Main point: Hydroxychloroquine was found to be more potent than chloroquine at inhibiting SARS-CoV-2 in vitro. Hydroxychloroquine sulfate 400 mg given twice daily for 1 day, followed by 200 mg twice daily for 4 more days is recommended to treat SARS-CoV-2 infection. AbstractBackground. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) first broke out in Wuhan (China) and subsequently spread worldwide. Chloroquine has been sporadically used in treating SARS-CoV-2 infection. Hydroxychloroquine shares the same mechanism of action as chloroquine, but its more tolerable safety profile makes it the preferred drug to treat malaria and autoimmune conditions. We propose that the immunomodulatory effect of hydroxychloroquine also may be useful in controlling the cytokine storm that occurs late-phase in critically ill SARS-CoV-2 infected patients. Currently, there is no evidence to support the use of hydroxychloroquine in SARS-CoV-2 infection.Methods. The pharmacological activity of chloroquine and hydroxychloroquine was tested using SARS-CoV-2 infected Vero cells. Physiologically-based pharmacokinetic models (PBPK) were implemented for both drugs separately by integrating their in vitro data. Using the PBPK models, hydroxychloroquine concentrations in lung fluid were simulated under 5 different dosing regimens to explore the most effective regimen whilst considering the drug's safety profile.Results. Hydroxychloroquine (EC50=0.72 μM) was found to be more potent than chloroquine (EC50=5.47 μM) in vitro. Based on PBPK models results, a loading dose of 400 mg twice daily of hydroxychloroquine sulfate given orally, followed by a maintenance dose of 200 mg given twice daily for 4 days is recommended for SARS-CoV-2 infection, as it reached three times the potency of chloroquine phosphate when given 500 mg twice daily 5 days in advance. Conclusions.Hydroxychloroquine was found to be more potent than chloroquine to Downloaded from https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciaa237/5801998 by guest on 16 March 2020 4 / 25 inhibit SARS-CoV-2 in vitro.

Objective. To estimate the prevalence of symptomatic knee osteoarthritis (OA) in China.Methods. Using data collected from the China Health and Retirement Longitudinal Study, a populationbased longitudinal survey conducted between 2011 and 2012, we estimated the prevalence of symptomatic knee OA according to sex, age, rural/urban area, socioeconomic status, and geographic region.Results. Among 17,128 individuals (8,367 men and 8,761 women; mean age 59.8 years) included in the analysis, 8.1% had symptomatic knee OA. The prevalence of symptomatic knee OA was higher in women (10.3%) compared with men (5.7%) (adjusted odds ratio [OR] 1.88 [95% confidence interval 1.64-2.17]). The prevalence of symptomatic knee OA increased with age (P for trend <0.01). Symptomatic knee OA was more common in rural areas than in urban areas (OR 1.84 [95% confidence interval 1.46-2.31]). The prevalence of symptomatic knee OA was lower among individuals who had received more years of education and who lived in more developed areas (P for trend <0.01). The North and East regions of China had the lowest prevalence of symptomatic knee OA (5.4% and 5.5%, respectively), followed by the North-East (7.0%), South-Central (7.8%), and North-West (10.8%) regions. The prevalence was highest (13.7%) in subjects living in the South-West region.Conclusion. Symptomatic knee OA in China was prevalent, and the prevalence varied according to sociodemographic, economic, and geographic factors. Epidemiologic studies identifying risk factors that contribute to variation in the prevalence of symptomatic knee OA in China are warranted.Knee osteoarthritis (OA) is the most common joint disorder in elderly individuals (1-4). Knee OA pain is a key symptom of persons seeking medical care and is the leading cause of disability (5-7). To date, the majority of population-based observational studies of knee OA have been conducted in developed countries (8-12), and only a few studies have been conducted in China (13,14). Thus, there is a paucity of data on the prevalence of knee OA and potential risk factors for knee OA in elderly individuals in China.China is a large country, with a population of 1.3 billion. In 2010, 25.3% of the population comprised individuals age 50 years or older (15). Socioeconomic development, environmental factors, lifestyle factors, and health care utilization varied greatly among residents in the different regions of China. Thus, based on these factors, one would expect a large variation in the prevalence of symptomatic knee OA (16,17). To date, data regarding the prevalence of symptomatic OA in this population are lacking. Epidemiologic studies comparing the prevalence of symptomatic knee OA according to sociodemographic factors, economic factors, and geographic areas, using the same research method, would not only provide important and valuable information for health care planners but would also shed light on our understanding of the potential risk factors for symptomatic knee OA.

PurposeTo examine the associations of near work related parameters with spherical equivalent refraction and axial length in Chinese children.MethodsA total of 1770 grade 7 students with mean age of 12.7 years were examined with cycloplegic autorefraction and axial length. Questions were asked regarding time spent in near work and outdoors per day, and near work related parameters.ResultsMultivariate models revealed the following associations with greater odds of myopia: continuous reading (> 45min), odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8; close television viewing distance (≤ 3m), OR, 1.7; 95% CI, 1.2-2.3; head tilt when writing, OR, 1.3; 95% CI, 1.1-1.7, and desk lighting using fluorescent vs. incandescent lamp, OR, 1.5; 95% CI, 1.2-2.0. These factors, together with close reading distance and close nib-to-fingertip distance were significantly associated with greater myopia (P<0.01). Among near work activities, only reading more books for pleasure was significantly associated with greater myopia (P=0.03). Television viewing distance (≤ 3 m), fluorescent desk light, close reading distance (≤20 cm) and close nib-to-fingertip distance (≤ 2 cm) were significantly associated with longer axial length (P<0.01). Reading distance, desk light, and reading books for pleasure had significant interaction effects with parental myopia.ConclusionsContinuous reading, close distances of reading, television viewing and nib-to-fingertip, head tilt when writing, reading more books for pleasure and use of fluorescent desk light were significantly associated with myopia in 12-year-old Chinese children, which indicates that visual behaviors and environments may be important factors mediating the effects of near work on myopia.

The clinical characteristics and outcomes of Chinese patients with sporadic ALS were different compared with patients from other countries. Compared with other studies, the age at onset of Chinese patients was earlier, the percentage of bulbar-onset ALS was lower and the prognosis was better. This study substantially advances the understanding of the clinical features and epidemiology of this rare disease.

The ACES is the first large-scale cohort study in China with baseline response rates over 90%. Continuous documentation of changes and risk factors of refractive errors in these cohorts would provide new insights into myopia control in school-aged children.