COVID-19 Resource Centre
Starting from December 2019, a new strain of human coronavirus was detected, initially called 2019-nCoV, in few patients with viral pneumonia in Wuhan, China. Although a specific treatment is currently still unavailable, physicians have several options to help patients by managing symptoms with drugs and supportive systems. The EAACI community is united in disseminating new research and knowledge on COVID-19. Find some of the most useful related content here, to better serve you and your patients.
More resources on COVID-19 will be added as they are released by our community of experts.
Highlights
June 2020
ECDA statement on COVID-19, chronic diseases and EU health capacity
"This paper outlines recommendations to EU institutions, national governments and relevant groups in Europe concerning the COVID-19 response and recovery plans with regard to chronic diseases.
The lessons from this crisis must be learnt. The below proposals aim to support reflections on preparedness for potential future pandemics or other crises, which may occur as a result of factors like climate change; but also to reinforce healthcare systems’ capacity to achieve long-term public health objectives."
Access here
14 June 2020
A compendium answering 150 questions on COVID‐19 and SARS‐CoV‐2
"This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19 and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development and epidemiology. Over 140 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease."
https://onlinelibrary.wiley.com/doi/abs/10.1111/all.14449
EAACI Allergy Journal
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11 February 2021 "A national registry, named DA‐COVID‐19 and involving 35 Italian dermatology units, was established in order to evaluate the impact of COVID‐19 pandemic on the management of adult AD patients treated with systemic immunomodulant/immunosuppressive medications or phototherapy. Demographic and clinical data were obtained at different timepoints by teledermatology during COVID‐19 pandemic, when regular visits were not allowed due to sanitary restrictions. Disease severity was assessed by both physician‐ and patient‐reported assessment scores evaluating itch intensity, sleep disturbances, and AD severity." https://onlinelibrary.wiley.com/doi/10.1111/all.14767
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31 January 2021
https://onlinelibrary.wiley.com/doi/10.1111/all.14754
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23 January 2021
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16 January 2021 "We provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres.
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30 December 2020
https://onlinelibrary.wiley.com/doi/10.1111/all.14726
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28 November 2020
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7 January 2021 "High expression of such endopeptidases may be associated not only with a higher risk of SARS‐CoV‐2 infection but also with microbial imbalances in severe asthma. Therefore, the aim of this study was to investigate associations of sputum endopeptidases gene expression with metagenomics composition and whether they could be used to stratify asthma patients according to risk of SARS‐CoV‐2 infection."
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31 December 2020
https://doi.org/10.1111/all.14728
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19 December 2020 https://doi.org/10.1111/all.14714
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15 December 2020
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15 December 2020
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12 December 2020 "Sputum induction (SI) is the gold standard approach to the non‐invasive study of airway inflammation. The multidisciplinary consensus on SI described in this article was developed by 22 experts in SI from different Spanish hospitals who drew on available scientific evidence in achieving consensuated opinions, compiled by means of an electronic survey." |
7 December 2020
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19 November 2020 |
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13 November 2020
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31 October 2020
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19 October 2020 "Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS‐CoV‐2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in non‐infected patients and should be temporarily interrupted during the course of the COVID‐19 infection." |
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10 October 2020 "In summary, our study provides the first evidence of regional differences in ACE2 expression in the sinonasal mucosa of patients with CRS and that ACE2 expression in CRS tissues is associated with type I IFN response and not type 2 response (Figure 2C)." |
10 October 2020 "Our findings might have important implications for the definition of asymptomatic COVID‐19 infections, diagnosis, serological survey, public health, and immunization strategies." |
04 October 2020 "In summary, despite the differences depending on phenotypes, the prevalence of asthma was not significantly different in patients with COVID-19, and asthma did not affect the outcomes of COVID-19 in multivariate analysis. Dementia, older age, and initial presentation of skin rash and anemia were independently associated with delayed viral clearance. On the other hand, in patients with headache initially, the viral clearance time was shortened" |
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30 September 2020 "ELISAs targeting RBD and S1 protein of SARS‐CoV‐2 are promising immunoassays which shall be further evaluated in studies verifying diagnostic accuracy and protective immunity against SARS‐CoV‐2." |
23 September 2020 "In summary, we show that small droplet emission varies for different breath manoeuvre performed during PFTs, with very low production in TV and sVC from FRC and low production during FEV. Consideration of performing PFTs in different clinical settings could account for these differences, with future focus of clinical risk also on room ventilation." |
21 September 2020 "Coronavirus disease‐19 (COVID‐19) is a new disease caused by SARS‐CoV‐2. Since the beginning of 2020, it has become one of the main challenges of our times, causing a high incidence of severe pneumonia, acute respiratory distress syndrome (ARDS), multiorgan failure and death1. At the root of COVID‐19 lies the sudden development of ‘cytokine storms’, hyper‐inflammatory responses involving the release of pro‐inflammatory cytokines (e.g., TNF, IL‐6, IL‐1, IL‐8, and MCP‐1) that impair the gas exchange function of the lung and lead in select patients, mostly with underlying comorbidities, to multiorgan failure and death." |
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18 September 2020 "The results support the recommendation that patients continue taking their prescribed asthma medications as usual and maintain good asthma control during the ongoing pandemic. For containment of viral transmission, social distancing is being encouraged, but measures should be taken to mitigate the negative impact on asthma" |
07 September 2020 "Thus, with the here presented cases we support the AMS declaration that MMR vaccination, as a preventive measure, might reduce the severity of COVID-19, although we differ in our view on the mechanisms by which we hypothesize this happens. Though randomized, clinical and mechanistic trials shall be needed to unravel this topic, taking in consideration there are hardly any safety concerns, we maintain our positive attitude toward MMR vaccination during this pandemic." |
27 August 2020 "In conclusion, for the first time, we provide the evidence that AR comorbidity may not have significant modifying effect on the development and expression of COVID‐19. ACE2 expression is not altered in AR patients. ACE2 gene expression in airways is regulated, at least in part, by the counter effect of type 2 and IFN inflammation." |
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16 August 2020 "In conclusion, atopic status seems to protect against the most severe, often fatal consequences of SARS‐CoV‐2 infection. Such finding may be of help for future studies investigating how to limit the clinical consequences of this infection." |
"Despite the clinical burden of severe asthma is substantial, there is evidence of a neutral effect of severe asthma in the clinical progression and hospitalization due to COVID-19 in a cohort of Italian severe asthma patients. Treatment with biologics for severe asthma also seems to have no significant effect on the outcome of COVID-19" |
"The nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2) is the most potent antioxidant in humans and can block the AT1R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are given: Kimchi in Korea, westernized foods and the slum paradox. It is proposed that fermented cabbage is a proof‐of‐concept of dietary manipulations that may enhance Nrf2‐associated antioxidant effects helpful in mitigating COVID‐19 severity." |
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05 August 2020 "Collectively, for the first time, our study provides evidence that delayed antibody responses correlate with poor clinical outcome of COVID‐19 patients. This notion is strongly supported by the reduction of SARS‐CoV‐2‐specific IgM and IgG levels and frequencies of ASCs and TFH cells in the early stage of disease in deceased patients compared with survived patients, which highlights the importance of early adaptive immune responses in patients with COVID‐19." |
"(...)the results obtained from this rationale together with the information related to previous pathologies and risk factors will allow the design of personalized strategies of reincorporation into academic activities in the future. This will significantly reduce the human and economic burden of future COVID‐19 infection waves in our community. The proposed strategy can be easily implemented by several research laboratories and might help in better activity plans in other locations to be ready for future outbreaks." |
02 August 2020 "In conclusion, our results on a consecutive ambulatory population of COVID‐19 cases suggest that blood level of MPO‐DNA complexes could be a useful biomarker of the early phase of SARS‐CoV‐2 infection. If further studies confirm that the dramatic production of NETs is a pathological mechanism of innate immunity involved in early step of SARS‐CoV‐2 infection, our data could open therapeutic perspectives by targeting NET production with inhibitors already tested in other lung infectious diseases." |
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01 August 2020 "In conclusion, in our large cohort of severe asthmatics, only a small minority experienced symptoms consistent with COVID‐19, and these patients had peculiar clinical features including high prevalence of NIDDM as comorbidity. Further real‐life registry‐based studies are needed to confirm our findings and to extend the evidence that severe asthmatics are at low risk of developing COVID‐19." |
"Our findings suggest that a natural SARS‐CoV‐2 infection, similar to that observed previously for rhinovirus (RV) infections,9 does not induce a protective antibody response inhibiting the virus‐receptor interaction in all infected patients and therefore underline the urgent need for the development of a SARS‐CoV‐2 vaccine. The molecular interaction assays could be useful for identifying subjects having developed protective antibodies and for screening candidate vaccines to induce antibodies that inhibit the RBD‐ACE2 interaction once they have been validated.." |
29 July 2020 "In sum, while additional studies are needed to uncover the mechanistic basis of varying COVID‐19 clinical presentations, our data associate significantly higher ACE2 protein expression in the serum of adults compared with infants and toddlers, and in adult males compared with adult females. These data suggest the potential systemic role of ACE2 protein levels in the differential clinical manifestations among various patient populations." |
Read more here
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EAACI Pediatric Allergy and Immunology Journal
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28 October 2020 "Tremendous efforts are undertaken to quickly develop COVID‐19 vaccines that protect vulnerable individuals from severe disease and thereby limit the health and socioeconomic impacts of the pandemic. Potential candidates are tested in adult populations, and questions arise of whether COVID‐19 vaccination should be implemented in children. Compared to adults, the incidence and disease severity of COVID‐19 are low in children, and despite their infectiveness, their role in disease propagation is limited. Therefore, COVID‐19 vaccines will need to have fully demonstrated safety and efficacy in preventing not only complications but transmission to justify childhood vaccination. This work summarizes currently tested vaccine platforms and debates practical and ethical considerations for their potential use in children. It also discusses the already deleterious effect of the pandemic on routine childhood vaccine coverage, calling for action to limit the risks for a rise in vaccine‐preventable diseases." https://onlinelibrary.wiley.com/doi/10.1111/pai.13401 |
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08 September 2020 "Multisystem inflammatory syndrome in children (MIS‐C) during the COVID‐19 pandemic raised a global alert from the Centers for Disease Control and Prevention's Health Alert Network. The main manifestations of MIS‐C (also known as pediatric MIS (PMIS)) in the setting of a severe inflammatory state include fever, diarrhea, shock, and variable presence of rash, conjunctivitis, extremity edema, and mucous membrane changes. In some cases, these symptoms progressed to multi‐organ failure. The low percentage of children with asymptomatic cases compared with mild illness and moderate illness could be correlated with the rare cases of MIS‐C. One potential explanation for the progression to severe MIS‐C disease despite the presence of readily detectable anti‐SARS‐CoV‐2 antibodies could be due to the potential role of antibody‐dependent enhancement (ADE). We reason that the incidence of the ADE phenomenon whereby the pathogen‐specific antibodies can promote pathology should be considered in vaccine development against SARS‐CoV‐2." |
15 September 2020 "Neonates appeared to bear more severe clinical courses. In addition to higher case fatality rates, newborns with COVID‐19 had much shorter time from symptom onset to death and longer time from symptom onset to discharge. Dyspnoea, sore throat and cough were more prominent in neonate patients, suggestive of both upper and lower respiratory tract infection, as opposed to upper respiratory tract symptoms mostly observed in children." https://onlinelibrary.wiley.com/doi/10.1111/pai.13371 |
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05 August 2020 "For the EU‐funded project PERMEABLE (PERsonalized MEdicine Approach for asthma and allergy Biologicals SeLEction), which addresses the availability of and access to advanced therapy of asthma in children across Europe, we performed a survey including 37 major pediatric asthma and allergy centres between September 2019 and July 2020. In total, the centres contributing to the survey treated approximately 1.000 young patients with severe asthma in 25 major European countries and Turkey with biologicals. In the light of the corona pandemic, we extended our survey asking the responsible clinicians whether they experienced a SARS‐CoV‐2 infection in any of the children they are caring for. The questions pertaining to corona infections were asked between March and July 2020." |
19 July 2020 "The current pandemic of the novel SARS‐CoV‐2 infection has affected over 10 million humans around the planet. The clinical manifestations of coronavirus disease 2019 (COVID‐19) are diverse, ranging from asymptomatic or mild flu‐like symptoms to atypical pneumonia, severe respiratory distress syndrome, systemic inflammation, immune dysregulation, and coagulopathy. Here, we describe a male infant patient with known ARPC1B deficiency, who was hospitalized for COVID‐19 pneumonia and improved without requiring intensive care or mechanical ventilation. Informed consent through protocols approved by the institutional review boards of the National Institute of Pediatrics was obtained from the patient’s family." https://onlinelibrary.wiley.com/doi/10.1111/pai.13322 |
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09 June 2020 "The coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) appears milder in children but little is known about neonates and about the chains of infections after delivery. When in early March 2020 a midwife in our large maternity and perinatal center returned from vacation in Ischgl, Austria, she triggered a COVID‐19 outbreak affecting 36 midwives, nurses and doctors. We reported previously on the successful containment of this outbreak and characterized the clinical symptoms and immunoglobulin development in staff members exposed to SARS‐CoV‐2." |
29 May 2020 "Infection by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the viral etiology of the novel coronavirus disease 2019 (COVID‐19), was first reported in Wuhan, China in late 2019. Peculiarly, the virus has not caused significant impact on pediatric populations, unlike other coronaviruses (1). Children comprise only 1.7% of COVID‐19 positive cases in the United States (2). Furthermore, children are noted to have a milder disease course (3, 4). However, much is unknown about the age, gender and race risk factors of COVID‐19 among children. There has been recent evidence suggestive of higher rates of COVID‐19 and related fatality rates in African American adult communities around the United States(5). However, there is limited data, to our knowledge, whether any race or ethnicity group is at higher risk for COVID‐19 infection in children." https://onlinelibrary.wiley.com/doi/abs/10.1111/pai.13298 |
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15 May 2020 "We found that a significant number of diseased did not develop relevant antibody responses three weeks after symptom onset. Our data also suggest that exposure to COVID‐19 positive co‐workers in a hospital setting is not leading to the development of measurable immune responses in a significant proportion of asymptomatic contact persons." https://onlinelibrary.wiley.com/doi/10.1111/pai.13278 |
"This allows the virus to bypass the efficient immune barrier of the upper airway mucosa in already infected, young, and otherwise healthy athletes. In conclusion, whether the virus or the adaptive immune response reaches the lungs first is a crucial factor deciding the fate of the patient. This “quantitative and time‐/sequence‐dependent” model has several implications for prevention, diagnosis, and therapy of COVID‐19 at all ages." |
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24 April 2020 "Clear understanding of the immune responses to the virus in children and the transmission potential of asymptomatic children are of paramount importance for the development of specific treatments and vaccine in order to effectively control the ongoing pandemic" https://onlinelibrary.wiley.com/doi/epdf/10.1111/pai.13267 |
22 April 2020 "Our report suggests that XLA patients might present high risk to develop pneumonia after SARS‐Cov2 infection, but can recover from infection, suggesting that B cell response might be important, but not strictly required to overcome the disease. However, there is need of larger observational studies to extend these conclusions to other patients with similar genetic immune defects." https://www.onlinelibrary.wiley.com/doi/10.1111/pai.13263 |
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22 April 2020 "Most countries affected by COVID‐19 have opted for nationwide confinement, which means that communication with the primary clinician is often performed by telemedicine. Optimal disease control of allergic, asthmatic and immunodeficient children should be sought according to usual treatment guidelines. This statement of the EAACI Section on Pediatrics puts forward six recommendations for the management of childhood allergies and immunodeficiencies based on six underlying facts and existing evidence." https://www.onlinelibrary.wiley.com/doi/10.1111/pai.13262 |
"Apart from massive testing of personnel in predefined phases and increased hygiene measures, including a general obligation to wear surgical face masks, we identified the need to monitor cases of illness across all groups of employees, to ensure social distancing within personnel and to evaluate contacts of clinical personnel outside of the hospital environment, in order to be able to interpret chains of infections and to disrupt them. Overall, only a bundle of measures is needed to contain such an outbreak." |
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04 April 2020 "Viral infections are well-known risk factors for an exacerbation of asthma. In the study by Yang et al., 40% of the COVID-19 patients with critical symptoms had an underlying long-term disease before the infection. Another study of 140 cases from Wuhan (China) did not report allergic diseases as co-morbidities among severe cases. However, more information needs to be gathered and analyzed to create reliable reports on risk factors for severe COVID-19." https://patients.eaaci.org/coronavirus-infection-and-asthma-what-do-we-know/ |
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17 June 2020 "We also revealed that the alarmin HMGB1 is critical for SARS-CoV-2 replication. In contrast, loss of the histone H3.3 chaperone complex sensitized cells to virus-induced death. Together this study reveals potential therapeutic targets for SARS-CoV-2 and highlights host genes that may regulate COVID-19 pathogenesis." This article was selected by Adam Klocperk, Marketa Bloomfield, Tomáš Milota, and Anna Sediva
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11 June 2020 "SARS-CoV-2 infection displays immense inter-individual clinical variability, ranging from silent infection to lethal disease. The role of human genetics in determining clinical response to the virus remains unclear. Studies of outliers—individuals remaining uninfected despite viral exposure and healthy young patients with life-threatening disease—present a unique opportunity to reveal human genetic determinants of infection and disease." |
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02 June 2020 "The article describes the initiation of the first clinical trial (ClinicalTrials.gov LY-CoV555) that uses monoclonal antibody binding S-protein of SARS-Cov-2 virus. The antibody was designed using the most potent clones of B cells from COVID-19 patients. Before vaccine available the access to the highly specific monoclonal antibody would be very useful and might enrich treatment strategies in COVID-19." Access here |
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01June 2020 "The dynamically changing epidemiological situation related to SARS-CoV-2 infection poses challenges also for allergists. Both allergic diseases affecting many organs, especially the respiratory system, and the procedures used by allergists give rise a number of questions about
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"Angiotensin-converting enzyme (ACE)2 receptor, an entry receptor for SARS-CoV and present on type 2 pneumocytes in the lung, ileal absorptive enterocytes, and nasal goblet secretory cells in nasal mucosa. Access here |
26 May 2020 "This interesting article shows that the ApoE e4e4 allele increases risks of severe COVID-19 infection, independent of pre-existing dementia, cardiovascular disease, and type-2 diabetes. This article was selected by Adam Klocperk, Marketa Bloomfield, Tomáš Milota, and Anna Sediva Access here |
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"This is a binational (Italian – Chinese) multicenter prospective study to assess cutaneous involvement in COVID-19, performed between 1.01-15.03.2020. The authors state that the dermatological manifestations could not be correlated to COVID-19 severity. Diffuse petechiae, gravity-dependent and multiple, generalized palpable purpura, and acroischemia (primarily finger/toe cyanosis, but no skin bulla nor dry gangrene) were seen in severe cases. Skin manifestations were observed in only 7.8% of the cohort, and these skin findings are generally mild and self-limiting and do not correlate with overall prognosis.” |
"Single center case-control study in Lombardia, Italy, of 1193 psoriasis patients treated with biologics compared to the Lombardia population as controls, assessing the risk of contracting COVID-19, and analysing mortality, and ICU admission rates. Furthermore severity of COVID-19 disease was reviewed. Access here |
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22 April 2020 This article was selected by FJS van der Velden, MD (resident paeds) & G. Tramper, PhD, MD (paediatrician, paediatric infectiologist) Access here |
26 March 2020 "In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services." https://www.sciencedirect.com/science/article/pii/S2213219820302531 |
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24 March 2020 "As COVID-19 continues to spread, it is important that we are ready to continue to care for patients, and to recognize patients who may potentially have, or have been exposed to, COVID-19." https://www.worldallergy.org/UserFiles/file/Preparing_your_office_COVID-19.pdf |
16 March 2020 "AIT and COVID-19 |
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