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The Public Health Agency of Sweden has analysed how many pregnant and postpartum women with SARS-CoV-2 infection have been treated in intensive care units (ICU) in Sweden between the March 19 and April 20, 2020, compared with non-pregnant women of similar age. Cases were identified in a special reporting module within the Swedish Intensive Care Registry (SIR). Fifty-three women aged 20-45 years with SARS-CoV-2 were reported in SIR, and thirteen (n=13) of these women were either pregnant or postpartum ( less then 1 week). The results indicate that the risk of being admitted to ICU may be higher in pregnant and postpartum women with laboratory-confirmed SARS-CoV-2 in Sweden, compared to non-pregnant women of similar age.Background Different skin manifestations of COVID-19 are being reported. Acral lesions on the hands and feet, closely resembling chilblains, have been recognized during the peak incidence of the COVID-19 pandemic. Material and methods A retrospective review of 22 children and adolescents with chilblain-like lesions seen over a short period of time in the Emergency Department of a children's hospital during the peak incidence of COVID-19 in Madrid, Spain. Results All patients had lesions clinically consistent with chilblains of the toes or feet, with three also having lesions of the fingers. Pruritus and mild pain were the only skin symptoms elicited, and only 10 had mild respiratory and/or GI symptoms. None had fever. Coagulation tests, hemogram, serum chemistry, and lupus anticoagulant were normal in all patients tested. One out of 16 tested cases had elevated D-dimer results, but without systemic symptoms or other laboratory anomalies. SARS-CoV-2 PCR tested in 19 cases was positive in just one case. Skin biopsies obtained in six patients were consistent with chilblains. On follow-up, all cases showed spontaneous marked improvement or complete healing. Conclusion Acute chilblains were observed during COVID-19 pandemic in children and teenagers. It is a mildly symptomatic condition with an excellent prognosis, usually requiring no therapy. Etiopathogenesis remains unknown.Aim The Coronavirus disease 2019 (COVID-19) outbreak is a major threat to human beings. Lung injury has been reported as the major outcome of COVID-19 infection. However, liver damage has also been considered to occur in severe cases. Current meta-analysis of retrospective studies was done to summarize available findings on the association between liver injury and severity of COVID-19 infection. Methods Online databases including PubMed, Scopus, Web of Science and Cochrane Library were searched to detect relevant publications up to 1 April 2020, using relevant keywords. To pool data, a fixed- or random-effects model was used depending on the heterogeneity between studies. Furthermore, publication bias test and sensitivity analysis were also done. Results In total, 20 retrospective studies with 3,428 COVID-19 infected patients (severe cases = 1,455 and mild cases = 1,973), were included in this meta-analysis. Higher serum levels of Aspartate aminotransferase (weighted mean difference = 8.84 U/L, 95% CI = 5.97 to 11.71, P less then 0.001), Alanine aminotransferase (weighted mean difference = 7.35 U/L, 95% CI = 4.77 to 9.93, P less then 0.001), total Bilirubin (weighted mean difference = 2.30 mmol/L, 95% CI = 1.24 to 3.36, P less then 0.001) and lower serum levels of Albumin (weighted mean difference = -4.24 g/L, 95% CI = -6.20 to -2.28, P less then 0.001), were associated with a significant increase in the severity of COVID-19 infection. Volasertib Conclusions The incidence of liver injury, as assessed by serum analysis (AST, ALT, total Bilirubin and Albumin levels), seems to be higher in patients with severe COVID-19 infection.Kidney transplantation might not be considered a life-saving procedure as there are alternative forms of renal replacement, although it is superior in the long-term life expectancy and overall costs. During COVID-19 outbreak, we have to deal with the post-immunosuppression COVID-19 increased risk, a burden less prominent in the case of liver and heart transplant candidates, who eventually will die if not transplanted. Since kidney grafts can also be transplanted from a living donor, the suspended elective activity has had a major significant impact for this organ compared to the others.We have read with great interest the letter of the European Task Force on Atopic Dermatitis (ETFAD) on SARS-CoV-2-infection and atopic dermatitis published in JEADV (March 2020)1 in which the authors state "Targeted treatment selectively interfering with type-2 inflammation such as dupilumab is not considered to increase the risk for viral infections and might thus be preferred …in a situation such as COVID-19 pandemic".1.The antimalarials, Chloroquine and Hydroxychloroquine (HCQ), and the antivirals Lopinavir/Ritonavir have been recently recorded as having anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) effects.1 In particular, regarding Italy, one of the countries most affected by the pandemic, the Italian Society of Infectious and Tropical disease (Lombardy section) has recommended the use of HCQ for treatment of coronavirus disease 2019 (COVID-19).When treating migraine patients in the current era of Coronavirus Disease 2019 (COVID-19), many institutions have moved away from face-to-face procedures like onabotulinumtoxinA injections,1 sometimes transitioning to the newer CGRP antibodies for migraine prevention. However, despite our best efforts to mitigate viral transmission, many of our migraine patients may eventually be exposed to SARS-CoV2. While most patients will have mild to moderate symptoms, a subset will become severely ill, with possible complications including respiratory failure and acute respiratory distress syndrome (ARDS). Given the possibility of this level of severe respiratory illness, we should consider what effect blocking calcitonin gene-related peptide (CGRP) might have on these patients.Background Healthcare workers are at the forefront of the ongoing COVID-19 pandemic and are at high risk for both the contraction and subsequent spread of virus. Understanding the role of anosmia as an early symptom of infection may improve monitoring and management of SARS-CoV2 infection. Methodology We conducted a systematic review of the literature of SARS-CoV2 infection/COVID-19 and anosmia to help inform management of anosmia in healthcare works. We report a case series of healthcare workers, who presented with a loss of sense of smell secondary to COVID-19 infection to demonstrate management principles. RT-PCR was used to confirm COVID-19 positivity and psychophysical testing of olfaction was performed using the British version of the University of Pennsylvania Smell Identification Test, UPSIT. Results The systematic literature search returned 31 articles eligible for inclusion in the study and informed our recommendations for clinical assessment and management. All three healthcare professionals who presented with loss of sense of smell subsequently tested positive for SARS-CoV-2. Psychophysical testing of olfaction using the UPSIT confirmed mild and moderate microsmia in two, respectively, and normosmia at day 17 in one. Conclusions Olfactory (± gustatory) dysfunction is indicative of COVID-19 infection and thus has important implications in the context of healthcare workers, or key workers in general, who work in close contact with others if not recognised as suffering from COVID. This leads to a potentially higher likelihood of spreading the virus. In conjunction with our literature review these findings have helped with creating recommendations on the assessment and management of olfactory dysfunction during the ongoing COVID-19 pandemic, both for healthcare workers and patients.Since CoronaVirus Disease 19 (COVID-19) was declared as a pandemic, all medical specialties were at the front, including dermatology. Daily, there are observations mentioning possible cutaneous manifestations of Sars-Cov-2. Among these manifestations, the most often was a rash which could be erythematous, morbilliform or urticarial mimicking viral exanthema, or chickenpox-like vesicles [1-3]. Anecdotally, dengue-like petechial eruption was reported [4].The coronavirus disease 2019 (COVID-19) has attracted extensive attention all around the world recently. Early screening, early diagnosis, early isolation, and early treatment remain the most effective prevention and control measures. Computed tomography (CT) plays a vital role in the screening, diagnosis, treatment, and follow-up of COVID-19, especially in the early screening, with a higher sensitivity than that of real-time fluorescence RT-PCR. The combination of CT and artificial intelligence has the potential to help clinicians in improving the diagnostic accuracy and working efficiency.Patients with the 'aggressive' form of multiple sclerosis accrue disability at an accelerated rate, typically reaching Expanded Disability Status Score (EDSS) ≥ 6 within 10 years of symptom onset. Several clinicodemographic factors have been associated with aggressive multiple sclerosis, but less research has focused on clinical markers that are present in the first year of disease. The development of early predictive models of aggressive multiple sclerosis is essential to optimize treatment in this multiple sclerosis subtype. We evaluated whether patients who will develop aggressive multiple sclerosis can be identified based on early clinical markers. We then replicated this analysis in an independent cohort. Patient data were obtained from the MSBase observational study. Inclusion criteria were (i) first recorded disability score (EDSS) within 12 months of symptom onset; (ii) at least two recorded EDSS scores; and (iii) at least 10 years of observation time, based on time of last recorded EDSS score. Patiensignificantly predicted aggressive multiple sclerosis [area under the curve (AUC) = 0.80, 95% confidence intervals (CIs) 0.75, 0.84, positive predictive value = 0.15, negative predictive value = 0.98]. The presence of all three signs was strongly predictive, with 32% of such patients meeting aggressive disease criteria. The absence of all three signs was associated with a 1.4% risk. Of the 556 eligible patients in the Swedish Multiple Sclerosis Registry cohort, 34 (6%) met criteria for aggressive multiple sclerosis. The combination of all three signs was also predictive in this cohort (AUC = 0.75, 95% CIs 0.66, 0.84, positive predictive value = 0.15, negative predictive value = 0.97). Taken together, these findings suggest that older age at symptom onset, greater disability during the first year, and pyramidal signs in the first year are early indicators of aggressive multiple sclerosis.New findings What is the topic of this review? The effect of extreme environments on the visual system. What advances does it highlight? The manner in which environmental stressors directly and indirectly affect the eye and vision. Abstract Much is known about the physiology and anatomy of the eye. Much less is known about the impact of different environments on the eye, and yet it is the pathophysiology that results from this interaction that is often the precursor to disaster. The present review focuses on the effect of different extreme environments on the visual system in particular, the manner in which such environments affect the sensory mechanism of that system. This article is protected by copyright. All rights reserved.