Japan COVID-19 Task Force: a nation-wide consortium to elucidate host genetics of COVID-19 pandemic in Japan

To elucidate the host genetic loci affecting severity of SARS-CoV-2 infection, or Coronavirus disease 2019 (COVID-19), is an emerging issue in the face of the current devastating pandemic. Here, we report a genome-wide association study (GWAS) of COVID-19 in a Japanese population led by the Japan COVID-19 Task Force, as one of the initial discovery GWAS studies performed on a non-European population. Enrolling a total of 2,393 cases and 3,289 controls, we not only replicated previously reported COVID-19 risk variants (e.g., LZTFL1, FOXP4, ABO, and IFNAR2), but also found a variant on 5q35 (rs60200309-A at DOCK2) that was associated with severe COVID-19 in younger (<65 years of age) patients with a genome-wide significant p-value of 1.2 x 10-8 (odds ratio = 2.01, 95% confidence interval = 1.58-2.55). This risk allele was prevalent in East Asians, including Japanese (minor allele frequency [MAF] = 0.097), but rarely found in Europeans. Cross-population Mendelian randomization analysis made a causal inference of a number of complex human traits on COVID-19. In particular, obesity had a significant impact on severe COVID-19. The presence of the population-specific risk allele underscores the need of non-European studies of COVID-19 host genetics.

Evaluating temperature and humidity gradients of COVID-19 infection rates in light of Non-Pharmaceutical Interventions

We evaluate potential temperature and humidity impact on the infection rate of COVID-19 with a data up to June 10th 2020, which comprises a large geographical footprint. It is critical to analyse data from different countries or regions at similar stages of the pandemic in order to avoid picking up false gradients. The degree of severity of NPIs is found to be a good gauge of the stage of the pandemic for individual countries. Data points are classified according to the stringency index of the NPIs in order to ensure that comparisons between countries are made on equal footing. We find that temperature and relative humidity gradients dont significantly deviate from the zero-gradient hypothesis. Upper limits on the absolute value of the gradients are set. The procedure chosen here yields 6 10-3 {degrees}C-1 and 3.3 10-3 (%)-1 upper limits on the absolute values of the temperature and relative humidity gradients, respectively, with a 95% Confidence Level. These findings do not preclude existence of seasonal effects and are indicative that these are likely to be nuanced.

Risk Adjusted Non-Pharmaceutical Interventions for the Management of COVID-19 in South Africa

A global analysis of the impact of non-pharmaceutical interventions (NPIs) on the dynamics of the spread of the COVID-19 indicates that these can be classified using the stringency index proposed by the Oxford COVID-19 Government Response Tracker (OxCGRT) team. The world average for the coefficient that linearises the level of transmission with respect to the OxCGRT stringency index is s = 0.01{+/-}0.0017 (95% C.I.). The corresponding South African coefficient is s = 0.0078 {+/-} 0.00036 (95% C.I.), compatible with the world average. Here, we implement the stringency index for the recently announced 5-tier regulatory alert system. Predictions are made for the spread of the virus for each alert level. Assuming constant rates of recovery and mortality, it is essential to increase s. For the system to remain sub-critical, the rate with which s increases should outpace that of the decrease of the stringency index. Monitoring of s becomes essential to controlling the post-lockdown phase. Data from the Gauteng province obtained in May 2020 has been used to re-calibrate the model, where s was found increase by 20% with respect to the period before lockdown. Predictions for the province are made in this light.

A case of peripheral facial paralysis with sequelae combined with acupuncture treatment / 全日本鍼灸学会雑誌

[Objective] Peripheral facial paralysis with sequelae (PFPS) reduces the quality of life (QOL) of patients. However, not much information is available on acupuncture treatment (AT) for PFPS. We report a case of a patient with PFPS whose sequelae and QOL were successfully improved by a combination of medication, physical therapy (PT) and AT.[Case] A 42-year-old woman. Her chief complaint was facial tightness, facial asymmetry, and synkinesis.[History of present illness] Left paralysis developed in November X-1, and Bell's palsy was diagnosed. Yanagihara Score (YS) was 6 points. She received intravenous steroid treatment during hospitalization for 9 days after second week after onset. In addition, she was given facial nerve decompression on January 24, X. but there wasno change. Subsequently, she visited the Department of Otolaryngology-Head and Neck Surgery, The University of Tokyo on 24 April. Electroneurography was 4%, YS was16 points and synkinesis was found. AT was started from May 29, X. [Acupuncture treatment] We performed AT on muscle for facial expression for contractural reduction. Also, weinstructed self-care techniques such as massage, open-eyelid exercise, individual muscle strengthening exercise and matters that require attention in everyday life. AT was performed 19 times, once every one to two weeks.[Assessment and Progress] Measurements of YS, synkinesis, synkinetic potential (SP), Facial Clinimetric Evaluation Scale (FS) were evaluated at about 7 and 15 months after onset. YS (point) changed from 24 to 34, synkinesis changed from (++) to (+), SP did not change, FS (point) increased from 41 to 57.[Discussion and Conclusion] Treatment for PFPS is limited and reduces QOL. We added regular acupuncture treatment to medication and PT for PFPS. As a result, we were able to relieve sequelae, contributing to improvement in the quality of life. It is suggested that AT might have efficacy for PFPS.

Therapy of stress (takotsubo) cardiomyopathy: present shortcomings and future perspectives.

Several therapeutic options are available for the treatment of the acute phase of stress cardiomyopathy, pharmacological (ß-blockers, diuretics, anticoagulants, antiarrhythmics, noncatecholamine inotropics [levosimendan]), and nonpharmacological (intra-aortic balloon pumping, extracorporeal membrane oxygenation), according to the wide possible clinical presentation and course of the disease. However, there is a gap in evidence, and very few data come from randomized and adequately powered studies. Some evidence supports the use of ß-blockers, in particular with a short half-life, in the case of left ventricular outflow tract obstruction, and angiotensin-converting enzyme inhibitors in secondary prevention. Future perspectives include the study of genetic basis of stress cardiomyopathy, role of miRNA and neurovegetative modulation. Randomized studies, however, are surely warranted.