PCCM at the Battlefront Against COVID-19 in Wuhan, China
Identifieur interne : 000347 ( Pmc/Corpus ); précédent : 000346; suivant : 000348PCCM at the Battlefront Against COVID-19 in Wuhan, China
Auteurs : Sinan Wu ; Renli Qiao ; Chen WangSource :
- Chest [ 0012-3692 ] ; 2020.
Url:
DOI: 10.1016/j.chest.2020.04.007
PubMed: 32298732
PubMed Central: 7153520
Links to Exploration step
PMC:7153520Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">PCCM at the Battlefront Against COVID-19 in Wuhan, China</title><author><name sortKey="Wu, Sinan" sort="Wu, Sinan" uniqKey="Wu S" first="Sinan" last="Wu">Sinan Wu</name><affiliation><nlm:aff id="aff1">Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China</nlm:aff></affiliation></author><author><name sortKey="Qiao, Renli" sort="Qiao, Renli" uniqKey="Qiao R" first="Renli" last="Qiao">Renli Qiao</name><affiliation><nlm:aff id="aff2">University of Southern California, Los Angeles, CA</nlm:aff></affiliation></author><author><name sortKey="Wang, Chen" sort="Wang, Chen" uniqKey="Wang C" first="Chen" last="Wang">Chen Wang</name><affiliation><nlm:aff id="aff3">Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32298732</idno><idno type="pmc">7153520</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153520</idno><idno type="RBID">PMC:7153520</idno><idno type="doi">10.1016/j.chest.2020.04.007</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000347</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000347</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">PCCM at the Battlefront Against COVID-19 in Wuhan, China</title><author><name sortKey="Wu, Sinan" sort="Wu, Sinan" uniqKey="Wu S" first="Sinan" last="Wu">Sinan Wu</name><affiliation><nlm:aff id="aff1">Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China</nlm:aff></affiliation></author><author><name sortKey="Qiao, Renli" sort="Qiao, Renli" uniqKey="Qiao R" first="Renli" last="Qiao">Renli Qiao</name><affiliation><nlm:aff id="aff2">University of Southern California, Los Angeles, CA</nlm:aff></affiliation></author><author><name sortKey="Wang, Chen" sort="Wang, Chen" uniqKey="Wang C" first="Chen" last="Wang">Chen Wang</name><affiliation><nlm:aff id="aff3">Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China</nlm:aff></affiliation></author></analytic><series><title level="j">Chest</title><idno type="ISSN">0012-3692</idno><idno type="eISSN">1931-3543</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Chen, S" uniqKey="Chen S">S. Chen</name></author><author><name sortKey="Yang, J" uniqKey="Yang J">J. Yang</name></author><author><name sortKey="Yang, W" uniqKey="Yang W">W. Yang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Li, Q" uniqKey="Li Q">Q. Li</name></author><author><name sortKey="Guan, X" uniqKey="Guan X">X. Guan</name></author><author><name sortKey="Wu, P" uniqKey="Wu P">P. Wu</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Tobin, M J" uniqKey="Tobin M">M.J. Tobin</name></author><author><name sortKey="Hines, E" uniqKey="Hines E">E. Hines</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brotherton, S E" uniqKey="Brotherton S">S.E. Brotherton</name></author><author><name sortKey="Etzel, S I" uniqKey="Etzel S">S.I. Etzel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Qiao, R" uniqKey="Qiao R">R. Qiao</name></author><author><name sortKey="Rosen, M J" uniqKey="Rosen M">M.J. Rosen</name></author><author><name sortKey="Chen, R" uniqKey="Chen R">R. Chen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Qiao, R" uniqKey="Qiao R">R. Qiao</name></author><author><name sortKey="Marciniuk, D" uniqKey="Marciniuk D">D. Marciniuk</name></author><author><name sortKey="Augustyn, N" uniqKey="Augustyn N">N. Augustyn</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="editorial"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Chest</journal-id><journal-id journal-id-type="iso-abbrev">Chest</journal-id><journal-title-group><journal-title>Chest</journal-title></journal-title-group><issn pub-type="ppub">0012-3692</issn><issn pub-type="epub">1931-3543</issn><publisher><publisher-name>American College of Chest Physicians</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32298732</article-id><article-id pub-id-type="pmc">7153520</article-id><article-id pub-id-type="publisher-id">S0012-3692(20)30693-0</article-id><article-id pub-id-type="doi">10.1016/j.chest.2020.04.007</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>PCCM at the Battlefront Against COVID-19 in Wuhan, China</article-title></title-group><contrib-group><contrib contrib-type="author" id="au1"><name><surname>Wu</surname><given-names>Sinan</given-names></name><degrees>MD</degrees><xref rid="aff1" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au2"><name><surname>Qiao</surname><given-names>Renli</given-names></name><degrees>MD, PhD, FCCP</degrees><email>rqiao@med.usc.edu</email><xref rid="aff2" ref-type="aff">b</xref><xref rid="cor1" ref-type="corresp">∗</xref></contrib><contrib contrib-type="author" id="au3"><name><surname>Wang</surname><given-names>Chen</given-names></name><degrees>MD, PhD</degrees><xref rid="aff3" ref-type="aff">c</xref></contrib><aff id="aff1"><label>a</label>Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China</aff><aff id="aff2"><label>b</label>University of Southern California, Los Angeles, CA</aff><aff id="aff3"><label>c</label>Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China</aff></contrib-group><author-notes><corresp id="cor1"><label>∗</label><bold>CORRESPONDENCE TO:</bold> Renli Qiao, MD, PhD, FCCP, University of Southern California, 2011 Zonal Ave, HMR911, Los Angeles, CA 90036 <email>rqiao@med.usc.edu</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>13</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>13</day><month>4</month><year>2020</year></pub-date><permissions><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><kwd-group id="kwrds0010"><title>Key Words</title><kwd>COVID-19 epidemic</kwd><kwd>Fang Cang Shelter Hospital</kwd><kwd>PCCM</kwd></kwd-group><kwd-group id="kwrds0015"><title>Abbreviations</title><kwd>CHEST, American College of Chest Physicians</kwd><kwd>COVID-19, coronavirus disease 2019</kwd><kwd>CTS, Chinese Thoracic Society</kwd><kwd>PCCM, pulmonary and critical care medicine</kwd></kwd-group></article-meta></front><body><p id="p0010">With its abrupt outbreak and rapid spread, coronavirus disease 2019 (COVID-19) has been an unprecedented challenge to the health-care system in China. More than 40,000 health workers from all over the country were called upon and dispatched to the Wuhan metropolitan area, the origin and center of the epidemic where the medical system was overwhelmed. Among the 78,064 confirmed cases at the time of this writing, more than two-thirds were from Wuhan, more than 8,000 are in serious condition, and more than 3,000 Wuhan health-care workers have been infected.<xref rid="bib1" ref-type="bibr">1</xref>, <xref rid="bib2" ref-type="bibr">2</xref>, <xref rid="bib3" ref-type="bibr">3</xref>, <xref rid="bib4" ref-type="bibr">4</xref></p><p id="p0015">In this large-scale mobilization of medical resources that has been the focus of media coverage for months, a key word frequently mentioned was that most physicians and nurses dispatched to Wuhan were from the department of “PCCM.” PCCM stands for pulmonary and critical care medicine. The term remains somewhat unfamiliar and even foreign to Chinese people, as well as to much of the rest of the world. PCCM as a combined concept has, for a long time, been a “peculiarly American hybrid.”<xref rid="bib5" ref-type="bibr"><sup>5</sup></xref></p><p id="p0020">Facing the sudden disastrous COVID-19 epidemic, characterized by lung infection rapidly leading to a critical condition, a well-trained PCCM specialist is the professional best suited to take on this challenge. The Chinese PCCM team has been undoubtedly serving as the mainstay from the very beginning, in defending and winning the fight against this pandemic. How did a “peculiarly American hybrid” become a well-established medical specialty and, in fact, pioneered in the subspecialty training (fellowship) in China? The American College of Chest Physicians (CHEST) has made an unparalleled contribution to this matter.</p><sec id="sec1"><title>Establishment of the PCCM Subspecialty in China</title><p id="p0025">Following the severe acute respiratory syndrome epidemic in 2003, Chinese leaders in the field began to recognize the importance of incorporating critical care into the practice of respiratory medicine. After careful consideration, they decided to adopt the US model of PCCM, which has proved to be successful, both in terms of addressing real-world situations and attracting promising candidates to the profession.<xref rid="bib6" ref-type="bibr"><sup>6</sup></xref></p><p id="p0030">The mission of CHEST encompasses medical education and international collaboration. In 2013, the Chinese Thoracic Society (CTS) and CHEST published an historical joint statement, declaring a collaboration in developing the PCCM subspecialty in China.<xref rid="bib7" ref-type="bibr"><sup>7</sup></xref> The China-CHEST PCCM fellowship program was launched in 2014. Curriculum and rotation structure were thoroughly planned, adapting the US model to the Chinese needs and culture. Seemingly coincidentally, the medical aspects required in the management of patients with COVID-19 encompass almost the entire curriculum content.<xref rid="bib7" ref-type="bibr">7</xref>, <xref rid="bib8" ref-type="bibr">8</xref>, <xref rid="bib9" ref-type="bibr">9</xref></p><p id="p0035">Experts from CHEST visited and provided hands-on training to faculties at each participating hospital. Under the supervision of a joint steering committee consisting of leading experts from CHEST and China, 54 PCCM fellows from 12 leading hospitals have since graduated from the program.<xref rid="bib7" ref-type="bibr"><sup>7</sup></xref><sup>,</sup><xref rid="bib8" ref-type="bibr"><sup>8</sup></xref> In December 2016, the National Health Commission of China announced that formal subspecialty training (ie, National Fellowship) would become an integrated component of the postgraduate medical education system in China, and PCCM was selected as one of three pilot subspecialties. The China-Chest PCCM Fellowship naturally transitioned to the Chinese national program. Currently, more than 900 PCCM fellows are enrolled in 79 programs across China.<xref rid="bib9" ref-type="bibr"><sup>9</sup></xref></p><p id="p0040">In line with the development of a PCCM fellowship program, a detailed standard for creation of a PCCM department was established by the CTS and the Chinese Association of Chest Physicians in 2018, consisting of six components: organization of the department, scope of practice, essential space and equipment, faculty and staff, administration body, and culture. Inclusion of medical and respiratory ICUs was emphasized as a main component of a PCCM department. By September 2019, more than 1,600 hospitals in China had participated and become compliant with requirements set forth by the PCCM Department Standardized Construction Program.<xref rid="bib9" ref-type="bibr"><sup>9</sup></xref></p><p id="p0045">Thus, prior to the outbreak of the COVID-19 epidemic, the Chinese PCCM field had already become a well-organized profession. Its highly respected leaders and a core team qualified by using an established set of standards have attracted a large number of enthusiastic applicants.</p></sec><sec id="sec2"><title>PCCM Is a Main Force in Fighting COVID-19</title><p id="p0050">Caught off-guard by the COVID-19 epidemic toward the end of 2019, PCCM professionals mobilized quickly. Large teams of PCCM professionals went to the front-line and took charge in most wards and units in every hospital in Wuhan. Several key leaders in PCCM have remained stationed in Wuhan, directing immediate action plans according to the rapidly changing situation. The following are some of the highlights that made a fundamental difference in turning the situation in Wuhan from turmoil into an organized counterattack.</p><sec id="sec2.1"><title>Assessing the Severity and Impact</title><p id="p0055">PCCM experts participated and led the first three groups of trained inspectors entering the epidemic area and assessing the situation. Nanshan Zhong, former president of the CTS and leader of the third group, confirmed the human-to-human transmission and the extremely high contagion of the new coronavirus on January 20, 2020. This declaration led to the development and roll out of a strict social distancing policy by the government, which included the closure of all public transportation, schools, and factories in affected areas.<xref rid="bib4" ref-type="bibr"><sup>4</sup></xref></p></sec><sec id="sec2.2"><title>Organized Actions</title><p id="p0060">Within 2 months, a management guideline was developed and repeatedly revised based on the rapid changes and accumulation of knowledge as the situation evolved. A standard guideline is vitally important in the management of a novel viral disease that affects the human body through unknown mechanisms and for which no specific treatment or vaccine is available. More than 100 clinical trials have been approved to test various treatment options, including the highly controversial use of corticosteroids and the efficacy of the promising antiviral agent remdesivir.</p></sec><sec id="sec2.3"><title>A Well-Prepared Team</title><p id="p0065">Although the clinical presentation of COVID-19 is diverse, the central issues in its management mirror those encountered on a daily basis in PCCM; these issues include isolation techniques for respiratory contagious diseases, hypoxemia, respiratory failure, sepsis, hemodynamic instability, and multiorgan failure. The Chinese PCCM fellows and faculty have been trained and equipped with structured, cutting-edge knowledge plus repeated experience in oxygen therapy, rational use of antibiotics, ventilator management, hemodynamic monitoring and support, and extracorporeal membrane oxygenation.</p></sec><sec id="sec2.4"><title>Epidemic Control: the Fang Cang Shelters</title><p id="p0070">Stemming transmission is the single most important tactic that can reverse epidemics. With a huge number of asymptomatic potential virus carriers, the initial policy of home isolation was not sufficiently effective and was complicated by growing fear and helplessness. Chen Wang, current president of the Chinese Association of Chest Physicians and former president of the CTS, initiated the construction of converted hospitals for the purpose of isolation and monitoring. Large public venues such as stadiums and college/school dorms were converted into preliminary medical facilities to admit suspected carriers and verified patients who remained asymptomatic or only mildly symptomatic. The facilities were named Fang Cang hospitals, a name derived from the concept of military container shelters. The goal was to admit at the earliest time all those who should be isolated or monitored. Within a matter of days, 16 such facilities were functioning at capacity, with 13,000 admissions in Wuhan alone. The facilities are staffed with medical professionals who can identify clinical deterioration at the earliest stage and immediately begin necessary responses, including initiating transfers to higher level hospitals designated for treating COVID-19. Supplies are provided by government agents, and daily activities of the inpatients are organized to minimize psychological stress. The establishment of Fang Cang hospitals is the crucial measure that has begun to curb the rapidly uprising trend in the curve of accumulated cases.</p></sec><sec id="sec2.5"><title>Backup Team</title><p id="p0075">Outside Wuhan and Hubei provinces, PCCM departments in the rest of the country are serving as the backup for the front-line fighters. They have assumed the responsibilities of their colleagues now working on the front-lines. In addition, the standardized construction process has greatly enhanced the staffing and equipment of PCCM departments and has enabled these departments to function as the designated treating center for COVID-19, in collaboration with other departments, in almost all hospitals cross China.</p></sec></sec><sec id="sec3"><title>International Collaboration</title><p id="p0080">During the years of effort in developing the PCCM subspecialty, no one would have foreseen an outbreak of COVID-19; however, with the designed professional scope of the program, the key role of the PCCM subspecialty in such epidemics or any other epidemics characterized by respiratory disease leading to critical conditions has been very clear. PCCM in China is an excellent model for collaboration among international professional societies. The COVID-19 epidemic has seriously challenged China, while also proving to be a common threat worldwide that warrants collaboration.</p><p id="p0085">CHEST, as a long-time close ally, has written to PCCM colleagues in China to express support in this extraordinary time. In the heartfelt letter is the following statement: “You are fighting not only for the Chinese people, but for the humans of the world….We firmly believe, with the well-established PCCM team we have built together over years of effort as the main force, we will definitely win this battle.”</p></sec></body><back><ref-list id="cebib0010"><title>References</title><ref id="bib1"><label>1</label><element-citation publication-type="other" id="sref1"><article-title>National Health Commission of the People's Republic of China: updates on the epidemic</article-title><ext-link ext-link-type="uri" xlink:href="http://www.nhc.gov.cn/xcs/yqtb/list_gzbd.shtml" id="intref0010">http://www.nhc.gov.cn/xcs/yqtb/list_gzbd.shtml</ext-link></element-citation></ref><ref id="bib2"><label>2</label><element-citation publication-type="journal" id="sref2"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>S.</given-names></name><name><surname>Yang</surname><given-names>J.</given-names></name><name><surname>Yang</surname><given-names>W.</given-names></name></person-group><article-title>COVID-19 control in China during mass population movements at New Year</article-title><source>Lancet</source><volume>395</volume><issue>10226</issue><year>2020</year><fpage>764</fpage><lpage>766</lpage><pub-id pub-id-type="pmid">32105609</pub-id></element-citation></ref><ref id="bib3"><label>3</label><element-citation publication-type="journal" id="sref3"><person-group person-group-type="author"><name><surname>Li</surname><given-names>Q.</given-names></name><name><surname>Guan</surname><given-names>X.</given-names></name><name><surname>Wu</surname><given-names>P.</given-names></name></person-group><article-title>Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia</article-title><source>N Engl J Med</source><volume>382</volume><issue>13</issue><year>2020</year><fpage>1199</fpage><lpage>1207</lpage><pub-id pub-id-type="pmid">31995857</pub-id></element-citation></ref><ref id="bib4"><label>4</label><element-citation publication-type="other" id="sref4"><person-group person-group-type="author"><collab>The People's Government of Hubei Province</collab></person-group><article-title>The announcement from the Hubei Provincial Novel Coronavirus Pneumonia Prevention and Control Headquarter</article-title><ext-link ext-link-type="uri" xlink:href="http://www.hubei.gov.cn/zhuanti/2020/gzxxgzbd/zxtb/202002/" id="intref0015">http://www.hubei.gov.cn/zhuanti/2020/gzxxgzbd/zxtb/202002/</ext-link></element-citation></ref><ref id="bib5"><label>5</label><element-citation publication-type="journal" id="sref5"><person-group person-group-type="author"><name><surname>Tobin</surname><given-names>M.J.</given-names></name><name><surname>Hines</surname><given-names>E.</given-names></name></person-group><article-title>Pulmonary and critical care medicine: a peculiarly American hybrid?</article-title><source>Thorax</source><volume>54</volume><issue>4</issue><year>1999</year><fpage>286</fpage><lpage>287</lpage><pub-id pub-id-type="pmid">10092686</pub-id></element-citation></ref><ref id="bib6"><label>6</label><element-citation publication-type="journal" id="sref6"><person-group person-group-type="author"><name><surname>Brotherton</surname><given-names>S.E.</given-names></name><name><surname>Etzel</surname><given-names>S.I.</given-names></name></person-group><article-title>Graduate medical education, 2018-2019</article-title><source>JAMA</source><volume>322</volume><issue>10</issue><year>2019</year><fpage>996</fpage><lpage>1016</lpage><pub-id pub-id-type="pmid">31503291</pub-id></element-citation></ref><ref id="bib7"><label>7</label><element-citation publication-type="journal" id="sref7"><person-group person-group-type="author"><name><surname>Qiao</surname><given-names>R.</given-names></name><name><surname>Rosen</surname><given-names>M.J.</given-names></name><name><surname>Chen</surname><given-names>R.</given-names></name><collab>on behalf of the CTS-ACCP Pulmonary and Critical Care Medicine Workgroup</collab></person-group><article-title>Establishing pulmonary and critical care medicine as a subspecialty in China: Joint Statement of the Chinese Thoracic Society and the American College of Chest Physicians</article-title><source>Chest</source><volume>145</volume><issue>1</issue><year>2014</year><fpage>27</fpage><lpage>29</lpage><pub-id pub-id-type="pmid">24030390</pub-id></element-citation></ref><ref id="bib8"><label>8</label><element-citation publication-type="journal" id="sref8"><person-group person-group-type="author"><name><surname>Qiao</surname><given-names>R.</given-names></name><name><surname>Marciniuk</surname><given-names>D.</given-names></name><name><surname>Augustyn</surname><given-names>N.</given-names></name><collab>on behalf of the China-CHEST PCCM Program Steering Committee</collab></person-group><article-title>Establishing Pulmonary and Critical Care Medicine in China: 2016 Report on Implementation and Government Recognition. Joint Statement of the Chinese Association of Chest Physicians and the American College of Chest Physicians</article-title><source>Chest</source><volume>150</volume><issue>2</issue><year>2016</year><fpage>279</fpage><lpage>282</lpage><pub-id pub-id-type="pmid">27180916</pub-id></element-citation></ref><ref id="bib9"><label>9</label><mixed-citation publication-type="other" id="sref9">Qiao R, Marciniuk DD, Buckley JD, et al. The Strategic Establishment of Pulmonary and Critical Care Medicine (PCCM) as a subspecialty in China: 3rd report from the China-CHEST PCCM Fellowship project. <italic>Chest</italic>. In press.</mixed-citation></ref></ref-list><fn-group><fn id="d32e208"><p id="ntpara0010"><bold>FINANCIAL/NONFINANCIAL DISCLOSURES:</bold> None declared.</p></fn></fn-group></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/StressCovidV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000347 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000347 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= StressCovidV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:7153520
|texte= PCCM at the Battlefront Against COVID-19 in Wuhan, China
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:32298732" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a StressCovidV1
| This area was generated with Dilib version V0.6.33. |  |