Sphingolipid metabolism and its relationship with cardiovascular, renal and metabolic diseases.

Sphingolipids (sphingomyelin, glycolipids, gangliosides) are located in cell membranes, plasma, and lipoproteins. In patients with cardiovascular, renal, and metabolic diseases, the profile of sphingolipids and their metabolites (ceramide, sphingosine, and sphingosine-1-phosphate) is modified, and these changes may explain the alterations in some cellular responses such as apoptosis. Furthermore, sphingosine and sphingosine-1-phosphate have been suggested to prevent COVID-19. This review also briefly mentions the techniques that allow us to study sphingolipids and their metabolites.

Los esfingolípidos (esfingomielina, glucolípidos y gangliósidos) se localizan en las membranas celulares, el plasma y las lipoproteínas. En pacientes con enfermedades cardiovasculares, renales y metabólicas, el perfil de los esfingolípidos y sus metabolitos (ceramida, esfingosina y esfingosina-1-fosfato) se modifica, y estos cambios pueden explicar las alteraciones en algunas respuestas celulares, como la apoptosis. Además, se ha sugerido que la esfingosina y la esfingosina-1-fosfato previenen la COVID-19. En esta revisión también se mencionan brevemente las técnicas que permiten el estudio de los esfingolípidos y sus metabolitos.

Impact of the COVID-19 pandemic on a healthy and physically active person. Case report and update of the main findings / Impacto de la pandemia por COVID-19 en persona sana y físicamente activa. Reporte de un caso y actualización de los principales hallazgos

Introducción. No todas las personas expuestas al COVID-19 desarrollan una en-fermedad respiratoria grave y el número de personas adultas jóvenes sin patologías previas, afectadas gravemente por el virus, viene en aumento. Se ha evidenciado un gran número de síntomas inespecíficos y complicaciones, posterior a la recuperación. Objetivo. Evaluar las repercusiones en un sujeto sano y físicamente activo que pre-sentó complicaciones médicas graves y complicaciones posteriores al COVID-19. Reporte de caso. Hombre de 41 años de edad, físicamente activo y sin enfermeda-des conocidas, en quien se documenta infección por SARS-CoV2 con prueba PCR positiva. Requirió 22 días en UCI, 17 días en hospitalización general, 57 días de incapacidad y posterior a doce meses presenta pérdida evidente de peso y de memo-ria, dificultad para pensar y concentrarse, pérdida de masa muscular, compromiso de la función hepática, cansancio y fatiga, dolor muscular, problemas para dormir, cambios en el estado de ánimo y alteraciones del gusto. De acuerdo con los actuales hallazgos, la producción de un tipo de anticuerpo impide que el sistema inmune ten-ga una respuesta adecuada contra la enfermedad. Sumado a esto, se ha descrito una nueva puerta de entrada del virus en el organismo: la proteína neuropilina-1 (NRP1), además de la posible disminución del surfactante que permite la flexibilidad de los pulmones. Lo anterior podría dar respuestas a las complicaciones en personas sanas y físicamente activas posterior a la infección por COVID-19. Conclusiones. Entendiendo que el COVID-19 es una enfermedad reciente, aún hay mucha información por recolectar para así entender su comportamiento en el cuerpo humano. Sin embargo, las investigaciones van dando evidencia del porqué el COVID-19 puede generar graves complicaciones médicas en personas sanas y físicamente activas. Son necesarias más investigaciones con esta población, para así realizar planteamientos de manejo clínico acordes a la enfermedad y evitar desenlaces fatales.

Introduction. Not all people exposed to COVID-19 develop a severe respiratory disease and the number of young adults without previous pathologies, seriously af-fected by the virus, is increasing. Many of non-specific symptoms and complications have been evidenced after the recovery. Objective. To evaluate the repercussions in a healthy and physically active subject who presented serious medical complications and post-COVID-19 complications.Case report. A 41-year-old man, physically active and without known diseases, in whom SARS-CoV2 infection with a positive PCR test is documented. He required 22 days in the ICU, 17 days in general hospitalization, 57 days of disability and after twelve months there is evident weight and memory loss, difficulty thinking and con-centrating, loss of muscle mass, compromised liver function, tiredness and fatigue, muscle pain, sleep problems, changes in mood, and alterations in the taste. According to the current findings, the production of a type of antibody prevents the immune system from having an adequate response against the disease. In addition to this, a new gateway for the virus into the body has been described: the protein neuropilin- 1 (NRP1), as well as the possible decrease in surfactant that allows the flexibility of the lungs. This could provide answers to complications in healthy and physically active people after COVID-19 infection. Conclusions. Understanding that COVID-19 is a recent disease, there is still a lot of information to collect to understand its behavior in the human body. However, research is providing evidence on why COVID-19 can cause serious medical compli-cations in healthy and physically active people. Understanding that it is a multifac-torial situation, more research is necessary with this population in order to carry out clinical management approaches according to the disease and avoid fatal outcomes.

Strengthening Health Systems To Face Pandemics: Subnational Policy Responses To COVID-19 In Latin America.

Nonpharmaceutical interventions such as stay-at-home orders continue to be the main policy response to the COVID-19 pandemic in countries with limited or slow vaccine rollout. Often, nonpharmaceutical interventions are managed or implemented at the subnational level, yet little information exists on within-country variation in nonpharmaceutical intervention policies. We focused on Latin America, a COVID-19 epicenter, and collected and analyzed daily subnational data on public health measures in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, and Peru to compare within- and across-country nonpharmaceutical interventions. We showed high heterogeneity in the adoption of these interventions at the subnational level in Brazil and Mexico; consistent national guidelines with subnational heterogeneity in Argentina and Colombia; and homogeneous policies guided by centralized national policies in Bolivia, Chile, and Peru. Our results point to the role of subnational policies and governments in responding to health crises. We found that subnational responses cannot replace coordinated national policy. Our findings imply that governments should focus on evidence-based national policies while coordinating with subnational governments to tailor local responses to changing local conditions.

A partisan pandemic: state government public health policies to combat COVID-19 in Brazil.

INTRODUCTION: To present an analysis of the Brazilian health system and subnational (state) variation in response to the COVID-19 pandemic, based on 10 non-pharmaceutical interventions (NPIs). MATERIALS AND METHODS: We collected daily information on implementation of 10 NPI designed to inform the public of health risks and promote distancing and mask use at the national level for eight countries across the Americas. We then analyse the adoption of the 10 policies across Brazil's 27 states over time, individually and using a composite index. We draw on this index to assess the timeliness and rigour of NPI implementation across the country, from the date of the first case, 26 February 2020. We also compile Google data on population mobility by state to describe changes in mobility throughout the COVID-19 pandemic. RESULTS: Brazil's national NPI response was the least stringent among countries analysed. In the absence of a unified federal response to the pandemic, Brazilian state policy implementation was neither homogenous nor synchronised. The median NPI was no stay-at-home order, a recommendation to wear masks in public space but not a requirement, a full school closure and partial restrictions on businesses, public transportation, intrastate travel, interstate travel and international travel. These restrictions were implemented 45 days after the first case in each state, on average. Rondônia implemented the earliest and most rigorous policies, with school closures, business closures, information campaigns and restrictions on movement 24 days after the first case; Mato Grosso do Sul had the fewest, least stringent restrictions on movement, business operations and no mask recommendation. CONCLUSIONS: The study identifies wide variation in national-level NPI responses to the COVID-19 pandemic. Our focus on Brazil identifies subsequent variability in how and when states implemented NPI to contain COVID-19. States' NPIs and their scores on the composite policy index both align with the governors' political affiliations: opposition governors implemented earlier, more stringent sanitary measures than those supporting the Bolsonaro administration. A strong, unified national response to a pandemic is essential for keeping the population safe and disease-free, both at the outset of an outbreak and as communities begin to reopen. This national response should be aligned with state and municipal implementation of NPI, which we show is not the case in Brazil.

Not far enough: Public health policies to combat COVID-19 in Mexico's states.

BACKGROUND: Mexican state governments' actions are essential to control the COVID-19 pandemic within the country. However, the type, rigor and pace of implementation of public policies have varied considerably between states. Little is known about the subnational (state) variation policy response to the COVID-19 pandemic in Mexico. MATERIAL AND METHODS: We collected daily information on public policies designed to inform the public, as well as to promote distancing, and mask use. The policies analyzed were: School Closure, Workplace Closure, Cancellation of Public Events, Restrictions on Gatherings, Stay at Home Order, Public Transit Suspensions, Information Campaigns, Internal Travel Controls, International Travel Controls, Use of Face Masks We use these data to create a composite index to evaluate the adoption of these policies in the 32 states. We then assess the timeliness and rigor of the policies across the country, from the date of the first case, February 27, 2020. RESULTS: The national average in the index during the 143 days of the pandemic was 41.1 out of a possible 100 points on our index. Nuevo León achieved the highest performance (50.4); San Luis Potosí the lowest (34.1). The differential between the highest versus the lowest performance was 47.4%. CONCLUSIONS: The study identifies variability and heterogeneity in how and when Mexican states implemented policies to contain COVID-19. We demonstrate the absence of a uniform national response and widely varying stringency of state responses. We also show how these responses are not based on testing and do not reflect the local burden of disease. National health system stewardship and a coordinated, timely, rigorous response to the pandemic did not occur in Mexico but is desirable to contain COVID-19.