ABSTRACT
Aim/Introduction: In SARS-CoV2 outbreak scenario, many considerations about possible long-term effects of this infection can be made. Early evidences reported in literature about the relation between long-COVID disease and brain involvement in patients with persistent neurological symptoms, found brain hypometabolism on 18F-FDG PET/CT. Our study aims to evaluate the impact of SARSCoV2 infection on brain metabolism in a long-term setting, also in asymptomatic patients. Material(s) and Method(s): Brain PET scans of 48 patients with documented previous SARS-CoV2 infection (COVID-group), performed from January to December 2021, were analysed and compared with brain PET scans of 48 patients, controlled for age and sex, who didn't experience the infection (control-group) using a quantitative software-aided approach. Patients with documented brain metastases or neurodegenerative diseases were excluded. No patient had neurological symptoms at the time of PET. CortexID Suite software (GE Healthcare) was applied for a segmentation analysis reporting Z score (ZS) values for each brain area in both groups. Basing on hypometabolism severity, the sample was divided as follows: normal (>=-1 ZS), mild (between -1 and -2 ZS), severe (<=-2 ZS). For COVID-group, time intercurred from infection to PET was recorded. Differences between ZS per areas between the two groups were evaluated using Mann-Withney-U test. Considering hypometabolism severity, Chi-Square test was applied to evaluate differences between groups. Finally, Pearson's test was used to correlate COVID-group ZS and time intercurred from infection. Result(s): Mean age of patients was 63.2 and 63.6 years old in the COVID-and control-group respectively. In both groups, 22/48 were male. In COVID-group 27/48 patients have had symptoms (cough, fever, dyspnoea) during SARS-CoV2 infection. The majority of brain areas showed a statistically significant difference in ZS values between groups. According to hypometabolism severity, left pre-frontal medial (p=0.032), right sensory-motor (p=0.014), right inferior parietal (p=0.001) and right lateral temporal (p=0.002) areas showed a statistically significant difference between COVIDand control-group with a prevalence in COVID-group of mild and severe brain hypometabolism. Lower ZS values were observed in patients with a longer time intercurred from infection to PET/CT scan. Conclusion(s): Our preliminary results confirm the impact of SARS-CoV2 infection on brain metabolism, consisting mostly in a mild hypometabolism. The presence of this metabolic pattern in patients without neurological symptoms suggests a devious action of the infection. Further studies, also using serial PET, are necessary to explore whether these metabolic alterations are transient or predictive of a future clinical manifestation.
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Introduction: Most reports related to humoral immune response to COVID 19 vaccines in people with Multiple Sclerosis (pwMS) were performed on mRNA-based vaccines. Objective(s): to analyze the longitudinal humoral immune responses to adenovirus-based vaccines (Sputnik V and AZD1222) in pwMS under different diseases modifying therapies (DMTs) Methods: IgG anti- SARS-COV-2 spike titers in a cohort of 101 pwMS and 28 healthy controls (HC) were measured 6 weeks after vaccination using the COVID-AR kit according to the manufacture instructions. Both patients and controls received two or three doses of Sputnik, AZD1222 or a mixed schedule (MS) of both vaccines. The neutralizing capacity was evaluated by measuring antibody neutralizing titers using SARS COV-2 pseudotyped particles. Result(s): 60.5% of pwMS were female, mean EDSS: 2.49 +/-1.5, age: 36.6 +/-10.7, disease duration 7.6 +/- 5.1 years. DMTs: 45 pwMS were under fingolimod, 23 under dimethyl fumarate, 14 under cladribine and 19 under antiCD20 monoclonal antibodies. Vaccines: 35.7% Sputnik V, 51.9% AZD1222 and 12.4 % MS. No antibody response to a 2nd dose was found in 41.3% of pwMS under fingolimod and 73.6% under antiCD20. We found a correlation between lower lymphocyte count and lower antibody titers in pwMS under fingolimod (r: 0.67, 95% CI: 0.46-0.81, p=<=0.0001). A correlation was also found between the antibody titer and the last dose of antiCD20 (r: 0.49, 95% CI: 0.03-0.7, p=0.03). In March 2022, 57 pwMS received their 3nddose, 6 patients under fingolimod and 7 under antiCD20 remained without any antibody response. We did not find differences in the neutralization capacity with different DMT and or vaccines. Multivariate regression analysis showed antiCD20 (beta= -,349, 95% CI: -3655.6-369.01, p=0.017) and fingolimod (beta=-,399, 95% CI: -3363.8-250.9, p=0.023) treatments as independent factor associated with low antibody response (r2 adjusted=0.157). Conclusion(s): This is the first report of longitudinal humoral immune response of patients under adenovirus-based vaccines, specially Sputnik V, that demonstrate that these vaccines have similar results to those obtained with mRNA-based vaccines.
ABSTRACT
The Covid-19 pandemic has severely impacted the world economy, generating an unprecedented shock that pushed carriers to adapt to the collapse of demand. Most of the related adaptation actions (e.g., blank sailings) appear as temporary initiatives being insufficient to reach a long run equilibrium. Moreover, while carriers managed to adjust their own supplied capacity to the ongoing crisis, the port sector has been greatly impacted by the fall in transport demand, not being able to counteract the demand shortages as effectively as the carriers. Against this backdrop, the paper introduces a model for assessing the effects of demand shocks (e.g., due to the pandemic) on the integration strategies of carriers. We focus on the possible initiatives that demand shocks may trigger on the horizontal and vertical integration among the actors of the shipping industry. In doing so, the present study provides useful insights for better understanding potential future market modifications and their impact on social welfare. Using non-cooperative games, profit-maximising strategies, in case of such integrations, are compared in order to study how carriers and terminal operators might react to demand shocks in the medium and long run. © 2022, The Author(s).
ABSTRACT
Peripheral inflammation flares up the ongoing damage within the central nervous system with neurodegenerative disease, such as Parkinson's disease, Alzheimer's disease, and multiple sclerosis. Therefore, systemic inflammation is considered a key feature in aggravation and evolution of the neurodegenerative diseases. Pro-inflammatory cytokines induce the synthesis of cytokines within the brain, being responsible of both pathological and behavioural changes. Recently, the coronavirus disease-2019, induced by the infection of the SARS-CoV-2, characterized by the peripheral “cytokine storm”, is associated to neurological disorders. In the present article we will summarize the main aspects related to the relationship between periphery and brain and its associated mechanisms.
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Various narratives in the media and social media have associated the alleged use of (hydroxy)chloroquine with lower lethality in certain municipalities compared to others. This essay aimed to demonstrate through logic and epidemiology the veracity or falsificability of this statement. Considering logic, epidemiologic, and ecological studies, the ecological fallacy of the supposed relationship between use of a drug and the lower lethality (indicative of higher proportion cured) of COVID-19 has been demonstrated. It can be concluded that comparing crude lethality rates between different municipalities without using scientific methods constitutes common sense and a disservice to health promotion and prevention of COVID-19.
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Considering that the training of academics of health sciences has been fragmented and incomplete, contributing to an innocuousness and ineffectiveness in understanding, preparing and taking action in the face of epidemics and other collective diseases, this essay aimed to demonstrate the need to improve the knowledge of health professionals in content and skills related to public health. In addition to simple diagnosis, several disciplines are proposed to be incorporated into the curricula of higher health courses, which can certainly bring about a substantial improvement in the skills and abilities of future professionals, as well as in teaching knowledge for the challenges of emerging and re-emerging diseases.
ABSTRACT
COVID-19 is an ongoing pandemic caused by the highly infectious coronavirus SARS-CoV-2 that is engaging worldwide scientific research to find a timely and effective eradication strategy. Great efforts have been put into anti-COVID-19 vaccine generation in an effort to protect the world population and block SARS-CoV-2 spread. To validate the protective efficacy of the vaccination campaign and effectively control the pandemic, it is necessary to quantify the induction of neutralizing antibodies by vaccination, as they have been established to be a correlate of protection. In this work, a SARS-CoV-2 pseudovirus neutralization assay, based on a replication-incompetent lentivirus expressing an adapted form of CoV-2 S protein and an ACE2/TMPRSS2 stably expressing cell line, has been minimized in terms of protocol steps without loss of accuracy. The goal of the present simplified neutralization system is to improve SARS-CoV-2 vaccination campaign by means of an easy and accessible approach to be performed in any medical laboratory, maintaining the sensitivity and quantitative reliability of classical serum neutralization assays. Further, this assay can be easily adapted to different coronavirus variants by simply modifying the pseudotyping vector.