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Introdução: Estudos indicam que os profissionais de saúde têm alto risco de desenvolver sintomas relacionados à saúde mental, especialmente depressão, ansiedade e estresse. Objetivo: identificar e sintetizar os estudos sobre os preditores relacionados a saúde mental entre enfermeiros que atuam na linha de frente no combate ao COVID- 19. Método: Trata-se de uma revisão de escopo, sem limitação de linguagem e ano, nas bases BVS, PubMed, SCIELO, CINAHL, SCOPUS, Web of Science, MedNar, CAPES e ProQuest. Foi realizada síntese narrativa. Resultados: A pandemia da COVID-19 trouxe sérios impactos a saúde mental dos profissionais de enfermagem, os achados revelaram cinco temas principais sentimento de insegurança, falta de equipamentos de proteção individual, falta de exames diagnósticos, mudanças no fluxo de atendimento e medo do desconhecido. Existe uma associação significativa entre o bem-estar físico e metal e a produtividade laboral. Conclusão: Destaca-se os desafios enfrentados pelos enfermeiros no combate da COVID-19, mesmo com a repercussões no ambiente de trabalho os enfermeiros ainda padecem de reconhecimento adequado que incluem situações de estresse, ansiedade, depressão e estão diretamente relacionadas à frustração, esgotamento físico e mental, sentimento de impotência e insegurança profissional vivenciados durante a pandemia, principalmente por jovens profissionais sem experiência no cuidado de pacientes críticos.
Introduction: Studies indicate that health professionals are at high risk of developing symptoms related to mental health, especially depression, anxiety and stress. Objective: identify and synthesize studies on mental health-related predictors among nurses who work on the front line in the fight against COVID-19. Method: This is a scope review, without language and year limitations, in the VHL, PubMed, SCIELO, CINAHL, SCOPUS, Web of Science, MedNar, CAPES and ProQuest databases. Narrative synthesis was performed. Results: The COVID-19 pandemic had serious impacts on the mental health of nursing professionals, the findings revealed five main themes: feeling of insecurity, lack of personal protective equipment, lack of diagnostic tests, changes in the flow of care and fear of the unknown. There is a significant association between physical and mental well-being and labor productivity. Conclusion: The challenges faced by nurses in the fight against COVID-19 are highlighted, even with the repercussions in the work environment, nurses still suffer from adequate recognition and include situations of stress, anxiety and even depression, which are directly related to frustration , physical and mental exhaustion, feeling of helplessness and professional insecurity experienced during the pandemic, especially by young professionals with no experience in caring for critically ill patients.
Introducción: Los estudios indican que los profesionales de la salud tienen un alto riesgo de desarrollar síntomas relacionados con la salud mental, especialmente depresión, ansiedad y estrés. Objetivo: identificar y sintetizar estudios sobre predictores relacionados a la salud mental entre enfermeros que trabajan en primera línea en la lucha contra el COVID-19. Método: Se trata de una revisión de alcance, sin limitaciones de idioma y año, en las bases de datos BVS, PubMed, SCIELO, CINAHL, SCOPUS, Web of Science, MedNar, CAPES y ProQuest. Se realizó una síntesis narrativa. Resultados: La pandemia de COVID-19 tuvo graves impactos en la salud mental de los profesionales de enfermería, los hallazgos revelaron cinco temas principales: sensación de inseguridad, falta de equipo de protección personal, falta de pruebas diagnósticas, cambios en el flujo de atención y miedo a lo desconocido. Existe una asociación significativa entre el bienestar físico y mental y la productividad laboral. Conclusiones: Se destacan los retos a los que se enfrentan las enfermeras en la lucha contra la COVID-19, aún con las repercusiones en el ámbito laboral, las enfermeras siguen sufriendo un reconocimiento adecuado e incluyen situaciones de estrés, ansiedad e incluso depresión, que están directamente relacionadas con la frustración , el agotamiento físico y mental, la sensación de impotencia y la inseguridad profesional experimentada durante la pandemia, especialmente por profesionales jóvenes sin experiencia en el cuidado de pacientes críticos.
Subject(s)
Pandemics , Systematic Reviews as Topic , Psychological Well-Being/psychology , Nurses/psychology , Anxiety/psychology , Mental Health , Libraries, Digital , Emotions , Burnout, Psychological/psychology , COVID-19/psychologyABSTRACT
INTRODUCTION: COVID-19 in Brazil has already caused, and it still causes, several impacts on health, economy, and education. The risk factors for death involved those with cardiovascular diseases (CVD), which were prioritized for the vaccination of COVID-19. OBJECTIVE: To investigate the clinical characteristics and outcomes between vaccinated and unvaccinated patients with cardiovascular diseases hospitalized for COVID-19 in Brazil in the year 2022. METHODS: A retrospective cohort was analyzed from the year 2022, with cases being hospitalized by COVID-19 being drawn from SIVEP-GRIPE surveillance. We compared clinical characteristics, comorbidities, and outcomes between CVD carriers and non-carriers, and we also compared vaccinated with two doses vs. those that are unvaccinated in CVD carriers. We performed chi-square, odds ratio, logistic regression, and survival analysis. RESULTS: We included, in the cohort, 112,459 hospital inpatients. An amount of 71,661 (63.72%) of the hospitalized patients had CVD. Regarding deaths, 37,888 (33.69%) died. Regarding vaccination against COVID-19, 20,855 (18.54%) people were not vaccinated with any dose among those with CVD. Death p- < 0.001 (OR 1.307-CI 1.235-1.383) and fever p- < 0.001 (OR 1.156-CI 1.098-1.218) were associated with the unvaccinated CVD carriers, and diarrhea p-0.015 (OR 1.116-CI 1.022-1.218), dyspnea p-0.022 (OR 1.074-CI 1.011-1.142), and respiratory distress p-0.021 (OR 1.070-CI 1.011-1.134) were also recorded. Those patients who possessed predictors of death, including invasive ventilation (p- < 0.001 (OR 8.816-CI 8.313-9.350)), were admitted to the ICU p- < 0.001 (OR 1.754-CI 1.684-1.827), and some had respiratory distress p- < 0.001 (OR 1.367-CI 1.312-1.423), dyspnea p < 0.001 (OR 1.341-CI 1.284-1.400), O2 saturation < 95% p- < 0. 001 (OR 1.307-CI 1.254-1.363), they were unvaccinated against COVID-19 p- < 0.001 (OR 1.258-CI 1.200-1.319), they were of male sex p- < 0.001 (OR 1.179-CI 1.138-1.221), they had diarrhea p-0.018 (OR 1.081-CI 1.013-1.154), and they may have been old p < 0.001 (OR 1.034-CI 1.033-1.035). Survival was shorter for the unvaccinated p-0.003, and p- <0.001. CONCLUSIONS: We highlight the predictors of death for those unvaccinated against COVID-19 in this research, and we evidenced the benefits of the COVID-19 vaccine in reducing deaths in hospitalized CVD patients.
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The general interest in the study of the interplay between peroxisomes and viruses has increased in recent years, with different reports demonstrating that distinct viruses modulate peroxisome-related mechanisms to either counteract the cellular antiviral response or support viral propagation. Nevertheless, mechanistical details are still scarce, and information is often incomplete. In this chapter, we present an overview of the current knowledge concerning the interplay between peroxisomes and different viruses. We furthermore present, compare, and discuss the most relevant experimental approaches and tools used in the different studies. Finally, we stress the importance of further, more detailed, and spatial-temporal analyses that encompass all the different phases of the viruses' infection cycles. These studies may lead to the discovery of novel peroxisome-related cellular mechanisms that can further be explored as targets for the development of novel antiviral therapies.
Subject(s)
Peroxisomes , Viruses , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic useABSTRACT
Introduction: The Fontan procedure is used to treat congenital heart defects and has improved long-term survival. Long-term complications include liver disease due to congestive hepatopathy. Fontan-related cirrhosis can manifest with ascites, gastrointestinal bleeding and encephalopathy. Case description: A 43-year-old man with history of Fontan surgery was admitted with COVID-19 pneumonia. There was rapid clinical and neurological deterioration, with coma and shock. CT imaging showed thrombosis of the Fontan conduit. The patient was successfully subjected to recanalization of the Fontan circulation, with progressive improvement of coma. Discussion: Fontan-associated liver disease is a major complication following the Fontan procedure. Clinicians must be aware of this pathology during patient follow-up. LEARNING POINTS: The Fontan procedure has improved the long-term survival of patients with single ventricle pathology.Fontan-associated liver disease is a result of haemodynamic changes associated with Fontan circulation; complications include hepatic encephalopathy and coma.Patients with Fontan circulation should be evaluated over time in order prevent and treat systemic complications.
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BACKGROUND: Kawasaki-like syndrome occurring in children during the COVID-19 pandemic has been labelled multisystem inflammatory syndrome in children (MIS-C) by the CDC and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) by the ECDC. CASE REPORT: We report the case of an 18-year-old male patient presenting with a 72-hour history of abdominal pain, fever, erythematous skin rash, vomiting and diarrhoea. Examination showed he also had shock and he was first thought to have oedematous cholecystitis. SARS-CoV-2 infection was also diagnosed. He was admitted to the ICU, and echocardiography showed cardiac dysfunction, with a low ejection fraction and low cardiac index. High-sensitivity troponin serum levels were elevated. The patient received inotropic and vasopressor support. As he fulfilled several criteria for MIS-C/PIMS-TS, he was administered acetylsalicylic acid, corticosteroids and immunoglobulin, with a good clinical response. CONCLUSION: This case emphasizes how this severe presentation of COVID-19 can easily be misdiagnosed if the clinician is less aware of this syndrome in younger patients. LEARNING POINTS: SARS-CoV-2 infection is a diagnostic challenge in some patients with atypical clinical presentations, who may have MIS-C/PIMS-TS.Physicians should be aware of this condition when evaluating teenagers and young adults with COVID-19.
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This manuscript describes a unique protocol for the rapid transformation of Medicago truncatula A17 cell suspension cultures mediated by Agrobacterium tumefaciens. Medicago cells were collected on day 7 of the growth curve, which corresponded to the beginning of the exponential phase. They were then co-cultured with Agrobacterium for 3 days before being spread onto a petri dish with appropriate antibiotic selection. The Receptor Binding Domain of the Spike protein of SARS-CoV-2 was used as a model to develop this protocol. The presence of the transgene was assessed using PCR, and the integrity of the product was evaluated by SDS-PAGE and Western-blotting.
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Pregnant women have an increased risk of developing severe coronavirus disease. In Brazil, the number of hospitalizations and adverse outcomes, including death caused by COVID-19, in women during the pregnancy-puerperal cycle was high in the first pandemic year. Doubts regarding vaccines' efficacy and safety for the mother and fetus delayed vaccination. This study evaluated the generation of IgG titers and neutralizing antibodies to the BNT162b2 mRNA vaccine in 209 healthy pregnant women. For this, were used the QuantiVac ELISA (IgG) and SARS-CoV-2 NeutraLISA kits (EUROIMMUN, Lübeck, SH) following the manufacturer's recommendations. One dose vaccine produced anti-SARS-CoV-2 IgG in 85% (81/95), and two produced in 95% (76/80) women. Among unvaccinated women, four of 34 (12%) showed protection. The first dose of the BNT162b2 vaccine protected 69% of the women with neutralizing antibodies (median of %IH = 97). In the second dose, protection occurred in 94% of the pregnant women (median of IH% = 97). This study showed no differences in IgG antibody titers between one- and two-dose of the BNT162b2 mRNA vaccine groups, boosting with the second dose increased the number of women who produced specific IgG and neutralizing antibodies, raising by 114-folds the chance of producing the SARS-CoV-2 neutralizing antibodies compared to the unvaccinated pregnant woman, which may contribute to reduce the chance of severe COVID-19.
Subject(s)
Antibodies, Neutralizing , COVID-19 , Pregnancy , Humans , Female , Pregnant Women , SARS-CoV-2 , BNT162 Vaccine , Brazil , COVID-19/prevention & control , Antibodies, Viral , Immunoglobulin GABSTRACT
Pregnant women have an increased risk of developing severe coronavirus disease. In Brazil, the number of hospitalizations and adverse outcomes, including death caused by COVID-19, in women during the pregnancy-puerperal cycle was high in the first pandemic year. Doubts regarding vaccines' efficacy and safety for the mother and fetus delayed vaccination. This study evaluated the generation of IgG titers and neutralizing antibodies to the BNT162b2 mRNA vaccine in 209 healthy pregnant women. For this, were used the QuantiVac ELISA (IgG) and SARS-CoV-2 NeutraLISA kits (EUROIMMUN, Lübeck, SH) following the manufacturer's recommendations. One dose vaccine produced anti-SARS-CoV-2 IgG in 85% (81/95), and two produced in 95% (76/80) women. Among unvaccinated women, four of 34 (12%) showed protection. The first dose of the BNT162b2 vaccine protected 69% of the women with neutralizing antibodies (median of %IH = 97). In the second dose, protection occurred in 94% of the pregnant women (median of IH% = 97). This study showed no differences in IgG antibody titers between one- and two-dose of the BNT162b2 mRNA vaccine groups, boosting with the second dose increased the number of women who produced specific IgG and neutralizing antibodies, raising by 114-folds the chance of producing the SARS-CoV-2 neutralizing antibodies compared to the unvaccinated pregnant woman, which may contribute to reduce the chance of severe COVID-19.
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Objetivo: Relatar a experiência de discentes e docentes de enfermagem no desenvolvimento de atividades lúdico-pedagógicas em uma Instituição de Longa Permanência para Idosos (ILPI) durante a pandemia por COVID-19. Síntese dos dados: Trata-se de um relato de experiência, a partir da vivência de acadêmicas e docentes de um projeto de extensão do curso de Enfermagem em uma Instituição de Longa Permanência para Idosos, no interior de Minas Gerais, nos meses de junho e julho de 2020. A equipe do projeto elaborou o planejamento de um bingo, sendo todos os idosos premiados com livros de colorir e gizes de cera. As ações se desdobraram em quatro etapas: planejamento das atividades; elaboração do material; entrega do material impresso; e operacionalização da ação. Com a entrega do material na instituição no dia 23 de julho, realizou-se a dinâmica no dia 20 de agosto de 2020. Conclusão: O planejamento e a elaboração de materiais, como o jogo do bingo e o livro de colorir, permitiram que o projeto de extensão desse seguimento ao trabalho mesmo no período da pandemia, propondo duas atividades que despertaram o interesse e a participação de todos os envolvidos.
Objective: To report the experience of nursing students and professors in the development of recreational and pedagogical activities in a Long-Term Care (LTC) Institution for older adults during the COVID-19 pandemic. Data synthesis: This is an experience report based on the experience of students and professors of an extension project of the Nursing program in a Long-Term Care Institution for older adults in the countryside of Minas Gerais in the months of June and July 2020. The project team prepared a bingo plan, with all the older adults being awarded with coloring books and crayons. The actions unfolded in four stages: planning of activities; preparation of the material; delivery of printed material; and operationalization of the action. With the delivery of the material to the institution on July 23, the action took place on August 20, 2020. Conclusion: The planning and construction of materials, such as the bingo game and the coloring book, allowed the project to extend this follow-up to work even during the pandemic period by proposing two activities that aroused the interest and participation of all those involved.
Objetivo: Informar la experiencia de dicentes y docentes de enfermería en el desarrollo de actividades lúdico-pedagógicas en una Institución para Ancianos de Larga Estancia (IALE) en la pandemia por Covid-19. Síntesis de datos: Se trata de un informe de experiencia, a partir de la vivencia de académicas y docentes de un proyecto de extensión del curso de Enfermería en una Institución para Ancianos de Larga Estancia, en el interior de Minas Gerais, en los meses de junio y julio de 2020. El equipo del proyecto elaboró la planificación de un bingo, premiando todos los ancianos con libros de colorear y crayón. Las acciones se desplegaron en cuatro etapas: planificación de las actividades; elaboración del material; entrega del material impreso; y operacionalización de la acción. Con la entrega del material en la institución en el día 23 de julio, se realizó la dinámica en el día 20 de agosto de 2020. Conclusión: La planificación y la elaboración de materiales, como el juego de bingo y el libro de colorear, permitieron que el proyecto de extensión diera continuidad al trabajo aunque en período de la pandemia, proponiendo dos actividades que despertaron el interés y la participación de todas las partes.
Subject(s)
Health of the Elderly , Nursing , Coronavirus Infections , Games, Recreational , Social Cognition , Homes for the AgedABSTRACT
OBJECTIVE: This rapid review aims to identify the types of technologies used by people with dementia and their supporters during the COVID-19 pandemic, and the issues which influenced technology adoption within their usual care routines. METHODS: PubMed, PsychInfo, Scopus, and Cochrane COVID reviews were searched to identify peer-review studies published since 2020. A total of 18 studies were included and synthesised thematically. RESULTS: Of these, most were conducted in the community (n = 15) with people with dementia only (n = 11) and involved qualitative methods (n = 11). The majority (n = 12) focused on digital off-the-shelf and low-cost solutions, such as free video conferencing platforms, to access care, socialise or take part in interventions. Whilst often well-accepted and associated with positive outcomes (such as improved social connectedness), lack of digital literacy or support to use technologies, limited access to appropriate technology, individuals' physical, cognitive, or sensory difficulties, were highlighted and likely to threaten the adoption of these solutions. The quality of the evidence was mixed, neither very robust nor easily generalisable which may be attributed to the challenges of conducting research during the pandemic or the need to rapidly adapt to a new reality. CONCLUSION: While COVID-19 has fast-tracked the adoption of technology, its use is likely to continue beyond the pandemic. We need to ensure this technology can leverage dementia support and care and that people with dementia are enabled and empowered to use it.
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The COVID-19 pandemic has triggered intensive research and development of drugs and vaccines against SARS-CoV-2 during the last two years. The major success was especially observed with development of vaccines based on viral vectors, nucleic acids and whole viral particles, which have received emergent authorization leading to global mass vaccinations. Although the vaccine programs have made a big impact on COVID-19 spread and severity, emerging novel variants have raised serious concerns about vaccine efficacy. Due to the urgent demand, drug development had originally to rely on repurposing of antiviral drugs developed against other infectious diseases. For both drug and vaccine development the focus has been mainly on SARS-CoV-2 surface proteins and host cell receptors involved in viral attachment and entry. In this review, we expand the spectrum of SARS-CoV-2 targets by investigating the COVID-19 signalome. In addition to the SARS-CoV-2 Spike protein, the envelope, membrane, and nucleoprotein targets have been subjected to research. Moreover, viral proteases have presented the possibility to develop different strategies for the inhibition of SARS-CoV-2 replication and spread. Several signaling pathways involving the renin-angiotensin system, angiotensin-converting enzymes, immune pathways, hypoxia, and calcium signaling have provided attractive alternative targets for more efficient drug development.
Subject(s)
COVID-19 , Humans , SARS-CoV-2 , COVID-19 Vaccines/metabolism , Pandemics/prevention & control , Receptors, Virus/metabolism , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic useABSTRACT
BACKGROUND: Knowledge about the epidemiology and risk factors surrounding COVID-19 contributes to developing better health strategies to combat the disease. OBJECTIVE: This study aimed to establish a survival analysis and identify the risk factors for patients with COVID-19 in an upper middle-income city in Brazil. METHODS: A retrospective cohort study was conducted with 280 hospitalized patients with COVID-19. The eCOVID platform provided data to monitor COVID-19 cases and help the communication between professionals. RESULTS: Age ≥ 65 years was associated with decreased survival (54.8%), and females had a lower survival rate than males (p = 0.01). Regarding risk factors, urea concentration (p<0.001), hospital length of stay (p = 0.002), oxygen concentration (p = 0.005), and age (p = 0.02) were associated with death. CONCLUSION: Age, hospital length of stay, high blood urea concentration, and low oxygen concentration were associated with death by COVID-19 in the studied population. These findings corroborate with studies conducted in research centers worldwide.
Subject(s)
COVID-19 , Female , Male , Humans , Aged , COVID-19/epidemiology , Brazil/epidemiology , Retrospective Studies , Risk Factors , OxygenABSTRACT
The COVID-19 pandemic, caused by the worldwide spread of SARS-CoV-2, has prompted the scientific community to rapidly develop efficient and specific diagnostics and therapeutics. A number of avenues have been explored, including the manufacture of COVID-related proteins to be used as reagents for diagnostics or treatment. The production of RBD and Spike proteins was previously achieved in eukaryotic cells, mainly mammalian cell cultures, while the production in microbial systems has been unsuccessful until now. Here we report the effective production of SARS-CoV-2 proteins in two plant model systems. We established transgenic tobacco BY-2 and Medicago truncatula A17 cell suspension cultures stably producing the full-length Spike and RBD recombinant proteins. For both proteins, various glycoforms were obtained, with higher yields in Medicago cultures than BY-2. This work highlights that RBD and Spike can be secreted into the culture medium, which will impact subsequent purification and downstream processing costs. Analysis of the culture media indicated the presence of the high molecular weight Spike protein of SARS-CoV-2. Although the production yields still need improvement to compete with mammalian systems, this is the first report showing that plant cell suspension cultures are able to produce the high molecular weight Spike protein. This finding strengthens the potential of plant cell cultures as production platforms for large complex proteins.
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The COVID-19 pandemic has been the focus of research the past two years. The major breakthrough was made by discovering pathways related to SARS-CoV-2 infection through cellular interaction by angiotensin-converting enzyme (ACE2) and cytokine storm. The presence of ACE2 in lungs, intestines, cardiovascular tissues, brain, kidneys, liver, and eyes shows that SARS-CoV-2 may have targeted these organs to further activate intracellular signalling pathways that lead to cytokine release syndrome. It has also been reported that SARS-CoV-2 can hijack coatomer protein-I (COPI) for S protein retrograde trafficking to the endoplasmic reticulum-Golgi intermediate compartment (ERGIC), which, in turn, acts as the assembly site for viral progeny. In infected cells, the newly synthesized S protein in endoplasmic reticulum (ER) is transported first to the Golgi body, and then from the Golgi body to the ERGIC compartment resulting in the formation of specific a motif at the C-terminal end. This review summarizes major events of SARS-CoV-2 infection route, immune response following host-cell infection as an important factor for disease outcome, as well as comorbidity issues of various tissues and organs arising due to COVID-19. Investigations on alterations of host-cell machinery and viral interactions with multiple intracellular signaling pathways could represent a major factor in more effective disease management.
Subject(s)
COVID-19 , Humans , Pandemics , SARS-CoV-2 , Angiotensin-Converting Enzyme 2 , Cytokine Release Syndrome , ComorbidityABSTRACT
Graves' disease is an autoimmune disorder that results in hyperthyroidism, caused by autoantibodies to the thyrotropin receptor (TRAbs) stimulating thyroid hormone synthesis, giving rise to a variety of systemic manifestations such as goitre, dermatopathy and orbitopathy. The authors present the case of a 28-year-old man admitted to hospital for a 3-week history of fatigue, shortness of breath, palpitations and diffuse goitre, after recent mild SARS-CoV-2 infection. Laboratory investigation revealed hyperthyroidism with TRAbs elevation. Thyroid ultrasound confirmed a diffusely heterogeneous and irregular thyroid gland and a nodular image below the sternal notch. Thyroid scintigraphy excluded the nodule and confirmed a Graves' disease pattern. Following the initiation of methimazole, the patient had complete resolution of symptoms and normalization of thyroid values. The results suggest a possible association between Graves' disease and SARS-CoV-2 infection acting as a trigger. Graves' disease is an important differential diagnosis to keep in mind when patients present with hyperthyroidism after COVID-19 disease. LEARNING POINTS: Graves' disease may be induced after SARS-CoV-2 infection by a possible autoimmune pathway.Graves' disease induced by SARS-CoV-2 infection responds well to antithyroid medication.
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The coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, leading to increased concerns about long-term patients' neuropsychiatric consequences. This study aims to describe the presence of depressive and anxiety symptoms in severe COVID-19 survivors and to identify associated baseline, in-hospital and post-discharge factors. This study is part of the MAPA longitudinal project conducted with severe COVID-19 patients admitted in Intensive Care Medicine Department (ICMD) of a University Hospital (CHUSJ) in Porto, Portugal. Patients with ICMD length of stay ≤ 24 h, terminal illness, major auditory loss or inability to communicate at follow-up assessment were excluded. All participants were assessed by telephone post-discharge (median = 101 days), with a comprehensive protocol assessing depressive and anxiety symptoms, cognition, Intensive Care Unit (ICU) memories recall and health-related quality of life. Out of a sample of 56 survivors (median age = 65; 68% males), 29% and 23% had depressive and anxiety symptoms, respectively. Depressive and anxiety symptoms were significantly more prevalent among younger survivors and were associated with cognitive complaints, emotional and delusions ICU memories and fear of having COVID-19 sequelae, sleep problems and pain after discharge (all p < 0.05). An important proportion of these survivors suffers from depression and anxiety symptoms post-discharge, namely younger ones and those who reported more cognitive complaints, ICU memories, fear of having COVID-19 sequelae, sleep problems and pain. These findings highlight the importance of psychological consequences assessment and planning of appropriate and multidisciplinary follow-up care after hospitalization due to COVID-19.
Subject(s)
COVID-19 , Sleep Wake Disorders , Stress Disorders, Post-Traumatic , Aftercare , Aged , Anxiety/psychology , COVID-19/epidemiology , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Pain , Patient Discharge , Prospective Studies , Quality of Life , Stress Disorders, Post-Traumatic/psychology , Survivors/psychologyABSTRACT
BACKGROUND: Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has proven to be a successful strategy for prevent severe infections. CoronaVac and BNT162b2 are the most used vaccines worldwide, but their use in heterologous vaccination schedules is still subjected to evaluation. METHODS: Fifty healthy individuals who received heterologous prime-boost vaccination with CoronaVac and BNT162b2 were enrolled in a post-vaccination serological follow-up longitudinal prospective study. We evaluated specific serum anti-receptor binding domain (RBD) IgG antibody levels, and their capacity to block RBD-ACE2 interaction with a surrogate neutralization assay. In 20 participants, we assessed antibody binding kinetics by surface plasmon resonance, and Fc-mediated functions by ADCC and ADCP reporter assays. RESULTS: Our baseline seronegative cohort, displayed seroconversion after two doses of CoronaVac and an important decrease in serum anti-RBD IgG antibodies levels 80 days post-second dose. These levels increased significantly early after the third dose with BNT162b2, but 73 days after the booster we found a new fall. Immunoglobulin functionalities showed a similar behavior. CONCLUSIONS: The heterologous prime-boost vaccination with CoronaVac and BNT162b2 generated an impressive increase in serum anti-RBD specific antibody levels followed by a drop. Nevertheless, these titers remained well above those found in individuals only vaccinated with CoronaVac in the same elapsed time. Serum IgG levels showed high correlation with antibody binding analysis, their capacity to block RBD-ACE2 interaction, and Fc-effectors mechanisms. Our work sheds light on the humoral immune response to heterologous vaccination with CoronaVac and BNT162b2, to define a post-vaccination correlate of protection against SARS-CoV-2 infection and to discuss the scheduling of future vaccine boosters in general population.
Subject(s)
COVID-19 , Viral Vaccines , Angiotensin-Converting Enzyme 2 , Antibodies, Viral , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Immunity, Humoral , Immunoglobulin G , Prospective Studies , SARS-CoV-2 , VaccinationABSTRACT
Chronic liver disease is associated with immune system dysfunction, which can lead to a greater risk of infections. Our goal was to assess the impact of chronic liver disease in Covid-19 outcome in hospitalized patients and to identify predictors of the infection's severity. A retrospective case-control study of adult patients hospitalized in Hospital da Senhora da Oliveira-Guimarães, between March 15th 2020 and March 15th 2021, was performed. Demographic factors, clinical and biochemical data were analyzed, as well as the need for oxygen therapy, non-invasive or mechanical ventilation, admission in the intensive care unit and mortality. A total of 336 patients were included, 168 with and 168 without chronic liver disease, with similar comorbidities and pulmonary involvement. Patients with chronic liver disease had a lower percentage of need for oxygen therapy. Regardless of the presence of chronic liver disease, older age, a previously diagnosed pulmonary disease or cardiac condition and more than 25% pulmonary involvement were associated with increased mortality. The need for non-invasive ventilation was higher if the patient was obese, had a previously diagnosed pulmonary disease or had a higher percentage of lung parenchyma involvement. The need for admission in the intensive care unit was associated with obesity and a greater than 25% pulmonary involvement. Chronic liver disease had no impact on Covid-19 severity. Regardless of the presence of chronic liver disease, obesity had an important role in all outcomes except mortality. A higher percentage of lung parenchyma involvement was associated with worst outcomes.
Subject(s)
COVID-19 , Adult , Humans , COVID-19/therapy , SARS-CoV-2 , Retrospective Studies , Case-Control Studies , Hospitalization , Obesity/complications , Obesity/epidemiology , OxygenABSTRACT
In addition to outdoor atmospheric contamination, indoor exposure to pollutants is a prime contributor to the overall human exposure, and may condition the expressiveness and severity of respiratory, cardiovascular, and allergic diseases. This situation has worsened due to COVID-19, as people have spent more time indoors to comply with social isolation and mandatory telework. The primary purpose of this study was to assess and compare indoor air quality (IAQ) in a significant sample of dwellings of workers from a Higher Education Institution (HEI) in Portugal who were teleworking and their usual workplace. The levels of carbon dioxide, carbon monoxide, and formaldehyde, particles with equivalent diameters of less than 10 µm, 5 µm, 2.5 µm, 1 µm, 0.5 µm, and 0.3 µm, and ultrafine particles, as well as the level of thermal comfort, were measured at both of the sites assessed. It was found that most of the houses studied, as well as the HEI, had good IAQ, although there were places where the concentrations of some pollutants were above the legal standards. On the other hand, a link was identified between the IAQ and the symptoms and diseases observed in the workers who participated in the study. These results offer the opportunity to make corrective interventions, thereby controlling the sources of pollutants and promoting better ventilation in order to reduce the risk for workers.
Subject(s)
Air Pollutants , Air Pollution, Indoor , COVID-19 , Air Pollutants/analysis , Air Pollution, Indoor/analysis , COVID-19/epidemiology , Communicable Disease Control , Humans , TeleworkingABSTRACT
Objective: Fatigue is among the most common symptoms of the long-term effects of coronavirus (long COVID). This study aims to compare the effectiveness of osteopathic manipulative treatment (OMT) combined with physiotherapy treatment (PT) compared to PT alone on fatigue and functional limitations after two months post randomization in adults with long COVID. Methods: This is a study protocol for a two-arm, assessor-blinded, pragmatic randomized controlled superiority trial. Seventy-six participants will be randomly allocated to OMT + PT or PT. The PT includes usual care interventions including motor and respiratory exercises targeting cardiorespiratory and skeletal muscle functions. The OMT entails direct and indirect musculoskeletal, viceral and cranial techniques. Patients will be evaluated before and after a 2-month intervention program, and at 3-month follow-up session. Primary objectives comprise fatigue and functional limitations at 2-month post randomization as assessed by the fatigue severity scale and the Post-COVID Functional State scale. Secondary objectives comprise fatigue and functional limitations at 3 months, and the perceived change post-treatment as assessed by the Perceived Change Scale (PCS-patient). Registration: This protocol was registered (NCT05012826) and received ethical approval (38342520.7.0000.5235). Participant recruitment began in August 2021 and is expected to conclude in July 2023. Publication of the results is anticipated in 2023.