonia epidemic and can actively promote the management of suspected or confirmed mild cases, monitoring of critical cases, and self-management of discharged patients. The application of this new management model is worthy of being promoted in our specialized treatment facilities and in countries with severe epidemics.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[74] Title: </​b>​Awake tracheal intubation in a suspected COVID-19 patient with critical airway obstruction.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​66.43<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-04<​br>​
 +<​b>​Publisher:​ </​b>​Anaesthesia Reports<​br>​
 +<​b>​Keywords:​ </b>, covid-19, aerosolisation,​ airway obstruction,​ awake tracheal intubation<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​anr3.12041">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​anr3.12041</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We report the airway management of a patient with suspected COVID-19 with impending airway obstruction requiring urgent surgical tracheostomy. To our knowledge, this is the first reported case of an awake tracheal intubation in a suspected COVID-19-positive patient. Various modifications were put in place during the awake tracheal intubation and surgical tracheostomy procedures to minimise aerosol generation from the patient, such as avoiding high-flow nasal oxygen, establishing conscious sedation with remifentanil before commencing airway topicalisation and avoiding transtracheal local anaesthetic infiltration. A multidisciplinary team discussion before performing the case highlighted aspects of both the airway management and the surgical procedure where particular care and modifications are required. There is a lack of national and international guidance for awake tracheal intubation and tracheostomy in COVID-19 cases. This report nevertheless addresses the key procedural modifications required.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[75] Title: </​b>​Severe SARS-CoV-2 Infection in Children With Suspected Acute Abdomen: A Case Series From a Tertiary Hospital in Spain.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​65.5<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-26<​br>​
 +<​b>​Publisher:​ </​b>​The Pediatric Infectious Disease Journal<​br>​
 +<​b>​Keywords:​ </​b>​Paediatrics And Reproductive Medicine, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​journals.lww.com/​pidj/​Abstract/​9000/​Severe_SARS_CoV_2_Infection_in_Children_With.96141.aspx">​https://​journals.lww.com/​pidj/​Abstract/​9000/​Severe_SARS_CoV_2_Infection_in_Children_With.96141.aspx</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We describe 5 children with severe SARS-CoV-2 infection, hemodynamic instability and suspected acute abdomen. This form of the disease has not been previously documented. Four of the cases were confirmed SARS-CoV-2 infection and 1 probable. All of them were previously healthy and needed a pediatric critical care unit admission. The respiratory symptoms were not dominant or were absent. Also, fever was observed. Laboratory testing revealed lymphopenia and high levels of C-reactive protein and procalcitonin with D-dimer, ferritin and interleukin-6 usually elevated. Respiratory support and inotropic support were almost always necessary. In all of them, deterioration occurred on the day of admission.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[76] Title: </b>A Case of Novel Coronavirus Disease 19 in a Chronic Hemodialysis Patient Presenting with Gastroenteritis and Developing Severe Pulmonary Disease.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​64.8<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-03-28<​br>​
 +<​b>​Publisher:​ </​b>​American Journal of Nephrology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, acute respiratory distress syndrome, end-stage renal disease, novel coronavirus disease 19, rennin-angiotensin-aldosterone system blockade, viral sepsis, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​www.karger.com/​Article/​FullText/​507417">​https://​www.karger.com/​Article/​FullText/​507417</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Novel coronavirus disease 2019 (COVID-19) is a highly infectious, rapidly spreading viral disease with an alarming case fatality rate up to 5%. The risk factors for severe presentations are concentrated in patients with chronic kidney disease, particularly patients with end-stage renal disease (ESRD) who are dialysis dependent. We report the first US case of a 56-year-old nondiabetic male with ESRD secondary to IgA nephropathy undergoing thrice-weekly maintenance hemodialysis for 3 years, who developed COVID-19 infection. He has hypertension controlled with angiotensin receptor blocker losartan 100 mg/day and coronary artery disease status-post stent placement. During the first 5 days of his febrile disease, he presented to an urgent care, 3 emergency rooms, 1 cardiology clinic, and 2 dialysis centers in California and Utah. During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infection until he developed respiratory symptoms and was admitted to the hospital. Imaging studies upon admission were consistent with bilateral interstitial pneumonia. He was placed in droplet-eye precautions while awaiting COVID-19 test results. Within the first 24 h, he deteriorated quickly and developed acute respiratory distress syndrome (ARDS), requiring intubation and increasing respiratory support. Losartan was withheld due to hypotension and septic shock. COVID-19 was reported positive on hospital day 3. He remained in critical condition being treated with hydroxychloroquine and tocilizumab in addition to the standard medical management for septic shock and ARDS. Our case is unique in its atypical initial presentation and highlights the importance of early testing.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[77] Title: </​b>​Coronavirus disease (COVID-19) in a paucisymptomatic patient: epidemiological and clinical challenge in settings with limited community transmission,​ Italy, February 2020.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​64.45<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-03-19<​br>​
 +<​b>​Publisher:​ </​b>​Eurosurveillance<​br>​
 +<​b>​Keywords:​ </b>, covid-19, italy, paucisymptomatic case, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​www.eurosurveillance.org/​content/​10.2807/​1560-7917.ES.2020.25.11.2000230">​https://​www.eurosurveillance.org/​content/​10.2807/​1560-7917.ES.2020.25.11.2000230</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Data concerning the transmission of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) in paucisymptomatic patients are lacking. We report an Italian paucisymptomatic case of coronavirus disease 2019 with multiple biological samples positive for SARS-CoV-2. This case was detected using the World Health Organization protocol on cases and contact investigation. Current discharge criteria and the impact of extra-pulmonary SARS-CoV-2 samples are discussed.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[78] Title: </​b>​COVID-19 in a patient with long-term use of glucocorticoids:​ A study of a familial cluster.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​61.38<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-01<​br>​
 +<​b>​Publisher:​ </​b>​Clinical Immunology<​br>​
 +<​b>​Keywords:​ </​b>​Immunology,​ atypical infection, covid-19, familial cluster, immunocompromised,​ incubation period, shedding duration, Health Sciences, Life Sciences, Medicine, Immunology and Microbiology<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1521661620302059">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1521661620302059</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Clusters of patients with novel coronavirus disease 2019 (COVID-19) have been successively reported globally. Studies show clear person-to-person transmission. The average incubation period is 2-14 days, and mostly 3-7 days. However, in some patients, this period may be longer. Here, we report a familial cluster of COVID-19 where a 47-year-old woman with long-term use of glucocorticoids did not develop any symptoms within the 14-day quarantine period but was confirmed with COVID-19 by tested positive of antibody on day 40 after she left Wuhan. Almost at the same time, her father and sister were diagnosed with COVID-19. The results suggest that the long-term use of glucocorticoids might cause atypical infections, a long incubation period, and extra transmission of COVID-19.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[79] Title: </​b>​The Imperfect Cytokine Storm: Severe COVID-19 with ARDS in Patient on Durable LVAD Support.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​61<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-01<​br>​
 +<​b>​Publisher:​ </​b>​JACC:​ Case Reports<​br>​
 +<​b>​Keywords:​ </b>, ards, ards, acute respiratory distress syndrome, covid-19, lvad, lvad, left ventricular assist device, mods, multiorgan dysfunction syndrome, ovid-19, coronavirus disease 2019, pea, pulseless electrical activity, pi event, pulsatility index event, rv, right ventricle, sars-cov-2, severe acute respiratory syndrome coronavirus 2, cytokine storm<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2666084920303314">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2666084920303314</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +As health systems worldwide grapple with the COVID-19 pandemic, patients on durable LVAD support represent a unique population at risk for the disease. We outline such a patient who developed COVID-19 complicated by "​cytokine storm" with severe ARDS and myocardial injury; and describe the challenges that arose during management.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[80] Title: </​b>​Coronavirus Disease 2019 (COVID-19) Pneumonia in a Hemodialysis Patient.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​60.33<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-01<​br>​
 +<​b>​Publisher:​ </​b>​Kidney Medicine<​br>​
 +<​b>​Keywords:​ </b>, coronavirus disease 2019 (covid-19), epidemic, hemodialysis,​ lopinavir/​ritonavir,​ severe acute respiratory syndrome coronavirus 2 virus (sars-cov-2)<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2590059520300492">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2590059520300492</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Coronavirus disease 2019 (COVID-19) is a highly infective disease caused by the severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2). Previous studies of the COVID-19 pneumonia outbreak were based on information from the general population. Limited data are available for hemodialysis patients with COVID-19 pneumonia. This report describes the clinical characteristics of COVID-19 in an in-center hemodialysis patient, as well as our experience in implementing steps to prevent the spread of COVID-19 pneumonia among in-center hemodialysis patients. The diagnosis, infection control, and treatment of COVID-19 in hemodialysis patients are discussed in this report, and we conclude with recommendations for how a dialysis facility can respond to COVID-19 based on our experiences.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[81] Title: </​b>​SARS-CoV-2 infection diagnosed only by cell culture isolation before the local outbreak in an Italian seven-week-old suckling baby.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​58.75<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-07-01<​br>​
 +<​b>​Publisher:​ </​b>​International Journal of Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Microbiology,​ covid-19, cell culture, diagnosis, sars-cov-2, suckling baby, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1201971220303428">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1201971220303428</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +SARS-CoV-2 emerged in China in December 2019 and has now been declared a pandemic by the World Health Organization. This paper described the case of a 7-week-old suckling baby from Italy who was SARS-CoV-2-positive only by the cell culture method, with no clinical suspicion of and/or risk factors for SARS-CoV-2 infection. The baby was referred to hospital, with signs and symptoms of upper respiratory tract infection, before the virus had spread to the province. Nasal and pharyngeal swabs and a nasopharyngeal aspirate were used for conventional and molecular diagnostic assays not including the SARS-CoV-2 virus. Bacteria referred to the resident population were revealed in nasal and pharyngeal swabs. No viruses were detected using both immunofluorescence assay and nucleic acid amplification assays in the nasopharyngeal aspirate. The baby was discharged in good condition after 3 days of hospitalisation. Later, a cytopathic effect on the cell monolayers currently used for respiratory viruses was observed and the viral particles were identified as Coronaviridae by transmission electron microscopy. SARS-CoV-2 was identified by RT-PCR performed both on cell culture and on the stored aliquot of the original sample. The virus isolate was named SARS-Cov-2/​human/​Parma/​1/​2020. Cell culture still remains the only reference diagnostic method also for emerging viruses, allowing it to reveal cytopathogenic viruses and demonstrate their infectivity.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[82] Title: </​b>​Rhabdomyolysis as Potential Late Complication Associated with COVID-19.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​58.38<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-07-01<​br>​
 +<​b>​Publisher:​ </​b>​Emerging Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Medical Microbiology,​ 2019 novel coronavirus disease, covid-19, china, sars-cov-2, wuhan, respiratory diseases, rhabdomyolysis,​ severe acute respiratory syndrome coronavirus 2, viruses, zoonoses, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​wwwnc.cdc.gov/​eid/​article/​26/​7/​20-0445_article">​https://​wwwnc.cdc.gov/​eid/​article/​26/​7/​20-0445_article</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We describe a patient in Wuhan, China, with severe acute respiratory syndrome coronavirus 2 infection who had progressive pulmonary lesions and rhabdomyolysis with manifestations of lower limb pain and fatigue. Rapid clinical recognition of rhabdomyolysis symptoms in patients with severe acute respiratory syndrome coronavirus 2 infection can be lifesaving.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[83] Title: </​b>​The first case of COVID-19 treated with the complement C3 inhibitor AMY-101.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​57.6<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-01<​br>​
 +<​b>​Publisher:​ </​b>​Clinical Immunology<​br>​
 +<​b>​Keywords:​ </​b>​Immunology,​ , Health Sciences, Life Sciences, Medicine, Immunology and Microbiology<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1521661620303314">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1521661620303314</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Acute respiratory distress syndrome (ARDS) is a devastating clinical manifestation of COVID-19 pneumonia and is mainly based on an immune-driven pathology. Mounting evidence suggests that COVID-19 is fueled by a maladaptive host inflammatory response that involves excessive activation of innate immune pathways. While a "​cytokine storm" involving IL-6 and other cytokines has been documented, complement C3 activation has been implicated as an initial effector mechanism that exacerbates lung injury in preclinical models of SARS-CoV infection. C3-targeted intervention may provide broader therapeutic control of complement-mediated inflammatory damage in COVID-19 patients. Herein, we report the clinical course of a patient with severe ARDS due to COVID-19 pneumonia who was safely and successfully treated with the compstatin-based complement C3 inhibitor AMY-101.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[84] Title: </​b>​Asymptomatic and Human-to-Human Transmission of SARS-CoV-2 in a 2-Family Cluster, Xuzhou, China.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​57.18<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-07-01<​br>​
 +<​b>​Publisher:​ </​b>​Emerging Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Medical Microbiology,​ 2019 novel coronavirus disease, covid-19, china, sars-cov-2, xuzhou, asymptomatic transmission,​ close contact, familial cluster, nosocomial transmission,​ respiratory infections, severe acute respiratory syndrome coronavirus 2, viruses, zoonoses, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​wwwnc.cdc.gov/​eid/​404.html?​aspxerrorpath=/​eid/​article/​26/​7/​20-0718_article">​https://​wwwnc.cdc.gov/​eid/​404.html?​aspxerrorpath=/​eid/​article/​26/​7/​20-0718_article</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We report epidemiologic,​ laboratory, and clinical findings for 7 patients with 2019 novel coronavirus disease in a 2-family cluster. Our study confirms asymptomatic and human-to-human transmission through close contacts in familial and hospital settings. These findings might also serve as a practical reference for clinical diagnosis and medical treatment.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[85] Title: </​b>​Report of EEG Finding on Critically Ill Patients with COVID-19.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​57.05<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-13<​br>​
 +<​b>​Publisher:​ </​b>​Annals of Neurology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Health Sciences, Life Sciences, Medicine, Neuroscience<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​ana.25814">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​ana.25814</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +In March 2020, we treated a cohort of 26 critically ill hospitalized SARS-CoV-2 infected patients who received EEGs to assess unexplained altered mental status, loss of consciousness,​ or poor arousal and responsiveness. Of the 26 patients studied, 5 patients had EEGs that showed Periodic Discharges (PD) consisting of high amplitude frontal monomorphic delta waves with absence of epileptic activity. These findings may suggest CNS injury potentially related to COVID-19 in these patients. This article is protected by copyright. All rights reserved.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[86] Title: </​b>​The First Case of 2019 Novel Coronavirus Pneumonia Imported into Korea from Wuhan, China: Implication for Infection Prevention and Control Measures.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​56.15<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-01-01<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Korean Medical Science<​br>​
 +<​b>​Keywords:​ </b>, 2019-ncov, coronavirus,​ outbreak, pneumonia, radiography,​ Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​jkms.org/​DOIx.php?​id=10.3346/​jkms.2020.35.e61">​https://​jkms.org/​DOIx.php?​id=10.3346/​jkms.2020.35.e61</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +In December 2019, a viral pneumonia outbreak caused by a novel betacoronavirus,​ the 2019 novel coronavirus (2019-nCoV),​ began in Wuhan, China. We report the epidemiological and clinical features of the first patient with 2019-nCoV pneumonia imported into Korea from Wuhan. This report suggests that in the early phase of 2019-nCoV pneumonia, chest radiography would miss patients with pneumonia and highlights taking travel history is of paramount importance for early detection and isolation of 2019-nCoV cases.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[87] Title: </​b>​Does recombinant human erythropoietin administration in critically ill COVID-19 patients have miraculous therapeutic effects?<​br><​br>​
 +<​b>​Altmetric Score: </​b>​55.5<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-19<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Medical Virology<​br>​
 +<​b>​Keywords:​ </​b>​Medical Microbiology,​ covid-19, acute respiratory distress syndrome, cytokine, erythropoietin,​ Health Sciences, Life Sciences, Medicine, Immunology and Microbiology<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​jmv.25839">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​jmv.25839</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +An 80-year-old man with multiple comorbidities presented to the emergency department with tachypnea, tachycardia,​ fever, and critically low O2 saturation and definitive chest computerized tomography scan findings in favor of COVID-19 and positive PCR results in 48 hours. He received antiviral treatment plus recombinant human erythropoietin (rhEPO) due to his severe anemia. After 7 days of treatment, he was discharged with miraculous improvement in his symptoms and hemoglobin level. We concluded that rhEPO could attenuate respiratory distress syndrome and confront the severe acute respiratory syndrome coronavirus 2 virus through multiple mechanisms including cytokine modulation, antiapoptotic effects, leukocyte release from bone marrow, and iron redistribution away from the intracellular virus.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[88] Title: </​b>​[Pregnancy with new coronavirus infection: clinical characteristics and placental pathological analysis of three cases].<​br><​br>​
 +<​b>​Altmetric Score: </​b>​54.85<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-03-01<​br>​
 +<​b>​Publisher:​ </​b>​Zhonghua bing li xue za zhi Chinese journal of pathology<​br>​
 +<​b>​Keywords:​ </b>, 2019-ncov, clinical characteristic,​ placental pathology, pneumonia, pregnant women, vertical transmission,​ Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​http://​journal.yiigle.com/​PartnerAdmin/​HttpError/​NotFound">​http://​journal.yiigle.com/​PartnerAdmin/​HttpError/​NotFound</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Objective: To investigate the clinical characteristics and placental pathology of 2019-nCoV infection in pregnancy,​and to evaluate intrauterine vertical transmission potential of 2019-nCoV infection. Methods: The placentas delivered from pregnant women with confirmed 2019-nCoV infection which were received in the Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology by February 4, 2020 were retrospectively studied. Their clinical material including placental tissue and lung CT, and laboratory results were collected, meanwhile, nucleic acid detection of 2019-nCoV of the placentas were performed by RT-PCR. Results: Three placentas delivered from pregnant women with confirmed 2019-nCoV infection, who were all in their third trimester with emergency caesarean section. All of the three patients presented with fever (one before caesarean and two in postpartum),​ and had no significant leukopenia and lymphopenia. Neonatal throat swabs from three newborns were tested for 2019-nCoV, and all samples were negative for the nucleic acid of 2019-nCoV. One premature infant was transferred to Department of Neonatology due to low birth weight. By the end of February 25, 2020, none of the three patients developed severe 2019-nCoV pneumonia or died(two patients had been cured and discharged, while another one had been transferred to a square cabin hospital for isolation treatment). There were various degrees of fibrin deposition inside and around the villi with local syncytial nodule increases in all three placentas. One case of placenta showed the concomitant morphology of chorionic hemangioma and another one with massive placental infarction. No pathological change of villitis and chorioamnionitis was observed in our observation of three cases. All samples from three placentas were negative for the nucleic acid of 2019-nCoV. Conclusions:​ The clinical characteristics of pregnant women with 2019-nCoV infection in late pregnancy are similar to those of non-pregnant patients, and no severe adverse pregnancy outcome is found in the 3 cases of our observation. Pathological study suggests that there are no morphological changes related to infection in the three placentas. Currently no evidence for intrauterine vertical transmission of 2019-nCoV is found in the three women infected by 2019-nCoV in their late pregnancy.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[89] Title: </b>A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​54.45<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-02-28<​br>​
 +<​b>​Publisher:​ </​b>​Clinical Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Biological Sciences, pregnant woman, preterm delivery, sars-cov-2, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​http://​doi.org/​10.1093/​cid/​ciaa200">​http://​doi.org/​10.1093/​cid/​ciaa200</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We presented a case of a 30-week pregnant woman with COVID-19 delivering a healthy baby with no evidence of COVID-19.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[90] Title: </​b>​COVID-19 tsunami: the first case of a spinal cord injury patient in Italy.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​54.05<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-17<​br>​
 +<​b>​Publisher:​ </​b>​Spinal Cord Series and Cases<​br>​
 +<​b>​Keywords:​ </b>, <br>
 +<​b>​DOI:​ </​b><​a href="​https://​www.nature.com/​articles/​s41394-020-0274-9">​https://​www.nature.com/​articles/​s41394-020-0274-9</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +INTRODUCTION:​ We present the report of the first, to our best knowledge, case of COVID-19 in a tetraplegic person. CASE PRESENTATION:​ A 56-year-old male with AIS A C4 tetraplegia developed fever during the night, without any prodrome. His general practitioner suspected a urinary tract infection and prescribed him antibiotic therapy. After 2 days of antibiotic therapy the fever still persisted, so the individual was admitted to the local hospital and treated with broad-spectrum antibiotics. After 2 days he was transferred to our spinal unit. Considering the worsening of the chest X-ray and fever despite 48 h of broad-spectrum antibiotic therapy, we strongly suspected viral pneumonia. SARS-CoV-2 was detected and antiviral therapy with Lopinavir/​Ritonavir,​ associated with hydroxychloroquine,​ was promptly started. Fever ceased after 2 days of therapy. DISCUSSION: Blood test and chest X-ray findings in this patient were similar to previously published findings regarding COVID-19. One difference between this case and the known clinical course of COVID-19 is that did not develop cough. Another interesting feature of our case is that, despite tetraplegia,​ the clinical course was not severe. Persons with COVID-19 remain asymptomatic,​ these results underscore the need for rehabilitation and SCI professionals to have a high index of suspicion for COVID-19 in their inpatient and outpatient clients. Only inpatient with fever hase being tested for COVID-19. All new patients are submitted to SARS-COV-2 Test. Moreover, routine testing of patients who have to participate in therapy in common gym areas may be warranted.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[91] Title: </​b>​Delayed Initiation of Remdesivir in a COVID-19-Positive Patient.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​53.95<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-20<​br>​
 +<​b>​Publisher:​ </​b>​Pharmacotherapy<​br>​
 +<​b>​Keywords:​ </​b>​Pharmacology And Pharmaceutical Sciences, covid-19, sars-cov-2, coronavirus,​ pneumonia, remdesivir, viral pneumonia, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​phar.2403">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​phar.2403</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We present a case of late initiation of remdesivir antiviral therapy in the successful treatment of a patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a mixed medical intensive care unit of a community teaching hospital. A previously healthy 40-year-old man was admitted to the hospital 3 days after the onset of coronavirus disease 2019 (COVID-19) symptoms including dry cough, fever, and shortness of breath progressing to intubation and increased mechanical ventilator support. A request for compassionate use remdesivir was submitted on the same hospital day as the positive COVID-19 polymerase chain reaction result. Supportive measures, in addition to a 5-day course of hydroxychloroquine,​ were maintained until remdesivir could be supplied on day 9 of hospitalization,​ 13 days after symptom onset. Sixty hours after initiating remdesivir, the patient was successfully extubated and able to transition to room air within 24 hours of extubation. Late initiation of remdesivir may be effective in treating SARS-CoV-2, unlike antivirals utilized for different disease states, such as oseltamivir,​ that are most effective when started as soon as possible following symptom onset. Urgent action is needed by regulatory agencies to work with drug manufacturers to expedite the study and approval of investigational agents targeting SARS-CoV-2 as well as to meet manufacturing demands.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[92] Title: </​b>​Spectrum of Imaging Findings on Chest Radiographs,​ US, CT, and MRI Images in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​53<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-25<​br>​
 +<​b>​Publisher:​ </​b>​Radiological Society of North America<​br>​
 +<​b>​Keywords:​ </​b>​Medical And Health Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​pubs.rsna.org/​doi/​10.1148/​radiol.2020202543">​https://​pubs.rsna.org/​doi/​10.1148/​radiol.2020202543</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +This case series examines the spectrum of imaging findings on chest radiographs,​ US, CT, and MRI images in 35 children admitted to a tertiary pediatric hospital in April-May 2020 with a post COVID-19 inflammatory condition known as multisystem inflammatory syndrome in children (MIS-C). The constellation of findings includes airway inflammation and rapid development of pulmonary edema on thoracic imaging, coronary artery aneurysms, and extensive right iliac fossa inflammatory changes on abdominal imaging. Awareness of this emerging condition and the expected multi-organ imaging findings will aid radiologists in the assessment of these complex cases.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[93] Title: </​b>​Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​52.25<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-25<​br>​
 +<​b>​Publisher:​ </​b>​JAMA Dermatology<​br>​
 +<​b>​Keywords:​ </b>, <br>
 +<​b>​DOI:​ </​b><​a href="​http://​doi.org/​10.1001/​jamadermatol.2020.2340">​http://​doi.org/​10.1001/​jamadermatol.2020.2340</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Importance: A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently been identified as the cause of a pandemic called coronavirus disease 2019 (COVID-19). In this context, some associated skin diseases have been described. Cutaneous lesions referred to as acute acro-ischemia have been reported as a possible sign of COVID-19 in adolescents and children. Objective: To evaluate the pathogenesis of these newly described acute acral lesions. Design, Setting, and Participants:​ This prospective case series was conducted at La Fe University Hospital, a tertiary referral hospital in Valencia, Spain, between April 9 and April 15, 2020. Among 32 referred patients, 20 children and adolescents with new-onset inflammatory lesions did not have a diagnosis. Exposures: Patients were not exposed to any drug or other intervention. Main Outcomes and Measures: We performed reverse transcriptase-polymerase chain reaction for SARS-CoV-2 and a range of blood tests for possible origins of the lesions. Skin biopsies were performed in 6 patients. Results: Of the 20 patients enrolled, 7 were female and 13 were male, with an age range of 1 to 18 years. Clinical findings fit into the following patterns: acral erythema (6 patients), dactylitis (4 patients), purpuric maculopapules (7 patients), and a mixed pattern (3 patients). None of the patients had remarkable hematologic or serologic abnormalities,​ including negative antibodies to SARS-CoV-2. Biopsies performed in 6 patients showed histologic findings characteristic of perniosis. Conclusions and Relevance: The clinical, histologic, and laboratory test results were compatible with a diagnosis of perniosis, and no evidence was found to support the implication of SARS-CoV-2 infection.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[94] Title: </​b>​Case report of COVID-19 in a kidney transplant recipient: Does immunosuppression alter the clinical presentation?<​br><​br>​
 +<​b>​Altmetric Score: </​b>​50.83<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-09<​br>​
 +<​b>​Publisher:​ </​b>​American Journal of Transplantation<​br>​
 +<​b>​Keywords:​ </​b>​Medical And Health Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​resolve/​doi?​DOI=10.1111/​ajt.15874">​https://​onlinelibrary.wiley.com/​resolve/​doi?​DOI=10.1111/​ajt.15874</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +COVID-19 is novel infectious disease with an evolving understanding of its epidemiology and clinical manifestations. Immunocompromised patients often present atypical presentations of viral diseases. Herein we report a case of a COVID-19 infection in a solid organ transplant recipient, in which the first clinical symptoms were of gastrointestinal viral disease and fever, which further progressed to respiratory symptoms in 48 hours. In these high risk populations,​ protocols for screening for SARS-Cov2 may be needed to be re-evaluated.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[95] Title: </​b>​COVID-19 in a MS patient treated with ocrelizumab:​ does immunosuppression have a protective role?<​br><​br>​
 +<​b>​Altmetric Score: </​b>​50.45<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-07-01<​br>​
 +<​b>​Publisher:​ </​b>​Multiple Sclerosis and Related Disorders<​br>​
 +<​b>​Keywords:​ </b>, <br>
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2211034820301978">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2211034820301978</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: Coronavirus disease 19 (COVID-19) is a novel disease entity that is spreading throughout the world. It has been speculated that patients with comorbidities and elderly patients could be at high risk for respiratory insufficiency and death. Immunosuppression could expose infected patients to even higher risks of disease complications due to dampened immune response. However, it has been speculated that overactive immune response could drive clinical deterioration and, based on this hypothesis, several immunosuppressants are currently being tested as potential treatment for COVID-19. METHODS: In this paper we report on a patient that has been treated with ocrelizumab (a B-cell depleting monoclonal antibody) for primary progressive multiple sclerosis who developed COVID-19. RESULTS: Despite complete B cell depletion, patient symptoms abated few days after hospitalization,​ and he was discharged to home-quarantine. Phone interview follow-up confirmed that, after 14 days, no new symptoms occurred. DISCUSSION: This report supports the putative role of immunosuppressive therapy in COVID-19 affected patients.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[96] Title: </b>A COVID-19 Transmission within a family cluster by presymptomatic infectors in China.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​49.23<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-03-23<​br>​
 +<​b>​Publisher:​ </​b>​Clinical Infectious Diseases<​br>​
 +<​b>​Keywords:​ </​b>​Biological Sciences, covid19, family cluster, presymptomatic infectors, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​http://​doi.org/​10.1093/​cid/​ciaa316">​http://​doi.org/​10.1093/​cid/​ciaa316</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We report a COVID-19 family cluster caused by a presymptomatic case. There were 9 family members, including 8 laboratory-confirmed with COVID-19, and a 6-year-old child had no evidence of infection. Amongst the 8 patients, one adult and one 13-month-old infant were asymptomatic,​ one adult was diagnosed as having severe pneumonia.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[97] Title: </​b>​Bilateral transient olfactory bulbs edema during COVID-19-related anosmia.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​48.05<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-22<​br>​
 +<​b>​Publisher:​ </​b>​Neurology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​n.neurology.org/​content/​early/​2020/​05/​22/​WNL.0000000000009850">​https://​n.neurology.org/​content/​early/​2020/​05/​22/​WNL.0000000000009850</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +An asymptomatic 27-year-old physician is diagnosed SARS-CoV-2 by occupational medicine after contagion (RT-PCR).<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[98] Title: </​b>​Two cases of coronavirus 2019-related cardiomyopathy in pregnancy.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​44.6<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-01<​br>​
 +<​b>​Publisher:​ </​b>​American Journal of Obstetrics & Gynecology MFM<​br>​
 +<​b>​Keywords:​ </b>, covid-19, cardiomyopathy,​ novel coronavirus,​ pregnancy<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2589933320300434">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S2589933320300434</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +At our institution,​ 2 of the initial 7 pregnant patients with confirmed coronavirus disease 2019 severe infection (28.6%; 95% CI, 8.2%-64.1%) developed cardiac dysfunction with moderately reduced left ventricular ejection fractions of 40%-45% and hypokinesis. Viral myocarditis and cardiomyopathy have also been reported in nonpregnant coronavirus disease 2019 patients. A case series of nonpregnant patients with coronavirus disease 2019 found that 33% of those in intensive care developed cardiomyopathy. More data are needed to ascertain the incidence of cardiomyopathy from coronavirus disease 2019 in pregnancy, in all pregnant women with coronavirus disease 2019, and those with severe disease (eg, pneumonia). We suggest an echocardiogram in pregnant women with coronavirus disease 2019 pneumonia, in particular those necessitating oxygen, or those who are critically ill, and we recommend the use of handheld, point-of-care devices where possible to minimize contamination of staff and traditional large echocardiogram machines.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[99] Title: </​b>​Ultrastructural Evidence for Direct Renal Infection with SARS-CoV-2.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​43.09<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-05<​br>​
 +<​b>​Publisher:​ </​b>​Journal of the American Society of Nephrology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, covid-19, sars-cov-2, acute kidney failure, autopsy, electron microscopy, renal pathology, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​jasn.asnjournals.org/​content/​early/​2020/​05/​05/​ASN.2020040432">​https://​jasn.asnjournals.org/​content/​early/​2020/​05/​05/​ASN.2020040432</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: A significant fraction of patients with coronavirus disease 2019 (COVID-19) display abnormalities in renal function. Retrospective studies of patients hospitalized with COVID-19 in Wuhan, China, report an incidence of 3%-7% progressing to ARF, a marker of poor prognosis. The cause of the renal failure in COVID-19 is unknown, but one hypothesized mechanism is direct renal infection by the causative virus, SARS-CoV-2. METHODS: We performed an autopsy on a single patient who died of COVID-19 after open repair of an aortic dissection, complicated by hypoxic respiratory failure and oliguric renal failure. We used light and electron microscopy to examine renal tissue for evidence of SARS-CoV-2 within renal cells. RESULTS: Light microscopy of proximal tubules showed geographic isometric vacuolization,​ corresponding to a focus of tubules with abundant intracellular viral arrays. Individual viruses averaged 76 microm in diameter and had an envelope studded with crown-like, electron-dense spikes. Vacuoles contained double-membrane vesicles suggestive of partially assembled virus. CONCLUSIONS:​ The presence of viral particles in the renal tubular epithelium that were morphologically identical to SARS-CoV-2, and with viral arrays and other features of virus assembly, provide evidence of a productive direct infection of the kidney by SARS-CoV-2. This finding offers confirmatory evidence that direct renal infection occurs in the setting of AKI in COVID-19. However, the frequency and clinical significance of direct infection in COVID-19 is unclear. Tubular isometric vacuolization observed with light microscopy, which correlates with double-membrane vesicles containing vacuoles observed with electronic microscopy, may be a useful histologic marker for active SARS-CoV-2 infection in kidney biopsy or autopsy specimens.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[100] Title: </​b>​COVID-19 Associated Hepatitis Complicating Recent Living Donor Liver Transplantation.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​42.85<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-04-17<​br>​
 +<​b>​Publisher:​ </​b>​Archives of Pathology & Laboratory Medicine<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Medicine, Health Professions,​ Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​www.archivesofpathology.org/​doi/​10.5858/​arpa.2020-0186-SA">​https://​www.archivesofpathology.org/​doi/​10.5858/​arpa.2020-0186-SA</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +We present a case of COVID-19 hepatitis in a living donor liver allograft recipient whose donor subsequently tested positive for COVID-19. The patient is a female infant with biliary atresia (failed Kasai procedure). She recovered well, with improving liver function tests for 4 days. On post-operative day (POD) 4 the patient developed respiratory distress and fever. COVID-19 testing (polymerase chain reaction) was positive. Liver function tests increased approximately 5-fold. Liver biopsy showed moderate acute hepatitis with prominent clusters of apoptotic hepatocytes and associated cellular debris. Lobular lymphohistiocytic inflammation was noted. Typical portal features of mild to moderate acute cellular rejection were also noted.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[101] Title: </​b>​Bedside Focused Cardiac Ultrasound in COVID-19 from the Wuhan Epicenter: The Role of Cardiac Point-of-Care Ultrasound, Limited Transthoracic Echocardiography,​ and Critical Care Echocardiography.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​42.25<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-01<​br>​
 +<​b>​Publisher:​ </​b>​Journal of the American Society of Echocardiography (Online)<​br>​
 +<​b>​Keywords:​ </​b>​Cardiovascular Medicine And Haematology,​ covid-19 infection, critical care echocardiography,​ focused cardiac ultrasound, limited transthoracic echocardiography,​ point-of-care ultrasound, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0894731720302157">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0894731720302157</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: Three cases of the application of focused cardiac ultrasound in patients with coronavirus disease 2019 are presented. METHODS: Cardiac point-of-care ultrasound, limited transthoracic echocardiography,​ and critical care echocardiography were applied in cases of heart failure, pulmonary embolism, and myocarditis with thrombus respectively. RESULTS: The impact on patient management and the global context of each presentation are discussed. CONCLUSIONS:​ Focused cardiac point-of-care ultrasound played an important, front-line role in the bedside management of patients during the COVID-19 pandemic in Wuhan, China.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[102] Title: </​b>​Virus Isolation from the First Patient with SARS-CoV-2 in Korea.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​42.08<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-01-01<​br>​
 +<​b>​Publisher:​ </​b>​Journal of Korean Medical Science<​br>​
 +<​b>​Keywords:​ </b>, 2019 novel coronavirus,​ culture, korea, microscopy, electron, phylogeny, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​jkms.org/​DOIx.php?​id=10.3346/​jkms.2020.35.e84">​https://​jkms.org/​DOIx.php?​id=10.3346/​jkms.2020.35.e84</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Novel coronavirus (SARS-CoV-2) is found to cause a large outbreak started from Wuhan since December 2019 in China and SARS-CoV-2 infections have been reported with epidemiological linkage to China in 25 countries until now. We isolated SARS-CoV-2 from the oropharyngeal sample obtained from the patient with the first laboratory-confirmed SARS-CoV-2 infection in Korea. Cytopathic effects of SARS-CoV-2 in the Vero cell cultures were confluent 3 days after the first blind passage of the sample. Coronavirus was confirmed with spherical particle having a fringe reminiscent of crown on transmission electron microscopy. Phylogenetic analyses of whole genome sequences showed that it clustered with other SARS-CoV-2 reported from Wuhan.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[103] Title: </​b>​Steroid-Responsive Encephalitis in Coronavirus Disease 2019.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​41.4<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-09<​br>​
 +<​b>​Publisher:​ </​b>​Annals of Neurology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, , Health Sciences, Life Sciences, Medicine, Neuroscience<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​ana.25783">​https://​onlinelibrary.wiley.com/​doi/​abs/​10.1002/​ana.25783</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory distress. Here, we described the case of a 60-year-old patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS-CoV-2, positive for pleocytosis and hyperproteinorrachia,​ and showed increased interleukin-8 and tumor necrosis factor-alpha concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high-dose steroid treatment, thus arguing for an inflammatory-mediated brain involvement related to COVID-19. ANN NEUROL 2020.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[104] Title: </​b>​AKI and Collapsing Glomerulopathy Associated with COVID-19 and APOL 1 High-Risk Genotype.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​40.45<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-19<​br>​
 +<​b>​Publisher:​ </​b>​Journal of the American Society of Nephrology<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, apol1, covid-19, sars-cov-2, collapsing glomerulopathy,​ kidney biopsy, nephrotic, Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​jasn.asnjournals.org/​content/​early/​2020/​06/​18/​ASN.2020050558">​https://​jasn.asnjournals.org/​content/​early/​2020/​06/​18/​ASN.2020050558</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: Kidney involvement is a feature of COVID-19 and it can be severe in black patients. Previous research linked increased susceptibility to collapsing glomerulopathy,​ including in patients with HIV-associated nephropathy,​ to apo L1 (APOL1) variants that are more common in those of African descent. METHODS: To investigate genetic, histopathologic,​ and molecular features in six black patients with COVID-19 presenting with AKI and de novo nephrotic-range proteinuria,​ we obtained biopsied kidney tissue, which was examined by in situ hybridization for viral detection and by NanoString for COVID-19 and acute tubular injury-associated genes. We also collected peripheral blood for APOL1 genotyping. RESULTS: This case series included six black patients with COVID-19 (four men, two women), mean age 55 years. At biopsy day, mean serum creatinine was 6.5 mg/dl and mean urine protein-creatinine ratio was 11.5 g. Kidney biopsy specimens showed collapsing glomerulopathy,​ extensive foot process effacement, and focal/​diffuse acute tubular injury. Three patients had endothelial reticular aggregates. We found no evidence of viral particles or SARS-CoV-2 RNA. NanoString showed elevated chemokine gene expression and changes in expression of genes associated with acute tubular injury compared with controls. All six patients had an APOL1 high-risk genotype. Five patients needed dialysis (two of whom died); one partially recovered without dialysis. CONCLUSIONS:​ Collapsing glomerulopathy in black patients with COVID-19 was associated with high-risk APOL1 variants. We found no direct viral infection in the kidneys, suggesting a possible alternative mechanism: a "​two-hit"​ combination of genetic predisposition and cytokine-mediated host response to SARS-CoV-2 infection. Given this entity'​s resemblance with HIV-associated nephropathy,​ we propose the term COVID-19-associated nephropathy to describe it.<​br>​
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 +<​b>​[105] Title: </​b>​Pulmonary embolism in cases of COVID-19.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​39.3<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-06<​br>​
 +<​b>​Publisher:​ </​b>​Tidsskrift for den Norske l槥forening tidsskrift for praktisk medicin ny r櫫e<​br>​
 +<​b>​Keywords:​ </b>, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​tidsskriftet.no/​2020/​05/​kort-kasuistikk/​lungeembolisme-ved-covid-19">​https://​tidsskriftet.no/​2020/​05/​kort-kasuistikk/​lungeembolisme-ved-covid-19</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: Emerging reports indicate a high incidence of venous thromboembolism in patients hospitalised for SARS-CoV-2 pneumonia during the spring 2020 pandemic. The pronounced pulmonary and systemic inflammatory responses observed in these patients may contribute to a transient hypercoagulable state. In this setting, pulmonary embolism may cause further respiratory distress and clinical deterioration. CASE PRESENTATION:​ We describe the clinical course of three patients admitted with SARS-CoV-2 infection and respiratory distress, where pulmonary embolism was detected during the course of the hospitalisation. Two of the cases occurred despite early institution of standard dosage of low molecular weight heparin thromboprophylaxis,​ and in one case, pulmonary embolism was diagnosed during the convalescent phase of an otherwise benign COVID-19 disease course. INTERPRETATION:​ These cases highlight the importance of awareness of the potentially increased incidence of venous thromboembolism in COVID-19 disease. Further research is required to establish appropriate clinical management guidelines for prevention of thromboembolic complications in COVID-19.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[106] Title: </​b>​Focal status epilepticus as unique clinical feature of COVID-19: A case report.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​38.55<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-05-01<​br>​
 +<​b>​Publisher:​ </​b>​Seizure<​br>​
 +<​b>​Keywords:​ </​b>​Neurosciences,​ covid-19, epilepsy, sars-cov-2, status epilepticus,​ viral infections, Health Sciences, Life Sciences, Medicine, Neuroscience<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1059131120301151">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S1059131120301151</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +SARS-CoV-2, a novel zoonotic coronavirus,​ is currently spreading all over the world, causing a pandemic disease defined coronavirus disease 2019 (COVID-19). The spectrum of COVID-19 ranges from asymptomatic or mild infection to rapidly progressive,​ acute respiratory distress syndrome and death [1].To the best of our knowledge, status epilepticus has never been described as initial presentation of COVID-19. We report a patient affected by COVID-19 whose primary presentation was a focal status epilepticus.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[107] Title: </​b>​COVID-19 infection in kidney transplant recipients.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​38.03<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-01<​br>​
 +<​b>​Publisher:​ </​b>​Kidney International<​br>​
 +<​b>​Keywords:​ </​b>​Clinical Sciences, covid-19, sars-cov-2 infection, immunosuppression,​ kidney transplantation,​ Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0085253820303616">​https://​linkinghub.elsevier.com/​retrieve/​pii/​S0085253820303616</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +By 21 March 2020 infections related to the novel coronavirus SARS-CoV-2 had affected people from 177 countries and caused 11,252 reported deaths worldwide. Little is known about risk, presentation and outcomes of SARS-CoV-2 (COVID-19) infection in kidney transplantation recipients, who may be at high-risk due to long-term immunosuppression,​ comorbidity and residual chronic kidney disease. Whilst COVID-19 is predominantly a respiratory disease, in severe cases it can cause kidney and multi-organ failure. It is unknown if immunocompromised hosts are at higher risk of more severe systemic disease. Therefore, we report on seven cases of COVID-19 in kidney transplant recipients (median age 54 (range 45-69), three females, from a cohort of 2082 managed transplant follow-up patients) over a six-week period in three south London hospitals. Two of seven patients presented within three months of transplantation. Overall, two were managed on an out-patient basis, but the remaining five required hospital admission, four in intensive care units. All patients displayed respiratory symptoms and fever. Other common clinical features included hypoxia, chest crepitation,​ lymphopenia and high C-reactive protein. Very high D dimer, ferritin and troponin levels occurred in severe cases and likely prognostic. Immunosuppression was modified in six of seven patients. Three patients with severe disease were diabetic. During a three week follow up one patient recovered, and one patient died. Thus, our findings suggest COVID-19 infection in kidney transplant patients may be severe, requiring intensive care admission. The symptoms are predominantly respiratory and associated with fever. Most patients had their immunosuppression reduced and were treated with supportive therapy.<​br>​
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 +----------------------------------------------------------------------<​br>​
 +<​b>​[108] Title: </​b>​Cardiac MRI of Children with Multisystem Inflammatory Syndrome (MIS-C) Associated with COVID-19: Case Series.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​37.6<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-06-09<​br>​
 +<​b>​Publisher:​ </​b>​Radiological Society of North America<​br>​
 +<​b>​Keywords:​ </​b>​Medical And Health Sciences, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​pubs.rsna.org/​doi/​10.1148/​radiol.2020202288">​https://​pubs.rsna.org/​doi/​10.1148/​radiol.2020202288</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +This case series examines cardiac MRI findings in four children and adolescents admitted to intensive care in April 2020 for multisystem inflammatory syndrome and Kawasaki disease-like features related to COVID-19. Acute myocarditis occurred less than 1 week after onset of fever and gastrointestinal symptoms. Physical examination showed rash and cheilitis/​conjunctivitis. All patients recovered after intravenous immunoglobulin therapy. SARS-CoV-2 RT-PCR was negative on nasopharyngeal,​ stool, and respiratory samples and was positive on serology. Cardiac MRI showed diffuse myocardial edema on T2-STIR sequences and native-T1 mapping, with no evidence of late gadolinium enhancement suggestive of replacement fibrosis or focal necrosis. These findings favor post-infectious myocarditis in children and adolescents with COVID-19.<​br>​
 +----------------------------------------------------------------------<​br><​br>​
 +----------------------------------------------------------------------<​br>​
 +<​b>​[109] Title: </b>A man in his nineties with fever and dry cough.<​br><​br>​
 +<​b>​Altmetric Score: </​b>​37.4<​br>​
 +<​b>​Pub_Date:​ </​b>​2020-01-01<​br>​
 +<​b>​Publisher:​ </​b>​Tidsskrift for den Norske l槥forening tidsskrift for praktisk medicin ny r櫫e<​br>​
 +<​b>​Keywords:​ </b>, , Medicine, Health Sciences<​br>​
 +<​b>​DOI:​ </​b><​a href="​https://​tidsskriftet.no/​2020/​03/​noe-laere-av/​en-mann-i-90-arene-med-feber-og-torrhoste">​https://​tidsskriftet.no/​2020/​03/​noe-laere-av/​en-mann-i-90-arene-med-feber-og-torrhoste</​a><​br><​br>​
 +<​b>​Abstract:​ </b>
 +BACKGROUND: COVID-19 can cause a fatal outcome in elderly patients, as this case report illustrates. CASE PRESENTATION:​ An active male in his nineties with a high level of function, despite several severe chronic diseases, was admitted to Oslo University Hospital after two days of fatigue, fever, dyspnoea and dry cough. He scored qSOFA 1 of 3 points due to high respiratory rate, and SIRS 2 of 4 points due to high respiratory rate and fever of 39.4 masculine C. PCR for influenza virus was negative and he received benzylpenicillin for pneumonia. The chest X-ray taken initially showed no lung affection. On day 5 after symptom debut he was tested for COVID-19 which was positive. He had not been travelling to high-risk areas or been exposed to any known confirmed COVID-19 patients. On the same day, a chest CT scan was performed that showed ground-glass opacities. In subsequent days the patient'​s health rapidly deteriorated. He developed irreversible respiratory failure with hypoxia without hypercapnia despite substantial oxygen support. Chest X-ray taken on disease day 7 showed progression of consolidations. The patient died 9 days after symptom debut. INTERPRETATION:​ This case illustrates a severe course of COVID-19 with fatal outcome. The patient was also one of the earliest admitted with COVID-19 in a Norwegian hospital and marked a new phase of the epidemic, as he had not been travelling to high-risk areas or been exposed to any confirmed COVID-19 patients.<​br>​
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 +
 +</​html>​
oa_db/covid19_case_reports_abstracts_pg2.txt · Last modified: 2020/06/28 03:06 by bpwhite