ABSTRACT
This work addresses the territorial organization, its interdependencies and urban development in a country faced with the lack of land and town planning, as is the case of the Democratic Republic of São Tomé and Príncipe. It is based on studies to unfold the potential of new mobile communication technologies and how they can be used to gain knowledge and approaches to different development challenges, mobility issues in particular. This work is backed by an understanding that territory is a resource and a strategic tool for tackling and providing responses to sustainability issues, and as the study shows, to better understand the outbreak of COVID-19 in a territory without planning and one eager to have information on which to base more rationale containing efforts. São Tomé and Príncipe has failed to design and implement sound development plans;public transportation remains one of the issues that suffers from the lack of synergy between urban growth and population needs. This contribution focuses on the feasibility of mining, visualizing and spatializing available 2G/3G geo-tagged data traffic minute-by-minute as a strategic tool to inform decision making towards implementing an interinstitutional approach to minimize the impact of COVID-19. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
ABSTRACT
Introduction: Endothelial dysfunction and coagulopathy have been reported as the basis of severe Acute Kidney Injury (AKI) associated with COVID-19. Endothelial biomarkers can detect kidney damage early and allow the adoption of efficient measures to prevent the progression of the disease and its complications. This finding could facilitate the follow-up of patients at higher risk, as well as provide early diagnosis strategies and promote the rational use of resources. The aim of this study is to assess the role of vascular biomarkers to predict the need for hemodialysis in critically ill patients with COVID-19. Method(s): This is a prospective study with 58 patients critically ill due to COVID-19 infection admitted to a tertiary hospital in Fortaleza, Northeast Brazil, from 2020 to 2021. General laboratory tests and vascular biomarkers such as VCAM-1, Syndecan-1, ACE-2, ICAM-1, Angiopoietin-1 and Angiopoietin-2 were quantified on admission to the intensive care unit (ICU). Result(s): There was a 40% mortality rate. VCAM and the Ang-2/Ang-1 ratio at ICU admission were associated with the need for hemodialysis. Vascular biomarkers (VCAM-1, Syndecan-1, angiopoietin-2/anogiopoietin-1 ratio) and thrombocytopenia were predictors of dialysis, and their cutoff values were useful to stratify patients with worse prognosis in the Kaplan-Meier analysis. In the cox multivariate regression analysis with models adjusted according to the presence or absence of platelets, VCAM-1 [O.R. 1.13 (95% CI: 1.01 - 1.27);p=0.034] was an independent predictor of dialysis in all models, and the Ang-2/Ang-1 ratio [O.R. 4.87 (95% C.I.: 1.732 - 13.719);p=0.003] was associated with the need for dialysis in the model without platelet input. Conclusion(s): Vascular biomarkers, mainly VCAM-1 and Ang-2/Ang-1 ratio, and coagulation disorders showed important predictive value for the need for hemodialysis in critically ill patients with COVID-19. No conflict of interestCopyright © 2023