Impacts of COVID-19 on the mental health of graduate students in the health area of a university in Ceara, Brazil

Graduate students experience an environment of intense demands. The COVID-19 pandemic caused the suspension of face-to-face academic activities, affecting the daily lives of these people. This study aimed to analyze the impact of COVID-19 on the mental health of stricto sensu graduate students in the health area of a public university in Ceara regardind the use of antidepressant and anxiolytic drugs. This cross-sectional, descriptive study uses a remote questionnaire from August 2021 to February 2022. Socio-demographic, clinical, medication use, and data from the "Self-Report Questionnaire" test were collected. 217 master's and doctoral students participated in the study, most of them female (71%), between 21 and 30 years old (55.3%) and without children (76.5%). The results showed an increase in the number of graduate students with symptoms of anxiety and/or depression after the pandemic (23.4%). Among the main symptoms, there is a strong indication of mental suffering (60.4%), nervousness, tension or concern (77.9%), sadness (55.3%), difficulties in carrying out daily activities with satisfaction (55.4%), and tiredness (65%). These symptoms were most prevalent among women. Regarding medication use (anxiolytics/antidepressants), 38.2% responded positively. Of these, 40.9% increased the dosage, and 79.5% experienced adverse reactions. In this way, the COVID-19 pandemic negatively affected graduate students' mental health, reinforcing the need for universities to develop strategies to mitigate these students' emotional suffering.Copyright © 2023, Conselho Federal de Farmacia. All rights reserved.

Educaci?n en contextos rurales en tiempos de pandemia. Relatos Brasil-Argentina

Santiago (USACH), Resumen. Este articulo tiene como objetivo describir y visibilizar las intervenciones realizadas por docentes para dar continuidad a las clases de aulas rurales durante la pandemia de la covid-19 en dos regiones de America Latina. Durante los meses de mayo y junio del ano 2020 se aplico un estudio de casos multiples en el estado de Minas Gerais (Brasil) y la provincia de Misiones (Argentina). Se entrevistaron 20 docentes y se utilizo el analisis de contenido categorico para procesar los relatos. Los hallazgos permitieron conocer tanto las dificultades presentes en las aulas rurales como la ineficacia y falta de especificidad territorial de las politicas educativas implementadas durante la pandemia. Por ultimo, los relatos de las y los docentes sirven de archivo historico al cual se puede volver y utilizar como guia para futuras intervenciones. Palabras clave: educacion rural;pandemia;Brasil;Argentina. Educacao em contextos rurais em tempos de pandemia. Relatos Brasil-Argentina Resumo. Este artigo tem como objetivo descrever e trazer a tona as intervencoes realizadas por pro-fessores para dar continuidade as aulas em salas de aula rurais durante a pandemia de COVID-19 em duas regioes da America Latina. Durante os meses de maio e junho de 2020, foi aplicado um estudo de caso multiplo no estado de Minas Gerais (Brasil) e na provincia de Misiones (Argentina). Vinte professores foram entrevistados e a analise de conteudo categorial foi usada para processar os relatos. As descobertas permitiram conhecer tanto as dificuldades presentes nas salas de aula rurais quanto a ineficacia e falta de especificidade territorial das politicas educacionais implementadas durante a pandemia. Por ultimo, os relatos dos professores servem como um arquivo historico que pode ser retomado e utilizado como guia para futuras intervencoes. Palavras-chave: educacion rural;pandemia;Brasil;Argentina. Rural education in pandemic times. Brazil-Argentina reports . This article aims to describe and make visible the interventions carried out by teachers to provide continuity to rural classrooms during the covid-19 pandemic in two regions of Latin America. During May and June 2020, we applied a multiple case study design in Minas Gerais (Brazil) and Mi-siones (Argentina). We interviewed twenty teachers and used categorical content analysis to process the reports. The findings revealed the difficulties in rural classrooms and the ineffectiveness of the territorial specificity of the educational policies implemented during the pandemic. Finally, the teachers' reports serve as a historical archive to which we can return and use as a guide for future interventions.

Author preferences for open access in Portugal: survey findings

Purpose: Surveying authors at doctoral-granting institutions of higher education in Portugal, the authors in this paper aim to seek to determine the extent to which Portuguese researchers prefer that their work appears in open access journals or open access repositories resulting in improved access to quality, peer-reviewed scientific information and faster scientific and technological advances. The authors also seek to gauge Portuguese author's familiarity with open access, the importance they attach to open access when choosing a publication outlet, and to determine their preferences for achieving open access. Design/methodology/approach: The methodology adopted in this research is the case study. The case study intends to understand a complex social phenomenon through an in-depth study holistically. In May 2020, the authors distributed a survey to faculty in all academic ranks at 14 Portuguese higher education institutions to learn the extent to which Portuguese authors currently make their research openly available, ascertain their awareness of open access, their support of the European Union (EU) open access goal and their preferences for achieving open access. Findings: Researchers at Portuguese universities overwhelmingly are aware of arguments in favor of open access and believe that open access benefits researchers in their fields. Portuguese researchers regularly publish in open access journals and deposit their papers in institutional or disciplinary repositories. Research limitations/implications: 16.7% of 740 potential respondents completed the survey. The relatively low response rate prevents extrapolations from being made to the universe. The study was implemented during the COVID-19 pandemic, which, due to the disruption created in all sectors, made data collection complex and delayed its subsequent treatment. Originality/value: Similar studies have been conducted at individual universities and in particular disciplines to determine the degree to which their faculty authors are aware of open access, its benefits, and preferences for achieving it. A similar study of Bulgarian university authors was conducted in 2018. No previous study of Portuguese authors at institutions of higher education has been conducted. The results will be useful to Portuguese institutions of higher education and academic libraries to establish and revise open access outreach and implementation services that may be helpful to their faculty in meeting EU open access and funder open access requirements. © 2023, Emerald Publishing Limited.

Influence of Deep Sedation in Intensive Care Medicine Memories of Critical COVID-19 Survivors.

Introduction: Critical care survivors sustain a variety of sequelae after intensive care medicine (ICM) admission, and the Coronavirus Disease 2019 (COVID-19) pandemic has added further challenges. Specifically, ICM memories play a significant role, and delusional memories are associated with poor outcomes post-discharge including a delayed return to work and sleep problems. Deep sedation has been associated with a greater risk of perceiving delusional memories, bringing a move toward lighter sedation. However, there are limited reports on post-ICM memories in COVID-19, and influence of deep sedation has not been fully defined. Therefore, we aimed to evaluate ICM-memory recall in COVID-19 survivors and their relation with deep sedation. Materials/Methods: Adult COVID-19 ICM survivors admitted to a Portuguese University Hospital between October 2020 and April 2021 (second/third "waves") were evaluated 1 to 2 months post-discharge using "ICU Memory Tool," to assess real, emotional, and delusional memories. Results: The study included 132 patients (67% male; median age = 62 years, Acute Physiology and Chronic Health Evaluation [APACHE]-II = 15, Simplified Acute Physiology Score [SAPS]-II = 35, ICM stay = 9 days). Approximately 42% received deep sedation (median duration = 19 days). Most participants reported real (87%) and emotional (77%) recalls, with lesser delusional memories (36.4%). Deeply sedated patients reported significantly fewer real memories (78.6% vs 93.4%, P = .012) and increased delusional memories (60.7% vs 18.4%, P < .001), with no difference in emotional memories (75% vs 80.4%, P = .468). In multivariate analysis, deep sedation had a significant, independent association with delusional memories, increasing their likelihood by a factor of approximately 6 (OR = 6.274; 95% confidence interval = 1.165-33.773, P = .032), without influencing real (P = .545) or emotional (P = .133) memories. Conclusions: This study contributes to a better understanding of the potential adverse effects of deep sedation on ICM memories in critical COVID-19 survivors, indicating a significant, independent association with the incidence of delusional recalls. Although further studies are needed to support these findings, they suggest that strategies targeted to minimize sedation should be favored, aiming to improve long-term recovery.

Anxiety symptoms in critically ill COVID-19 survivors and its association with post-discharge health concerns

Introduction: Evidence suggest that critically ill COVID-19 patients are at higher risk of developing anxiety symptoms, which may be related to or exacerbated by patients concerns regarding their health status and recovery. Objective(s): To assess anxiety symptoms in critically ill COVID-19 survivors, 1-2 months after hospital discharge and to analyze its association with concerns reported by patients regarding their own health status and recovery. Method(s): In the framework of MAPA prospective research, this preliminary study included COVID-19 patients admitted in the Intensive Care Medicine Department (ICMD) of a University Hospital. Patients were excluded if they had an ICMD length of stay (LoS) <=24h, terminal illness, major auditory impairment or inability to communicate at the evaluation time. Participants were assessed at a scheduled telephone follow-up appointment, with Generalized Anxiety Disorder Scale (GAD-7). Additional questions were asked to assess the survivors' post-discharge concerns regarding discrimination against for COVID-19, infection of a family member, re-infection or sequelae related to COVID-19. Result(s): Eighty-three patients were included (median age=63 years;63% male) and 24% had anxiety symptoms. Anxiety scores were higher in survivors who reported being afraid of being discriminated against for COVID-19 (30% vs 10%;p=0.034), being re-infected (100% vs 79%;p=0.032) and having sequelae (94% vs 44%;p<0.001). Conclusion(s): These findings revealed that anxiety is common in COVID-19 survivors and is associated with post-discharge patients concerns that may limit patient daily living. This study emphasizes the importance of psychological assessment and follow-up of the COVID-19 survivors, in order to support these patients recovery.

Depression and health-related quality of life in critical COVID-19 survivors

Introduction: Long-term neuropsychiatric consequences of critical illness are well known. Therefore, it is expected that critical COVID-19 patients might also present several psychiatric symptoms such as depression, with inevitable negative effect on healthrelated quality of life (HRQoL), commonly used as an indicator of illness and treatment impact. Objective(s): To identify depressive symptoms in critical COVID-19 survivors and to examine its association with HRQoL domains. Method(s): This preliminary study involved critical COVID-19 patients admitted into the Intensive Care Medicine Department (ICMD) of a University Hospital, between October and December of 2020. Patients with an ICMD length of stay (LoS)<=24h, terminal illness, major auditory loss, or inability to communicate at the follow-up time were excluded. From 1-2 months after discharge, all participants were evaluated by telephone at follow-up appointment, with Patient Health Questionnaire (PHQ-9) (depression) and EuroQol 5-dimension 5-level EQ-5D-5L (HRQoL). This study is part of the longitudinal MAPA project. Result(s): Eighty-three patients were included with a median age of 63 years (range: 31-86) and the majority were male (63%). The most reported problems on EQ-5D-5L domains were usual activities (82%) and mobility (76%). About 27% presented depressive symptoms, and with more problems of self-care (68%vs41%;p=0.029), pain/discomfort (86%vs49%;p=0.002), and anxiety/depression (96%vs54%;p<0.001). Conclusion(s): These preliminary results are in line in previous studies in critical COVID-19 survivors, with depression being associated with worse HRQoL. Bearing this in mind, follow-up approaches with an early screening and treatment of these psychiatric symptoms will be fundamental to optimize the recovery of these patients.

Delirium and health-related quality of life in severe COVID-19 survivors

Introduction: Severe COVID-19 survivors experience long-term neuropsychiatric morbidity, particularly those who developed delirium, with a negative impact on health-related quality of life (HRQoL). Objective(s): To identify the cases of delirium in severe COVID-19 patients and to describe its association with post-hospital discharge HRQoL. Method(s): In the context of the longitudinal MAPA project, we included adult patients (>= 18 years old) admitted with COVID-19 to the Intensive Care Medicine Department (ICMD) of a Portuguese University Hospital (October 2020-April 2021). Exclusion criteria were: ICMD length of stay <=24h, terminal illness, major auditory loss, or inability to communicate at the time of assessment. Delirium during ICMD stay was ascertained based on patients' clinical records. HRQoL was evaluated using the 5-Level EQ-5D questionnaire (EQ-5D-5L), at a scheduled telephone follow-up appointment on average 1-2 months after hospital discharge. Result(s): Overall, 124 patients were included with a median age of 62 (range: 24-86) years, being mostly male (65%). About 19% had delirium, 42% were deeply sedated and 43% required invasive mechanical ventilation. Most survivors reported problems on the EQ-5D-5L domains: usual activities (85%), mobility (73%) and anxiety/depression (65%). Patients with delirium reported more pain/discomfort (75%vs46%;p=0.011) and considerably anxiety/ depression (83%vs60%;p=0.032). Conclusion(s): These findings pointed that COVID-19 patients who experienced delirium reported worse HRQoL, regarding pain/discomfort and anxiety/depression. This study highlights the importance of not only prevention but also early screening of delirium during hospital stay, as well as the crucial role of the timely interventions at discharge, in order to minimize delirium longterm impacts.

Depressive symptoms and health-related quality of life in critical COVID-19 survivors: Preliminary results of 1-year follow-up

Introduction: A higher risk of mental health consequences in critical COVID-19 patients is expected due to several reasons, including prolonged mechanical ventilation with exposure to high sedation. In this context, post-discharge depression has been reported in previous COVID-19 studies, with a profound impact on patients' health-related quality of life (HRQoL). Objective(s): To identify depressive symptoms in COVID-19 survivors 1-year after hospital discharge and to analyse its association with HRQoL. Method(s): As part of the longitudinal MAPA project, this study enrolled critical COVID-19 patients admitted in the Intensive Care Medicine Department of a University Hospital (March-May 2020). Participants were assessed through telephone by an intensive care nurse and a psychologist, with the Patient Health Questionnaire (PHQ-9) (depressive symptoms), EuroQol five-dimension fivelevel questionnaire (EQ-5D-5L) and EQ-Visual Analogue Scale (EQ-VAS) (global health status patient record). Result(s): A sample of 55 survivors (median age=66 years;69% males) were included, with 20% showing depressive symptoms. Pain/discomfort (67%) and anxiety/depression (67%) were the most EQ-5D-5L domains reported. Survivors scoring for depression had more problems in all HRQoL areas (mobility:91%vs.48%, p=0.015;self-care:64%vs.27%, p=0.035;usual activities:91%vs.50%, p=0.017;pain/discomfort:100%vs.59%, p=0.010;anxiety/depression:100% vs.59%, p=0.010). Moreover, they had a lower EQ-VAS median, corresponding a worse self-perception of health status (50vs.80, p=0.010). Conclusion(s): Even after 1-year, a significant proportion of survivors presented depressive symptoms with repercussions in all HRQoL dimensions and association with worse self-perception of global quality of life. Taking this in mind, early screening and treatment of depression in COVID-19 survivors will be crucial, minimizing its impact on quality of life.

Development of posttraumatic stress disorder symptoms after intensive care - how to prevent it?

Introduction: Over the last decade, there has been identified that critical illness survivors have high rates of psychiatric disorders such as posttraumatic stress disorder (PTSD). The experience of admission to intensive care units (ICU) and illusory memories may cause short and long-term psychological disorders. Objective(s): To evaluate psychiatric disorders, such as PTSD, after ICU discharge, and determine the prevalence, risk factors, and prevention strategies for PTSD in these patients. Method(s): Non-systematic review through research in PubMed. Addicionally, a case report will be exposed, after the patient was diagnosed with SARS-CoV-2 and stayed in ICU for more than 30 days. Result(s): The development of PTSD has been related to the number of adverse memories patients recall from their ICU experience. Some studies have shown that approximately 47% of patients remember real facts and 34% have illusory memories relative to their stays in the ICU. There were identified some risk factor associated to the increased risk of post-ICU PTSD, such as early post-ICU memories or psychotic experiences, pre-ICU psychopathology, benzodiazepine sedation during ICU and substantial acute stress symptoms occurring < 1 month after exposure to a traumatic stressor. Conclusion(s): High levels of anxiety and the development by patients of PTSD are being recognized as significant problems occurring after a stay in an ICU. The results of this study highlight the need to recognise the risk factors and to establish a early follow-up after ICU stay. This way is possible to identify patients who are at risk of developing acute PTSD-related symptoms, and early intervention can be institued.

CEREBROVASCULAR DISEASES IN PATIENTS WITH SARS-COV-2 INFECTION: A NATIONAL SERIES

Background and aims: There is a higher incidence of cerebrovascular disease (CVD) in patients with SARS-CoV-2 infection. We aim to describe a national series of CVD in patients with confirmed SARS-CoV-2 infection. Methods: Fourteen Brazilian Stroke Centers registered clinical, neuroimaging and laboratory findings from April to November 2020. Results: We included 344 patients in the final analysis. Age ranged from 20-95 (median 57[57, 75] years). Cerebral ischemia (CI) occurred in 83.7%(n=288), intraparenchymal hemorrhage (IPH) 6.7%(n=23), central venous thrombosis (CVT) 5.2%(n=18) and subarachnoid hemorrhage (SAH) 4.4% (n=15). CVD was the first symptom of SARS-CoV-2 in 37.8% of cases - among those with SAH, 60% had no systemic symptoms. CI cases had higher values of Dimer-D compared to others. Involvement of at least two arterial territories occurred in 13.8%. Among IPH patients, 25% were under anticoagulation with heparin. Patients with SAH had a spontaneous etiology in 35.7%. Dimer-D levels at admission were associated with worse outcomes (mRS3-6) (OR1.14, 95%CI1.008-1.29, p=0.03), in an adjusted analysis. The time of onset of neurological symptoms (TONS) since SARS-CoV-2 infection was indirectly related to neurological severity at admission (-0.17, p=0.04,). In-hospital treatment with corticosteroids was associated with in-hospital encephalopathy (OR2.5,95%CI 1.01-6.16,p=0.04). Poor outcome (mRS3-5) occurred in 54.1% of cases. Conclusions: Patients with CVD and SARS-CoV-2 are at higher risk of unfavorable outcomes. The TONS since infection is related to neurologic severity;and serum Dimer-D levels may be useful for prognostication. The higher prevalence of non-aneurysmal SAH cases suggests pathophysiological mechanisms other than a hypercoagulable state.

MAIN BLOOD SERUM METABOLITES RESPONSIBLE FOR THE DISCRIMINATION OF HOSPITALIZED PATIENTS WITH MODERATE SYMPTOMS WITH OR WITHOUT COVID-19

Introduction: The variation in human blood serum metabolites resulting from an infection can assist in understanding mechanisms of pathogen action and body response and improve diagnosis. Aim: To map serum signatures of hospitalized symptomatic patients, positive or negative to SARS-CoV-2. Methods: Patients (n = 64) admitted to Anhembi Field Municipal Hospital, a hospital set up for initial care to patients with moderate symptoms, were analyzed being discriminated in positive (n = 32) or negative patients. Age and gender were matched to ensure homogeneity in the basal metabolic rates. Three Nuclear Magnetic Resonance (NMR) data set were recorded on Bruker AVANCE III 600 MHz spectrometer for serum samples analyzed in MetaboAnalyst 5.0 software platform. Results and discussion: The mean age of groups was 54.92 ±12.41 and 54.30 ±12.15, for positive and negative patients, divided in 16 female and 16 male. The ethnicity was 56.2% vs 46.8% caucasian, 34.3% mixed race in both groups, and 9.3% 12.5% vs black in positive and negative groups, respectively. BMI was 24 ±6.93 vs 33.5 ±7.85 in comparison to positive and negative patients, respectively. In both groups 50% of patients presented alveolar infiltrate. Although the groups were not paired by comorbidities, they were homogeneous ensuring that the metabolic variation is due to COVID-19 as similar percentage of patients with arterial hypertension, diabetes and dyslipidemia. Clinical symptoms were also remarkably similar between the groups in relation to: fever, dry cough, dyspnea and myalgia. The Partial Least Squares - Discriminant Analysis (PLS-DA) performed onto noesy1d data discriminated positively from negative patients. Also, it covered lower variance. Combining NMR techniques, it was possible to depict the main metabolites that distinguished the COVID-19 signatures. Alanine, glucose, cholesterol, and glutamine were increased, and lactate decreased in COVID-19. Conclusion: These results suggest NMR as an excellent tool to differentiate hospitalized patients with moderate symptoms as COVID-19 positive or negative. The Ethics Research Committee of the University of Campinas approved all of the experimental procedures, and all individuals signed the informed consent form.

HEMOSTASTATIC ALTERATIONS WITH DISEASE SEVERITY IN THE EARLY SYMPTOMATIC PHASE OF COVID-19

Introduction: The main factors associated with disease severity in Covid-19 are age, sex, body weight, hypertension, and diabetes. Biomarkers of hemostatic activation have been shown to be independent predictors of disease severity in different populations. Aim: To evaluate whether biomarkers of hemostatic activation were associated with clinical outcomes in patients admitted to a field hospital set up to provide initial care to patients in the early symptomatic phase of Covid-19. Methods: Data and samples were obtained from June to September 2020. Laboratory evaluation included complete blood counts, PT, aPTT, fibrinogen, D-dimer, factor VIII activity, Von Willebrand Factor (VWF) (activity and antigen), C reactive protein (CRP) and P-selectin (ELISA). Patients were segregated by outcome, with clinical worsening defined as need for ICU, mechanical ventilation, pulmonary embolism, deep vein thrombosis or death. Results and discussion: In total 209 were enrolled in the study, of which 24 presented clinical deterioration (11.5%). In both groups there was more male patients. In the group of clinical worsening the mean age was 58.1 and improvement was 53.6 years old. Concerning smoking, 3.2% of patients that improved smoke. Regarding pulmonar infiltrate, it was verified in 50% in the group that worsening versus 41% in clinical improvement. No differences could be observed between patient subgroups regarding the presence of fever (63.2% vs. 62.5%), dry cough (75.1% vs. 87.5%) and dyspnea (65.9% vs. 54.2%) at admission. As main comorbidities, the groups presented chronic obstructive pulmonary disease (2.2% vs 8.3%), asthma (3.2% vs 4.2%), chronic heart failure (1.1% vs 8.3%), arterial hypertension (46% vs 41.7%) and diabetes (28.1% vs 33.3%) in comparing improved with clinical deterioration patients. In general, it was verified a significant decrease in platelet number (p = 0.0426), and an increase in the parameters of aPTT (0.0084), CRP (p = 0.0450), vWF antigen (p = 0.0022) and ristocetin cofactor (p = 0.0032). Conclusion: Our results demonstrate that hemostasis activation is associated with clinical deterioration even at the early phases of Covid-19. The Ethics Research Committee of the University of Campinas approved all of the experimental procedures, and all individuals signed the informed consent form.

COVID-19 and smoking: a high-risk association. (Special Section: COVID-19 - public health contributions.)

The objective of the article was to examine the relationship of tobacco smoking with the risk of acquiring COVID-19. Gas exchange, lung function, and blood circulation, processes directly affected in COVID-19, improve quickly after smoking cessation. Quitting smoking and avoiding exposure to tobacco smoke and vapors can have a positive impact, reducing the risk involved in COVID-19 and smoking.

A CASE OF KRETSCHMER'S SENSITIVE DELUSION RELATED TO COVID-19 PANDEMIC

The COVID-19 pandemic has already infected more than 182 million people and killed more than 4 million all over the globe. In addition to its direct health effects, lockdowns and other draconian public health measures, along with an expected economic crisis of unprecedent magnitude, unpre- dictable social effects are being generated.

P.0811 Factors and outcomes associated with delirium in critically ill COVID-19 patients

Introduction: Evidence demonstrates that 25-33% of hospitalized patients with COVID-19 develop delirium [1,2], with rates up to 65% in critically ill patients [3]. Several potential reasons, including the use of deep sedation and invasive mechanical ventilation (IMV), as well as the restrictions to limit infection transmission, such as prohibition of family visits and minimal contact with health staff were identified [4]. Although factors and outcomes associated with delirium are well documented, limited data are available regarding severe COVID-19 patients. Aims: This study aims to estimate the rates of delirium in critically ill COVID-19 patients and to analyze factors that may be associated with its development, as well as to examine long-term outcomes. Methods: From March to May 2020 (in COVID-19 first wave), all adult patients (≥18y.o.) admitted due to COVID-19, in the Intensive Care Medicine Department (ICMD) of a University Hospital (CHUSJ), in Porto, Portugal, were assessed, unless they had a ICMD length of stay (LoS) ≤24h, terminal illness or major sensory loss or inability to communicate at the time of follow-up. Participants were evaluated during a scheduled telephone follow-up appointment with a comprehensive protocol, including: Six-item Cognitive Impairment Test (6CIT) (cognitive impairment);Patient Health Questionnaire (PHQ-9) (symptoms of depression);General Anxiety Disorder (GAD-7) (symptoms of anxiety);and EuroQol five-dimension five-level questionnaire (EQ-5D-5L) (health-related quality of life-HRQoL), which includes EQ-Visual Analogue Scale (EQ-VAS) (global health status patient perception). Data on acute illness severity, sedative/analgesic drugs use, respiratory support and major complications (including delirium, nosocomial infections and difficulty weaning from mechanical ventilation) during ICMD stay, were obtained from hospital electronic records review. Patients with and without delirium were compared, using Mann-Whitney test for continuous variables, and Chi-square or Fisher tests for paired categorical variables (significance level of 0.05). This study is part of an ongoing larger multidisciplinary research project (MAPA-Mental Health in Critically ill patients with COVID-19). Results: The sample included 59 patients (median age=65 years;66.1% male). Delirium was registered in almost half of the sample (49.2%). Patients with delirium were significantly older (median=72 vs. 62;p=0.010) and presented more nosocomial infections (82.8% vs 53.3%;p=0.032) particularly ventilator-associated pneumonia (75.9% vs. 33.3%;p=0.003). Also, they were significantly more likely to be deeply sedated (89.7% vs 60%;p=0.021), more often required IMV (89.7% vs 60%;p=0.021). Moreover, those with delirium stayed longer in the hospital (median=67 vs 37 days;p=0.014). Concerning HRQoL, assessed at follow-up appointment, patients who have developed delirium reported more problems in self-care (48.3% vs 10%;p=0.003) and in everyday activities (79.3% vs 53.3%;p=0.035) after hospital discharge. Nevertheless, no statistically significant differences were found for cognitive impairment, symptoms of anxiety and depression. Conclusions: Delirium was common in this critically ill COVID-19 sample, namely in older patients, who have been deeply sedated, invasively ventilated or had major ICU complications. It was associated with longer hospital stay and worse HRQoL. Recognizing potential associated factors will allow the identification of high-risk patients that should be targeted for early screening with preventive interventions to minimize the adverse outcomes associated to delirium in critical COVID-19 patients. No conflict of interest

Emergency Remote Teaching and Learning: An Experience Report

In 2020, the world was plagued by the COVID-19 pandemic, given this circumstance;new ways of acting were implemented to stop the transmission of the virus. Non-essential services were transferred to work-from-home and educational institutions, with all their human structure, needed to operate in emergency and remotely. The graduate course and the necessary guidelines suddenly started to be carried out virtually employing communication and information technologies (ICT). Therefore, the objective of this paper was to report a work experience that involved three post-doctoral students and one doctoral student from a Brazilian graduate program in Education, in exchange in Portugal, during the 2020 Research Stay year. For that, forms were sent via Google Forms to the participants to collect their perceptions about the teaching and learning practice while using ICT, in an emergency remote way. Afterward, the data collected was organized in spreadsheets and qualitative analysis of the data was carried out with Content Analysis techniques. The results show that many tools were already used frequently and, during the pandemic, the free time to invest in other academic activities increased. The authors concluded that the physical distance and the use of technologies made it possible to reduce distances and increase social interaction for the efficient teaching-learning process in times of crisis. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Digital health literacy and online information queries in Portuguese university students

Background Worldwide there is an overwhelming amount of information about COVID-19 circulating online, also named infodemic. Misinformation (the unintentional) and disinformation (the intentional) spreading of false information have proven to be very dangerous to public health. Hence, more than ever, people need skills for searching, evaluating and integrating information related to health in daily life, i.e., health literacy. Until now, little is known about the digital health literacy of university students and their information-seeking behaviour. Hence, this study aimed to analyse the associations between university students' digital health literacy and online information queries during the beginning of the COVID-19 pandemic (and infodemic) in Portugal. Methods A cross-sectional study of 3.084 Portuguese university students (75.7% females), with an average age of 24.2 (SD = 7.5), was conducted using an online survey. We used sociodemographic data (sex, age, subjective social status) and the digital health literacy questionnaire adapted to the specific COVID-19 context. Online information queries included the topics related to SARS-CoV-2 and COVID-19 searched by students. Logistic regression models were performed. Results Online information queries (e.g., individual measures to protect against infection, current spread of the virus, current situation assessments and recommendations) were associated with an increased odds of achieving sufficient digital health literacy. Conclusions Online information queries related to epidemiological and public health topics are significantly associated with digital health literacy in times of COVID-19. Further studies are needed, including programs that improve digital health literacy among university students and increase the availability of high-quality content information.

Artificial neural networks to predict COVID-19 progression of moderate hospitalized patients using early clinicalparameters and blood tests

Background : The early prediction of Covid-19 progression could improve patient's treatment. It is important to develop mathematical models to perform this task using simple blood tests. Aims : To obtain a neural network (ANN) to predict the progression (death vs discharge and intubation vs discharge) of Covid-19 in patients with confirmed diagnosis. Methods : The patients included in this work were diagnosed with Covid-19 by RT-PCR. All data were collected from hospitalized patients admitted to Anhembi Field Municipal Hospital (São Paulo-Brazil), a hospital set up for initial care to patients with moderate symptoms during the pandemic, between June/2020 and October/2020. Blood was collected at the patient's admission. The inputs considered were: sex, age, ethinicity, body mass index, tabagism, ex-tabagism, alveolar infiltrate, arterial hypertension, diabetes, heart rate, respiration rate, body temperature, oxygen saturation, D-dimer, activated partial thromboplastin time, prothrombin time, levels of: hemoglobin, platelet, leukocytes, lymphocytes, monocytes, neutrophils, lactate dehydrogenase, C-reactive protein, and creatinine. Two ANNs were proposed, as shown at Table 1. The best ANN was defined by a 5-fold cross-validation scheme. Finally, a test step was performed to verify the ANN performance. ANNs with one and two hidden layers were tested. The number of neurons ranged from 5 to 35. Results : The main results are shown at Table 2. The best models were obtained with different ANN's structures, which show the influence of the different outcome. The models presented high ACC, AUC, PPV, NPV, and TNR. The ANN 2 presented better performance than ANN 1. We believe that this may be due the data homogeneity that rises from the inclusion criteria adopted in the study. Conclusions : The results showed that the ANNs could be used to predict the progression of Covid-19 based on simple blood tests. The models could be used in the future after an external validation with high number of patients.