Metabolomic spittle analysis of post COVID-19 patients

Post COVID-19 patients have been suffering from persistent symptoms even after long periods. The physiopathology of these clinical manifestations still has a lack of knowledge. The objective was to evaluate the total expression of metabolites and spittle biological pathways in patients with 60 days post COVID-19. We included 30 post-hospital discharge patients and we compared seven non COVID-19 patients control. All COVID-19 patients were assessed by demographic characteristics, pulmonary function, exercise capacity, quality of life and body composition. The metabolomic analysis was performed in the patient's splits. From the total of post COVID-19 patients, 66% were male, 60+/-14 years. The lean body mass was 30+/-7kg and fat mass 34+/-13kg. Spirometry mean severity showed FVC of 4+/-1L, FEV1 3+/-1L. Pimax and Pemax values were 90+/-31(cmH2O) and 97+/-31(cmH2O), respectively. The quality of life evaluated by the SGRQ questionnaire showed a mean percentage of magnitude of symptoms 32+/-15, activities 41+/-25, impact 13+/-11 and total of 24+/-15. Physical capacity was measured by the distance in the 6MWT, and presented an average of 413+/-131. The metabolomic analysis showed 19 metabolites statistically significant difference between groups. We observed 3 metabolites overexpressed and 16 with lower expression in post COVID19 patients. From those metabolites, we can have attention to Sphinganine(p=0.03), Piperenol A triacetate(p=0.02) and 1-Monopalmitin(p=0.03) were lower expressed in control group. The creatin was one of the non-expressed metabolites in post hospital discharge COVID-19 patients compared to the control group. Thus, metabolomic analysis can demonstrate different metabolites in post COVID-19 patients to answer persistent symptoms.

Colchicine reduces the activation of NLRP3 inflammasome in COVID-19 patients.

OBJECTIVE: To evaluate whether colchicine treatment was associated with the inhibition of NLRP3 inflammasome activation in patients with COVID-19. METHODS: We present a post hoc analysis from a double-blinded placebo-controlled randomized clinical trial (RCT) on the effect of colchicine for the treatment of COVID-19. Serum levels of NOD-like receptor protein 3 (NLRP3) inflammasome products-active caspase-1 (Casp1p20), IL-1ß, and IL-18-were assessed at enrollment and after 48-72 h of treatment in patients receiving standard-of-care (SOC) plus placebo vs. those receiving SOC plus colchicine. The colchicine regimen was 0.5 mg tid for 5 days, followed by 0.5 mg bid for another 5 days. RESULTS: Thirty-six patients received SOC plus colchicine, and thirty-six received SOC plus placebo. Colchicine reduced the need for supplemental oxygen and the length of hospitalization. On Days 2-3, colchicine lowered the serum levels of Casp1p20 and IL-18, but not IL-1ß. CONCLUSION: Treatment with colchicine inhibited the activation of the NLRP3 inflammasome, an event triggering the 'cytokine storm' in COVID-19. TRIAL REGISTRATION NUMBERS: RBR-8jyhxh.

SARS-CoV-2 structures detection in artificial saliva using ATR-FTIR associated with Linear Discriminant Analysis

Here, we used ATR-FTIR platform supported by artificial intelligence algorithms to identify unique infrared vibrational modes of a pseudotyped human immunodeficiency virus type-1 (HIV-1) coupled to Spike (S) protein of SARS-CoV-2 (HIV/NanoLuc-SARS-CoV-2 pseudotype virus). © Optica Publishing Group 2022 The Authors.

SARS-CoV-2 structures detection in artificial saliva using ATR-FTIR associated with Linear Discriminant Analysis

Here, we used ATR-FTIR platform supported by artificial intelligence algorithms to identify unique infrared vibrational modes of a pseudotyped human immunodeficiency virus type-1 (HIV-1) coupled to Spike (S) protein of SARS-CoV-2 (HIV/NanoLuc-SARS-CoV-2 pseudotype virus). © Optica Publishing Group 2022 The Authors.

CONSCIENTIZAÇÃO PARA DOAÇÃO DE SANGUE E CADASTRO PARA DOAÇÃO DE MEDULA ÓSSEA EM PERÍODO DE INTERAÇÕES SOCIAIS LIMITADAS

Considerando a situação da pandemia de COVID-19 que diminuiu significativamente o número de pessoas aptas a doar sangue e que as doenças do sangue, câncer, cirurgias e traumas continuam, o Programa de Extensão “Amizade Compatível - uma doação para a vida” manteve initerruptamente o seu objetivo em conscientizar a comunidade da importância do cadastro e doação de sangue (DS) e de medula óssea (MO). Dessa maneira, o objetivo deste trabalho é apresentar ações extensionistas de conscientização para doação de sangue e de medula óssea realizadas em período de interações sociais limitadas. Materiais e métodos: Foram promovidos por alunos extensionistas, pela plataforma Google Meet, dezenove encontros com a participação de universitários, pacientes e seus familiares, profissionais de saúde, membros de associações, atiradores do Tiro de Guerra (TG) do município de Uberaba e comunidade em geral, durante 15 meses, com os temas: Indicações de hemocomponentes, Tipos Sanguíneos, Quem precisa de sangue, Abordagem de Redes Sociais para incentivo a DS, Campanhas Universitárias para captação de DS com curso de Medicina, Odontologia e Direito, Leucemia Pediátrica e uso de hemocomponentes, Conscientização para DS e para o cadastro de MO, Comemoração do Dia Nacional do Doador de MO, Comemoração do Dia Estadual da Anemia Falciforme, Comemoração do Dia Mundial da Luta contra o Câncer, Comemoração do Dia Nacional e Internacional da Talassemia além de relatos de pacientes com doença falciforme, talassemia, leucemia mieloide aguda, familiares de paciente com leucemia linfóide aguda e com doador de medula óssea. O programa também realizou na Universidade e no Hospital Universitário a Campanha intitulada Junho Vermelho para incentivar o espírito solidário das pessoas para doação de sangue. A divulgação de todas as ações foi realizada pelas redes sociais do Programa de Extensão, da Universidade e de forma particular pelos incentivadores e parceiros do programa de extensão. Resultados: O total de participantes dos dezenove encontros foi de 1636 pessoas. Momentos de relato de pacientes e seus familiares sobre a doença, sobre a dependência de transfusões e sobre a busca do doador de MO foram os que mais sensibilizaram os participantes. As postagens da Campanha do Junho Vermelho contaram com 2951 interações. Discussão: Ações extensionistas realizadas de forma online constituíram uma maneira segura de conscientizar a população da importância da realização da DS e o cadastro para doação de MO, de proporcionar o contato de alunos/comunidade com pacientes e profissionais de saúde, além de trazer à tona a dificuldade de os hemocentros manterem seus estoques de sangue principalmente em período de pandemia. Conclusão: A partir de diferentes plataformas online é possível contactar com facilidade diferentes públicos e realizar ações extensionistas de conscientização para DS e MO, colocando não só o universitário, potencial doador, em contato com os necessitam diretamente da transfusão sanguínea, mas também a comunidade em geral.

Systematic review on burnout syndrome in healthcare professionals in the COVID-19 pandemic

Objective: To review the national scientific production on the effects of the pandemic by coronavirus and its reflex on health professionals, with emphasis on Burnout Syndrome and its main tripod: emotional exhaustion, depersonalization and reduction of personal achievement.

A rare case of EBV reactivation in an immunocompetent patient

Introduction: Hepatic involvement during an active primary Epstein-Barr virus (EBV) infection often results in mild, self-resolving elevation of transaminases and is associated with infectious mononucleosis (IM). EBV rarely reactivates, and most cases occur in immunocompromised individuals. We present a rare case of EBV reactivation in an immunocompetent patient only presenting with cholestatic liver injury. Case Description/Methods: A 19-year-old female with a history of resolved EBV IM one year prior presented with dark urine and jaundice. She had no fever, abdominal pain, nausea, vomiting, weight changes or night sweats. She had no history of illicit drug, tobacco or alcohol use, recent travel, or sick contacts. Her medications were loratadine and an OCP;she denied use of acetaminophen or herbal supplements. Family history was unrevealing. On exam she was jaundiced but otherwise normal. Initial laboratory tests showed AST 97 U/L, ALT 75 U/L, ALP 165 U/L, T-BILI 8.1 mg/dL, D-BILI 5.7 mg/dL. CT abdomen revealed splenomegaly. Work up revealed ASMA titer (1:40), but otherwise negative/ normal ANA, IgG, AMA, HCV Ab, HBV serologies, HAV IgM, CMV PCR, iron studies, tick borne serologies, SARS CoV-2 PCR, A1AT and ceruloplasmin. On the second day, the T-BILI peaked to 12.4 mg/dL, AST 151 U/L, ALT 131 U/L, ALP 237 U/L. (Fig.1) EBV serologies were positive (EBV VCA IgG >750.0 U/ml, EBV VCA IgM >160.0 U/ml), EBV viral load of 23,500 copy/ ml and negative monospot test. On day four, the LFTs improved and she was discharged. One month later LFTs had normalized, and she was asymptomatic. Discussion: EBV reactivation causing cholestatic liver injury is extremely rare in immunocompetent individuals. Furthermore, EBV-induced hepatitis is usually associated with IM but our patient's sole complaint was jaundice and dark urine. Interestingly, she had mononucleosis due to EBV one year prior with unremarkable LFTs. The fact that the hepatitis was caused by the reactivation of the virus instead of a primary infection may be the reason for lack of other symptoms. It is unclear whether EBV reactivation increases the risk of hepatitis. The diagnosis can be made without a liver biopsy if thorough work up for hepatitis is negative and the EBV serologies are positive. The disease is often self-limited and the use of antivirals is controversial and thus there is no clear indication. Our case demonstrates that EBV reactivation presenting without the 'classic' IM symptoms may be under-recognized as a cause of cholestatic liver injury. (Figure Presented).

The spectrum of clinical and serological features of covid-19 in urban hemodialysis patients

BACKGROUND AND AIMS: The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. METHOD: Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units. RESULTS: In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status. CONCLUSION: COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies.