From the New England Journal of Medicine:

Neuropathological features of COVID-19: “In conclusion, histopathological examination of brain specimens obtained from 18 patients who died 0 to 32 days after the onset of symptoms of COVID-19 [coronavirus disease 2019] showed only hypoxic changes and did not show encephalitis or other specific brain changes referable to the virus. There was no cytoplasmic viral staining on immunohistochemical analysis. The virus was detected at low levels in 6 brain sections obtained from 5 patients; these levels were not consistently related to the interval from the onset of symptoms to death. Positive tests may have been due to in situ virions or viral RNA from blood.” OPEN ACCESS at

Spread of SARS-CoV-2 in the Icelandic population: “Most persons in the targeted-testing group who received positive tests early in the study had recently traveled internationally, in contrast to those who tested positive later in the study. Children under 10 years of age were less likely to receive a positive result than were persons 10 years of age or older, with percentages of 6.7% and 13.7%, respectively, for targeted testing; in the population screening, no child under 10 years of age had a positive result, as compared with 0.8% of those 10 years of age or older. Fewer females than males received positive results both in targeted testing (11.0% vs. 16.7%) and in population screening (0.6% vs. 0.9%). The haplotypes of the sequenced SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] viruses were diverse and changed over time. The percentage of infected participants that was determined through population screening remained stable for the 20-day duration of screening.” OPEN ACCESS at


Emergency department patients in the early months of the coronavirus disease 2019 (COVID-19) pandemic—what have we learned: “The early months of the COVID-19 pandemic in the US demonstrate that ED care-seeking behavior is sensitive to an array of external factors … The pace at which ED visits return to pre-pandemic levels will be partially tied to how politicians, policy makers, and administrators unwind pandemic response decisions and partially tied to patient preferences for ED care. Enduring anxiety associated with the perceived risks of contracting COVID-19 and lasting access to on-demand substitutes for ED visits, such as telehealth visits, can be expected to influence where the public seeks care for acute needs for the foreseeable future.” OPEN ACCESS at

Monoclonal antibodies for prevention and treatment of COVID-19: “Neutralizing antibodies have an important role in the protection or recovery from many viral infections. Several monoclonal antibody products will enter clinical trials over the next few months and be assessed for their ability to limit or modify SARS-CoV-2 infection. In addition, a drug that reliably prevented progression of COVID-19 would greatly reduce the concerns and uncertainty associated with SARS-CoV-2 infection and give physicians a therapeutic tool they must have for their patients. Establishing the therapeutic or prophylactic efficacy of monoclonal antibodies would be a major advance in the control of the COVID-19 pandemic.” OPEN ACCESS at

Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2: “In this case series of hospitalized children who met criteria for PIMS-TS, there was a wide spectrum of presenting signs and symptoms and disease severity, ranging from fever and inflammation to myocardial injury, shock, and development of coronary artery aneurysms. The comparison with patients with KD [Kawasaki disease] and KD shock syndrome provides insights into this syndrome, and suggests this disorder differs from other pediatric inflammatory entities.” OPEN ACCESS at

From the BMJ

Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: “Before a safe and effective vaccine becomes available, healthcare professionals remain susceptible to COVID-19. Despite being at high risk of exposure, study participants were appropriately protected and did not contract infection or develop protective immunity against SARS-CoV-2. Healthcare systems must give priority to the procurement and distribution of personal protective equipment, and provide adequate training to healthcare professionals in its use.” OPEN ACCESS at

Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: “Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.” OPEN ACCESS at

There is no stopping COVID-19 without stopping racism: “We urge all physicians and public health experts to take a firm stance against racism. We urge that we as a community use our understanding of the science and transmission of COVID-19 to protect those who choose to protest peacefully against racism by guiding them with the information necessary to minimise viral transmission. We urge our institutions to make every effort to ensure that our fight against racism within our own walls is transparent; that racist actions and words are seen, heard, and dismantled; that racist people are held to account; that efforts against racism are actively studied and taught as part of our life-long learning in medicine; that power structures that are based on racist ideologies are taken down and replaced; that people from ethnic minorities are treated with the utmost respect, equity, and justice — including in their promotions to positions of leadership; and that patients from ethnic minorities are no longer killed by racism that has haunted medicine since its inception as a field. There is so much work to be done.” OPEN ACCESS at

From the Lancet

Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: “Consistent with previous modelling studies and country-specific COVID-19 responses to date, our analysis estimated that a high proportion of cases would need to self-isolate and a high proportion of their contacts to be successfully traced to ensure an effective reproduction number lower than 1 in the absence of other measures. If combined with moderate physical distancing measures, self-isolation and contact tracing would be more likely to achieve control of severe acute respiratory syndrome coronavirus 2 transmission.” OPEN ACCESS at

GM-CSF blockade with mavrilimumab in severe COVID-19 pneumonia and systemic hyperinflammation: “We aimed to examine whether mavrilimumab, an anti-granulocyte–macrophage colony-stimulating factor receptor-α monoclonal antibody, added to standard management, improves clinical outcomes in patients with COVID-19 pneumonia and systemic hyperinflammation. Between March 17 and April 15, 2020, 13 non-mechanically ventilated patients received mavrilimumab and 26 patients in the control group received standard care. Mavrilimumab treatment was associated with improved clinical outcomes compared with standard care in non-mechanically ventilated patients with severe COVID-19 pneumonia and systemic hyperinflammation. Treatment was well tolerated. Confirmation of efficacy requires controlled testing.” OPEN ACCESS at

Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: “About one in five individuals worldwide could be at increased risk of severe COVID-19, should they become infected, due to underlying health conditions, but this risk varies considerably by age. Our estimates are uncertain, and focus on underlying conditions rather than other risk factors such as ethnicity, socioeconomic deprivation, and obesity, but provide a starting point for considering the number of individuals that might need to be shielded or vaccinated as the global pandemic unfolds.” OPEN ACCESS at

From the MJA

Mental health of people in Australia in the first month of COVID-19 restrictions: “In the first month of restrictions, clinically-significant depressive and generalised anxiety symptoms, thoughts of being better off dead or of self-harm, and irritability were at least double those in non-COVID affected populations. In addition, one in four had mild to moderate symptoms. The most vulnerable people had lost jobs, lived alone or in poorly-resourced areas, were providing care to dependent family members, were members of marginalised minorities, women or young. The implications: A public mental health approach which includes, universal, selective and indicated strategies in health and non-health sector is needed urgently for recovery.” OPEN ACCESS at

Recovery from the pandemic: Evidence-based public policy to safeguard Australian health: “Beyond stimulus for decarbonisation, investments in affordable housing, mass transit infrastructure, safe routes for walking and cycling, regeneration of degraded ecosystems and infrastructure to support working from home would also benefit health through reduced homelessness, improved levels of physical activity and improved urban air quality. Australia has been successful in controlling the pandemic because of evidence-based decision making. It is essential that decisions about the stimulus for economic recovery are similarly grounded in evidence. The health and wellbeing of current and future generations of Australians depends on it.” OPEN ACCESS at

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