Background The spread of a highly pathogenic, novel coronavirus (SARS-CoV-2) has emerged as a once-in-a-century pandemic, having already infected over 63 million people worldwide. Novel therapies are urgently needed. Janus kinase-inhibitors and Type I interferons have emerged as potential antiviral candidates for COVID-19 patients due to their proven efficacy against diseases with excessive cytokine release and their direct antiviral ability against viruses including coronaviruses, respectively. Methods A search of MEDLINE and MedRxiv was conducted by three investigators from inception until July 30th 2020 and included any study type that compared treatment outcomes of humans treated with Janus kinase-inhibitor or Type I interferon against controls. Inclusion necessitated data with clearly indicated risk estimates or those that permitted their back-calculation. Outcomes were synthesized using RevMan. Results Of 733 searched studies, we included four randomized and eleven non-randomized trials. Five of the studies were unpublished. Those who received Janus kinase-inhibitor had significantly reduced odds of mortality (OR, 0.12; 95% CI, 0.03–0.39, p< 0.001) and ICU admission (OR, 0.05; 95% CI, 0.01–0.26, p< 0.001), and had significantly increased odds of hospital discharge (OR, 22.76; 95% CI, 10.68–48.54, p< 0.00001) when compared to standard treatment group. Type I interferon recipients had significantly reduced odds of mortality (OR, 0.19; 95% CI, 0.04–0.85, p< 0.05), and increased odds of discharge bordering significance (OR, 1.89; 95% CI, 1.00–3.59, p=0.05). Conclusions Janus kinase-inhibitor treatment is significantly associated with positive clinical outcomes in terms of mortality, ICU admission, and discharge. Type I interferon treatment is associated with positive clinical outcomes in regard to mortality and discharge. While these data show promise, additional well-conducted RCTs are needed to further elucidate the relationship between clinical outcomes and Janus kinase-inhibitors and Type I interferons in COVID-19 patients.

We evaluated the effects of replacing some soybean meal (SBM) protein with fish meal (FM) protein in diets adequate and slightly deficient in CP, with or without .75% sodium bentonite (NaB) on performance and ruminal and blood metabolites of individually fed Suffolk lambs. Diets were based on corn, SBM, and cottonseed hulls. In Exp. 1, five lambs were assigned to each of the three dietary treatments (11% CP with 3% FM, 13% CP with 0 or 3% FM). Lambs fed diets that contained 11% CP with 3% FM or 13% CP with 0% FM had similar DMI and ADG. Gain and feed efficiency were slightly improved (P = .18) by the 13% CP diet with 3% FM. In Exp. 2, 32 lambs were assigned to four dietary treatments (13.5% CP of DM) in a 2 x 2 factorial arrangement (0 or 3% FM, and 0 or .75% NaB on an as-fed basis). The DMI and ADG were increased (P < .05) by FM and NaB supplementation. Interactions (P < .05) revealed that NaB increased DMI, ADG, gain per feed (g/kg of DMI), and plasma urea N concentration in the absence of FM but not in the presence of FM in the diet. Neither FM nor NaB influenced (P = .25) wool growth. Total ruminal VFA were increased (P < .06) by FM and NaB. Differences in mineral content of phalanx bone, liver, and kidney were small and may be related to the mineral content of diets and the effect of NaB on mineral solubilities. Similar DMI and ADG of lambs fed FM and NaB separately and in combination suggest that their beneficial effect is not additive.

ObjectivesThis study examined knowledge and perceptions of COVID-19, prevalence of pre-existing conditions and access to essential resources among residents of internally displaced person (IDP) camps in Somalia, where overcrowded settlements with weakened infrastructure, inadequate water, sanitation, and hygiene facilities, and limited access to health services make this vulnerable population particularly susceptible to a COVID-19 outbreak.DesignA descriptive, cross-sectional survey.SettingTwelve IDP camps across six areas of the Lower Shabelle region in Somalia.Participants401 adult Somali IDP camp residents.ResultsThe majority of participants were female (86%) and had received no formal education (89%). While 58% reported being in ‘good’ health, half of the participants reported having one or more pre-existing conditions. Though 77% of respondents reported taking at least one COVID-19 preventative public health measure, respondents reported a lack of access to adequate sanitation, an inability to practice social distancing and nearly universal inability to receive a COVID-19 screening exam. Questions assessing knowledge surrounding COVID-19 prevention and treatment yielded answers of ‘I don’t know’ for roughly 50% of responses. The majority of participants were not familiar with basic information about the virus or confident that they could receive medical services if infected. 185 (47%) respondents indicated that camp living conditions needed to change to prevent the spread of COVID-19.ConclusionThis study highlights low levels of COVID-19 knowledge and limited access to essential prevention and treatment resources among individuals living in Somali IDP camps. A massive influx of additional resources is required to adequately address COVID-19 in Somalia, starting with codesigning interventions to educate those individuals most vulnerable to infection.

Background Novel coronavirus (SARS-CoV-2) has infected over 17 million. Novel therapies are urgently needed. Janus-kinase (JAK) inhibitors and Type I interferons have emerged as potential antiviral candidates for COVID-19 patients for their proven efficacy against diseases with excessive cytokine release and by their ability to promote viral clearance in past coronaviruses, respectively. We conducted a systemic review and meta-analysis to evaluate role of these therapies in COVID-19 patients. Methods MEDLINE and MedRxiv were searched until July 30th, 2020, including studies that compared treatment outcomes of humans treated with JAK-inhibitor or Type I interferon against controls. Inclusion necessitated data with clear risk estimates or those that permitted back-calculation. Results We searched 733 studies, ultimately including four randomized and eleven non-randomized clinical trials. JAK-inhibitor recipients had significantly reduced odds of mortality (OR, 0.12; 95%CI, 0.03-0.39, p=0.0005) and ICU admission (OR, 0.05; 95%CI, 0.01-0.26, p=0.0005), and had significantly increased odds of hospital discharge (OR, 22.76; 95%CI, 10.68-48.54, p<0.00001), when compared to standard treatment group. Type I interferon recipients had significantly reduced odds of mortality (OR, 0.19; 95%CI, 0.04-0.85, p=0.03), and increased odds of discharge bordering significance (OR, 1.89; 95%CI, 1.00-3.59, p=0.05). Conclusions JAK-inhibitor treatment is significantly associated with positive clinical outcomes regarding mortality, ICU admission, and discharge. Type I interferon treatment is associated with positive clinical outcomes regarding mortality and discharge. While these data show promise, additional randomized clinical trials are needed to further elucidate the efficacy of JAK-inhibitors and Type I interferons and clinical outcomes in COVID-19.

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