Symptoms and Biomarkers of Long Covid in People Living with and without Hiv

Background: HIV is a risk factor for severe acute COVID-19, but it is unknown whether HIV is a risk factor for long COVID. Method(s): We conducted a prospective observational cohort study of US adults with HIV (PWH) and HIV-seronegative adults with first SARS-CoV-2 infection within 4 weeks together with people who never had COVID-19. At enrollment, participants recalled the presence and severity of 49 long COVID-associated symptoms in the month prior to COVID-19. The same symptom survey was administered at 1, 2, 4, and 6 months post-COVID or post-enrollment for never- COVID participants. Post-COVID participants donated blood 1 and 4 months post-COVID, and never-COVID participants donated blood 0-1 times. Antibody titers to 18 coronavirus antigens and levels of 30 cytokines and hormones were quantified (Meso Scale Discovery). The Mann Whitney U test was used to compare continuous variables between groups, and Pearson's chi-squared test for categorical variables. Spearman correlation analyses were used to build networks of associations between cytokines and symptoms. Result(s): 341 participants enrolled between June 2021 and September 2022. Of these, 73 were PWH post-COVID, 121 were HIV-seronegative post-COVID, 78 were PWH never-COVID, and 69 were HIV-seronegative never-COVID. Over 85% of participants were vaccinated prior to COVID-19. Most participants with HIV were male sex at birth (83% post-COVID, 59% never-COVID), on ART ( >95%), with median CD4 counts >500. Over 60% of participants reported 1+ new or worsened symptoms 2-6 months post-COVID, with higher percentages in PWH at 2 months post-COVID (p< 0.05). PWH were more likely to report body ache, pain, confusion, memory problems, and thirst and had higher levels of creatine phosphokinase post-COVID than HIV-seronegative people. SARS-CoV-2 and non-SARS human coronavirus antibody titers did not differ between PWH and HIV-seronegative post-COVID participants. Cytokine associations with each other (network density) were significantly enriched at 1 month post-COVID in both PWH and HIV-seronegative people, with significantly less enrichment at 4 months post-COVID and in never- COVID participants. Levels of four analytes (cortisol, C5a, TGF-beta1, and TIM-3) associated with specific symptoms of long COVID. Conclusion(s): PWH may experience more symptoms post-COVID with a slightly different symptom profile than people without HIV. Inflammatory networks were active in PWH and people without HIV at 1 month post-COVID.

Research on Mask Wearing Recognition Based on Deep Learning

Since the outbreak of COVID-19 epidemic, research results have shown that the COVID-19 transmitted by droplets, and the most effective means of epidemic prevention is to wear masks. In public places where crowds gather, it is particularly important to use technical means to detect the situation of wearing masks, and remind people to wear masks in time to prevent cross-infection. This paper mainly starts with the target detection and tracking technology in the field of computer vision, and takes the recognition of whether to wear a mask as the entry point. Using python as the development tool, based on the convolutional neural network, the YOLOv2 algorithm is used as the core algorithm, and the ResNet50 network structure is built. Compared with other existing system test experiments, we can see that the system we built has better detection performance. © 2022 Association for Computing Machinery.

The growth, adventitious bud formation, bioactive flavonoid production, antioxidant response, and cryptochrome-mediated light signal transduction in Isatis tinctoria L. hairy root cultures exposed to LED lights

The root of Isatis tinctoria L. is highly appreciated as a Traditional Chinese herbal medicine for the prevention and adjuvant treatment of respiratory diseases caused by coronaviruses viruses such as SARS and COVID-19. I. tinctoria hairy root cultures (ITHRCs) provide a better alternative to field cultivation for the production of antiviral flavonoids. For the first time, ITHRCs were exposed to different colors of LED lights i.e., red, green, blue, red/green/blue (1/1/1, RGB), and white, in an attempt to promote the root growth and enhance the production of bioactive flavonoids. Results revealed that the biomass productivity (7.15 ± 0.63 g/L) in ITHRCs with an initial inoculum size of 0.2% cultured for 50 days under blue light increased by 1.86-fold relative to that under dark (control), and yields of rutin (320.49 ± 27.56 μg/g DW), quercetin (388.75 ± 9.17 μg/g DW), kaempferol (787.90 ± 83.43 μg/g DW), and isorhamnetin (269.11 ± 20.08 μg/g DW) increased by 4.15-fold, 9.31-fold, 9.09-fold, and 2.88-fold as compared with control, respectively. Interestingly, the emergence of adventitious buds was noticed in ITHRCs under all light treatments. Additionally, the enhanced densities of chloroplasts and root hairs were found in blue-light grown ITHRCs as against control, which might account for the elevated biomass productivity. Moreover, blue light induced oxidative stress in ITHRCs in terms of the overproduction of oxidation products and the enhancement of antioxidant enzyme activity. Furthermore, blue light significantly activated photoreceptor (CRY1) and key regulator of light signaling (HY5), thus leading to the up-regulated expression of MYB4 and structural genes (such as CHS and FLS) responsible for flavonoid biosynthesis. And, the transcriptional activation of CUC1 was likely related to the formation of adventitious buds in ITHRCs. Overall, the simple supplementation of blue LED light makes ITHRCs more attractive as plant factories for obtaining higher productivity of biomass and medicinally important flavonoids. © 2023 Elsevier B.V.

[Epidemiological characteristics of an epidemic of 2019-nCoV Omicron variant infection in Beijing].

Objective: To analyze the epidemiological characteristics and transmission chain of an epidemic of COVID-19 in Haidian district, Beijing. Methods: Descriptive epidemiological method was used to analyze the epidemiological characteristics of the epidemic, and field investigation and big data technology were used to analyze the transmission chain of the epidemic. Results: From April 27 to May 13, 2022, an epidemic of COVID-19 occurred in Haidian district. The strains isolated from the cases were identified by whole genome sequencing as Omicron variant (BA.2.2 evolutionary branch). A total of 38 infection cases were detected, including 34 confirmed cases and 4 asymptomatic cases. Most cases were mild ones (88.2%), no severe, critical or death cases occurred. The early clinical symptoms were mainly sore throat (50.0%) and cough (29.4%). The epidemic lasted for 17 days, resulting in 7 generations of the cases and involving 3 community transmissions, 2 working place transmissions and 8 family transmissions; the main infection routes were co-residence (47.6%) and co-space exposure (31.6%). The intergenerational interval M(Q1, Q3)was 3 (1, 6) days. The overall secondary attack rate was 1.5% (37/2 482), and the family secondary attack rate was 36.7% (18/49). Conclusions: The cases in this COVID-19 epidemic caused by Omicron variant had mild clinical symptoms, but the case clustering in families and communities was obvious, the transmission was rapid, and the risk for co-space exposure was high. It is necessary to use information technology to identify close contacts in the local population for the rapid and effective blocking of the epidemic spread.

Hydrophobic RuO2/Graphene/N-doped porous carbon hybrid catalyst for Li-air batteries operating in ambient air

Li–air batteries have received significant attention for their ultrahigh theoretical energy density. However, the byproducts induced by attacking air hinder the conversion of Li–O2 batteries to Li–air batteries. Humidity is one of the main obstacles, not only causing side reactions with the discharge products but also leading to rapid corrosion of the lithium anode. Here, we fabricated a novel composite hydrophobic catalyst by loading RuO2 and graphene on N-doped porous carbon. The catalyst was endowed with hydrophobicity and showed superior catalytic performance and low affinity to water in the air. A Li–air battery equipped with this novel composite catalyst exhibited eminent cycling performance in pure oxygen (over 470 h), humid oxygen [∼40% relative humidity (RH), over 310 h], and ambient air (∼42% RH, over 330 h) at a current density of 500 mA g−1, and the discharge specific capacity increased from 13122.1 to 19358.6 mAh g−1. © 2022

CHANGES IN PATTERNS OF REFERRAL FOR INPATIENT REHABILITATION CANCER PATIENTS DUE TO COVID-19

Introduction There is a paucity of literature reflecting how the initial phases of COVID-19 and the changes to hospital processes affected referrals to cancer physiatry and inpatient cancer rehabilitation admissions. Methods A retrospective cross-sectional descriptive study was performed to evaluate inpatient hospital admissions, referrals to physiatry, and the number of patients admitted to inpatient rehabilitation and subsequent discharge disposition. There were no active interventions. Results In 2019 vs 2020, there were 10,274 vs 7,051 inpatient hospital admissions, 387 vs 337 referrals to physiatry, and 108 vs 102 rehabilitation admissions. There was an increase in referrals in 2020 (3.8% vs 4.8%, p=0.001) with no significant change to rehabilitation admissions (27.9% vs 30.3%: p= 0.485). There was an increase in hematological services referrals and a decrease in neurosurgical services in 2020 (20.4% vs 31.4%;48.2% vs 26.5%;p = 0.01). There was an increased frequency of transfer back to primary acute care service in 2020 (7.4% vs 21.8%;p = 0.01). Conclusions During the COVID-19 pandemic, there was an increase in referrals to physiatry despite a decrease in hospital admissions, suggesting the importance of rehabilitation. There was an increase in the percentage of referrals by hematological services accompanied by a decrease in neurological services, likely due to decreased elective procedures. Finally, return to primary increased, which may be reflective of increased acuity of patients.

A randomized phase II trial of carboplatin with or without nivolumab in metastatic triple-negative breast cancer

Background: Platinum agents induce DNA crosslinking and cause accumulation of genotoxic stress, which leads to immune activation via IFN-γ signaling, making the combination with nivolumab (PD-1 antibody) an attractive strategy to enhance the benefit of either agent alone in metastatic triple-negative breast cancer (mTNBC). Methods: In this phase II open-label, investigator-initiated, multicenter trial, patients with unresectable locally advanced or mTNBC treated with 0-1 prior lines of chemotherapy in the metastatic setting were randomized 1:1 to carboplatin (AUC 6) with or without nivolumab (360 mg) IV every 3 weeks. Stratification factors included: germline BRCA (gBRCA) status, prior neo/adjuvant platinum, and number of prior lines of metastatic therapy. After approval of PD-L1 inhibition for mTNBC, the study was amended to include first-line mTNBC only and PD-L1 status was added as a stratification factor. Patients randomized to carboplatin alone were allowed to crossover at progression to receive nivolumab (+ nab-paclitaxel post-amendment). The primary objective was to compare progression-free survival (PFS) per RECIST 1.1 criteria of carboplatin with or without nivolumab in first-line mTNBC in the S intent-to-treat (ITT) population. Key secondary objectives were objective response rate (ORR), overall survival (OS), clinical benefit rate, and duration and time to objective response. PD-L1 status was confirmed centrally using the SP142 Ventana assay (positive, ≥1% IC). Paired researchbiopsies at baseline, on-treatment and at progression were performed, if safely accessible. The trial closed to accrual prior to reaching target accrual due to approval of PD-1 inhibition in combination with platinum-based chemotherapy for PD-L1+ mTNBC. Results: Between 1/30/2018 and 12/9/2020, 78 patients enrolled. Three patients did not receive protocol treatment, and the safety analysis was conducted among the 75 that received any treatment;37 received carboplatin + nivolumab (Arm A), 38 received carboplatin alone (Arm B). Median age was 59.1 yrs (range: 25.4-75.8). Four patients (5.3%) had a known gBRCA1/2 mutation. Sixty-two (82.7%) patients received 0 prior lines (ITT population) and 13 (17.3%) 1 prior line of metastatic therapy. Sixty-seven patients (89.3%) experienced any grade ≥2 treatment-related adverse event (AE). The most frequent AE were platelet count decrease (n=40;53.3%), anemia (n=36;48.0%), neutrophil count decrease (n=33;44.0%) and fatigue (n=24;32.0%). Grade 3/4 AE were observed in 46 (61.3%) patients, and there was one grade 5 AE (COVID19 pneumonia). Any grade ≥2 immune-related AE (irAE) were observed in 25 of the 37 (67.6%) patients treated with carboplatin + nivolumab. Grade 3/4 irAE were observed in 11 (29.7%) patients. In the ITT population (32 on Arm A;30 on Arm B), median PFS was 4.2 months with carboplatin + nivolumab, and 5.5 months with carboplatin (stratified HR 0.98, 95% CI [0.51-1.88];p=0.95). ORR was 25% vs. 23.3%, respectively. At a median follow-up of 23.5 months, median OS was 17.5 months vs. 10.7 months (stratified HR 0.63, 95% CI [0.32-1.24];p=0.18). In patients with PD-L1+ mTNBC (13 on Arm A;11 on Arm B), median PFS was 8.3 months and 4.7 months, respectively (stratified HR 0.63, 95% CI [0.21-1.89];p=0.41). ORR was 23.1% vs. 27.3%, respectively. Median OS was 17.5 months vs. 9.6 months (stratified HR 0.59, 95% CI [0.20-1.75];p=0.34). Conclusions: Addition of nivolumab to carboplatin in patients with previously untreated mTNBC, unselected by PD-L1 status, did not significantly improve PFS. A trend toward improved PFS and OS was observed in patients with PD-L1+ mTNBC. Tissue, blood and intestinal microbiome biomarker analyses are planned;bulk tumor and single-cell sequencing, and TCR sequencing in peripheral blood are ongoing.

Structure-Based Discovery and Structural Basis of a Novel Broad-Spectrum Natural Product against the Main Protease of Coronavirus

Over the past 20 years, the severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome CoV (MERS-CoV), and SARS-CoV-2 emerged, causing severe human respiratory diseases throughout the globe. Developing broad-spectrum drugs would be invaluable in responding to new, emerging coronaviruses and to address unmet urgent clinical needs. Main protease (Mpro;also known as 3CL(pro)) has a major role in the coronavirus life cycle and is one of the most important targets for anti-coronavirus agents. We show that a natural product, noncovalent inhibitor, shikonin, is a pan-main protease inhibitor of SARS-CoV-2, SARS-CoV, MERS-CoV, human coronavirus (HCoV)-HKU1, HCoV-NL63, and HCoV-229E with micromolar half maximal inhibitory concentration (IC50) values. Structures of the main protease of different coronavirus genus, SARS-CoV from the betacoronavirus genus and HCoV-NL63 from the alphacoronavirus genus, were determined by X-ray crystallography and revealed that the inhibitor interacts with key active site residues in a unique mode. The structure of the main protease inhibitor complex presents an opportunity to discover a novel series of broad-spectrum inhibitors. These data provide substantial evidence that shikonin and its derivatives may be effective against most coronaviruses as well as emerging coronaviruses of the future. Given the importance of the main protease for coronavirus therapeutic indication, insights from these studies should accelerate the development and design of safer and more effective antiviral agents. IMPORTANCE The current pandemic has created an urgent need for broad-spectrum inhibitors of SARS-CoV-2. The main protease is relatively conservative compared to the spike protein and, thus, is one of the most promising targets in developing anticoronavirus agents. We solved the crystal structures of the main protease of SARSCoV and HCoV-NL63 that bound to shikonin. The structures provide important insights, have broad implications for understanding the structural basis underlying enzyme activity, and can facilitate rational design of broad-spectrum anti-coronavirus ligands as new therapeutic agents.

Bleeding Complications in Patients with Cancer and COVID 19- Analysis from the COVID 19and Cancer Consortium (CCC19) Registry

Background : Patients (pts) with COVID-19 are reported to have increased risk of venous thromboembolism yet bleeding has been an under recognized complication. Rates of bleeding remain unexamined in all patients especially in pts with cancer and COVID-19. Aim: To estimate the incidence of bleeding complication in patients with cancer and COVID 19 Methods: The CCC19 international registry (NCT04354701) aims to investigate complications of COVID-19 in pts with cancer. Our aim was to investigate the frequency of bleeding in hospitalized adult pts with cancer andCOVID-19, enrolled between March 16, 2020 and Feb 8, 2021. The incidence of bleeding complications was captured as defined by CCC19 and included both major and non major bleeding. Associated baseline clinic-pathologic prognostic factors and outcomes such as need for mechanical ventilation, intensive care unit (ICU) admission and mortality rates were assessed Results :3849 pts met analysis inclusion criteria. Bleeding was reported in 276 (7%) pts with median age of 70years;incidence was 6.6 % in females and 7.6 % in males, 6.5% in non-Hispanic white pts, 8.2 % in non-Hispanic Black pts, and 7.8 % in Hispanic pts. 74% had solid cancer and 29% had hematologic malignancies, 33% had received anti-cancer therapy in preceding 30 days, and 8% had surgery within 4weeks. In pts taking antiplatelet or anticoagulant medications at baseline, 7.2% developed bleeding. Need for mechanical ventilation, ICU admission, 30-day mortality, and total mortality were significantly higher in those with bleeding complications compared to those without, p<0.05 Conclusion : We describe the incidence of bleeding in a large cohort of pts with cancer and COVID-19. Bleeding events were observed in those with adverse outcomes including mechanical ventilation, ICU admission, and high mortality;the overall mortality of 43% in patients with bleeding complications is especially notable. This important complication may reflect underlying COVID-19 pathophysiology as well as iatrogenic causes. [Formula presented] Disclosures: Kumar: Diagnostica Stago: Honoraria. Zon: AMAGMA AND RLZ: Consultancy, Current holder of individual stocks in a privately-held company. Byeff: Pfizer, BMS, Takeda,Teva, Merck, United health: Consultancy, Current equity holder in publicly-traded company, Current holder of stock options in a privately-held company. Nagaraj: Novartis: Research Funding. Hwang: astrazaneca,Merck,bayer, Genentech: Consultancy, Research Funding. McKay: Myovant: Consultancy;Bayer: Membership on an entity's Board of Directors or advisory committees;AstraZeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees;Exelixis: Consultancy, Membership on an entity's Board of Directors or advisory committees;Calithera: Membership on an entity's Board of Directors or advisory committees;Tempus: Research Funding;Merck: Consultancy, Membership on an entity's Board of Directors or advisory committees;Tempus: Membership on an entity's Board of Directors or advisory committees;Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding;Janssen: Membership on an entity's Board of Directors or advisory committees;Bristol Myers Squibb: Consultancy, Membership on an entity's Board of Directors or advisory committees;Sanofi: Membership on an entity's Board of Directors or advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees;Dendreon: Consultancy;Caris: Other: Serves as a molecular tumor board;Vividion: Consultancy;Sorrento Therapeutics: Consultancy;Bayer: Research Funding. Warner: Westat, Hemonc.org: Consultancy, Current holder of stock options in a privately-held company. Connors: Pfizer: Honoraria;CSL Behring: Research Funding;Alnylam: Consultancy;Bristol-Myers Squibb: Honoraria;takeda: Honoraria;Abbott: Consultancy. Rosovsky: Janssen: Consultancy, Research Funding;BMS: Consultancy, Research Funding;Inari: Consultancy, Membership on an entity's Board of Directors or advisory committees;Do a: Consultancy, Membership on an entity's Board of Directors or advisory committees.

Predicting the Length of Stay of Patients in Hospitals

Due to the intensive treatment process of coronavirus pneumonia cases, it is important to predict the Length of Stay (LOS) of patients at the hospital to allow better management of resources and increase the efficiency of hospital services to provide improved healthcare. To predict LOS, we used four artificial neural network models namely the Multilayer Perceptron (MLP), Convolutional Neural Network (CNN), Multilayer Perceptron with PCA (PCA+MLP), and the Bidirectional Long Short Term Memory (BiLSTM) model to analyze the advantages and disadvantages of the different models using the Microsoft Hospital Length of Stay data. The proposed method is compared with the state-of-the-art models and a simple MLP model. Our models achieved an accuracy between 73% and 88% with the CNN model providing the highest accuracy. © 2021 IEEE.

THE GLOBAL SCRAMBLE FOR PPE AMID COVID-19: LESSONS FROM THE EU EXPORT RESTRICTIONS AND IMPORT FACILITATION THROUGH REGULATORY COOPERATION ON PPE

As the COVID-19 pandemic continues to spread around the world, unprecedented disruption to the global economy and international trade have prompted widespread fears especially when it comes to the scramble for personal protective equipment (hereinafter "PPE"), as a result of critical shortages. Government officials around the world have raised concerns about how to ensure that their countries have adequate access to PPE. Many governments have introduced trade-related measures, such as restricting exports of critical PPE and medical supplies. Governments are also mounting special efforts including temporarily revising import procedures and easing technical barriers to ensure the supply of PPE in response to a crisis-within-a-crisis. Such trade-related measures on both export restrictions and import facilitation in response to COVID-19 have brought considerable attention to the role of the multilateral trading system in promoting stability and predictability of international trade flows in a time of global crisis and have also exposed the existing limits of international trade law. This article presents an overview of both the European Union's export restrictions and import facilitation measures on PPE, as an example, and provides analyses of issues associated measures in the international trade law regime.

Research and practice of all-on-line hybrid teaching mode under epidemic conditions

The COVID-19 that has continued since the end of 2019 has made the use of online teaching an important and feasible way to relieve the pressure of offline school hours during the epidemic, avoid the large-scale spread of the epidemic, and ensure that the annual teaching plan is completed on time. The online teaching caused by the epidemic is different from the normal online teaching application in terms of reasons, expected purpose, and organization methods. Based on the comparative analysis of the existing main online teaching organization forms, the online teaching organization forms in special periods are discussed from the aspects of curriculum content design and teaching methods. We have proposed an all-on-line hybrid teaching model of online self-study and online live broadcast interaction. Teaching practice shows that it has promotion value for teaching organization and implementation under special circumstances of teacher-student space isolation, and has reference significance for the application of online teaching in daily teaching reform. © 2021 ACM.

Do Beijing's Capital Controls Bind Hong Kong? Reality or Illusion

The ongoing impact of COVID-19 on global economic growth is likely to result in a retreat from financial globalization, including restrictions on capital movements. This concern arises from the experience of short-term capital control policies being implemented by countries in past financial crisis. This trend, together with China's long history of using capital controls, has further sparked fears in Hong Kong regarding the extent to which the capital control restrictions from Beijing could impact Hong Kong's open financial policy on capital transfers. With this context, this article evaluates situations where concerns have been raised and seeks to ascertain whether Hong Kong could be legally liable for the implementation of capital controls in Beijing. © 2021 The Author(s) (2021). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Thrombotic complications with SARS-CoV-2 infection in patients with cancer on high-risk therapies: Data from the COVID-19 and Cancer Consortium (CCC19)

Background: Patients (pts) with cancer have a high risk of venous thromboembolic (VTE) complications, further enhanced by anti-cancer treatments, specifically hormonal therapies, targeted therapies (VEGF inhibitors, other TKIs) and immune checkpoint inhibitors (ICIs). We hypothesized that high-risk therapies would predispose pts with cancer and COVID-19 to higher risk of VTE complications. Methods: CCC19 is the largest international registry (NCT04354701) recording outcomes of pts with cancer and COVID-19. The registry was queried for hospitalized pts who developed VTE and received systemic cancer treatment in the year prior to COVID-19. Incidence of VTE was analyzed as the primary endpoint;30-day any cause mortality & need for ICU admission at baseline were secondary endpoints in pts with and without VTE respectively. Pts were stratified by treatment type and time from last treatment dose: <2 wk, 2-4 wk, 1-3 months (mos), 3-12 mos. Results: As of February 9th 2021, 4217 hospitalized pts with complications data were present in the registry. 1867 (44%) pts had received systemic anti-cancer therapy within the year prior to COVID-19 and were analyzed. There were a total of 186 (10%) VTE events. Of these, VTE incidence was 141 (10.5%) in pts with solid tumors and 57 (9%) in pts with hematologic malignancies. Overall 30-day mortality was 20% and 22% in pts with and without VTE respectively, while direct admission to ICU at presentation was seen in 17% and 10% of pts with and without VTE, respectively. Treatment timing and drug exposures are below (Table). Receipt of systemic anti-cancer treatment within 3 mos vs 3-12 mos was associated with increased rate of VTE, OR 2.44, 95% CI 1.18-5.84, p=0.011 (univariate Fisher test). Conclusions: We describe the incidence of VTE events in pts with cancer and COVID-19 with recent systemic cancer therapy. ICI and VEGFi were associated with numerically higher rates of VTE;other examined drugs and drug classes were not. Timing of therapy appears to modify risk of VTE. Although retrospective, with possible selection and confounding biases, our analysis suggests that factors other than anticancer drug exposures may drive VTE events in this population.

Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium.

BACKGROUND: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. PATIENTS AND METHODS: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). RESULTS: A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. CONCLUSIONS: Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies. CLINICAL TRIAL IDENTIFIER: NCT04354701.

Tackling Technical Barriers to PPE: Pathways to Mutual Recognition Agreements in the Post-Pandemic Future

As the coronavirus disease (COVID-19) continues to spread around the world, international trade has prompted widespread fears especially when it comes to the scramble of essential goods. Technical barriers to trade (TBT) are necessary to ensure the quality of exports, and for the protection of human, animal, and plant life or health. TBT varies from country to country and this issue is more pronounced when it comes to personal protective equipment (PPE) amid COVID-19. Mutual recognition plays an important role in facilitating the trade of essential goods, in particular during a pandemic. However, the number of existing mutual recognition agreements (MRAs) on essential goods for a pandemic is limited. It is envisaged that in the post-pandemic future, more countries will endeavour to negotiate MRAs on essential goods. However, issues such as origin-based bias under MRAs remain arguably unclear. This article seeks to analyse the role mutual recognition plays when it comes to trade in PPE in time of global pandemic, identify the issues with existing MRAs on PPE and suggest a model provision for the future MRA negotiations. © 2021 Kluwer Law International BV, The Netherlands

Facing COVID-19: Forensic doctors of public security departments should improve infected cadaver identification and personal protection procedures

Because of the nature of the human identification system, forensic doctors working in public security departments are responsible for cadaver examination and conducting crime scene investigations. These processes contain inherent risks, which often include various injury, poisoning hazards, and probable exposure risks with virus such as COVID-19. This paper discusses the occupational protections used for forensic doctors, such as crime scene corpse identification, autopsy building construction, risk assessment, and protective measures. Finally, we suggest the introduction of relevant rules and regulations that could guarantee the stability and safety of crime scene investigations and cadaver examinations. These measures may be helpful for forensic institutes and doctors working in public security departments. © 2020 Journal of Forensic Science and Medicine Published by Wolters Kluwer - Medknow.