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1.
EMBO Journal ; : e111737, 2022.
Article in English | MEDLINE | ID: covidwho-2164323

ABSTRACT

Bat-origin RshSTT182 and RshSTT200 coronaviruses (CoV) from Rhinolophus shameli in Southeast Asia (Cambodia) share 92.6% whole-genome identity with SARS-CoV-2 and show identical receptor binding domains (RBDs). In this study, we determined the structure of the RshSTT182/200 receptor binding domain (RBD) in complex with human angiotensin-converting enzyme 2 (hACE2) and identified the key residues that influence receptor binding. Binding of the RshSTT182/200 RBD to ACE2 orthologs from 39 animal species, including 18 bat species, was used to evaluate its host range. The RshSTT182/200 RBD broadly recognized 21 out of 39 ACE2 orthologs, although its binding affinities for the orthologs were weaker than those of the RBD of SARS-CoV-2. Furthermore, RshSTT182 pseudovirus could utilize human, fox and Rhinolophus affinis ACE2 receptors for cell entry. Moreover, we found that SARS-CoV-2 induces cross-neutralizing antibodies against RshSTT182 pseudovirus. Taken together, the findings indicate that RshSTT182/200 can potentially infect susceptible animals, but requires further evolution to obtain strong interspecies transmission abilities like SARS-CoV-2.

2.
Frontiers in Public Health ; 10:1011592, 2022.
Article in English | MEDLINE | ID: covidwho-2163183

ABSTRACT

Background: Non-pharmaceutical interventions (NPIs) against COVID-19 may prevent the spread of other infectious diseases. Our purpose was to assess the effects of NPIs against COVID-19 on infectious diarrhea in Xi'an, China.

3.
Asian International Studies Review ; 3(1), 2022.
Article in English | Scopus | ID: covidwho-2138338

ABSTRACT

China's wolf warrior diplomacy has attracted extensive attention since 2020. One of the most prominent "wolf warriors"is Zhao Lijian, China's Ministry of Foreign Affairs spokesperson. Based on weekly Google Trends datasets between August 21, 2016 and August 8, 2021, this study provides a quantitative description of the development of Zhao Lijian diplomacy. Employing Granger causality tests and autoregressive distributed lag models, this study finds that Zhao Lijian diplomacy is part of China's wolf warrior diplomacy. Most importantly, COVID-19 may be the only factor that has driven the rise of Zhao Lijian diplomacy. This study contributes to academia by presenting a new quantitative approach to international relations studies and contributes to our understanding of China's foreign policy. © 2022 by Kerry Liu.

4.
Health Equity ; 6(1):836-844, 2022.
Article in English | Web of Science | ID: covidwho-2121688

ABSTRACT

Background: COVID-19 vaccination rates among U.S. young adults, particularly in communities of color, remain lower than other age groups. We conducted a qualitative, community-based participatory study to explore beliefs and attitudes about COVID-19 vaccines among young adults in Black/African American, Latinx, and Asian American or Pacific Islander (AAPI) communities in the San Francisco Bay Area.Methods: We conducted six focus groups between June and August 2021. Participants were recruited by partnering with community-based organizations in the San Francisco Bay Area. Focus groups included Black/African American (N=13), Latinx (N=20), and AAPI (N=12) participants between 18 and 30 years of age. Emerging themes were identified using a modified Grounded Theory approach.Results: Prominent themes among all three racial-ethnic groups included mistrust in medical and government institutions, strong conviction about self-agency in health decision-making, and exposure to a thicket of contradictory information and misinformation in social media. Social benefit and a sense of familial and societal responsibility were often mentioned as reasons to get vaccinated. Young adult mistrust had a generational flavor fueled by anger about increasing inequity, the profit-orientation of pharmaceutical companies and health institutions, society's failure to rectify injustice, and pessimism about life prospects.Conclusion: Factors influencing vaccine readiness among Black/African American, Latinx, and AAPI young adults have a distinct generational and life-course texture. Outreach efforts should appeal to young adults' interest in family and social responsibility and the social benefits of vaccination, while being cognizant of the friction mandates pose for young adults' sense of self-agency. Efforts will be most effective coming from trusted messengers with a proven commitment to communities of color and health equity.

5.
Chinese Pharmacological Bulletin ; 38(2):267-274, 2022.
Article in Chinese | EMBASE | ID: covidwho-2114744

ABSTRACT

Aim To elucidate the effective components of Ganoderma applanatum and its mechanism of preventing the coronavirus disease 2019(COVID-19).Methods To begin with, UHPLC-Q-Exactive-Orbitrap-MS was established to identify the main chemical constituents of G.applanatum.Then, the predicted targets of G.applanatum were selected by Swiss Target Prediction.GO analysis and KEGG analysis of core target genes were performed using the DAVID database.Finally, to explore the potential mechanism of G.applanatum against COVID-19, core functional components-core target-metabolism path network diagram was constructed using Cytoscape 3.8.0, and molecular docking was used to analyze the binding force of the core effective compounds with angiotensin-converting enzyme II(ACE2)and three SARS CoV-2 proteins, nonstructural protein-15 Endoribonuclease(NSP15), the receptor-binding domain of spike protein(RBD of S protein), and main protease(Mpro/3CLpro).Results Sixty-two components were identified from G.applanatum by UHPLC-Q-Exactive-Orbitrap-MS study;30 active components were closely associated with 32 core targets including IL6, PTGS2, and MAPK1;KEGG analysis showed that it might treat COVID-19 through signaling pathways, such as PI3K-Akt signaling pathway, TNF signaling pathway, tuberculosis, and so on;molecular docking analysis showed that 1,4-Dihydroxy-2-naphthoic acid, parthenolide, 7,8-Dihydroxycoumarin, and other vital compounds had a certain degree of affinity with ACE2 and three SARS CoV-2 proteins.Conclusion This study clarifies the chemical composition and the potential mechanism of G.applanatum, providing a scientific basis for screening the effective ingredients of G.applanatum. Copyright © 2022 Publication Centre of Anhui Medical University. All rights reserved.

6.
ASAIO Journal ; 68(Supplement 3):27, 2022.
Article in English | EMBASE | ID: covidwho-2058271

ABSTRACT

Introduction: The impact of treatment experience with ECMO prior to the COVID-19 pandemic era on the outcomes of ECMO during the COVID-19 pandemic has not been well investigated. The aim of this study was to investigate the differences in the outcomes of ECMO between highvolume hospitals in Japan before the COVID-19 pandemic and low-volume hospitals. Method(s): This is a prospective observational cohort study of patients with fatal COVID-19 pneumonia in Japan receiving ECMO. The association between patient background, high/low-volume hospitals, and survival from February 2020 to November 2021 were evaluated. Prognostic factors were assessed by Kaplan-Meier and Cox proportional hazards analyses. High-volume hospitals were defined as those with a total of at least 20 cases prior to the COVID-19 pandemic era. Result(s): Ten hospitals (1.1% of a total of 900 ICUs in Japan) were classified as high-volume hospitals, with a median number of ECMO cases of 35.5 (IQR, 25.5-40.5). There were a total of 1,214 ECMO cases during the COVID-19 pandemic, of which 1030 (85%) were treated in low-volume hospitals and 184 (15%) were treated in high-volume hospitals. Kaplan-Meier analysis demonstrated slightly better survival in high-volume hospitals in 30-day (p=0.062) and 60-day (p=0.11) survivals, whereas, in 90-day survival, the two groups were almost identical (p=0.87). Cox proportional hazards analysis also failed to demonstrate that high-volume hospital before the COVID-19 pandemic era was independent prognostic factor (HR, 0.97;95%CI, 0.74-1.28). Conclusion(s): In Japan, high-volume hospital prior to the COVID-19 pandemic era was not independent prognostic factor.

7.
7th Thermal and Fluids Engineering Conference, TFEC 2022 ; 2022-May:477-481, 2022.
Article in English | Scopus | ID: covidwho-2027065

ABSTRACT

The overall purpose of this study is to investigate expiratory events such as coughs and sneezes in the ejection scale framework, i.e. within a short time span immediately after the expiration process. We conducted large eddy simulations (LES) and compared the results with a recent theoretical model put forth by Balachandar et al. [2]. The theoretical model [2] has been formulated to estimate the evolution of expiratory events such as coughs and sneezes. Some of the key features of the model include estimates for the time evolution of the puff centroid, its size, as well as the number and size of droplets suspended within. The theoretical model includes closure parameters that have been obtained from LES [6, 7]. The simulations cover a wide range of parameters, such as the ejection volume of the puff, its momentum, the ejection angle (whether horizontal, inclined, or vertical), and the ambient humidity. One of the important findings is that while certain aspects such as the front-most location and the lateral extent of the puff, show large variability from one realization to the other, global parameters, such as the centroid location, total volume, and buoyancy show are much less sensitive to turbulent fluctuations. The results also indicate that humid ambient conditions favor stronger gravitational settling of the ejected virus-laden droplets, thus decreasing the risk of infection from the dominant airborne route. Furthermore, the simulations highlight a mechanism for transporting a relatively large amount of droplets over distances upward of 2 meters in a time span on the order of one second. This mechanism, which is also observed in experiments, consists of fast moving detached vortex rings that propagate in a seemingly random direction. We further quantify the size and viral content of the detached portions. © 2022 Begell House Inc.. All rights reserved.

8.
13th Asian Control Conference, ASCC 2022 ; : 682-687, 2022.
Article in English | Scopus | ID: covidwho-1994838

ABSTRACT

At the beginning of 2020, Coronavirus Disease 2019 (COVID-19) spread widely all over the world, leading to a public health crisis in the world. Automatic COVID-19 CT segmentation can not only assist radiologists in understanding images, but also help physicians to calibrate diagnoses and provide image-guided clinical diagnosis. However, due to the inhomogeneous intensity distribution of COVID-19 in CT scans, the ambiguous and missing boundaries, and highly variable shapes of lesions, it is quite challenging to develop an automatic solution. Therefore, this paper proposes a novel Multi-Attention Guided U-Net++ (MA-UNet++) for COVID-19 segmentation. In this network, we design a novel long-skip channel-wise attention module and introduce a spatial-wise attention module to re-weight the feature representation and capture rich contextual relationships at different scales. The experiment evaluated on the COVID-19 CT Segmentation dataset, demonstrate the MA-UNet++ achieves higher segmentation accuracy than the state-of-art methods. © 2022 ACA.

9.
Journal of Shandong University ; 58(10):89-94, 2020.
Article in Chinese | GIM | ID: covidwho-1975281

ABSTRACT

Objective: To analyze the epidemiological characteristics of confirmed cases of coronavirus disease 2019 (COVID-19) in Xi'an, so as to provide scientific basis for the prevention and control measures.

10.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927874

ABSTRACT

RATIONALE: Some biomarkers of host response to viral infection are associated with COVID-19 outcomes, but these biomarkers do not directly measure viral burden. The association between plasma viral antigen levels and clinical outcomes has not been previously studied. Our aim was to investigate the relationship between plasma SARS-CoV-2 viral antigen concentration and proximal clinical deterioration in hospitalized patients. METHODS: SARS-CoV-2 nucleocapsid antigen concentrations were measured using a validated microbead immunoassay (Quanterix, NIH/NIAID laboratory) in plasma collected at enrollment from 256 subjects in a prospective observational cohort of hospitalized patients with COVID-19 from 3 hospitals, admitted between March 2020 and August 2021. Relationships between viral antigen concentration and clinical status at 1 week as measured by the World Health Organization (WHO) ordinal scale as well as ICU admission were assessed. Models were adjusted for age and sex, baseline comorbidities including immunosuppression, endogenous neutralizing antibodies, baseline COVID-19 severity, smoking status, remdesivir therapy, steroid therapy, and vaccine status. Missing covariate data were imputed using multiple imputation by chained equations. RESULTS: The median viral antigen concentration for the 35 subjects who deteriorated by 1 week was 4507 (IQR 1225-9665) pg/mL compared to 494 (IQR 18-3882) pg/mL in the 212 subjects who did not (p = 0.0004 Figure a). Using ordinal regression, each doubling in viral antigen concentration was significantly associated with a worse WHO ordinal scale at 1 week (unadjusted OR 1.07, 95% CI 1.02-1.13;adjusted OR 1.10, 95% CI 1.02-1.18). Among 168 patients not in the ICU at baseline, the median viral antigen concentration for the 40 patients who progressed to the ICU was 4697 (IQR 482- 10410) pg/mL vs. 459 (IQR 15-3062) pg/mL in the 128 patients who did not progress to require ICU care (p = 0.0001 Figure b). Using logistic regression, each doubling in viral antigen concentration was significantly associated with ICU admission (unadjusted OR 1.18, 95% CI 1.06-1.32, adjusted OR 1.40, 95% CI 1.11-1.76). CONCLUSIONS: Higher plasma viral antigen concentration at hospital admission is independently associated with a significantly worse clinical status at 1 week and a higher odds of ICU admission among hospitalized patients with COVID-19. This novel finding indicates that plasma viral antigen concentration may identify hospitalized COVID-19 patients at highest risk of short-term clinical deterioration in both clinical practice and research. Results of plasma antigen tests are available within 2-3 hours and could be integrated for identifying hospitalized COVID-19 patients who might benefit from early intervention.

11.
Asian Journal of Organic Chemistry ; : 11, 2022.
Article in English | Web of Science | ID: covidwho-1925860

ABSTRACT

One of the structural uniqueness of arylnaphthalene lignans (ANLs) is their potential atropoisomerism, which may result in bioactivity discrepancy. However, the stable ANL atropisomers rarely exist in nature. In the course of our phytochemical study of Justicia procumbens, we isolated nine ANL glycosides (1-9) with four of them (1-4) being identified as new stable atropisomers. Their absolute configurations were determined based on the analysis of the circular dichroism (CD) and electronic circular dichroism (ECD) data. The ANL compounds were evaluated for their antiviral potential as entry inhibitors against the infections of H5N1 influenza virus, vesicular stomatitis virus (VSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with 5 being the most potent one with IC50 values ranging from 0.0063-1.13 mu M. The atropisomers did not display significant antiviral activity, indicating that a free rotation of the biphenyl aryl-aryl bond could play a significant role in the antiviral activity of ANL compounds.

12.
Nan Fang Yi Ke Da Xue Xue Bao ; 42(6): 955-956, 2022 Jun 20.
Article in Chinese | MEDLINE | ID: covidwho-1924684

ABSTRACT

As a member of the dibenzyl isoquinoline alkaloid family, cepharathine is an alkaloid from the traditional Chinese medicine cepharathine, which is mainly used for treatment of leukopenia and other diseases. Recent studies of the inhibitory effect of cepharathine against SARS-CoV-2 have attracted widespread attention and aroused heated discussion. As the original discoverer of the anti-SARS-CoV-2 activity of cepharanthine, here we briefly summarize the discovery of cepharanthine and review important progress in relevant studies concerning the discovery and validation of anti-SARS-CoV-2 activity of cepharathine, its antiviral mechanisms and clinical trials of its applications in COVID-19 therapy.


Subject(s)
Benzylisoquinolines , COVID-19 , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Benzylisoquinolines/pharmacology , Benzylisoquinolines/therapeutic use , Humans , SARS-CoV-2
13.
Journal of Army Medical University ; 44(3):195-202, 2022.
Article in Chinese | Scopus | ID: covidwho-1903991

ABSTRACT

Objective To construct an XGBoost prediction model to predict disease severity of COVID-19 based on clinical characteristics dataset of COVID-19 patients.Methods A total of 347 laboratory-confirmed COVID-19 patients with complete medical information admitted from Feb 10 to April 5, 2020 were screened from the medical record system of Huoshenshan Hospital.Firstly, 21 features with significant differences were screened out as input features for the training model.Bayesian optimization was performed on the constructed XGBoost model to adjust the parameters, and the optimal combination of features was filtered based on feature importance.To further analyze the positive and negative effects of the numerical size of each feature on the prediction results, each feature importance was quantified and attributed by using SHapley Additive explanations (SHAP).Finally, the performance of the XGBoost prediction model was evaluated, and the model was compared and discussed with other machine learning methods, including support vector machine (SVM), naive Bayes ( NB ) , logical regression ( LR) , and k-nearest neighbors ( KNN ).Results In this study, 21 features with significant differences between the severe and non-severe groups were selected for training and validation.The optimal subset with 10 features in the k-nearest neighbor model obtained the highest value of area under curve ( AUG) among the 4 models in the validation set.XGBoost and support vector machine were better than other machine learning methods in terms of prediction performance (AUG;0.942 0, and 0.959 4 on the test set, respectively) , and the training speed of XGBoost was significantly faster.Conclusion A prediction model based on XGBoost is successfully built to achieve early prediction of disease severity of GOVID-19 patients. © 2022 Journal of Army Medical University. All rights reserved.

14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(6): 846-851, 2022 Jun 10.
Article in Chinese | MEDLINE | ID: covidwho-1903512

ABSTRACT

Objective: To investigate the epidemiological characteristics of COVID-19 caused by 2019-nCoV Delta variant in Shangyu district, Shaoxing of Zhejiang province in 2021, and provide evidence for the improvement of COVID-19 control and prevention measures. Methods: The incidence data of COVID-19 in Shangyu from December 7 to 21, 2021 was obtained from Shangyu District Center for Disease Control and Prevention. The epidemiological characteristics of the cases, i.e. the population, time and space distributions, were analyzed, and the incubation period and time-varying reproduction numbers (Rt) were calculated. Results: From December 7 to 21, 2021, a total of 380 COVID-19 cases caused by 2019-nCoV Delta variant were detected in Shangyu, the median age of the cases was 52 years, M (Q1,Q3: 38, 61). The male to female ratio of the cases was 1∶1.25, and the cases were mainly workers (36.58%) and farmers (27.63%). The epidemic affected 9 townships (or community) of Shangyu, especially Caoe and Baiguan communities with the cases accounting for 57.10% and 31.53% respectively. The median incubation period of cases was 4.00 days, M (Q1,Q3: 3.00, 5.75). The basic reproduction number (R0) was 4.06, and the Rt was 5.62 in early phase of the outbreak (the highest) and continuously decreased to less than 1.00 within 10 days after the detection of the outbreak. The number of COVID-19 cases decreased to 0 within 14 days after the outbreak (December 7-21), and the main detection methods were screening in centralized isolation (55.53%) and home isolation (40.00%). The infection rates of close contacts and secondary close contacts were 2.06% and 0.46% respectively. Conclusion: The epidemic of COVID-19 in Shangyu characterized by short incubation period, large number of infected people, and case clustering, suggesting the strong transmission of Delta variant (B.1.617.2). Comprehensive prevention and control measures, such as management of close contacts and secondary close contacts, and high-risk area, are essential for the rapid control of the epidemic.


Subject(s)
COVID-19 , Epidemics , Basic Reproduction Number , COVID-19/epidemiology , China/epidemiology , Female , Humans , Male , Middle Aged , SARS-CoV-2
15.
2nd International Conference on Bioinformatics and Intelligent Computing, BIC 2022 ; : 1-5, 2022.
Article in English | Scopus | ID: covidwho-1902107

ABSTRACT

Since the outbreak and spread of COVID-19 in large areas of the world, the importance of rapid diagnosis of COVID-19 has increased. In the first week after the onset of COVID-19, the density of lesions is uneven, and chest CT is often difficult to show local subpleural ground-glass shadows, resulting in missed diagnosis. The COVID-19 intelligent diagnosis system based on the convolutional neural network algorithm can not only accurately identify the feature points, reduce the workload of doctors and improve the diagnosis efficiency, but also reduce the rate of missed diagnosis and misdiagnosis, which is conducive to epidemic control. © 2022 ACM.

17.
Polish Journal of Environmental Studies ; 31(3):2823-2835, 2022.
Article in English | Scopus | ID: covidwho-1847844

ABSTRACT

Coronavirus Disease 2019 (COVID-19) lockdown was related to a significant reduction in air pollutant emissions. However, severe air pollution events still occurred frequently in Taiyuan, north China. To better understand this unusual phenomenon, O3 and other pollutants have been investigated before, during and after the COVID-19 lockdown in the early 2020. Results show that PM10, PM2.5, SO2, NO2 and CO underwent a more marked reduction while O3 pollution was amplified during lockdown and the average concentrations O3-8hr during AL stage (101.92 μg m-3) exceeded its Grade I limiting value (100 μg m-3). O3 were negatively correlated with the other pollutants and positively correlated with temperature, visibility and the average solar irradiance during the daytime. The increase in daylight hours and average solar irradiance might be the key factors leading to the increase in O3 concentrations. The reduction of PM2.5 and NO2 promoted the rise in O3 during the lockdown. The majority of the O3 was likely formed by photooxidation in the shadow of Taiyuan and linked with air masses from the northern part of Shanxi Province before the lockdown and Henan, Hebei and Shandong during and after the lockdown. © 2022, HARD Publishing Company. All rights reserved.

18.
10th International Conference on Communications, Signal Processing, and Systems, CSPS 2021 ; 878 LNEE:557-565, 2022.
Article in English | Scopus | ID: covidwho-1826329

ABSTRACT

The worldwide spread of COVID-19 has greatly hit global economy by now. The world’s major economies including both developed and developing countries have felt the resulting impact on their financial markets. Accordingly, learning residents’ consumption structure is significant for boosting consumption demand and recovering financial market. In this paper, the Extend Linear Expenditure System (ELES) model is explored to learn both urban and rural residents’ consumption structures of China during COVID-19. In specific, the indices of marginal propensity to consume, income elasticity of demand, and price elasticity can be yielded via the ELES model based on the disposable income and the consumption data. Furthermore, the consumption structures before and during the corona virus epidemic can be quantitatively compared. Extensive experimental results demonstrate that the epidemic has made profound impacts on the consumption structure of residents. Among them, the marginal propensities on food and medical services have greatly increased, while the proportions of other expenditures have been decreased. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

19.
Respirology ; 27(SUPPL 1):193, 2022.
Article in English | EMBASE | ID: covidwho-1816645

ABSTRACT

Introduction/Aim: Harnessing Youth Voice is one of the most effective strategies for communicating with young people. In September 2021, the Youth Voices COVID-19 video competition was created following a need for innovative strategies to disseminate COVID-19 health and wellbeing information to adolescents. The aims were to (1) reach and engage young people to improve COVID-19 health literacy and vaccine uptake among high school students (aged 12- 18 years) and (2) provide an opportunity for adolescent leadership, advocacy and skills development. Methods: The competition was held over 1 month. High school students across NSW were invited to submit a 45 second video addressing (1) COVID-19 vaccinations, (2) looking after your wellbeing during the pandemic, or (3) tackling COVID-19 misinformation. Videos were judged by a panel of health, education and industry experts and prizes awarded to the top three videos within and outside of western Sydney. An evaluation survey was distributed to participants post-competition. Results: The competition engaged 92 students (from 43 high schools), with 84 video entries submitted. The winning videos were uploaded online and to date have been viewed >4000 times. Participants (n = 58) agreed that the competition improved their understanding of COVID-19 (84% agreement) and increased their confidence to receive the vaccine (88% agreement). Participants reported gaining technology skills (71%), confidence (62%) and communication skills (57%) from taking part. Conclusion: The video competition was an innovative and effective strategy for improving the COVID-19 health literacy and vaccine confidence of high school students. Moreover students developed a broad range of translatable skills for real world learning. Youth involvement enables young people to influence practices and decisions that affect them.

20.
Journal of Internal Medicine of Taiwan ; 32(5):333-341, 2021.
Article in Chinese | Scopus | ID: covidwho-1791940

ABSTRACT

Coronavirus disease of 2019(COVID-19) is a highly contagious viral disease, causing reparatory symptoms, ranging from flu-like symptoms to acute respiratory distress. Since the end of 2019, COVID-19 has posed a tremendous threat to the healthcare systems nationwide. Multiple public health interventions, including mandating social distancing, closing outpatient visits, or postponing elective procedures have been implemented to mitigate the impact on disease transmission and prevent consumption of medical resources. Since the beginning of the pandemic, resources have been shifted away from chronic disease management and prevention. Osteoporosis, a chronic condition, which requires continuous and concerted medical attention to alleviate the long-term consequences such as osteoporotic fractures, morbidities, or mortalities. In this review article, we will discuss the strategies to cope with osteoporosis, especially focusing on pharmaceutical management considerations during the era of COVID-19 pandemic. We will also discuss different drug distribution models when outpatient clinics are not readily available or mandatory social distancing policy is employed. After all, we will propose alternative therapeutic options when the continuity of particular medications cannot be maintained. © 2021 Society of Internal Medicine of Taiwan. All rights reserved.

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