ABSTRACT
Introduction: Daily sleep may be affected by several conditions, including stress. Stress has been shown to impact our physical and mental health. Perceived stress can affect sleep quantity, quality, and architecture, with a detrimental effect on emotional responses to daily stressors. Moreover, poor quantity/quality sleep can increase the risk of severe medical and mental disorders that in turn can have a negative effect on sleep. However, some beneficial sleep/stress management interventions seem to have a mediator impact on a stress-sleep relationship. Physical activity (PA) is reported to prevent the negative effects of perceived stress on sleep, in stress conditions, as COVID-19 pandemic lockdown. The study aimed to conduct a preliminary analysis on the relationship between PA, perceived daily stress (pdStress), and sleep parameters from data collected through Garmin and Apple wearable devices by LUCA app, a psychophysiological well-being application, helping to recognize and manage stress. Materials and methods: Data from Australian users have been collected for 14 consecutive days. No inclusion and exclusion criteria were applied. PA and sleep parameters were selected if present on both Garmin and Apple devices. We assessed: PA by daily calories consumption during active daily periods, and total steps;sleep as time spent asleep;pdStress as the total score obtained from four specific daily, day-framed questions investigating the ability to relax, the presence of somatic, and emotional/cognitive symptoms [total score range: 0-12;the higher is the score the higher is the pdStress.] Statistical analysis included linear mixed models, with pdStress total score as independent variable and sleep duration as dependent variable. PA parameters were added separately as moderators of pdStress and sleep relationship, with age, sex, and the brand of the wearable devices as covariates. Results: Sample: 46 Australian users (19 from Garmin and 27 Apple wearable devices), including 27 females (58.7%);age between 20 and 60 years (years;m=40.8, sd=±9.1). On average, the sample was characterized by: low to moderate levels of PA;mild levels of pdStress;and sleep duration as WHO’s recommendations. The analyses showed a statistically significant inverse association between level of pdStress and sleep duration (p < 0.001). This relationship was moderated by PA measured by active calories consumptions (p = 0.015) and total steps (p = 0.038), with higher activity levels resulting in a reduction of the strength of the inverse association between pdStress and sleep. Discussion: Our results confirm the detrimental relationship between pdStress and nighttime sleep duration, as reported by the literature. Moreover, our data show that high levels of PA can reduce the negative effect of pdStress on sleep duration. Despite the limitations concerning the limited number of subjects, device-related recording errors, indirect sleep parameters, and non-sophisticated PA measures, our results underline the importance of PA programs when daily stress conditions and sleep alterations occur. Acknowledgment: Data collection was sponsored by Mebidio LTD. We thank all participants involved in the study.
ABSTRACT
OBJECTIVES: Despite the considerable research efforts being made to learn more about COVID-19, little is known about the presence of SARS-CoV-2 genetic material in biological fluids other than respiratory droplets, blood, and feces. The aim of this post-mortem study was to assess the presence of SARS-CoV-2 RNA in the knee synovial fluid, synovial tissue, and bone tissue of COVID-19 patients in order to discover whether the joint is a possible route of transmission during orthopaedic surgical procedures, and clarify the possible role of SARS-CoV-2 as a directly arthritogenic virus. METHODS: Post-mortem synovial fluid, synovial tissue and bone tissue samples were collected from the knees of five patients who died of COVID-19 in our hospital between September and October 2020, and analysed for the presence of SARS-CoV-2 using a commercial real-time polymerase chain reaction (RT-PCR) panel. Quantitative RT-PCR was used to test post-mortem nasopharyngeal swabs of all of the patients. RESULTS: No SARS-CoV-2 RNA was detected in any of the knee samples, despite the positivity of the throat swab. CONCLUSIONS: Our findings indicate that SARS-CoV-2 was not detected in knee synovial fluid, synovial membrane or bone. This makes it unlikely that these are potential sources of contagion, and suggests that SARS-CoV-2 is not directly arthritogenic.
ABSTRACT
Background: Despite the considerable research efforts being made to learn more about COVID-19, little is known about the presence of SARS-CoV-2 genetic material in biological fluids other than respiratory droplets, blood, and feces 1,2. In particular, little is known about the presence of SARS-CoV-2 in the joints either post mortem 3 or in vivo 4. To the best of our knowledge, only Lopéz-Gonzalez et al.5 have published a description of acute arthritides occurring during hospitalisation due to COVID-19, and they did not find any SARS-CoV-2 genetic material in the patients' synovial fluid samples. Objectives: The aim of this post mortem study was to assess the presence of SARS-CoV-2 RNA in the knee synovial fluid, synovial tissue, and bone tissue of COVID-19 patients in order to discover whether the joint is a possible route of transmission during orthopaedic surgical procedures, and clarify the possible role of SARS-CoV-2 as a directly arthritogenic virus. Methods: Post mortem synovial fluid, synovial tissue and bone tissue samples were collected from the knees of five patients who died of COVID-19 in our hospital between September and October 2020, and analysed for the presence of SARS-CoV-2 using a commercial real-time polymerase chain reaction (RT-PCR) panel. Quantitative RT-PCR was used to test post mortem nasopharyngeal swabs of all of the patients. Results: No SARS-CoV-2 RNA was detected in any of the knee samples, despite the positivity of the throat swab. Conclusion: Our findings indicate that SARS-CoV-2 was not detected in knee synovial fluid, synovial membrane or bone. Therefore, our results suggest that all healthcare professionals performing surgical procedures on the joints of COVID-19 patients are exposed to a risk of contagion due to exposure to respiratory droplets, blood and body fluids, but not to direct exposure to joint-or bone-related tissues. Furthermore, given that some case reports of arthritis in COVID-19 patients 5-8 show that it is possible that COVID-19 patients display viral-mediated arthralgias and arthritis, the absence of the virus in the knee highlighted by our study suggests that it is unlikely that SARS-CoV-2 has a direct inflammatory action on the joint, but it could induce an inflammation-related reaction, manifesting as a reactive arthritis 9.
ABSTRACT
In the space of four decades, Brazil has faced two serious pandemics: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and Coronavirus disease 2019 (COVID-19). The country's response to HIV/AIDS was coordinated by several stakeholders and recognised the importance of scientific evidence in guiding decision-making, and a network offering monitoring and antiretroviral treatment was provided through coordinated efforts by the country's universal health system. Conversely, the lack of a centrally coordinated strategy and misalignment between government ministries regarding the COVID-19 pandemic response, together with the denial of scientific evidence, promotion of ineffective treatments and insufficient vaccination efforts, have all led to the uncontrolled spread of infection, the near-total collapse of the health system and excess deaths.