Therapeutical potential of enzyme replacement: New insights and perspectives in human endothelial cells treated with chloroquine

BACKGROUND AND AIMS: COVID-19 is a pandemic with no end in sight. There is only one approved antiviral agent but global stocks are deemed insufficient. Despite in vitro antiviral activity, clinical trials of chloroquine and hydroxychloroquine were disappointing, and they may even impair outcomes. Chloroquine causes zebroid deposits reminiscent of Fabry disease (a-galactosidase A deficiency) and endothelial cells are key targets of COVID-19. The study aims to investigate in vitro the effect of enzyme replacement therapy (ERT) in chloroquine-induced endothelial dysfunction. METHOD: We have explored the effect of chloroquine on cultured endothelial cells and its modulation by recombinant α-galactosidase A (agalsidase-β). Following doseresponse studies, 0.5 μg/mL chloroquine was added to cultured human endothelial cells. Neutral red and Lysotracker were used to assess lysosomes. Cytotoxicity was evaluated by the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) - MTT assay and cell stress by assessing reactive oxygen species (ROS) and nitric oxide (NO). In endothelial cells, chloroquine induced dose-dependent cytotoxicity at in vitro test concentrations for COVID-19 therapy. RESULTS: Chloroquine significantly induced the accumulation of acid organelles (P<0.05), increased ROS levels, and decreased NO production (P<0.05), in vitro. These adverse effects of chloroquine on endothelial cell biology were decreased by agalsidase-β (P<0.05). CONCLUSION: Chloroquine-induced endothelial cell cytotoxicity and stress is attenuated by agalsidase-β treatment. This suggests that endothelial cell injury may contribute to the failure of chloroquine as therapy for COVID-19 and may be at least in part related to causing dysfunction of the lysosomal enzyme α-galactosidase A. (Figure Presented).

Evaluation of the nursing process in care of patients with COVID-19 in reference hospitals

Objective: to evaluate how the nursing process has been developed in the health care of patients with COVID-19, in the Reference Hospitals of the state of Rio Grande do Norte. Method: cross-sectional, descriptive-exploratory study, with a quantitative approach, conducted with 55 nurses from 11 referrence hospitals for COVID-19. The Snowball technique and an online form have been used. In the analysis and interpretation of the data, simple descriptive statistics was used. Results: of the total, 43.6% (n=24) of the nurses were able to perform the nursing process. The investigation was the most frequently performed stage (45.4%-n=25). Difficulties in performing the phases of the nursing process were reported by 83.6% (n=46). The nursing care implementation step was the most challenging (36.3%-n=20). Conclusion: the nursing process is still a fragility of the profession, since its phases are interrelated and successive, and the break of this cycle compromises the effectiveness of the care provided. © 2021 Universidade Federal da Bahia. All rights reserved.

The role of primary care in the fight against the COVID-19

The new coronavirus (Covid-19) disease is caused by SARS-CoV-2 and represents the causative agent of a potentially fatal disease that has proved to be a global public health problem. The pandemic caused by Covid-19 has caused severe damage to health systems in several countries. In view of the large number of infected people and the lack of specific treatment, several nations have faced overcrowding in their hospitals. With the confirmation of cases of this disease in Brazil, several actions have been taken by managers, both at the hospital level and at the level of primary care, in order to minimize the damage in the Unified Health System (SUS). This article presents a brief analysis of the role of primary care in the fight against Covid-19 at the national level, in addition to the impact on public health and future perspectives. Based on the large number of infected people in the world and the experience of different health systems, it is imperative to adapt and adequation the SUS in conducting response mechanisms for the pandemic, with primary care being a fundamental part of this process.

Electronic tools for physical activity and quality of life of medical students during COVID-19 pandemic social isolation

Aim: This study investigates the impact of social isolation, weight changes, and physical activity (PA) by the electronic tools (eTools) on the quality of life (QoL) of Brazilian medical students during the COVID-19 pandemic. Methods: In this observational longitudinal study, one hundred eighty-nine medical students completed an e-questionnaire, which used the WHOQOL-Bref instrument to report QoL and sociodemographic characteristics, health conditions, and lifestyles related to PA. Cronbach's alpha and Friedman/Dunn and Spearman's correlation tests were performed. Based on descriptive and inferential statistics, a multiple linear regression was used to evaluate the potential predictors of QoL. Results: The COVID-19 pandemic particularly affected the psychological and social domains. Time spent indoors and a non-ideal BMI had a negative impact on QoL. Being female and sexual minority-group membership were associated with lower QoL scores in the psychological and physical domains, respectively. Access to PA eTools was positively associated with QoL. Being monitored by a physical education teacher contributes to satisfactory PA levels during online classes. Conclusion: This study provides novel insights into the access of PA eTools on QoL during the COVID-19 pandemic. During periods of social distancing, people should pay extra attention to self-care strategies to protect mental health and promote positive lifestyle patterns. In addition, using online PA resources monitored by physical education teachers could be a strategy to maintain satisfactory levels of exercise. © 2021 Universidade Estadual Paulista - UNESP. All rights reserved.