ABSTRACT
BACKGROUND: One of the efforts to reduce hypertension rates in the community is through an educational campaign that refers to the NIH's National Heart, Lung, and Blood Institute curricula or abbreviated as NHLBI. However, during the coronavirus disease 2019 (COVID-19) pandemic, one of the hardest hit areas is health promotion, and there is a significant obstacle regarding the most effective way to transfer knowledge, attitude and practice towards society without transmitting the virus. AIM: To evaluate the impact of the virtual anti-hypertensive educational campaign towards knowledge, attitude, and the practice of hypertension management in the primary care setting during the COVID-19 pandemic. METHODS: An online action research with a randomized crossover-controlled trial using a pretest-posttest control group design. The study was conducted in October 2020-April 2021. The population in this study were patients with hypertension who were treated in the Mojo primary health care setting. A purposive sampling technique was done to receive 110 participants using an online questionnaire and invitation letter. RESULTS: A total of 110 participants were included in the analysis, 55 in the intervention group and 55 in the control group. Following the Virtual Anti-Hypertensive Educational Campaign implementation, the only parameter that showed significant improvement was knowledge and attitude (P < 0.001). There is no significant change in the practice parameters (P = 0.131). CONCLUSION: The Virtual Anti-Hypertensive Educational Campaign implementation in our study population seems to be effective to improve knowledge and attitude of participants, nevertheless, this program seems to be ineffective to improve the practice of hypertension management aspect in participants. Future study with longer durations and more comprehensive programs need to be done to scrutinize the clinical impact of this program nationwide.
ABSTRACT
Aim The infection of the SARS-CoV-2 virus potentially causes a cytokine storm with elevated IL-6 and IL-1ß levels. Statin therapy was common among COVID-19 patients due to their cardiovascular comorbidities. However, the effect of statins on COVID-19 infection is unclear. The aim of this study was to evaluate the impact of statin administration on IL-6 and IL-1ß level in peripheral blood mononuclear cells (PBMCs) after SARS-CoV-2 spike protein stimulation. Methods The PBMCs were isolated from a hypertensive patient and stimulated by the SARS-CoV-2 subunit S1 spike protein. The PBMCs were then divided into four treatment groups and treated with simvastatin at various doses (10 µM, 25 µM, 50 µM, and control). IL-6 and IL-1ß were measured from the supernatant using the ELISA method. Results The stimulation of SARS-CoV-2 spike protein in PBMC cell culture statistically increased IL-6 and IL1ß expression of 5.2 and 35.07 fold, respectively (p<0.05). The expressions of IL-6 and IL-1ß were not statistically significant among three simvastatin doses and control. Conclusion Statin administration did not have significant effect on IL-6 and IL-1ß levels in PBMCs after SARS-CoV-2 spike protein stimulation in this study, a further study is needed.
ABSTRACT
Since the first report of pneumonia outbreak in Wuhan by the end of 2019 Coronavirus Disease 2019 (COVID-19) has become a global pandemic;causing millions of deaths globally and affecting the rest of worldwide population. The disease is caused by severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) which enters hosts by inhabiting Angiotensin-Converting Enzyme-2 (ACE-2) receptors expressed in the endothelium layer of not only the respiratory tracts but also various organs in the body. COVID-19 has been reported to trigger multiple cardiovascular manifestations. Since endothelial dysfunction plays an important role in cardiovascular events and the endothelium is heavily involved in COVID-19 pathophysiology it is important to investigate their associations and previously established drug potencies to improve endothelial functions as possible treatment options for COVID-19. In this review we summarize endothelial dysfunction biomarkers involved in COVID-19 and drugs that have shown potential endothelial protective properties to better understand the incidence of endothelial dysfunction in COVID-19 and its future treatment. We searched in PubMed Wiley Online Library EBSCO ScienceDirect databases for literatures containing following keywords: Endothelial dysfunction COVID-19 and biomarkers. Eligible publications were then assessed and studied to comprise our literature review. A total of 96 studies matched our criteria and provided scientific evidence for our review. Materials were then compiled into a review summarizing endothelial biomarkers involved in COVID-19 and potentially repurposed drugs targeting endothelium for COVID-19. Various endothelial dysfunction biomarkers were found to be elevated in COVID-19 and is found to be related to its severity such as adhesion molecules selectins PAI-1 and von Willebrand Factors. Multiple drugs targeting the endothelium are also potential and some are under investigation for COVID-19.
ABSTRACT
The current condition of the community is being faced with a pandemic outbreak which could be exposed to interaction activities between one human and another one of them is transacting at the cashier. The need for transactions is difficult to avoid so a design is needed that can minimize the spread of the virus while creating a sense of security and comfort for its users when carrying out these activities. The interaction barrier is a partition or divider that can limit one side to another which can be a solution to this problem. Using qualitative methods to identify and analyze visitor needs when transacting during the pandemic this design begins with conducting interviews and observations of users when carrying out transactions at the cashier as initial data to formulate problems which are then developed based on theories related to color shape and materials to analyze existing design needs. The design result is a functional interaction barrier which emphasizes the aspects of shape and color according to the needs of transaction activities at the cashier facility to help users stay healthy free from the risk of being exposed to germs and viruses. The results of this design are also expected to be a reference for a study as well as a design reference with a similar theme in order to minimize the spread of the virus during the pandemic and the new normal period.
ABSTRACT
Background. Several studies have reported that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can directly infect endothelial cells, and endothelial dysfunction is often found in severe cases of coronavirus disease 2019 (COVID-19). To better understand the pathological mechanisms underlying endothelial dysfunction in COVID-19-associated coagulopathy, we conducted a systematic review and meta-analysis to assess biomarkers of endothelial cells in patients with COVID-19. Methods. A literature search was conducted on online databases for observational studies evaluating biomarkers of endothelial dysfunction and composite poor outcomes in COVID-19 patients. Results. A total of 1187 patients from 17 studies were included in this analysis. The estimated pooled means for von Willebrand Factor (VWF) antigen levels in COVID-19 patients was higher compared to healthy control (306.42 [95% confidence interval (CI) 291.37-321.48], p<0.001; I2:86%), with the highest VWF antigen levels was found in deceased COVID-19 patients (448.57 [95% CI 407.20-489.93], p<0.001; I2:0%). Meta-analysis showed that higher plasma levels of VWF antigen, tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 antigen (PAI-1) antigen, and soluble thrombomodulin (sTM) were associated with composite poor outcome in COVID-19 patients ([standardized mean difference (SMD) 0.74 [0.33-1.16], p<0.001; I2:80.4%], [SMD 0.55 [0.19-0.92], p=0.003; I2:6.4%], [SMD 0.33 [0.04-0.62], p=0.025; I2:7.9%], and [SMD 0.55 [0.10-0.99], p=0.015; I2:23.6%], respectively). Conclusion. The estimated pooled means shows increased levels of VWF antigen in COVID-19 patients. Several biomarkers of endothelial dysfunction, including VFW antigen, t-PA, PAI-1, and sTM, are significantly associated with increased composite poor outcome in patients with COVID-19. Keywords: Endothelial dysfunction, von Willebrand Factor, tissue-type plasminogen activator, plasminogen activator inhibitor-1, thrombomodulin, COVID-19 PROSPERO registration number: CRD42021228821