Telepsychology for psychotherapists: lessons learned in times of Covid-19

The necessary health measures proposed to mitigate the viral spread of SARS-CoV-2, such as physical distancing and quarantines, have had an impact not only on the mental health of the population but have also forced changes in the provision of psychological services. The present study aims to gather essential information on the concept, advantages, disadvantages, uses and recommendations of telepsychology in times of COVID-19. To this end, a systematic review of the scientific evidence available in the Scopus, PubMed and Web of Science databases was carried out. Among the results, accessibility, reduction of stigma and flexibility in its application are highlighted. Limitations such as insecurity of data privacy, access barriers and low clinical training in the competencies required for this format are also mentioned. On the other hand, favorable evidence was found for its use in the treatment of post-traumatic stress disorder, panic and agoraphobia, generalized anxiety, and trauma. It is concluded that psychotherapeutic intervention through telepsychology, in consideration of certain recommendations and critical suggestions, can offer satisfactory results for the patient and therapist and be suitable for various age ranges and disorders. © 2022, Sociedad Interamericana de Psicologia. All rights reserved.

Hypercoagulability in COVID-19 and its putative association with the downregulation of protein C signalling

Background: Hematological complications associated with prothrombotic events with extrapulmonary manifestations have been demonstrated in autopsies of patients affected by coronavirus disease 2019 (COVID-19). Based on the close relationship of coagulation and immune response, we hypothesized that hypercoagulability in COVID-19 could result from the activation of tissue factor (F3) and subsequent alterations in Activated Protein C (APC) signaling (Figure 1). Aim(s): We aimed to identify changes in the expression of APC signaling network in liver, peripheral blood and nasal epithelium of COVID-19 patients that may contribute to local and systemic disarrangement of hemostasis. Method(s): For the expression of PROC and receptor genes public single-cell- RNA- sequencing datasets were analyzed from COVID-19 patients and healthy individuals, using the toolkit Scanpy 1.7.2 in Phyton. Result(s): The key compounds of Protein C (PC) activation and signaling;PROCR, F2R, THBD, S1PR1 and PROC were downregulated in COVID-19 patients;a greater expression of F3 in all COVID-19 tissues analyzed and upregulation of AGTR1, NFKB1, PTPN1, THBS1, PTGS2, PLAU, SERPINE1 and F5 pro-inflammatory and procoagulant genes in the liver of COVID-19 patients compared to control (Figure 2B, E and G). The hepatocyte PROC expression was changed in COVID-19 patients from hepatocyte 4 ADH1B+ PCK1+ in healthy liver (Figure 2F) to hepatocyte 3 CYP2A6+ in the liver of COVID-19 patients (Figure 2A). The ACE2 expression was increased in all COVID-19 tissues (Figure 2B, E and G) overlapping the PROC expression in the epithelium (Figure 2D) and liver tissues (Figure 2A). There was a co-expression of ACE2, PROC, PROS1, RHOA, and RAC1 in ciliated cells of COVID-19 patients (Figure 2C-D). Conclusion(s): The results provide evidence indicating a deficient synthesis and activation of PC and its receptors in COVID-19 patients that might contribute to a pronounced hypercoagulable state in response to endothelial COVID-19- related injury.

Anxiety and indifference in dental careduringthe COVID-19 pandemic

AIM: At present, the population is affected by the immediate impact of the infection by SARS-CoV-2 (CO-VID-19), therefore, in dental care, the patient manifests anxiety and anguish, which causes a inadequate access to oral care services. Objective(s): To determine the relationship between anxiety and indifference in dental care during the COVID-19 pandemic. Material(s) and Method(s): A quantitative, prospective, correlational, cross-sectional, descriptive design study carried out in 179 patients seen in the dental service of a medical center in Chimbote (Peru) who accepted their participation through informed consent. The survey technique was used, modified dental anxiety, anxiety dueto COVID-19 and dental indifference, questionnaires we reused as instruments. Data analysis required descriptive and inferential statistics, with a confidence level of 95%. Result(s): 66% presented moderate dental anxiety, 45% mildanxietydueto COVID-19 and 69% average indi-fference. Dental anxiety was significantly correlated with indifference. Conclusion(s): The Peruvian patients showed that, the greater the fear of dental care, the greater the lack of interest in their oral health. Copyright © 2022, Ediciones Avances S.L.. All rights reserved.

COVID-19 anxiety, psychological well-being and preventive behaviors during the COVID-19 pandemic in Latin America and the Caribbean: relationships and explanatory model

This study assesses the relationship between COVID-19 anxiety and subjective well-being in terms of the mediating role of COVID-19 preventive behaviors. Additionally, the contribution of sociodemographic factors (sex and age) and risk perception on COVID-19 anxiety and its potential measurement invariance was tested in 5655 participants from 12 countries in Latin America and the Caribbean. A mixture of both latent and observable variables were analyzed using a system of structural equations. The Coronavirus Anxiety Scale (CAS), Preventive COVID-19 Infection Behaviors Scale (PCIBS) and single-item measures were used to assess the perceived probability of death, perceived severity and concern about transmitting COVID-19. The results indicated that there is a significant and relevant direct effect of COVID-19 anxiety on participants' well-being. Furthermore, COVID-19 anxiety significantly predicted both preventive behavior (beta = .29, p < .01) and well-being (beta = -.32, p < .01). The effects of COVID anxiety and preventive behavior explained 9.8% of the variance in well-being (R-square = .098);whereas, 8.4% of the variance in preventive behavior was associated with COVID anxiety (R-square = .084). Likewise, perceived likelihood of death from COVID, perceived severity of COVID, and concerns about COVID transmission were positively related to anxiety. Age was negatively related to anxiety, with men being less anxious than women. The results are invariant by country, i.e., the broad relationships found in the combined sample are also present in each individual country. The findings indicate that, although the exact relationships between variables may vary between countries, there are enough similarities to provide useful information about the impact of the COVID-19 pandemic in each of the countries included in the study.