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In contrast, the levels of related kinases, phosphatases, and transfer proteins were unaltered in the Npc1-null mouse model as observed by Western blot analysis. Our discovery of phosphoinositide lipid biomarkers for NPC1 opens new perspectives on the pathophysiology underlying this fatal neurodegenerative disease. Published under license by The American Society for Biochemistry and Molecular Biology, Inc.Information about the clinical presentation and course of COVID-19 is rapidly evolving. Data are emerging from retrospective clinical studies conducted in Wuhan, China, showing the symptoms and characteristics of COVID-19 caused by severe acute respiratory virus coronavirus 2 (SARS-CoV-2) infection, including fever, cough, and shortness of breath. Alantolactone Radiographic data on COVID-19 cases reveal bilateral opacities on chest radiography and ground-glass opacities on computed tomography. Data on laboratory markers and mortality and morbidity are also emerging. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Current Centers for Disease Control and Prevention guidelines state that patients with moderate to severe asthma may be at greater risk for more severe disease if infected with SARS-CoV-2; however, no published data support this suggestion. During this pandemic, it is recommended that patients with asthma continue taking all controller inhalers and other asthma medication as prescribed to prevent exacerbations and limit outpatient clinic and emergency room exposure. Symptoms that may differentiate COVID-19 from asthma exacerbations caused by another trigger may include fever, fatigue, anorexia, or myalgias. Patients with suspected or confirmed COVID-19 should avoid nebulizer treatments due to the risk of aerosolization. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.No specific data exists regarding management of patients with cystic fibrosis (CF) who are infected with COVID-19. Based on expert opinion, strategies for outpatient management include use of elexacaftor-tezacaftor-ivacaftor to reduce pulmonary exacerbations, telemedicine, adherence to prescribed regimens, prompt and aggressive treatment of CF exacerbations, and communication about COVID-19 with patients with CF. Strategies for inpatient management may vary due to special precautions to avoid the aerosolization of COVID-19 with the use of nebulized medications and other therapies. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.During the COVID-19 pandemic, Cleveland Clinic has put in place several pulmonary function testing precautions to reduce the risk of infection. Precautions include efforts to perform only essential testing, wear personal protective equipment, reduce exposure to aerosolized particles, manage virtually by phone conference, conserve scare medications, clean equipment as recommended, consolidate testing, and defer testing. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Positive airway pressure (PAP) therapy is an open system that can generate contact, droplet, and airborne COVID-19 thereby increasing the risk of transmission of COVID-19 like other procedures such as tracheal intubation, noninvasive ventilation, and cardiopulmonary resuscitation. Medically prudent recommendations have been established for home use of PAP therapy in asymptomatic patients and patients with suspected or confirmed COVID-19. Recommendations for sleep clinics and sleep laboratory activities are also discussed as well as the emergency use of PAP devices as a substitute for ventilation. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Numerous societal changes in response to the COVID-19 pandemic, such as school closings and event cancellations, have caused anxiety and fear for children and young people. There are ways to help young people cope with the current situation including establishing an open dialogue, creating a structured daily routine with a schedule with assigned roles, and using social media and video conferencing to remain socially connected. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Hydroxychloroquine (HCQ) has multiple potential antiviral mechanisms of action that differ according to the pathogen studied (eg, Chikungunya, Dengue virus, human immunodeficiency virus, poliovirus, Zika virus). Data on HCQ for treatment of coronavirus disease 2019 (COVID-19) are rapidly evolving. To date there is no evidence from randomized controlled trials that any single therapy improves outcomes in patients infected with COVID-19. There are also no clinical trial data supporting prophylactic HCQ therapy in COVID-19. Hydroxychloroquine (HCQ) use in patients with COVID-19 is being investigated examining prophylaxis, postexposure prophylaxis, and treatment regimens. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Patients with COVID-19 and acute cardiac injury as measured by an elevated high-sensitivity troponin I or troponin T upon admission or during hospitalization have a mortality rate of over 50% in initial reports. The mechanism of SARS-CoV-2 and associated myocardial injury, whether SARS-CoV-2 patients with myocardial injury are a distinct population, and possible treatment options for myocardial injury associated with SARS-CoV-2 are unknown. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Hyperglycemia is common in critically ill patients and is associated with worse outcomes in those admitted to an intensive care unit. Glucose control helps prevent and control infections and their complications. For critically ill patients with COVID-19, management of hyperglycemia must consider caregiver protection and the frequency of monitoring glucose based on patient safety and the use of personal protective equipment. If steroids are used in the management plan, be aware of steroid-induced hyperglycemia. An endocrinology consult may be beneficial to help manage drip rate and frequency of glucose checks. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.Extracorporeal membrane oxygenation (ECMO) is a means of cardiopulmonary support for refractory respiratory and cardiac failure. ECMO is a resource-intensive therapy that can be considered in highly selected patients. Expert centers should employ an evidence-based ARDS treatment algorithm and a multidisciplinary approach to recommending ECMO upon failure of conventional therapy. Caring for ECMO patients requires adequate infection control and safety precautions for healthcare workers. Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.