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Background Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. Methods An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. Results The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. Conclusions The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities., For patients with acute COVID-19 pneumonia who require oxygen support, the International Task Force made suggestions for remdesivir and dexamethasone, but against hydroxychloroquine. Post-discharge management of COVID-19 survivors is a research priority. https://bit.ly/32B96uI

Cornelia de Lange Syndrome (CdLS) is a multi-organ system birth defects disorder linked, in at least half of cases, to heterozygous mutations in the NIPBL gene. In animals and fungi, orthologs of NIPBL regulate cohesin, a complex of proteins that is essential for chromosome cohesion and is also implicated in DNA repair and transcriptional regulation. Mice heterozygous for a gene-trap mutation in Nipbl were produced and exhibited defects characteristic of CdLS, including small size, craniofacial anomalies, microbrachycephaly, heart defects, hearing abnormalities, delayed bone maturation, reduced body fat, behavioral disturbances, and high mortality (75–80%) during the first weeks of life. These phenotypes arose despite a decrease in Nipbl transcript levels of only ∼30%, implying extreme sensitivity of development to small changes in Nipbl activity. Gene expression profiling demonstrated that Nipbl deficiency leads to modest but significant transcriptional dysregulation of many genes. Expression changes at the protocadherin beta (Pcdhb) locus, as well as at other loci, support the view that NIPBL influences long-range chromosomal regulatory interactions. In addition, evidence is presented that reduced expression of genes involved in adipogenic differentiation may underlie the low amounts of body fat observed both in Nipbl+/− mice and in individuals with CdLS., Author Summary Cornelia de Lange Syndrome (CdLS) is a genetic disease marked by growth retardation, cognitive and neurological problems, and structural defects in many organ systems. The majority of CdLS cases are due to mutation of one copy of the Nipped B-like (NIPBL) gene, the product of which regulates a complex of chromosomal proteins called cohesin. How reduction of NIPBL function gives rise to pervasive developmental defects in CdLS is not understood, so a model of CdLS was developed by generating mice that carry one null allele of Nipbl. Developmental defects in these mice show remarkable similarity to those observed in individuals with CdLS, including small stature, craniofacial abnormalities, reduced body fat, behavioral disturbances, and high perinatal mortality. Molecular analysis of tissues and cells from Nipbl mutant mice provide the first evidence that the major role of Nipbl in the etiology of CdLS is to exert modest, but significant, effects on the expression of diverse sets of genes, some of which are located in characteristic arrangements along the DNA. Among affected genes is a set involved in the development of adipocytes, the cells that make and accumulate body fat, potentially explaining reductions in body fat accumulation commonly observed in individuals with CdLS.

S / Developmental Biology 295 (2006) 349 – 353 reported to participate in both the retinoid signaling pathway and the transforming growth factor-beta (TGF-beta) pathway. Smad2 is a intracellular mediator of the TGF-beta signaling cascade, regulating gene transcription. Depending upon the co- activator, Smad2 can function as either an enhancer or repressor. Research has indicated that mice harboring Tgif mutations are more susceptible to teratogenesis induced by exogenous all – trans retinoic acid (RA), resulting in HPE and exencephaly. Smad2 heterozygous embryos are also suscepti- ble to exogenous RA. In addition, the use of a Smad2 hypomorphic allele reinforces the observation that Smad2 is involved in susceptibility, as hypomorphic heterozygous are less susceptible to the effects of RA than hypomorphic homozygotes. There are many factors involved in retinoid signaling, including both the retinoid cascade and RA synthesis and degradation. Analysis of gene transcription to determine the inherent susceptibility to RA in the Smad2+/ embryos was undertaken. Results indicate that Adh4 and Cyp26A1 are affected in early development. When the promoters of these genes were analyzed, many Smad Binding Elements (SBEs) were observed, indicating potential interaction of TGF-beta signaling in the synthesis and degradation of RA. doi:10.1016/j.ydbio.2006.04.082 Developmental defects in multiple organ systems in a mouse model of Cornelia de Lange Syndrome Shimako Kawauchi 1 , Rosaysela Santos 1 , Martha Lopez-Burks 2 , Abigail Chua 2 , Leonard M. Kitzes 1 , Arthur D. Lander 2 , L. Calof 1 Department of Anatomy and Neurobiology, University of California, Irvine, USA Department of Developmental and Cell Biology, University of California, Irvine, USA Cornelia de Lange Syndrome (CdLS) is a dominantly- inherited, multi-system birth defects syndrome with highly variable presen- tation. Individuals with CdLS have characteristic facial features, hirsutism, limb defects, heart defects, gastrointestinal system defects, and growth and cognitive retardation. Recent work has shown that CdLS is caused by heterozygous mutation of a gene, NIPBL (Nipped-B like), whose product is involved in regulation of the cohesin system of chromosomal structural proteins (Krantz et al., 2003, Nat. Genet. 36:631). We have developed a mouse model for CdLS, using mice heterozygous for a gene-trap mutation in Nipbl. Surviving Nipbl+/ mice exhibit a number of organ system defects characteristic of CdLS, including small body and head size, heart defects, hearing abnormalities, and delayed bone maturation. Nipbl+/ mice also show a very high incidence (¨75%) of perinatal mortality, indicating that these animals have other, as yet undetected, abnormalities. RNase protection assays demonstrate that the phenotypes of Nipbl+/ mice are associated with a decrease in Nipbl transcript levels to only ¨75% of wildtype, implying that these developmental events are extremely sensitive to small changes in Nipbl function. Supported by seed grants from the Cornelia de Lange Syndrome Foundation and the Center for Hearing Research at the University of California, Irvine. doi:10.1016/j.ydbio.2006.04.083 Contribution of aberrant placentation to fetal alcohol syndrome Garen S. Wolff 1 , Po J. Chiang 1 , Susan S. Smith 2 , Roberto Romero 3 , D. Randall Armant 1 Department of OB/GYN, Wayne State University, Detroit, MI, USA Department of Nutritional Sciences, University of Wisconsin, Madison, WI, USA Perinatology Research Branch, NICHHD, NIH, DHHS, Bethesda, MD, USA The teratogen ethanol causes fetal alcohol syndrome, which is associated with intrauterine growth retardation (IUGR) and neurological birth defects. A contributing factor to IUGR is cytotrophoblast cell (CTC) apoptosis during placentation. Using a human first trimester CTC line (HTR-8/SVneo), we examined the relationship between CTC apoptosis and exposure to ethanol. Exposure for 0– 2 h to 0, 25, 50 or 100 mM ethanol demonstrated a significant time-and dose-depen- dent increase in CTC death measured by TUNEL. Prolifera- tion (expression of nuclear antigen Ki-67) was also inhibited by ethanol. Increased externalization of phosphatidyl serine, the presence of pyknotic, TUNEL-positive nuclei and preven- tion of cell death by caspase inhibitors suggested that ethanol caused apoptosis, as opposed to necrosis. Moreover, there was no evidence of cell rupture and the release of lactate dehydrogenase. Production of heparin-binding EGF-like growth factor (HBEGF), which prevents CTC apoptosis due to low oxygen in the first trimester, increased with exposure to 25– 50 mM ethanol. During treatment with 100 mM ethanol, 1 nM HBEGF eliminated cell death and 5 nM restored CTC proliferation. HBEGF antagonists confirmed its specificity. We conclude that CTC apoptosis due to maternal alcohol abuse could cause IUGR; however, ethanol-induced production of HBEGF could provide an endogenous protective mechanism. Supported by NIH grants AA12057, AA11085 and AA014535 and the intramural research program of NICHHD. doi:10.1016/j.ydbio.2006.04.084 Influence of hormones on growth and differentiation of cells that do not express neurofibromin Kate F. Barald, Therese M. Roth, Poornapriya Ramamurthy University of Michigan Medical School, Department of Cell and Developmental Biology, Ann Arbor, MI, USA The tumor suppressor gene, Neurofibromatosis Type 1 (NF1) is responsible for one of the most common autosomal