Phytocompounds as a source for the development of new drugs to treat respiratory viral infections

Respiratory viruses have an important history as a threat to global health. However, this problem has been aggravated due to the appearance of new outbreaks caused by a newly discovered virus or variant. Recently, the new coronavirus (SARS-CoV-2) has been a major concern for health authorities, and it was classified as a pandemic by the World Health Organization. Secondary metabolites obtained from plants represent an alternative to the discovery of new active molecules and have already shown potential to combat different viruses. In an effort to demonstrate the broad spectrum of antiviral action from these metabolites, this work describes the compounds that were effective against the major viruses that cause respiratory infections in humans. In addition, their mechanisms of action were highlighted as an approach to better understanding the virus-bioactive substance relationship. Finally, this study warns that, although phytocompounds have a broad antiviral action spectrum, the development of products and clinical trials based on these secondary metabolites is still scarce and therefore deserves greater attention from the scientific community. © 2023 Elsevier B.V.

Autonomic Dysfunction after Covid-19 Immunization - Case Report

Background: The infection caused by the SARS-CoV-2 continues affecting millions of people worldwide and vaccines to prevent the coronavirus disease (COVID-19) are considered the most promising approach for curbing the pandemic. Otherwise, cardiovascular and neurological complications associated with the vaccines were speculated and some few case reports were published. Objective(s): We describe a case of postural orthostatic tachycardia syndrome (POTS) after viral vector COVID-19 vaccination and the possible autoimmune process of the syndrome. Method(s): A 35-year-old female, without previous symptoms or comorbidities, developed intermittent palpitation, intense fatigue and dyspnea, compromising her daily activities, triggered by upright position, seven days following the second dose of the Oxford vaccine. Physical examination was normal, except for a heart rate (HR) increase of 33 beats/min from supine to standing position, with no significant change in blood pressure and reproduction of symptoms. Result(s): A 24-hour Holter monitoring revealed episodes of spontaneous sinus tachycardia correlated with palpitation and fatigue. Extensive diagnostic investigations excluded primary cardiac, endocrine, infectious and rheumatologic etiologies. The patient underwent an autonomic function test which demonstrated normal baroreflex sensitivity, as well as normal cardiovagal and adrenergic scores. Head-up tilt test showed persistent orthostatic tachycardia (HR increase from a medium of 84 beats/min in supine position to 126 beats/min during upright tilt), without hypotension, consistent with the diagnostic criteria for POTS. According to the current guidelines, general behavior recommendations, pharmacotherapy with low dose of propranolol associated with the autonomic rehabilitation were oriented. Along three months of follow-up, the patient reported a gradually improvement in her symptoms. Conclusion(s): POTS is a heterogeneous disorder of the autonomic nervous system characterized by orthostatic tachycardia associated with symptoms of orthostatic intolerance. Although the physiopathology of COVID-19 vaccine and autonomic disorders remains speculative, autoimmune response is one of the possible mechanisms. Based on clinic presentation, the time frame of symptom onset is consistent with other well-known post-vaccination syndromes, which may be an indicator of an autoimmune process induced by immunization. Further studies are needed to assess causal relationship between immunization and autonomic dysfunction.Copyright © 2023

Air Pollution and COVID-19 Mortality in Brazil

Long-term exposure to poor air quality has been associated with respiratory viral infections such as influenza and measles. Some epidemiological studies in North America, Europe, and Asia also suggest that exposure to air pollution is associated with increased SARS-CoV-2 infection and mortality associated with COVID-19. However, few studies have been conducted on this topic in South America. In this study, we investigate the association between ambient PM2.5, NO2, and O-3 and their interaction with COVID-19-associated deaths in Brazil, the largest country in South America. We apply a negative binomial mixed model with zero inflation using municipality-level COVID-19 deaths as the endpoint and the long-term average of PM2.5, NO2, and O-3 as the exposure. We added a random intercept by state to account for potential correlations between communities within the same state. After adjusting the model for several potential confounders, including meteorological variables, demographic characteristics, socioeconomic aspects, and healthcare conditions, we found a positive association between PM2.5 and COVID-19 deaths in Brazil, where a 1 mu g/m(3) increase in the long-term average of PM2.5 was associated with a 10.22% (95% CI: 9.35;11.09) increase in COVID-19 deaths. In contrast, O-3 and NO2 showed negative associations. As suggested by the literature in other countries, our results suggest that air pollution is an important cofactor that increases the risk of death from COVID-19 in Brazil. The effects of air pollution in Brazil are pronounced, indicating the need for improved air quality control policies.

Machine learning models to characterize the cough signal of patients with COVID-19

Automatic recognition of audio signals is a challenging signal task due to the difficulty of extracting important attributes from such signals, which relies heavily on discriminating acoustic features to determine the type of cough audio coming from COVID-19 patients. In this work, the use of state-of-the-art pre-trained models and a convolutional neural network for the extraction of characteristics of a cough signal from patients with COVID-19 is analyzed. A comparison of three machine learning models has been proposed to extract the features containing relevant information, leading to the recognition of the COVID-19 cough signal. The first model is based on a basic convolutional neural network, the second is based on a YAMNet pre-treatment model, and the third is a VGGish pre-trained model. The experimental results carried out with a ComPare 2021 CCS database show that models, of the three, used, VGGish to provide better performance when extracting the characteristics of the audio signals of the COVID-19 cough signal, having as results the performance metrics f1 score and accuracy with values of 30.76% and 80.51%, representing an improvement of 6.06% and 3.61% compared to the YANMet model, and the confusion matrices, which validate the mentioned model. © 2022 Latin American and Caribbean Consortium of Engineering Institutions. All rights reserved.

Remote teaching in times of social distancing: a study in the accounting and actuarial sciences courses

Purpose: Considering the imposed social isolation measures to contain the spread of the SarsCov-2 virus, the cause of COVID-19 pandemic, the in-person classes started to be held remotely. Those measures had an impact on education, mainly because they had to be adopted quickly, with no time for preparation. In our current study, we investigate how remote teaching has been occurring in the undergraduate courses of Accounting and Actuarial Sciences at a Public Higher Education Institution (PHEI), in times of social distancing. Methodology: An e-survey was carried out with teachers and students, in order to obtain information on the subject. The collected data were processed using statistical techniques to generate the results. Results: It came across that the studied PHEI did not have resources such as a Flipped classroom, Digital Whiteboard or any other technological tools to support remote classes, since the remote teaching modality became a need during the COVID-19 pandemic. The PHEI launched, via public notices, programs for digital inclusion in order to acquire mobile data and equipment, such as computers/smartphones/tablets for students;however, only few of the students could have access to those resources. Contributions of the Study: Our research results contribute to the state-of-the-art regarding undergraduate courses, by investigating their evolution towards remote learning. Such contributions provide information and knowledge on this subject to the national scientific literature, and give support and guidance to other courses offered by public and/or private higher education institutions.

Mental Health in times of COVID-19: Policy Brief

Issue The COVID-19 pandemic caused profound disruptive changes worldwide. Mental health (MH) and wellbeing (WB) have been particularly affected, namely with increased levels of anxiety, depression, post-traumatic stress disorder and burnout symptoms. Several factors can have contributed to individuals' vulnerability, including perceived uncertainty, the strict measures adopted, the socioeconomic hardship and the direct effects of the virus. Although the pandemic is primarily a public health and a socioeconomic crisis, it could turn into a serious MH crisis with all the associated implications. Description As a Health Observatory, National Institute of Health Doutor Ricardo Jorge, in collaboration with Institute of Environmental Health of Lisbon School of Medicine, and Portuguese Society of Psychiatry and Mental Health, coordinated an observational study to characterize the MH and WB of general population and health professionals residing in Portugal, during pandemic's first wave. Anxiety, depression, post-traumatic stress disorder, burnout and resilience were selected as main outcomes, measured using validated instruments with sound psychometric properties. Results High levels of psychological distress were observed among general population and health professionals. Women, younger, individuals with lower income or unemployed, lower educational level and frontline health professionals were most susceptible to psychological suffering. The research team produced a Policy Brief with a set of 14 recommendations for immediate action to ensure equal access to psychological and emotional support for all citizens, to reduce the impact of mental disorders and to promote MH. Lessons The mitigation of psychological suffering is of paramount importance, from an equitable perspective focus on identified vulnerable sub-groups. Particular attention should also be given to citizens infected with SARS-CoV-2 and patients with COVID-19, who faced direct consequences of the disease. Key messages In a pandemic context, monitorization of population’s mental health is of paramount importance. Health Observatories should have an active and reinforced role in this public health area to mitigate potential negative impacts of pandemics.

Mental health during the COVID-19 pandemic in Portugal

Background Mental health is being impacted by COVID-19, as a result of both the globalized perception of health risk and the massive social and economic measures, required to control the pandemic. A main goal of this study, the SM-COVID19, was to characterize the mental health of the general population and to identify vulnerable groups, during the first lockdown in Portugal. Methods Cross-sectional online survey, conducted between May 22 and July 20, 2020, with a nationwide non-probabilistic sample of adults residing in Portugal (≥18 years old). Data were collected with sound psychometric scales for symptoms of anxiety, depression and post-traumatic stress disorder (PTSD), work-life balance, resilience, work-related variables, and sociodemographics. Logistic regression models were used to assess risk and protective factors for mental health suffering. Results Overall, 3982 individuals participated in the study (female, 79.1%;mean age, 45.15±12.31 years;71.0% completed higher education studies). The prevalence of symptoms of moderate to severe anxiety was 26.5% (95% Confidence Interval (CI): 24.0-29.1), of depression symptoms was 26.0% (95%CI, 23.6-28.7), and of PTSD symptoms was 26.5% (95%CI, 24.0-29.2). Moreover, more than one third of the respondents (41.2%;95%CI: 38.3-44.1) reported symptomatology for at least one of these three psychiatric disorders. Women, individuals who suspended their professional activity (or in layoff or unemployed) during the lockdown, and those with difficulties in managing work and family demands had higher odds for psychological suffering. Conclusions The COVID-19 pandemic is a public health crisis with major interpersonal, social and economic impacts at the individual level. Mental health and wellbeing are being severely affected, as confirmed by the high prevalence of symptoms of psychological suffering herein. Mental health protection measures need to be defined and implemented, mainly targeting the most vulnerable groups. Key messages COVID-19 pandemic is associated with high prevalence of anxiety, depression and PTSD. Observed mental health inequities imply effective vulnerable-groups-focused mental health promotion programs.

Debtor-financing in judicial recovery and covid-19 pandemia impacts on the brazilian entrepreneurs

Objectives: The instant work investigates the effects of the COVID-19 pandemia on Brazilians entrepreneur, through analysis of two premises: (i) in 2020, the number of judicial reorganization requests would increase exponentially;(ii) the legislative measures promulgated by law #14,112/2020 upon law #11,101/2005, especially, the financing to debtors under judicial reorganization, would be useful and effective to the utilization of judicial recovery as a means of maintaining and preserving the company. Methodology: The deductive method was adopted, as from document research, as well as from analysis of data collected by other official statistical surveys and economic measurements. Results: It is appropriate to state that the sanitary measures for pandemia containment have deeply affected Brazilian entrepreneurs. However, the number of judicial reorganization requests has not increased, as expected, and the changes implemented upon bankruptcy legislation, as to debtor financing, have not yet proven efficient to foster the use of judicial reorganization. Contributions: Despite legal incentives created on behalf of debtor financing under judicial reorganization, there still is a high reputational cost to the entrepreneur which avails itself of this tool, turning the credit granted to this grantee more financially burdensome, on account of regulatory motivations. Finally, it can be mentioned that a judicial recovery request implies, to the debtor, the taking up of several obligations representing a significant tranche of expenses to the entrepreneur in distress, thereby discouraging such requests. © 2021, Centro Universitário Curitiba - UNICURITIBA. All rights reserved.

BioASQ Synergy: A strong and simple baseline rooted in relevance feedback

This paper presents the participation of the University of Aveiro Biomedical Informatics and Techologies (BIT) group in the Synergy task of the ninth edition of the BioASQ challenge. Given availability of feedback data between rounds, we explored a traditional relevance feedback approach. More precisely, we performed query expansion by selecting the highest tf-idf terms from snippets judged as relevant by experts. Then, the revised query is processed by our BioASQ-8b pipeline consisting of BM25 followed by a lightweight neural reranking model. Our system achieved results above the median, which given its simplicity can be considered satisfactory. Furthermore, in two batches our best results were only second to the runs submitted by the top performing team. Code to reproduce our submissions are available on https://github.com/bioinformatics-ua/BioASQ9-Synergy. © 2021 Copyright for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).

Cognitive performance in convalescent covid-19 patients

Introduction: Hypoxia caused by pulmonary diseases has been associated with decreased cognitive performance for decades. COVID-19 pneumonia, a result of infection by the SARS-CoV-2 virus, became a pandemic only a few months ago and the existing knowledge about its possible impact on cognitive processes is still poor. Objective: To evaluate the cognitive performance in patients recovered from COVID-19. Method: 42 people convalest from COVID-19 were evaluated using the Montreal Cognitive Assessment Test (MoCA) and compared with the results of 100 healthy subjects. Socio-demographic variables were controlled and clinical variables were obtained from the patients to study the possible influence on cognitive performance in them. Results: Lower performance was found in patients in the variables: working memory (p = 0.005), attention (p = 0.026), abstraction (p = 0.021), delayed memory (p = 0.001) and in the total score of the MoCA (p = 0.007). A significant correlation was found between the result obtained in Moca and age (r =-0.520, p = 0.001), educational level (r = 0.551, p = 0.000), forced vital capacity (FVC) [(r = 0.667, p = 0.000)], forced respiratory volume (FEV1) [(r = 0.573 (p = 0.001)] and the 6-minute walk test (6MWD) [(r = 0.563, p = 0.002)]. Predictor variables of cognitive performance were found FVC, 6MWD and schooling. Conclusions: Cognitive performance can be affected by COVID-19, particularly aspects related to memory, attention and abstraction. Given the multifactorial determination of cognitive performance, it is necessary to expand the psychological, clinical and laboratory variables to be taken into accountin future studies. © 2020, Editorial Ciencias Medicas. All rights reserved.

COVID-19 diagnosis by RT-qPCR in alternative specimens

BACKGROUND: The high demand for adequate material for the gold standard reverse transcription real-time polymerase chain reaction (RT-qPCR)-based diagnosis imposed by the Coronavirus disease 2019 (COVID-19) pandemic, combined with the inherent contamination risks for healthcare workers during nasopharyngeal swab (NP) sample collection and the discomfort it causes patients, brought the need to identify alternative specimens suitable for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVES: The aim of this work was to compare saliva and gingival fluid swabs to NP swabs as specimens for RT-qPCR-based SARS-CoV-2 diagnosis. METHODS: We compared gingival fluid swabs (n = 158) and saliva (n = 207) to the rayon-tipped NP swabs obtained from mild-symptomatic and asymptomatic subjects as specimens for RT-qPCR for SARS-CoV-2 detection. FINDINGS: When compared to NP swabs, gingival fluid swabs had a concordance rate of 15.4% among positive samples, zero among inconclusive, and 100% among negative ones. For saliva samples, the concordance rate was 67.6% among positive samples, 42.9% among inconclusive, and 96.8% among negative ones. However, the concordance rate between saliva and NP swabs was higher (96.9%) within samples with lower cycle threshold (Ct) values (Ct > 10 <= 25). MAIN CONCLUSIONS: Our data suggests that whereas gingival fluid swabs are not substitutes for NP swabs, saliva might be considered whenever NP swabs are not available or recommended.