Selective visuoconstructional impairment following mild COVID-19 with inflammatory and neuroimaging correlation findings.

People recovered from COVID-19 may still present complications including respiratory and neurological sequelae. In other viral infections, cognitive impairment occurs due to brain damage or dysfunction caused by vascular lesions and inflammatory processes. Persistent cognitive impairment compromises daily activities and psychosocial adaptation. Some level of neurological and psychiatric consequences were expected and described in severe cases of COVID-19. However, it is debatable whether neuropsychiatric complications are related to COVID-19 or to unfoldings from a severe infection. Nevertheless, the majority of cases recorded worldwide were mild to moderate self-limited illness in non-hospitalized people. Thus, it is important to understand what are the implications of mild COVID-19, which is the largest and understudied pool of COVID-19 cases. We aimed to investigate adults at least four months after recovering from mild COVID-19, which were assessed by neuropsychological, ocular and neurological tests, immune markers assay, and by structural MRI and 18FDG-PET neuroimaging to shed light on putative brain changes and clinical correlations. In approximately one-quarter of mild-COVID-19 individuals, we detected a specific visuoconstructive deficit, which was associated with changes in molecular and structural brain imaging, and correlated with upregulation of peripheral immune markers. Our findings provide evidence of neuroinflammatory burden causing cognitive deficit, in an already large and growing fraction of the world population. While living with a multitude of mild COVID-19 cases, action is required for a more comprehensive assessment and follow-up of the cognitive impairment, allowing to better understand symptom persistence and the necessity of rehabilitation of the affected individuals.

Contact and intrinsic coagulation pathways are activated and associated with adverse clinical outcomes in COVID-19.

Coagulation activation is a prominent feature of severe acute respiratory syndrome coronavirus 2 (COVID-19) infection. Activation of the contact system and intrinsic pathway has increasingly been implicated in the prothrombotic state observed in both sterile and infectious inflammatory conditions. We therefore sought to assess activation of the contact system and intrinsic pathway in individuals with COVID-19 infection. Baseline plasma levels of protease:serpin complexes indicative of activation of the contact and intrinsic pathways were measured in samples from inpatients with COVID-19 and healthy individuals. Cleaved kininogen, a surrogate for bradykinin release, was measured by enzyme-linked immunosorbent assay, and extrinsic pathway activation was assessed by microvesicle tissue factor-mediated factor Xa (FXa; MVTF) generation. Samples were collected within 24 hours of COVID-19 diagnosis. Thirty patients with COVID-19 and 30 age- and sex-matched controls were enrolled. Contact system and intrinsic pathway activation in COVID-19 was demonstrated by increased plasma levels of FXIIa:C1 esterase inhibitor (C1), kallikrein:C1, FXIa:C1, FXIa:α1-antitrypsin, and FIXa:antithrombin (AT). MVTF levels were also increased in patients with COVID-19. Because FIXa:AT levels were associated with both contact/intrinsic pathway complexes and MVTF, activation of FIX likely occurs through both contact/intrinsic and extrinsic pathways. Among the protease:serpin complexes measured, FIXa:AT complexes were uniquely associated with clinical indices of disease severity, specifically total length of hospitalization, length of intensive care unit stay, and extent of lung computed tomography changes. We conclude that the contact/intrinsic pathway may contribute to the pathogenesis of the prothrombotic state in COVID-19. Larger prospective studies are required to confirm whether FIXa:AT complexes are a clinically useful biomarker of adverse clinical outcomes.

Skills for Working from Home: Construction and validation of the scale

Many workers migrated to teleworking during the COVID-19 pandemic. Performing work tasks entirely at home brought challenges, especially for those who had no previous experience with the modality, such as work-family conciliation and the use of digital technologies. This study reports the development and evidence of psychometric validity of the Skills for Working from Home scale (SWHS). The survey was applied to 7,608 government employees from Brazilian public agencies. Descriptive statistical analyses, and exploratory, confirmatory, and reliability factor analyses were performed. The instrument has a bifactorial empirical structure that assesses skills for balancing work and other activities (soft skills) and skills for using digital communication resources in work interactions (hard skills). The SWHS can be used to identify the adaptation and preparation for working from home, as well as to investigate possible associations between these skills and other indicators (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Portuguese) Muitos trabalhadores migraram para o teletrabalho durante a pandemia de COVID-19. A realizacao das tarefas integralmente em casa trouxe desafios, principalmente aqueles que nao possuiam experiencia anterior com a modalidade, como a conciliacao trabalho-familia e o uso de tecnologias digitais. Este estudo relata o desenvolvimento e as evidencias de validade psicometrica da Escala de Habilidades para o Teletrabalho em Casa (EHTC). A pesquisa foi aplicada a 7.608 servidores de diferentes orgaos publicos brasileiros. Realizaram-se analises estatisticas descritivas, fatoriais exploratorias e confirmatorias e de confiabilidade. O instrumento possui uma estrutura empirica bifatorial que avalia habilidades para o balanceamento entre trabalho e outras atividades (soft skills) e para utilizacao de recursos digitais nas interacoes de trabalho (hard skills). A EHTC pode ser usada para identificar a adaptacao e o preparo para o teletrabalho em casa e investigar associacoes entre essas habilidades e outros indicadores. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) Muchos trabajadores migraron para el teletrabajo durante la pandemia de COVID-19. Realizar las tareas integralmente en casa trajo desafios, especialmente para quienes no tenian experiencia previa con la modalidad, como la conciliacion trabajo-familia y el uso de tecnologias digitales. Este estudio reporta el desarrollo y las evidencias de validad psicometrica de la Escala de Habilidades para el Teletrabajo en Casa (EHTC). La investigacion se aplico a 7.608 funcionarios de organos publicos brasilenos. Se realizaron analisis estadisticos descriptivos, factoriales exploratorios, confirmatorios y de confiabilidad. El instrumento posee una estructura empirica bifactorial que evalua habilidades para equilibrar el trabajo y otras actividades (soft skills) y para el uso de recursos digitales en las interacciones laborales (hard skills). La EHTC puede ser utilizada para identificar la adaptacion y preparacion para el teletrabajo en casa e investigar posibles asociaciones entre estas habilidades y otros indicadores. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Evaluation of the Panbio™ COVID-19 Antigen Rapid Diagnostic Test in subjects infected with Omicron using different specimens (preprint)

Community testing is a crucial tool for the early identification of SARS-CoV-2 infection and transmission control. The emergence of the highly mutated Omicron variant (B.1.1.259) raised concerns about its primary site of replication, impacting sample collection, and its detectability by rapid antigens tests. We tested the Antigen Rapid Diagnostic Test (Ag-RDT) performance using nasal, oral, and saliva specimens for COVID-19 diagnosis in 192 symptomatic individuals, using RT-qPCR from nasopharyngeal samples as control. Variant of Concern (VOC) investigation was determined by the 4Plex SARS-CoV-2 screening kit. SARS-CoV-2 positivity rate was 66.2%, with 99% of the positive samples showing an amplification profile consistent with that of the Omicron variant. Nasal Ag-RDT showed higher sensitivity (89%) than oral (12.6%) and saliva (22.1%) Ag-RDTs. Our data showed the good performance of the Ag-RDT in a pandemic scenario dominated by the Omicron VOC. Furthermore, our data also demonstrated that nasal specimens perform better than oral and saliva ones for Omicron Ag-RDT detection.

A SARS-CoV-2 negative antigen rapid diagnostic in RT-qPCR positive samples correlates with a low likelihood of infectious viruses in the nasopharynx. (preprint)

SARS-CoV-2 transmission occurs even among fully vaccinated individuals; thus, prompt identification of infected patients is central to control viral circulation. Antigen rapid diagnostic tests (Ag-RDT) are highly specific, but sensitivity is variable. Discordant RT- qPCR vs Ag-RDT results are reported, raising the question of whether negative Ag-RDT in positive RT-qPCR samples could imply the absence of infectious viruses. To study the relationship between a negative Ag-RDT results with virological, molecular, and serological parameters, we selected a cross sectional and a follow-up dataset and analyzed virus culture, subgenomic RNA quantification, and sequencing to determine infectious viruses and mutations. We demonstrated that a positive SARS-CoV-2 Ag-RDT result correlates with the presence of infectious virus in nasopharyngeal samples. A decrease in sgRNA detection together with an expected increase in detectable anti-S and anti-N IgGs was verified in negative Ag-RDT / positive RT-qPCR samples. The data clearly demonstrates the less likelihood of a negative Ag-RDT sample to harbor infectious SARS-CoV-2 and consequently with a lower transmissible potential.

Visuospatial processing impairment following mild COVID-19 (preprint)

Severe Acute Respiratory Syndrome Coronavirus 2 infection causes coronavirus disease 2019. COVID-19 was an unknown infection that reached pandemic proportions in 2020 and has shown to bring long-term negative consequences. Here, we used a case-control design to investigate the performance of relatively young people recovered from COVID 19 in objective neuropsychological tests. We found significant differences between groups for all measures of the ROCFT with a large difference in the copy, a moderate difference in immediate recall, and a large difference in delayed recall. No significant differences were found for the measures from all the other five neuropsychological tests used.About one quarter of COVID 19 patients were below the 10th percentile according to normative data.

Boosting SARS-CoV-2 qRT-PCR detection combining pool sample strategy and mathematical modeling (preprint)

qRT-PCR is the gold standard technique available for SARS-CoV-2 detection. However, the long test run time and costs associated with this type of molecular testing are a challenge in the actual pandemic scenario. Due to high testing demand, pooling sample strategy is an interesting approach to allow cost savings. We aim to evaluate pooling tests in experimental procedures, as well as perform in silico statistical modeling analysis validated with specimen samples obtained from a mass testing program of Industry Federation of the State of Rio de Janeiro (Brazil). Although the sensitivity reduction in samples pooled with 32 individuals was observed, the high-test sensitivity is maintained even when 16 and 8 samples were pooled. The in silico analysis showed high-cost savings in populations with positive rates lower than 15.0% according to the pool size. This data was validated with the results obtained in our mass testing program: statistical modeling predicted a cost saving of 48.0%, which in practice, was 51.5%, already considering the expenditures with pool sampling that were analyzed individually. Our data confirmed that mathematical modeling is a powerful strategy to improve the pooling approach for SARS-CoV-2 mass testing around the world while maintaining high sensitivity and robustness.