ANXIETY AND COPING MECHANISMS AMONG UNIVERSITY STUDENTS DURING THE COVID-19 LOCKDOWN

The outbreak of COVID-19 and the resulting lockdown had a great psychological impact on the lives ofpeople in general and on the lives ofstudents in particular. The current study aims to find the level of anxiety and the types of coping mechanisms utilized by university students during the lockdown period. Furthermore, the relationship between these two variables is also addressed. The participants of this study consist of 260 university students. Hopkins Symptoms Checklist and the Coping Strategies Inventory are the instruments that were used as measurement tools. The results showed that university students have probable anxiety, and their most commonly used coping mechanism is social withdrawal. The study also found a statistically significant correlation between social withdrawal, problem avoidance, and expression of emotion with anxiety. According to the findings, there exists a significant difference in anxiety between male and female students. In addition, a significant difference in the use of coping mechanisms among female and male students existed in the use of social withdrawal and expression emotion coping mechanisms, which were both used more by female students. The findings of this study highlight the need for psychological services to be available in the universities of the region.

"A scuola di Astroparticelle”: a synergy between school education and scientific research

The outreach program "A scuola di Astroparticelle” was proposed in 2016 by the National Institute for Nuclear Physics (INFN - Napoli Division) in collaboration with the Physics Department "Ettore Pancini” of the Federico II University in Napoli, CNR-SPIN and CNR-ISASI Institutes. Its main goal is to engage teachers and students of High Schools in astroparticle physics projects. For the third edition (2018/19), the activities, which are also part of the Italian Educational Program PCTO - "Percorsi per le Competenze Trasversali e per l'Orientamento”, involved 18 schools for a total of 21 projects on several topics. Some projects were strictly related to astroparticles as cosmic rays, while others were more technical, as the development of particle detectors, or cross-disciplinary projects. Students worked for the entire school year and prepared materials for the final event. More than 600 students attended the event and presented their work to a jury with a poster and an oral presentation in plenary sessions. Since 2018, the program is part of OCRA - Outreach Cosmic Ray Activities - a national outreach project of INFN with the aim of collecting, within a common framework, the numerous outreach activities in cosmic-ray field carried out at the local level. The fourth edition (2019-20), in spite of the difficult situation due to the COVID-19 pandemic, has also seen the participation of 22 schools that carried out part of the activities in an online format. The project realized using the open data of the Pierre Auger Observatory will be presented in detail. © Copyright owned by the author(s) under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0)

Examining Black and Hispanic physicians and other healthcare providers' attitudes toward the COVID-19 vaccine.

OBJECTIVES: Recognizing that the voice delivering the message is as important as the information being shared, we examined vaccine perceptions and willingness to encourage patients to obtain COVID-19 vaccinations among Black and Hispanic healthcare providers. METHODS: We conducted a cross-sectional, online survey of Black and Hispanic healthcare providers who were members of the National Medical Association (NMA), National Hispanic Medical Association (NHMA), and National Pharmaceutical Association (NPhA) between January 11 - March 3, 2021, shortly after emergency use authorization (EUA) for the Pfizer and Moderna COVID-19 vaccines. Three multivariable logistic regression models were used to determine factors associated with the willingness to encourage COVID-19 vaccination. RESULTS: The analytic sample consisted of 542 fully completed surveys. Pharmacists reported intent to take the vaccine (75.0% "as soon as you can" vs 91.4% for MD/DOs; p<0.001) and encouraged patients to get vaccinated (78.6% vs 91.0% for MD/DOs; p = 0.01). Providers in a suburban practice location were less likely to recommend vaccines to patients (OR=0.43, 95%CI: 0.22-0.87) and personal family (OR=0.45, 95%CI: 0.22-0.92) compared to those practicing in urban areas. Providers over age 45 were also more likely to report intent to take the vaccine themselves as soon as it was available (OR=3.72, 95%CI: 1.30-10.64). CONCLUSIONS: This is likely the first cross-sectional study in the United States demonstrating the substantial vaccine confidence among Black and Hispanic healthcare providers who serve minoritized communities that have borne the greatest risk of adverse COVID-related outcomes.

SPECIALIZED PRO-RESOLVING MEDIATORS (SPMS) and INFLAMMATORY NETWORKS in PATIENTS AFFECTED by ADULT ONSET STILL'S DISEASE (AOSD) and COVID-19

Background: Uncontrolled systemic infammation characterizes COVID-19 and autoinfammatory diseases such as adult-onset Still's disease (AOSD). Biosynthesis of pro-resolving mediators (SPMs), i.e. lipoxins (LX), resolvins (Rv), pro-tectins (PD), and maresins (MaR), ensures infammation shutdown and tissue repair, limiting neutrophils recruitment and stimulating macrophages to remove apoptotic cells. Among protectins, reduction of PD1 was found in the lungs of mice infected with the H5N1 infuenza virus and experimental treatment with PD1 resulted in increased animals' survival (Morita M et al 2013). Objectives: We investigated the effects of SPMs in pathogenesis and clinical evolution of AOSD and compared these data with mild and severe COVID-19. Finally, we analyzed the potential role of PD1 in modulating the infammatory response of macrophages obtained from AOSD patients, COVID-19 patients and healthy donors (HDs). Methods: 21 patients hospitalized for COVID-19 (10 ICU and 11 hospitalized in medical clinical unit) and 13 patients with AOSD were enrolled. Plasma PD1 levels from patients and controls were analyzed by ELISA, and mono-cytes-derived macrophages were polarized into M1 and M2 phenotype. We analyzed the effect of PD-1 on macrophages differentiation. At 10 days, macrophages were analyzed for surface expression of subtypes markers by flow cytometry. Cytokines production was measured in supernatants by Bio-Plex Assays. Peripheral blood mononuclear cells (PBMCS) from 3 AOSD patients, 2 COVID-19 patients and 3 HDs were obtained. Next-generation deep sequencing was then performed to identify the differences in PBMCs transcripts profiles. Results: AOSD patients with systemic scored (SS) ≥1 showed an increase of PD1 levels compared to AOSD patients with lower systemic score (p=0.04) (Figure 1A). Similarly, plasma levels of PD1 were increased in COVID-19 patients independently from their clinical subsets, compared to HDs (p=0.02). In vitro treatment with PD1 of monocytes-derived macrophages from AOSD and COVID-19 patients induced a signifcant increase of M2 polarization vs control (p<0.05) (Figure 1B). Furthermore, a signifcant release of IL-10 and CCL4 from M2 macrophages was observed when compared to control (p<0.05) (Figure 1C). In the transcriptomes from 3 AOSD patients (2 mild and 1 severe), 2 COVID-19 patients (1 mild and 1 ICU) and 2 HDs, we observed that genes involved in infammation, lipid catabolism and monocytes activation were spe-cifcally dysregulated in AOSD and COVID-19 patients when compared to HDs. Among them pla2g15, pla2g12a, pla2g2d, involved in mobilization of SPMs precursors, were signifcant upregulated in patients compared to HDs (p<.01, ;log2FoldChange;>1.2) (Figure 1D). The largest part of the genes involved in infammation, lipid catabolism, and monocytes activation are less expressed in AOSD patients when compared to COVID19 patients, as reported in Table 1. Conclusion: The counterbalance by SPMs during infammation is still a largely unexplored pathway. Our study suggests that an imbalance of SPMs in autoin-fammatory diseases as well as COVID-19. The modulation of SPMs as observed in our experiments, might represent a new possible therapeutic strategy during AOSD and COVID-19.

Severe Neutropenia after Sarilumab Administration in Two COVID-19 Patients: Case Reports and Literature Review

BACKGROUND: Two years have passed since the WHO declared a pandemic state for SARS-CoV2 infection. COVID-19 pathogenesis consists of a first viral phase responsible for early symptoms followed by an inflammatory phase, which is cytokine-mediated, responsible for late-onset signs up to acute respiratory distress syndrome. Considering that interleukin (IL)6 plays a key role in the development and maintenance of inflammation, drugs targeting both IL6 and IL6 receptors have been evaluated. CASE REPORTS: The present study reports the cases of two hospitalized patients with severe respiratory COVID-19 treated with a single dose of intravenous sarilumab, a monoclonal anti-IL6 antibody, along with standard of care medications and high-flow oxygen therapy. Although a few days following sarilumab administration, clinical and biochemical conditions started ameliorating, these patients developed severe and self-limiting neutropenia. CONCLUSION: Sarilumab may represent a promising weapon to treat the fearsome hyperinflammatory phase;however, more trials are needed to decide whether to use it in combination with other drugs or alone, and to better understand pharmacokinetics and side effects.

TENOFOVIR DISOPROXIL FUMARATE and SEVERITY of COVID-19 in PEOPLE with HIV INFECTION

Background: Effective, safe, and affordable antivirals are needed for COVID-19. Several lines of reseach suggest that tenofovir may be effective against COVID-19 but no large-scale human studies with appropriate adjustment for comorbidities have been conducted. We describe the incidence, clinical severity and mortality of laboratory-confirmed SARS-CoV-2 infection by antiretroviral therapy (ART) among HIV-positive individuals with virological control adjusting for key potential confounders including hypertension, diabetes, chronic renal disease, cardiovascular disease, and treatment with immunosuppressants or corticosteroids. Methods: We studied HIV-positive individuals on ART in 2020 at 69 HIV clinics in Spain from February 1 to December 31. These 69 clinics serve approximately 44% of all persons on ART with virological suppression in Spain. We collected data on sociodemographics, ART, CD4-cell count, HIV-RNA viral load, comorbidities and the following outcomes: laboratory-confirmed SARS-CoV-2 infection, COVID-19 hospitalization, intensive care unit (ICU) admission and death. We compared 48-week risks, relative risks, relative differences and 95% confidence intervals (CI) for individuals receiving tenofovir disoproxyl fumarate (TDF)/emtricitabine (FTC), tenofovir alafenamide (TAF)/FTC, abacavir (ABC)/lamivudine (3TC), and other regimes. All estimates were adjusted for clinical and sociodemographic characteristics via inverse probability weighting. Results: Of 51,558 eligible individuals, 39.6% were on TAF/FTC, 11.9% on TDF/FTC, 26.6% on ABC/3TC, 21.8% on other regimes. There were 2,402 documented SARS-CoV-2 infections (425 hospitalizations, 45 ICU admissions, 37 deaths). Compared with TAF/FTC, the estimated risk ratios (RR) (95% CI) of hospitalization were 0.66 (0.43, 0.91) for TDF/FTC and 1.29 (1.02, 1.58) for ABC/3TC, the RRs of ICU admission were 0.28 (0.11, 0.90) for TDF/FTC and 1.39 (0.70, 2.80) for ABC/3TC, and the RRs of death were 0.37 (0.23, 1.90) for TDF/FTC and 2.02 (0.88-6.12) for ABC/3TC. The corresponding RRs of hospitalization for TDF/FTC were 0.49 (0.24, 0.81) in individuals ≥50 years and 1.15 (0.59, 1.93) in younger individuals. Conclusion: Our findings suggest that, compared with other antiretrovirals, TDF/FTC lowers COVID-19 severity among HIV-positive individuals with virological control. This protective effect may be restricted to individuals aged 50 years and older. Confirmatory randomized trials of TDF/FTC for the prophylaxis and early treatment of COVID-19 are warranted.

The Digital Platform Experience of a Leading Country in Wine Tourism: From COVID-19 to the New Era

The paper's goals are to comprehend strategies for tourism destinations after the coronavirus. The research question (RQ) is if the digital platform experience of a leading country in wine tourism can help to overcome COVID-19 and to turn the sector. The general topics related to destinations, specifically Italian wine tourism destinations, have been elaborated on in the introduction. Starting with a literature review relating to the destination tourism crisis in the tourism sector, the paper highlights the potential and basic lessons for coping with the current crisis. The method, which is connected to a wine tourism destination in Italy, emphasizes both qualitative and quantitative approaches. The results demonstrate the best practices as well as the bottlenecks. The discussions would result in the creation of strategic alternatives specific to the sector and its destinations. The study limits, considering bottlenecks that might arise in the future. The findings emphasize that the sector requires substantial funding from information and communication technology (ICT) to build smart destinations.

Pain crisis management in a patient with sickle cell disease during SARS-CoV-2 infection: A case report and literature review

Patients with sickle cell disease (SCD) are more susceptible to severe coronavirus disease 2019 (COVID-19) infection, in comparison with the general population, due to the possibility that the inflammatory state, along with hypoxia and hypercoagulability may increase the risk of developing acute SCD-related complications. The present study reports the case of a 33-year-old female affected by SCD, who although vaccinated against COVID-19, tested positive for SARS-CoV-2 and developed febrile pneumonia. During hospitalization, the patient complained about generalized intense pain, along with fever recurrence and increased inflammatory marker, procalcitonin and haemoglobin S levels. The patient was treated with an intravenous analgesic therapeutics cocktail in combination with red blood cell manual exchange procedure and broad-spectrum antibiotic therapy, achieving the rapid resolution of pain and an improvement in the laboratory test results. From the case presented herein, it is thus suggested that patients with SCD and COVID-19 infection need to be critically evaluated by clinicians, as such patients may develop severe outcomes, attributed to the overlap of two difficult to treat conditions. © 2022 by the authors.

[A possible relationship between anti-SARS-CoV-2 vaccination and glomerular diseases: food for thought for the nephrologist]

In order to fight the SARS-CoV-2 pandemic, mass-vaccination programs have been launched globally starting December 2020. The pace of COVID-19 vaccines development was impressive and although data from clinical trials and post-authorization studies showed acceptable safety profile, additional studies and long-term population-level surveillance are needed. A possible link between all type of vaccination and immunological diseases is perhaps one of the hottest topics in literature;correspondingly, there is growing concern over the small but growing number of case reports linking COVID-19 vaccines with the development of glomerular disease. Our group conducted a systematic review of such cases. Results showed that IgA nephropathy (IgAN) and Minimal Change Disease (MCD) are the most frequently associated glomerulopathies. Interestingly, IgAN cases are mostly flares occurring few hours after the second dose of RNA vaccines and have a good clinical outcome, while both de novo and recurring MCD can occur up to 28 days after the first or second dose of vaccines. RNA vaccines are the most common vaccine type to be associated with glomerulopathy. Of course, this may simply reflect the more widespread use of these vaccines. However, compared to traditional vaccines, they do seem produce a higher antibody response and a stronger CD8+ T- and CD4+ T-cell response, including higher production of chemokines and cytokines.

Evaluation of the elecsys sars-cov-2 antigen test

Background: In the context of the SARS-CoV-2 pandemic, the development and validation of rapid diagnostic methods are of high priority. This study was performed to evaluate the Elecsys SARS-CoV-2 Antigen test (Roche) on a Cobas e 602 system [antigen-detecting rapid diagnostic test (Ag-RDT)].Materials and Methods: The Ag-RDT was performed using nasopharyngeal (NP) swabs in UTM (Copan) according to manufacturer. Diagnostic accuracy was determined in NP samples in comparison rRT-PCR performed on a CFX96™ System (Bio-Rad) using ELITe MGB amplification Kit (ELITech) detecting the ORF8 and RdRP genetic loci of SARSCoV-2 after RNA extraction. Whitin-laboratory imprecision was evaluated according to CLSI EP-15 A3 protocol using pooled UTM of NP samples previously treated with Extraction Solution C stored at -20°C. A recovery study was performed by duplicate analysis of serial dilutions ranging from 1:10 to 1:5120 of a high viral load sample (ORF8 Ct 17.3,RdRP Ct 18.2).Results: A total of 114 NP samples were included;99 (86.8%) were rRT-PCRpositive. The median patient age was 49 years, 56 were male. The area under the ROC curve (AUC) for rRT-PCR positivity was 0.952 (95% CI, 0.895-0.983;p<0.0001), with an optimal cut-off of 0.531 COI, associated with 81.8% sensitivity and 100.0% specificity. The suggested cut-off of 1.0 was associated with 62.6% sensitivity and 100.0% specificity.In positive rRT-PCR samples a strong correlation was found between Ct of target genes and Ag-RDTI: log(COI Ag-RDT)= 21.576 + -13.809 log (Ct ORF8), r=0.94, P<0.001 and log (COI Ag-RDT)= 25.243 + -16.257 log (Ct RdRP), r=0.95, P<0.001.An agreement of 100%, 100%, 69.6%, 7.7% and 0.0% was found between Ag-RDT and rRT-PCR in subgroup of samples with Ct<=25 (n=22), 25-30 (n=23), 30-35 (n=23), 35-40 (n=26) and >40 (n=5), respectively.At a 4.84 COI a SD of 0.237 and a within-laboratory CV of 4.9% was found slightly higher than that indicated from the manufacturer (CV 3.5%).A linear response was found from 8.0 to 3996 COI with a recovery within ±10%.Conclusions: Elecsys SARSCoV-2 Antigen showed a good performance in particular in samples with high viral loads. This test has the potential to become an important tool for a rapid diagnosis in situations with limited access to rRT-PCR.

Urban Green Spaces and Public Health Outcomes: a systematic review of literature

Background As stressed by COVID-19 pandemic, urbanicity might represent a risk factor for chronic non-communicable diseases or generally impacting on healthy lifestyle, among them physical activity. Methods In light of this, we performed a systematic review aimed to explore the association between urban greenspaces and two important health indicators for both mental and physical health. In particular, our aims were to analyze the association between publicly accessible urban greenspaces exposure, and mental health outcomes (MH) and objectively-measured physical activity (PA). The review was conducted from 2000/01/01 to 2020/09/30 searching in two electronic databases: PubMed/Medline and Excerpta Medica dataBASE (EMBASE). Only articles in English were included. Results Out of 356, a total of 34 studies were included in our review, of which 19 assessed MH outcomes, the remaining dealt with PA. Only a few included studies found a non-effect or a negative effect on MH outcomes, whereas, all the others demonstrated a positive effect of urban greenspace and both MH and PA. However, our results stressed not only the importance of green space presence, but also the importance of maintenance, renovation, closeness to residential areas, the presence of interactive activities, and perceived security aspects. Conclusions To conclude, even some methodological limitations of the included studies, results are concordant in demonstrating that urban greenspaces show potentially beneficial effects on mental health and physical activity. Our results are significant for public health experts and policymakers involved in urban planning, community health promotion, and improvement of health and social equity. Key messages Urban green spaces are important factors, impacting on both physical and mental health. Policymakers involved in urban planning should pay more attention in urban green spaces.

ADEM post SARS-CoV-2 infection in a paediatric patient with fisher Evans syndrome

Background and aims: SARS-CoV-2 is a single-strained RNA virus belonging to Corona viridae's family. In paediatric age the majority of patients are asymptomatic, however several neurological manifestations associated with SARS-CoV-2 infection have been detected in a percentage of cases ranging from 17.3% to 36.4%. Acute Disseminated Encephalomyelitis (ADEM) has been recently included among the potential complications of SARS-CoV-2 infection. The available data regarding paediatric patient show only one case. Methods: Case report: We present a case regarding a six-year-old child suffering from Fisher Evans Syndrome treated with Sirolimus and Thalidomide therapy and affected by SARS-CoV-2 infection. Results: Case report: We present a case regarding a six-year-old patient suffering from Fisher Evans Syndrome who was given Sirolimus and Thalidomide therapy. After ten days since the first positive nasopharyngeal swab for Sars-CoV-2, in which he had no symptoms, he presented an episode of generalized tonic-clonic seizure with spontaneous resolution. The patient underwent MRI which showed the typical picture of Acute Disseminated Encephalomyelitis. His clinical course was favourable, with a good response to cortisone therapy and a progressive improvement of the neuroradiological and electroencephalographic picture. Conclusions: According to our knowledge, this is the second case of an Acute Disseminated Encephalomyelitis following SARS-CoV-2 infection in a paediatric patient, characterized by monosymptomatic onset, in which the immunosuppressive therapy practiced for the Fisher Evans Syndrome has probably contributed to a favourable evolution of ADEM, in contrast to other case described in the literature.

COVID-CANCER HUIL - Registry of oncological patients with diagnosis of COVID-19 at Hospital Universitario Infanta Leonor in Madrid (Spain): One year of pandemic

Background: During the first year of the SARS-CoV-2 pandemic the management and treatment of COVID-19 have been improved. However, cancer patients continue to be one of the most affected. We evaluate the mortality rate due to COVID-19 and associated risk factors in the cancer population diagnosed in our center during the first year of pandemic. Methods: We retrospectively reviewed the medical records of 189 cancer patients who were diagnosed with COVID-19 between March 5, 2020 and February 28, 2021. Mortality rate nd associated risk factors were studied. Results: Mortality rate: 55/189 patients. Mean age: 72 years (34-95), 125/189 male patients. Predominant histologies: lung cancer (72/189), colorectal (31/189), breast (24/189). Predominant staging: metastatic disease (113/189). Predominant cancer treatment: chemotherapy (63/189);118/189 patients were receiving any type of oncological treatment with palliative intention. Mortality was associated with male gender (45/55 vs 10/55, p=0.004), presence of comorbidities (48/55 vs 7/55, p=0.01), lung cancer (28/72 deaths with this tumor vs 27/117 with the rest, p=0.02), palliative intention cancer treatment (41/55 vs 12/55, p=0.02), older median age (76 vs 71, p = 0.02), higher median CRP (p=115.6 mg/dl vs 46 mg/dl), lower median lymphocytes (600/mm3 vs 1000/mm3 p<0.001). No specific treatment against COVID-19 significantly decreased mortality. Neither IL-6 nor ferritin were prognostic biomarkers. In multivariate analysis, male gender (OR 2.58, 95% CI 1.1-5.9, p = 0.02), lung cancer (OR 2.0, CI 1.0-3.8, p = 0.03), cancer treatment with palliative intention (OR 2.4, CI 1.07-5.3, p = 0.03), higher median CRP (OR 1.0, CI 1.00-1.01, p <0.001), as well as low lymphocyte median (OR 0.5, CI 0.25-1.0, p = 0.56), continued to be evidenced as risk factors, regardless of comorbidities, staging, sex, and palliative intention cancer-specific treatment, among other variables. Conclusions: Men with lung cancer under cancer-specific treatment with palliative intention who present, at the diagnosis of SARS-CoV-2 infection with elevated CRP above 115 mg/dl and a decrease in lymphocytes below 600/mm3 have a higher risk of presenting fatal complications. Legal entity responsible for the study: Medical Oncology department, Hospital Universitario Infanta Leonor. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

First wave mortality data versus full pandemic period from the COVID-CANCER HUIL study

Background: Cancer patients are one of the most affected by the current pandemic caused by SARS-CoV-2. Social inequalities influence the incidence rate of this disease, as we have seen in the high incidence in our center. In our study, we asked whether the last covid-19 treatment advances, the capacity for restructuring the health centers and their non-saturation, influences the cancer patients outcomes. Methods: Retrospective review of 189 cancer patients diagnosed in our center with COVID-19 from March 5, 2020 to February 28, 2021. Study data was collected and managed using REDCap. We compared COVID-19 diagnoses in first-wave cancer patients versus the full pandemic period until data cut-off, as well as patient characteristics and mortality rates. Results: Mortality rate: 55/189 patients during the entire pandemic period vs 40/85 patients in the first wave (p = 0.03). Median age: 72 years (34-95) vs 76 (34-94), 125/189 men in all the period vs 50/85 (p = 0.2). Most frequent histologies: lung cancer (72/189 vs 22/85, p = 0.07), colorectal (31/189 vs 19/85, p = 0.23), breast (24/189 vs 10/85, p = 0.82). Staging: 113/189 metastatic disease at diagnosis of infection vs 32/85 in first wave (p <0.001). During the 2 subsequent waves in our center, where 104 more patients have been detected, mortality has dropped significantly: from the initial 47% to 14.4% in the rest of the period (40/85 vs 15/104, p <0.001), despite having more metastatic involvement in infected patients. Conclusions: In our center, one of the worst hit by the coronavirus crisis in Spain, with a supersaturation of almost 250% in the middle of the first wave, we have verified how the knowledge of the behavior of this disease, improvements in its treatment and a multidisciplinary management in Oncology ward have led to a significant decrease in mortality, going from almost 50% in the first wave to less than 15%, despite having suffered the disease during the two subsequent waves a greater number of patients with metastatic disease. Legal entity responsible for the study: Medical Oncology Department, Hospital Universitario Infanta Leonor. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Psychological distress, low-income, and socio-economic vulnerability in the COVID-19 pandemic.

OBJECTIVES: Although literature broadly reports the impact of COVID-19 on global mental health, little is known about the extent of its deleterious impact on the most vulnerable individuals. The present study aimed to evaluate the level of psychological distress of adult's residents of two urban shantytown communities located in São Paulo city, Brazil. STUDY DESIGN: This was a cross-sectional study. METHODS: An online questionnaire was divided into four sections: (1) informed consent, (2) socio-economic data, (3) 12-item general health questionnaire, and (4) Brazilian food insecurity scale was applied. RESULTS: Of the 495 family headship (448 females and 47 males), the mean age was 36.1 years, 85% have an indication of psychological distress, 61.4% had a monthly income less than or equal to $70, and the incidence of households experiencing moderate or severe food insecurity was 40%. Multivariate logistic regression revealed that respondents who experienced moderate or severe food insecurity (odds ratio [OR] = 2.701, confidence interval [CI] 95% = 1.265-5.769; P = 0.010) and lower monthly income (OR = 2.031, CI 95% = 1.056-3.908; P = 0.034) had a higher risk of psychological distress. On the other hand, having an employment is a protective factor against the stressful situations caused by COVID-19 pandemic (P = 0.029). CONCLUSION: The present study identified low-income younger women residents of urban slums who suffer from food insecurity as high-risk groups to have psychological distress. Our findings are of particular importance because they showed the intersection of vulnerabilities during the COVID-19 outbreak.

Impact of COVID-19 on adolescent girls and young women in a community-based HIV prep programme in south africa

Background The coronavirus (COVID-19) pandemic has severely impacted healthcare service delivery, including preexposure prophylaxis (PrEP) worldwide. COVID-19 may increase the vulnerability of adolescent girls and young women (AGYW). We investigated the impact of COVID-19 on HIV, STIs and pregnancy in a community-based PrEP programme for AGYW in South Africa. Methods We used data from an ongoing study of strategies to improve the prevention-effective use of PrEP among AGYW living in a peri-urban and a rural community in the Eastern Cape, South Africa. PrEP services have been provided since October 2018;AGYW are expected to attend monthly PrEP service activities with Xpert® testing for STIs at the 6-, 12- and 24-months visits. PrEP services were partially impacted during the South African lockdown (March-April 2020). An observational analysis of PrEP service utilization and HIV, STI and pregnancy results was conducted comparing data from before COVID-19 introduction and during the COVID-19 epidemic in South Africa. Results A total of 546 AGYW attending PrEP services for ≥3 months were included in our analysis. The number of AGYW visits for PrEP and HIV testing dropped by 29% (p<0.001) during the COVID-19 epidemic in South Africa. HIV test positivity increased from 0.54% to 1.94% during the COVID-19 epidemic (p=0.03). STI test positivity increased from 23 to 30% (p=0.20) for Chlamydia trachomatis, 7% to 14% for Neisseria gonorrhoeae (p=0.08), and 8 to 12% for Trichomonas vaginalis (p=0.32). Pregnancy test positivity increased from 1.2% before to 4.1% during the COVID-19 epidemic (p=0.002). Conclusion South African AGYW substantially decreased their visits for PrEP in a community-based PrEP study during the COVID-19 epidemic, while rates of new HIV infection, STIs, and pregnancy increased, indicating unprotected sex. The impact of COVID-19 on healthcare services, the economy and social interactions has enhanced the vulnerability and health risks of AGYW in our setting.

The role of the SARS-COV 2 pandemic on the delay of diagnosis in a case of multiple myeloma associated with AL amyloidosis in HIV-HBV positive patient on antiretroviral treatment

COVID-19 has devastated healthcare systems all over the world and is still raging in Italy. In many countries, patients with chronic illnesses are suffering from delay in diagnostic and treatment management. We report a challenging case of a HIV patient who experienced delay in diagnosis of multiple myeloma due to COVID-19 pandemic restrictions. Global cooperation to ensure equity and responsiveness to local contexts is essential on the difficult path ahead to ending the COVID-19 pandemic, as treatment for one potentially curable disease should not be performed at the expense of another.

High-flow nasal cannula oxygenation and tocilizumab administration in patients critically ill with COVID-19: A report of three cases and a literature review

Since late 2019, SARS-CoV2 has spread worldwide, leading the WHO to declare a pandemic state. Italy was deeply affected by the virus, particularly North Italy. Several molecules have been tested for the treatment of coronavirus disease (COVID-19), comparing the treatment efficacy and collateral effects. To date, no antiviral drugs have been approved for the treatment of the COVID-19 viral phase or for the inflammatory phase. Undoubtedly, oxygen support plays a key role in the management of patients affected by this virus. The present study reports the cases of 3 patients critically ill with COVID-19. Despite antiviral therapy, their clinical conditions deteriorated a few days following admis- sion, particularly as regards respiratory performance, together with chest X-ray findings and arterial blood gas parameters. The levels of inflammatory markers were also elevated. The patients were treated with high-flow nasal cannula (HFNC) oxygenation along with a double dose of tocilizumab. A few days following HFNC and tocilizumab administration, the respiratory rates and arterial blood gas data were ameliorated alongwithchestX-rayresults.TheuseofHFNCwasthenslowly reduced until it was terminated, with the patients achieving a successful discharge. On the whole, as presented herein, it is indisputable more data and guidelines for COVID-19 therapies are warranted in order to guide clinicians as to the appropriate clinical treatment which will guarantee an optimal therapeutic response. © 2020 World Academy of Sciences Journal. All rights reserved.