Association between phase angle and adverse clinical outcomes in hospitalized patients with COVID-19: A systematic review.

Phase angle, obtained by bioelectrical impedance, is an indicator of cellular integrity and has been proposed as a prognostic parameter in patients who are critically ill. This systematic review aimed to evaluate the association between phase angle and adverse clinical outcomes in hospitalized patients with coronavirus disease-2019 (COVID-19). An extensive literature search was performed in the MEDLINE/PubMed, Embase, and Web of Science databases, with interest in observational studies evaluating the association between phase angle and adverse clinical outcomes in individuals aged ≥18 years hospitalized with COVID-19. Studies were independently selected by two reviewers, according to eligibility criteria. Subsequently, data were extracted and presented in a qualitative synthesis. The evaluation of the quality of the studies was performed according to the Newcastle-Ottawa scale. The full methodology was published in PROSPERO (ID CRD42022306177). A total of 392 articles were identified, resulting in seven selected studies, of which six were prospective cohorts and one was retrospective. In the quality assessment, six studies obtained scores equal to or greater than seven, indicating a low risk of bias. A total of 750 participants composed the samples of the selected studies. Five studies reported an independent association between phase angle and adverse clinical outcomes during hospitalization for COVID-19, with emphasis on prolonged hospitalization and mechanical ventilation and higher mortality in patients with a lower phase angle. Thus, phase angle measurement can be useful in the early identification of risks in patients hospitalized with COVID-19, for the purpose of adequacy of clinical management.

Detraining and retraining in badminton athletes following 1-year COVID-19 pandemic on psychological and physiological response.

Purpose: Badminton is a racket sport, with fast and explosive movements and mental skills employed to anticipate the opponent's movements. The COVID-19 pandemic, led to social restriction in Brazil and sport event cancellations, subsequently, sports training was banned. Thus, the objective of this study was to compare the impact of long-period detraining due to COVID-19 social restriction (8 months and 1-year) on cardiorespiratory fitness, body composition, nutritional behavior, and profile of mood states in badminton athletes and to verify if the athletes who returned to their regular training 4 months earlier than athletes who stopped their daily training routine during 1-year would improve these variables. Methods: Twenty-three young badminton athletes were analyzed: retrained group (14 athletes who stopped their daily training routine for 8 months due to the COVID-19 pandemic plus 4 months of retraining), and detrained group (9 athletes who stopped their daily training routine during 1 year of the COVID-19 pandemic but performed home-based training). We evaluated body composition, cardiorespiratory fitness, nutritional behavior, and mood states profiles. Results: Retrained athletes showed lower body fat (- 24.1% vs. + 20.8%, p < 0.001) and higher fat-free mass (+ 6.0% vs. - 0.2%, p = 0.007) after 1 year compared with the detrained group. For cardiorespiratory fitness [retrained: baseline = 55.5 ± 5.3 (47.1, 63.9) and after 1 year = 58.1 ± 2.4 (54.2, 61.9), ES = 0.65 vs. detrained: baseline = 53.4 ± 6.7 (47.2, 59.5) and after 1 year = 53.1 ± 5.6 (48.0, 58.3), ES = - 0.03] and nutritional behavior, including sauces and spices [retrained: baseline = 8.9 ± 7.0 (4.5, 13.4), and after 1 year = 3.4 ± 2.9 (1.8, 5.5), ES = - 1.11 vs. detrained: baseline = 6.8 ± 6.7 (1.6, 11.9) and after 1 year = 6.3 ± 5.5 (2.1, 10.6), ES = - 0.08], the ESs were medium and large, respectively, for Retrained but trivial for detrained group. For depression, ES was trivial in the retrained [baseline = 2.7 ± 3.3 (0.7, 4.7) and after 1 year = 2.6 ± 2.9 (0.8, 4.4), ES = 0.03] and moderate for detrained [baseline = 1.0 ± 1.5 (- 0.1, 2.1) and after 1 year = 1.8 ± 2.7 (- 0.3, 3.8), ES = 0.50]. Conclusions: Young badminton athletes who returned to their regular daily training 4 months earlier than athletes who stopped their daily training routine during 1-year due to COVID-19 social restriction decreased fat mass and increased fat-free mass. There were no significant differences between groups for cardiorespiratory fitness, nutritional behavior, and profile of mood state response.

Monitoring of the SARS-CoV-2 Omicron BA.1/BA.2 variant transition in the Swedish population reveals higher viral quantity in BA.2 cases (preprint)

Throughout the SARS-CoV-2 pandemic, multiple waves of variants of concern have swept across populations, leading to a chain of new and yet more contagious lineages dominating COVID-19 cases. Here, we tracked the remarkably rapid shift from Omicron BA.1 to BA.2 sub-variant dominance in the Swedish population during January-March 2022. By analysis of 174,933 clinical nasopharyngeal swab samples using a custom variant-typing RT-PCR assay, we uncover nearly two-fold higher levels of viral RNA in cases with Omicron BA.2. Importantly, increased viral load in the upper pharynx upon BA.2 infection may provide part of the explanation why Omicron BA.2 is more transmissible and currently outcompetes the BA.1 variant across populations.

Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system.

The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

Epidemiology and Etiopathogeny of COVID-19.

Despite the recent announcement of the new pathogenic coronavirus to man, SARS-CoV2, a large number of publications are presented to the scientific community. An organized and systematic review of the epidemiological, etiological, and pathogenic factors of COVID-19 is presented. This is a systematic review using the databases MEDLINE, EMBASE, Web of Science, SCIELO; the descriptors coronavirus, SARS-CoV-2, etiology, epidemiology, pathophysiology, pathogenesis, COVID-19, with publications from December 2019 to January 2021, resulting in more than 800 publications and 210 selected. The data suggest that COVID-19 is associated with SAR-CoV-2 infection, with the transmission of contagion by fomites, salivary droplets, and other forms, such as vertical and fecal-oral. The bat and other vertebrates appear to be reservoirs and part of the transmission chain. The virus uses cell receptors to infect human cells, especially ACE2, like other coronaviruses. Heat shock proteins have different roles in the infection, sometimes facilitating it, sometimes participating in more severe conditions, when not serving as a therapeutic target. The available data allow us to conclude that COVID-19 is a pandemic viral disease, behaving as a challenge for public health worldwide, determining aggressive conditions with a high mortality rate in patients with risk factors, without treatment, but with the recent availability of the first vaccines.

Ultrastructural analysis of nasopharyngeal epithelial cells from patients with SARS-CoV-2 infection (preprint)

The nasal epithelium is an initial site for SARS-CoV-2 infection, responsible for the ongoing COVID-19 pandemic. However, the pathogenicity and morphological impact of SARS-CoV-2 on the nasopharynx cells from symptomatic patients with different viral loads remain poorly understood. Here, we investigated the ultrastructure of nasal cells obtained from individuals at distinct disease days and with high and low SARS-CoV-2 loads. Squamous and ciliated cells were the main cells observed in SARS-CoV-2 negative samples. We identified virus-like particles (VLPs) and replication organelles (RO)-like structures in the squamous cells from high viral load samples after 3- and 4-days of symptoms. Ultrastructural changes were found in those cells, such as the loss of microvilli and primary cilium, the increase of multivesicular bodies and autophagosomes, and signs of cell death. No ciliated cells were found in those samples. Squamous cells from low viral load sample after 5 days of symptoms showed few microvilli and no primary cilium. VLPs and RO-like structures were found in the ciliated cells only. No ultrastructural alterations were seen in the cells from low viral load individuals after 10- and 14-days of symptoms. Our results shed light on the ultrastructural effects of SARS-CoV-2 infection on the human nasopharyngeal cells.

COVID-19 pandemic impacts physical activity levels and sedentary time but not sleep quality in young badminton athletes.

PURPOSE: Regular physical activity is a good strategy to maintain the health of athletes, and prevent pain and decreased joint flexibility during the pandemic. On the other hand, higher sedentary time during the pandemic period can have deleterious effects. The objective of this study was to compare physical activity levels, sedentary time, and sleep parameters during the pre-COVID period and the COVID-19 pandemic period in young badminton athletes. METHODS: Fifteen young badminton athletes were evaluated during a pre-COVID period (July 2019) and during the COVID-19 period (July 2020). Sleep parameters, physical activity level, and sedentary time were measured using a tri-axial accelerometer. Participants wore the accelerometer on their dominant wrist for 7 days consecutively. In addition, the average of each sleep parameter [time in bed and total sleep time in hours per day, sleep efficiency (%), wake after sleep onset (WASO, total per day), and sleep latency (minutes per day)] was reported over the 7-day period. RESULTS: Athletes presented increased sedentary time (pre-COVID = 7.0 ± 1.1 vs.COVID-19 = 8.9 ± 1.9 h/day, p = 0.004, d = 1.30) and significant decreases in the total PA observed in counts per day (pre-COVID = 2,967,064.4 ± 671,544.1 vs. COVID-19 = 1,868,210.2 ± 449,768.4 counts/day, p = 0.001, d = 1.99), time in vigorous PA (pre-COVID = 7.7 ± 0.9 vs. COVID-19 = 6.1 ± 1.2 h/day, p = 0.001, d = 1.56), and time in moderate-to-vigorous PA (pre-COVID = 8.1 ± 0.9 vs. COVID-19 = 6.5 ± 1.3 h/day, p = 0.001, d = 1.48). There were no significant differences for time in light and moderate PA or in sleep parameters (p > 0.05). CONCLUSION: Young badminton athletes presented increased sedentary time, and decreased total physical activity, time in MVPA, and time in vigorous activities during the COVID-19 pandemic compared to the pre-COVID period, however, there were no significant differences in sleep parameters.

Abdominal Wall Surgery after SARS-CoV-2: Time to Reestablish Postponed Non-essential Procedures?

Pandemic by the COVID-19 has found us unprotected to provide an adequate and rapid sanitary response. The hospital network of our public health system has provided most of the resources for the treatment of patients affected by the infection. Non-essential (non-priority) surgeries have been postponed. The optimal and proportionate reestablishment of these non-priority surgeries can be a problem. This article offers a technical and non-technical view of reestablishment non-priority surgeries from the perspective of abdominal wall surgery. Resumen La pandemia por el COVID-19 nos ha encontrado desprotegidos ante la dificultad para dar una respuesta sanitaria adecuada y rápida. La red de hospitales del sistema sanitario público ha dispuesto la mayoría de los recursos para el tratamiento de los pacientes afectos por la infección. Las cirugías no esenciales (no prioritarias) han sido aplazadas. El reinicio óptimo y proporcionado de estas cirugías no prioritarias puede representar un problema. En el presente artículo se ofrece una perspectiva técnica y no técnica del reinicio de las cirugías no prioritarias desde la óptica de la cirugía de la pared abdominal.

Estimation and monitoring of COVID-19 transmissibility from publicly available data (preprint)

The COVID-19 pandemic began in the city of Wuhan, China, at the end of 2019 and quickly spread worldwide. The disease is caused by contact with the SARS-CoV-2 virus, which probably jumped from an animal host to humans. SARS-CoV-2 infects various tissues in the body, notably the lungs, and patients usually die from respiratory complications. Mathematical models of the disease have been instrumental to guide the implementation of mitigation strategies aimed at slowing the spread of the disease. One of the key parameters of mathematical models is the basic reproduction ratio R0, which measures the degree of infectivity of affected individuals. The goal of mitigation is to reduce R0 as close or below 1 as possible, as it means that new infections are in decline. In the present work, we use the recursive least-squares algorithm to establish the stochastic variability of a time-varying R0(t) from eight different countries: Argentina, Belgium, Brazil, Germany, Italy, New Zealand, Spain, and the United States of America. The proposed system can be implemented as an online tracking application providing information about the dynamics of the pandemic to health officials and the public at large.