The Impact of Covid-19 on Online Discussions: the Case Study of the Sanctioned Suicide Forum

The COVID-19 pandemic has been at the center of the lives of many of us for at least a couple of years, during which periods of isolation and lockdowns were common. How all that affected our mental well-being, especially the ones' who were already in distress? To investigate the matter we analyse the online discussions on Sanctioned Suicide, a forum where users discuss suicide-related topics freely. We collected discussions starting from March 2018 (before pandemic) up to July 2022, for a total of 53K threads with 700K comments and 16K users. We investigate the impact of COVID-19 on the discussions in the forum. The data show that covid, while being present in the discussions, especially during the first lockdown, has not been the main reason why new users registered to the forum. However, covid appears to be indirectly connected to other causes of distress for the users, i.e. anxiety for the economy. © 2023 ACM.

Inflammasome but Not Ifn-I/Iii Response Is Altered in Children with Long Covid

Background: Severe COVID-19 is less common in children than in adults. Increasing evidence show that distinct immune-pathological changes can persist weeks or months after SARS-CoV2 infection, leading to Long COVID (LC). We investigated the systemic type I/III interferon (IFN-I/III) and inflammation response in peripheral blood mononuclear cells (PBMCs) of children with and without LC symptoms. Method(s): Blood samples were collected from children attending Umberto I hospital of Rome, within 3-6 months after a SARS-CoV-2 positive test and from control children. RNA was extracted from PBMCs for determining the levels of IFN-I (IFN-Alpha2, -Beta, -Epsilon and -Omega), IFN-III (IFN-Lambda1-3), NLRP3 and IL-1beta genes, and miR-141 expression by quantitative RealTime-PCR assays, normalized to housekeeping GUS gene and RNU6B, respectively. Result(s): 28 participants (M 12.5y SD 3.0) with LC symptoms, 28 participants (M 11.8y SD 3.0) without LC symptoms and 18 children who've never had SARS-CoV- 2 infection (M 10.5y SD 3.1) were enrolled. Comparing the three study groups, we found reduced levels of IFN-Lambda1, IFN-Lambda2 and IFN-Lambda3 (p=0.006, p< 0.001, p=0.012, respectively;Kruskal-Wallis (KW) test) mRNA in patients who have had SARS-CoV-2 infection as opposed to control group, whereas transcript levels of IFN-Epsilon (p= 0.019;KW test) were increased in the former with respect to the latter group;as well, remaining IFN-I genes analyzed showed a tendency to be up-regulated. As far as NLRP3 and IL-1beta levels was concerned, these genes were increased in LC patients (p< 0.001 for both genes;KW test). Additionally, miR-141, which has been reported to regulate inflammasome response, was overexpressed in LC patients (p< 0.001;Mann-Whitney test). Conclusion(s): These results showed a decreased levels of IFN-III mRNAs and an overexpression of IFN-Epsilon in children after 3-6 months of SARS-CoV-2 infection regardless of development of LC symptoms, suggesting that SARSCoV- 2 could have caused dysregulation of IFN response through unknown mechanisms (e.g. epigenetic modifications). Also, we found an overexpression of miR-141, NLRP3 and IL-1beta mRNAs in LC patients, indicating that a prolonged activation of inflammasome pathways could be associated with the development of LC symptoms.

Long COVID-19 syndrome: Association of cardiopulmonary impairment with a persistent platelet activation

Background: A considerable proportion of patients do not fully recover from COVID-19 infection and report symptoms that persist beyond the initial phase of infection: This condition is defined long-COVID-19 syndrome (LCS). LCS can involve lungs as well as several extrapulmonary organs, including the cardiovascular system. The risk and 1-year burden of cardiovascular diseases (CVD) is increased in COVID-19 survivors, even in subjects at low risk of CVD. Recently, we documented that acute COVID- 19 infection induces altered platelet activation state characterized by a prothrombotic phenotype and by the formation of platelet-leukocyte aggregates (PLA), that may be involved in the pulmonary microthrombi found in autoptic specimens. No data are yet available on the contribution of platelet activation to residual pulmonary impairment and procoagulant potential in LCS patients. Purpose(s): To study platelet activation status, microvesicle (MV) profile, platelet thrombin generation capacity (pTGC) in LCS patients enrolled at 6 months after resolution of the acute phase (6mo-FU), compared to acute COVID-19 infection patients. Method(s): 6mo-FU COVID-19 patients (n=24) with established LCS were enrolled at Centro Cardiologico Monzino. Residual pulmonary impairment was assessed by Cardiopulmonary Exercise Testing (CPET) and 64-rows- CT scan evaluation. Platelet activation (P-selectin, Tissue Factor [TF] and PLA) and MV profile were assessed by flow cytometry;pTGC by calibrated automated thrombogram. 46 patients enrolled during acute COVID-19 infection and 46 healthy subjects (HS) were used for comparison. Result(s): Dispnea in LCS patients was confirmed by CPET showing compromised alveolus-capillary membrane diffusion and residual pulmonary impairment. TF+-platelet and -MV levels were 3-fold (1.5% [1.2-2.9] vs 2.4% [1.6-5.7]) and 2-fold (217/mul [137-275] vs 435/mul [275-633]) lower at 6mo-FU compared to acute phase, being comparable to HS. pTGC behaved similarly. At 6mo-FU, the MV profile, in terms of total number and cell origin, returned to physiological levels. Conversely, although lower than that measured in acute phase, a 2.5-fold higher platelet P-selectin expression (6.9% [3-13.5] vs 11.7% [5.2-18.9]) and PLA formation (35.5% [27.4- 46.8] vs 67.7% [45.7-85.3]) was observed at 6mo-FU compared to HS. Interestingly, a significant correlation between PLA formation and residual pulmonary impairment was observed (r=-0.423;p=0.02). Conclusion(s): These data strengthen the hypothesis that the presence of PLA in the bloodstream, and thus also in the pulmonary microcirculation, may contribute to support pulmonary dysfunction still observed in LCS patients.

Antibody response to heterologous prime-boost vaccination with ChAdOx1 nCoV-19 and BNT162b2 up to 28 weeks: A comparison between vaccination regimens

Background: The occurrence of side effects, such as thrombotic events, related to vaccination with ChAdOx1 nCoV-19, led in many countries to heterologous messenger RNA (mRNA) boosting. Method(s): We tested the antibody response to SARS-CoV- 2 spike protein 4 and 15 weeks after heterologous priming with the ChAdOx1 (ChAd) vector vaccine followed by boosting with BNT162b2(ChAd/ BNT) comparing data of homologous regimen (BNT/BNT, ChAd/ ChAd), subjects positive for SARS-CoV- 2 after the first dose of BNT162b2 (BNT1dose/CoV2) and convalescent COVID-19. We also evaluated again at 28 weeks after completion of the primary schedule any differences between residual antibody response resulting from a heterologous course and the one deriving from homologous regimen. Healthy subjects naive for SARS-CoV- 2 infection were assessed for serum IgG anti-S- RBD response 21 days after priming (T1), 4 (TFULL), 15 (T15W) and 28 (T28W) weeks after booster dose. Result(s): The median IgG anti-S- RBD levels at TFULLof Chad/BNT group were significantly higher than the BNT/BNT group and ChAd/ChAd. Those of BNT/BNT group were significantly higher than ChAd/ChAd. IgG anti-S- RBD of BNT1dose/CoV2 group were similar to BNT/BNT, ChAd/BNT and ChAd/Chad group. The levels among COVID-19 convalescent were significantly lower than ChAd/ BNT, BNT/BNT, ChAd/Chad and BNT1dose/CoV2. The proportion of subjects reaching an anti-S- RBD titer > 75 AU/ml, correlated high neutralizing titer, was of 94% in ChAd/BNT and BNT/BNT, 60% in BNT1dose/CoV2, 25% in ChAd/ChAd and 4.2% in convalescent. At T15Wthe titer of ChAd/BNT was still significantly higher than other vaccine schedules, while the anti-S- RBD decline was reduced for ChAd/ChAd and similar for other combinations. At T28W weeks) there was a significant difference of median ChAd/BNT vs ChAd/ Chad (p = 0.0166), with 36.11 AU/ml and 5.5 AU/ml, respectively. The decay of antispike antibody to RBD at 170 days was 1342 AU/ week for ChAd/ChAd, and 19.22 AU/week for ChAD/BNT. Conclusion(s): Our data highlight the magnitude of IgG anti-S- RBD response in the ChAd/BNT dosing and higher IgG levels were still detectable after 28 weeks after booster dose supporting the current national guidelines for heterologous boosting. The analysis of effectiveness of vaccine combinations in this cohort is ongoing, during the omicron variant spread.

RSV circulation during SARS-CoV-2 pandemic era: what happened in Italy

Background: In the northern hemisphere, Respiratory Syncytial Virus (RSV) is more frequently detected from December to February. In Italy, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) presented a peak in incidence from the end of December 2021 to February 2022. Aim(s): To evaluate how SARS-CoV-2 pandemic has influenced RSV circulation. Method(s): We evaluated 389 children, aged 0-18 years, admitted for respiratory tract infections from September 2021 to January 2022 throughout Italy, from the north to the south. Children underwent nasal washing from 1 to 3 days after hospitalization. A (RT)-PCR was developed for detecting 15 respiratory viruses, including RSV, influenza virus A and B, human coronavirus OC43, 229E, NL-63 and HUK1, adenovirus, rhinovirus, parainfluenza virus 1-3, human bocavirus and human metapneumovirus. Result(s): We detected a virus in 338 children (86.9%): RSV was found in 267 (68.7%), other viruses in 71 (18.3%). 51 children (13.1%) resulted negative. Dividing our observational period in two-week timeframes, we found that RSV showed an early peak from October to the first half of December 2021 compared to its usual seasonality. In a previous study, we have demonstrated that RSV circulation was incredibly low from September 2020 to January 2021, in contrast with what we found in the same period in 2021-2022. Comparing RSV and SARS-CoV-2 incidences, we found that these two viruses spread in opposite ways: when SARS-CoV-2 present an incidence peak, RSV circulation reduced and viceversa. Conclusion(s): The relationship between RSV and SARS-CoV-2 showed that viral interference plays a crucial role in their epidemiology.

Covid-19 in children: disease spectrum and risk factors

Introduction: Children infected with the severe acute respiratory coronavirus 2 (SARS-CoV-2) are mostly asymptomatic or mild symptomatic. Some children experience persistent symptoms after SARS-CoV-2 infection, which may be consistent with Long COVID. Aim(s): To assess the frequency of both acute and persisting Coronavirus disease (COVID-19) symptoms in children and to search for the presence of risk factors for acute or persisting COVID-19 symptoms. Method(s): We included 697 children, aged between 0 and 18 years, who had previous SARS CoV-2 infection. Children and parents were asked questions regarding symptoms in the acute phase of COVID-19 and also persistent symptoms (extending beyond or developing 30 days and 90 days after initial diagnosis). Result(s): 79,2% of children were symptomatic in the acute phase of COVID-19;the most common acute symptoms were fever (49,6%), cough (22,1%), headache (37,9%) and asthenia (25,8%). 26,8% of children reported symptoms 30 days after initial diagnosis and 10,2% of children presented symptoms 90 days after initial diagnosis;the most common reported symptom was asthenia respectively in 12,3% (after 30 days) and in 4,9% of children (after 90 days). Persisting symptoms after 30 days were mostly present in overweigh or obese girls (35,8% vs 64,2%, p-value 0,03) and in children with asthenia (41,3% vs 20,3, p-value 0,001) in the acute phase. Children with symptoms 90 days after initial diagnosis most frequently had asthenia in the acute phase. Conclusion(s): We confirm that SARS-CoV-2 infection in children is generally mild. Also children can experience persisting symptoms that are significantly more frequent if they have a symptomatic disease and asthenia.

Characterization of TF positive small extracellular vesicles in SARS-CoV- 2 infection

Background: Coronavirus-2 (SARS-CoV- 2) infection causes a sustained prothrombotic state driven by a massive Tissue Factor (TF) expression in circulating platelets, leukocytes and microvesicles (MVs). Whether also circulating small extracellular vesicles (sEVs), in addition to large MVs (MVs), can contribute to this hypercoagulable scenario through TF expression is not yet known, mainly due to methodological issues in detecting and sizing the smallest vesicles. Aim(s): To characterize TF expression and activity in circulating sEVs, compared to that of MVs, of COVID-19 patients during acute phase infection and after symptom remission. Method(s): MVs and sEVs were isolated by plasma differential centrifugation from 10 COVID-19 patients enrolled at acute phase infection (T0) and at six-month- follow- up (T1). Ten healthy subjects (HS) were analyzed as controls. sEVs were counted by Nano Tracking Assay. In sEVs TF expression was analyzed within CD9/CD63/CD81pos events by imaging flow cytometry (IFC) and ExoViewTM microarray, while TF activity by FXa generation assay. TF expression and activity in MVs were evaluated for comparison. Result(s): By IFC analysis COVID-19 patients at T0 have about 1.5-and 4-fold higher number of TFpos-sEVs and -MVs, respectively, compared to HS, with a trend toward reduction to physiological levels at T1. By microarray analysis sEVs behaved similarly (36 +/- 12 and 25 +/- 10 TFpos-spots at T0 and T1, respectively;p = 0.0281). sEVs-associated TF is functionally active thus able to partially support FXa formation as sEVs preincubation with TF-neutralizing antibody reduced FXa generation by ~30%. However, although sEVs number is significantly higher compared to that measured for MVs (~600-fold in HS), functional activity of sEV is one-third lower compared to that of MVs. Conclusion(s): These data suggest that, in COVID-19 patients, the altered procoagulant phenotype could also be supported by TF carried by sEVs, although their functional activity is significantly lower than that of MVs.

Long-COVID- 19 syndrome: From the clinical evidences to a pathophysiological mechanism

Background: Long-COVID- 19 syndrome (LCS) is defined as symptoms persisting beyond initial phase of infection. Among them, pulmonary fibrotic damage remains in 25-30% of COVID-19 patients at 3-6 month-follow- up. We documented that acute COVID-19 patients have massive platelet activation characterized by the formation of platelet-leukocyte aggregates (PLA), that may be involved in the pulmonary microthrombi found in autoptic specimens, and by a prothrombotic phenotype. No data are currently available on contribution of platelet activation to residual pulmonary impairment and procoagulant potential in LCS patients. Aim(s): To characterize platelet activation, microvesicle (MV) profile, platelet thrombin generation capacity (pTGC) in LCS patients at 6-month- follow- up (6mo-FU) compared to acute COVID-19 infection patients. Method(s): Twentyfour 6mo-FU COVID-19 patients with established LCS defined according to their residual pulmonary impairment assessed by Cardiopulmonary Exercise Testing (CPET) and 64-rows- CT scan evaluation were enrolled. Platelet activation (P-selectin, Tissue Factor [TF] and PLA) and MV profile were evaluated by flow cytometry;pTGC by calibrated automated thrombogram. Fortysix patients enrolled during acute COVID-19 infection and 46 healthy subjects (HS) were used for comparison. Result(s): Dispnea in LCS patients was confirmed by CPET showing compromised alveolus-capillary membrane diffusion and residual pulmonary impairment. TF+-platelet and -MV levels were 3-and 2-fold lower at 6mo-FU compared to acute phase, being comparable to HS, as well as pTGC. At 6mo-FU, the MV profile (total number and derived from different cells) returned to physiological levels. Conversely, although lower than that measured in acute phase, a 2.5-fold higher platelet P-selectin expression and PLA formation was observed at 6mo-FU compared to HS. Interestingly, a significant correlation between PLA formation and residual pulmonary impairment was observed. Conclusion(s): These data strengthen the hypothesis that the presence of PLA in the bloodstream, and thus also in the pulmonary microcirculation, may contribute to support pulmonary dysfunction still observed in LCS patients.

Repurposing of montelukast in COVID-19 patients in order to modulate platelet activation

Background: Sustained platelet activation, thrombosis, vascular damage, fibrotic response as well as inflammatory overload are typical features of COVID-19 pathology. Common denominator in these processes is leukotrienes (LTs). Elevated levels of LTE4 have been detected in bronchoalveolar lavage of COVID-19 patients so the use of LT receptor antagonists as a potential therapeutic for COVID-19 patient treatment has been hypothesized. A first phase III randomized double-blind clinical trial testing montelukast in COVID-19 patients has been indeed proposed. Aim(s): To investigate whether montelukast affects the expression of the major markers of platelet activation such as tissue factor (TF), P-selectin, as well as the formation of platelet-leukocyte aggregates and microvesicle (MV) release observed in COVID-19 syndrome. Method(s): Blood from healthy subjects (HS;n = 4-6) was plasma-depleted and reconstituted with plasma pools (n = 3) from COVID-19 patients (4 patients/pool) or from the same HS blood donors. To assess the effect of montelukast on cell activation, blood from HS was preincubated for 30 minutes with the drug. Circulating cell-associated TF expression, platelet activation markers, and MV release were analyzed by flow cytometry. Result(s): Plasma from COVID-19 patients significantly increased (4-fold) the number of TF+-and P-selectin+- platelets of HS recapitulating the platelet activation status of COVID patients. Montelukast prevented platelet activation induced by plasma from COVID-19 patients and it reduced the formation of circulating monocyte-and granulocyte-platelet aggregates, decreasing the number of those TF+ by 4-times. Finally, it completely inhibited the release of TF+ circulating MVs, reducing by more than 2-times those derived from platelets. Conclusion(s): Our data indicate that leukotrienes contribute to sustain platelet activation occurring in the COVID-19 patient, which can however be prevented by treatment with montelukast. Until results from ongoing trials will be available, our data provide the molecular basis by which the drug may be effective in the treatment of COVID-19.

Models for Digitally Contact-Traced Epidemics

Contacts between people are the main drivers of contagious respiratory infections. For this reason, limiting and tracking contacts is a key strategy for controlling the COVID-19 epidemic. Digital contact tracing has been proposed as an automated solution to scale up traditional contact tracing. However, the required penetration of contact tracing apps within a population to achieve a desired target in controlling the epidemic is currently under discussion within the research community. In order to understand the effects of digital contact tracing, several mathematical models have been studied. In this article, we propose a novel compartmental SEIR model with which it is possible, differently from the models in the related literature, to derive closed-form conditions regarding the control of the epidemic. These conditions are a function of the penetration of contact tracing applications and testing efficiency. Closed-form conditions are crucial for the understandability of models, and thus for decision makers (including digital contact tracing designers) to correctly assess the dependencies within the epidemic. Feeding COVID-19 data to our model, we find that digital contact tracing alone can rarely tame the epidemic: for unrestrained COVID-19, this would require a testing turnaround of around 1 day and app uptake above 80% of the population, which are very difficult to achieve in practice. However, digital contact tracing can still be effective if complemented with other mitigation strategies, such as social distancing and mask-wearing.

Astraea: Anonymous and Secure Auditing Based on Private Smart Contracts for Donation Systems

Many regions are in urgent need of facial masks for slowing down the spread of COVID-19. To fight the pandemic, people are contributing masks through donation systems. Most existing systems are built on a centralized architecture which is prone to the single point of failure and lack of transparency. Blockchain-based solutions neglect fundamental privacy concerns (donation privacy) and security attacks (collusion attack, stealing attack). Moreover, current auditing solutions are not designed to achieve donation privacy, thus not appropriate in our context. In this work, we design a decentralized, anonymous, and secure auditing framework Astraea based on private smart contracts for donation systems. Specifically, we integrate a Distribute Smart Contract (DiSC) with an SGX Enclave to distribute donations, prove the integrity of donation number (intention) and donation sum while preserving donation privacy. With DiSC, we design a Donation Smart Contract to refund deposits and defend against the stealing attack the collusion attack from malicious collector and transponder. We formally define and prove the privacy and security of Astraea by using security reduction. We build a prototype of Astraea to conduct extensive performance analysis. Experimental results demonstrate that Astraea is practically efficient in terms of both computation and communication. IEEE

Comparing the Impact of Social Media Regulations on News Consumption

Users online tend to consume information adhering to their system of beliefs and ignore dissenting information. During the COVID-19 pandemic, users get exposed to a massive amount of information about a new topic having a high level of uncertainty. In this article, we analyze two social media that enforced opposite moderation methods, Twitter and Gab, to assess the interplay between news consumption and content regulation concerning COVID-19. We compare the two platforms on about three million pieces of content, analyzing user interaction with respect to news articles. We first describe users' consumption patterns on the two platforms focusing on the political leaning of news outlets. Finally, we characterize the echo chamber effect by modeling the dynamics of users' interaction networks. Our results show that the presence of moderation pursued by Twitter produces a significant reduction of questionable content, with a consequent affiliation toward reliable sources in terms of engagement and comments. Conversely, the lack of clear regulation on Gab results in the tendency of the user to engage with both types of content, showing a slight preference for the questionable ones which may account for a dissing/endorsement behavior. Twitter users show segregation toward reliable content with a uniform narrative. Gab, instead, offers a more heterogeneous structure where users, independent of their leaning, follow people who are slightly polarized toward questionable news.

Contact Tracing Made Un-relay-able

Automated contact tracing is a key solution to control the spread of airborne transmittable diseases: it traces contacts among individuals in order to alert people about their potential risk of being infected. The current SARS-CoV-2 pandemic put a heavy strain on the healthcare system of many countries. Governments chose different approaches to face the spread of the virus and the contact tracing apps were considered the most effective ones. In particular, by leveraging on the Bluetooth Low-Energy technology, mobile apps allow to achieve a privacy-preserving contact tracing of citizens. While researchers proposed several contact tracing approaches, each government developed its own national contact tracing app. In this paper, we demonstrate that many popular contact tracing apps (e.g., the ones promoted by the Italian, French, Swiss government) are vulnerable to relay attacks. Through such attacks people might get misleadingly diagnosed as positive to SARS-CoV-2, thus being enforced to quarantine and eventually leading to a breakdown of the healthcare system. To tackle this vulnerability, we propose a novel and lightweight solution that prevents relay attacks, while providing the same privacy-preserving features as the current approaches. To evaluate the feasibility of both the relay attack and our novel defence mechanism, we developed a proof of concept against the Italian contact tracing app (i.e., Immuni). The design of our defence allows it to be integrated into any contact tracing app. To foster the adoption of our solution in contact tracing apps and encourage developers to integrate it in the future releases, we publish the source code. © 2021 ACM.

Novel Foods and Sustainability as Means to Counteract Malnutrition in Madagascar

Although the trends of international reports show an increase in overweight and obesity, even in developing countries, there are still areas of the world, such as Sub-Saharan Africa, strongly affected by undernutrition. Specifically, in Madagascar, the percentage of stunted children under 5 is extremely high. Furthermore, the COVID-19 pandemic is expected to increase the risk of all forms of malnutrition, especially in low-income countries, including Madagascar, with serious intergenerational repercussions. This narrative review aims at investigating eating habits and cooking methods of the Malagasy population, addressing sustainable healthy diets through promotion of novel foods. While novel foods are a recent concept, there are data that describe how they may contribute to counteract food insecurity and malnutrition considering context and place. Efforts to promote native, traditional foods as Moringa oleifera, an indigenous plant in Asia and Africa including Madagascar, rich in protein and micronutrients, as well as edible insects, alternative sustainable source of protein, lipids, iron, and zinc, would provide not only nutritional but also cultural and economic benefits. The potential synergies between food traditions and agroecology have the potential to impact health addressing larger issues of sustainability and food security. Regional, national, and international policies are needed to develop and support one health approach actions.

Guillain-Barre syndrome associated to COVID-19 infection: a review of published case reports. / Síndrome de Guillain-Barré asociado a infección por COVID-19: revisión de casos publicados.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic is a major worldwide health disorder. There is an increasing number of neurological complications recognized with COVID-19 including patients with GBS and its variants. DEVELOPMENT: A review of the clinical cases of GBS associated to COVID-19 infection published in the last months has been developed. We included 48 patients (31 men, mean age 56.4 years). The most common COVID-19 symptoms were cough (60.4%) and fever (56.3%). Mean time from COVID-19 symptoms to neurologic manifestations was 12.1 days, but in nine patients (18.8%) developed GBS within seven days. Eleven patients (22.9%) presented cranial nerve involvement in the absence of muscle weakness; 36 presented the classic sensory motor variant (75%) and one had a pure motor variant (2.1%). The electrodiagnostic pattern was considered demyelinating in 82.4% of the generalized variants. The presence of hyposmia/dysgeusia was associated with a latency shorter than seven days to GBS onset of symptoms (30% vs 15.6%), and cranial nerve involvement in the absence of weakness (30.8% vs 17.1%). Most patients (87.5%) were treated with intravenous immunoglobulin. Neurological outcome was favorable in 64.6%; 29.2% had respiratory failure and 4.2% died shortly after being admitted. CONCLUSIONS: GBS in patients with SARS-CoV-2 infection resembles clinically and electrophysiology the classical forms. Further studies are necessary to understand whether GBS frequency is actually increased due to SARS-CoV-2 infection and explore pathogenic mechanisms.

TITLE: Síndrome de Guillain-Barré asociado a infección por COVID-19: revisión de casos publicados.Introducción. La pandemia por la enfermedad por coronavirus 2019 (COVID-19) es un importante problema para la salud mundial. Hay un incremento en las complicaciones neurológicas reconocidas por la COVID-19, incluyendo el síndrome de Guillain-Barré (SGB) y sus variantes. Desarrollo. Se realizó una revisión de los casos publicados en los últimos meses de SGB asociado a infección por COVID-19. Incluimos a 48 pacientes (31 hombres; edad media: 56,4 años). Los síntomas de COVID-19 más comunes fueron tos (60,4%) y fiebre (56,3%). El tiempo promedio entre los síntomas de COVID-19 y el SGB fue de 12,1 días, pero nueve pacientes (18,8%) desarrollaron SGB en menos de siete días. Once pacientes (22,9%) presentaron afectación de los nervios craneales en ausencia de debilidad muscular, 36 presentaron la variante clásica sensitivomotora (75%) y uno tuvo una variante motora pura (2,1%). El patrón electrofisiológico se consideró desmielinizante en el 82,4% de las variantes generalizadas. La presencia de hiposmia/disgeusia estuvo asociada con una latencia menor a los siete días hasta el inicio de los síntomas del SGB (30 frente a 15,6%) y a la afectación de los nervios craneales en ausencia de debilidad (30,8 frente a 17,1%). La mayoría de los pacientes (87,5%) fueron tratados con inmunoglobulina endovenosa. La evolución neurológica fue favorable en el 64,6%, el 29,2% tuvo insuficiencia respiratoria y hubo un 4,2% de muertes. Conclusiones. El SGB en pacientes con infección por SARS-CoV-2 es similar clínica y electrofisiológicamente a las formas clásicas. Se requieren más estudios para comprender si la frecuencia del SGB realmente aumentó debido a la pandemia por COVID-19 y explorar los mecanismos patógenos involucrados.

COVID-19 pandemic: A paradigm shift in the West?

In this article, we develop evidence-based recommendations to efficiently administer the limited resources of the healthcare facilities in medium and low income countries in the context of a pandemic. We searched MedLine database using the MeSH terms “Pneumonia, viral/prevention and control”, “Pneumonia, viral/transmission”, “Coronavirus Infections/prevention and control”, “Coronavirus Infections/transmission”, “COVID-19”, “Masks/classification”, “Masks/microbiology”, “Respiratory Protective Devices”, among others. We recommend that the general population wears a face mask. On the institutional level, ventilation and appropriate bed distancing proved to be effective preventive measures. The most important factor in the containment of an outbreak is the timely identification of infected patients. Negative pressure and ventilation systems are also highly recommended. Using a full face mask together with a surgical mask might be an option to deal with N95 respirators shortage. We present an integral strategy with coping measures for healthcare institutions and the society in general. © 2020 Sociedad de Anestesiologia de Chile. All rights reserved.

Give more data, awareness and control to individual citizens, and they will help COVID-19 containment

The rapid dynamics of COVID-19 calls for quick and effective tracking of virus transmission chains and early detection of outbreaks, especially in the “phase 2” of the pandemic, when lockdown and other restriction measures are progressively withdrawn, in order to avoid or minimize contagion resurgence. For this purpose, contact-tracing apps are being proposed for large scale adoption by many countries. A centralized approach, where data sensed by the app are all sent to a nation-wide server, raises concerns about citizens’ privacy and needlessly strong digital surveillance, thus alerting us to the need to minimize personal data collection and avoiding location tracking. We advocate the conceptual advantage of a decentralized approach, where both contact and location data are collected exclusively in individual citizens’ “personal data stores”, to be shared separately and selectively (e.g., with a backend system, but possibly also with other citizens), voluntarily, only when the citizen has tested positive for COVID-19, and with a privacy preserving level of granularity. This approach better protects the personal sphere of citizens and affords multiple benefits: It allows for detailed information gathering for infected people in a privacy-preserving fashion;and, in turn this enables both contact tracing, and, the early detection of outbreak hotspots on more finely-granulated geographic scale. The decentralized approach is also scalable to large populations, in that only the data of positive patients need be handled at a central level. Our recommendation is two-fold. First to extend existing decentralized architectures with a light touch, in order to manage the collection of location data locally on the device, and allowthe user to share spatio-temporal aggregates-if and when they want and for specific aims-with health authorities, for instance. Second, we favour a longerterm pursuit of realizing a Personal Data Store vision, giving users the opportunity to contribute to collective good in the measure they want, enhancing self-awareness, and cultivating collective efforts for rebuilding society. © 2020, University of Skovde. All rights reserved.