Impact of atrial fibrillation and anticoagulation on the risk of death, thromboembolic disease and bleeding in patients with COVID-19: the ACO-VID Registry.

OBJECTIVE: To describe the clinical profile, risk of complications and impact of anticoagulation in COVID-19 hospitalized patients, according to the presence of atrial fibrillation (AF). METHODS: Multicenter, retrospective, and observational study that consecutively included patients >55 years admitted with COVID-19 from March to October 2020. In AF patients, anticoagulation was chosen based on clinicians' judgment. Patients were followed-up for 90 days. RESULTS: A total of 646 patients were included, of whom 75.2% had AF. Overall, mean age was 75 ± 9.1 years and 62.4% were male. Patients with AF were older and had more comorbidities. The most common anticoagulants used during hospitalization in patients with AF were edoxaban (47.9%), low molecular weight heparin (27.0%), and dabigatran (11.7%) and among patients without AF, these numbers were 0%, 93.8% and 0%. Overall, during the study period (68 ± 3 days), 15.2% of patients died, 8.2% of patients presented a major bleeding and 0.9% had a stroke/systemic embolism. During hospitalization, patients with AF had a higher risk of major bleeding (11.3% vs 0.7%; p < .01), COVID-19-related deaths (18.0% vs 4.5%; p = .02), and all-cause deaths (20.6% vs 5.6%; p = .02). Age (HR 1.5; 95% CI 1.0-2.3) and elevated transaminases (HR 3.5; 95% CI 2.0-6.1) were independently associated with all-cause mortality. AF was independently associated with major bleeding (HR 2.2; 95% CI 1.1-5.3). CONCLUSIONS: Among patients hospitalized with COVID-19, patients with AF were older, had more comorbidities and had a higher risk of major bleeding. Age and elevated transaminases during hospitalization, but not AF nor anticoagulant treatment increased the risk of all-cause death.

[Inflammation of BCG Inoculation Site Scar after the First Dose of an Anti-SARS-CoV-2 mRNA Vaccine]. / Inflamação na Cicatriz BCG após Primeira Dose de Vacina mRNA Anti-SARS-CoV-2.

Inflammatory reactions in the Bacillus Calmette-Guérin (BCG) inoculation scar site have been previously described, in association with viral infections. The inflammation of the scar in association with other vaccines has been described with the flu vaccine and, more recently, after the second dose of mRNA anti-SARS-CoV-2 vaccines (mRNA-1273 e BNT162b2), in two healthcare workers. We present the case of a 27-year-old female, without a relevant past medical history, including no previous SARS-CoV-2 infection, and with inflammation of the BCG scar eight days after the first dose of the mRNA anti-SARS-CoV-2 vaccine. Pharmacovigilance and the notification of adverse events should be encouraged, as a way of warding off hesitation in this process.

Reações inflamatórias no local da cicatriz da vacina Bacillus Calmette-Guérin (BCG) foram previamente descritas em relação a infeções virais. A inflamação da cicatriz da BCG em relação à administração de vacinas foi reportada com a vacina da gripe, e, mais recentemente, após a segunda dose das vacinas mRNA anti-SARS-CoV-2 disponíveis (mRNA-1273 e BNT162b2), em dois profissionais de saúde. Aqui apresentamos o caso de uma jovem de 27 anos, sem história pregressa relevante, incluindo infeção por SARS-CoV-2, com inflamação da cicatriz da BCG oito dias após a primeira administração de vacina mRNA anti-SARS-CoV-2. A farmacovigilância e a notificação de reações adversas devem ser incentivadas, de forma a não criar hesitação nesse processo.

Authenticity in industrial heritage tourism sites: Local community perspectives

Our research addresses the perceived authenticity by the local community, as a means of enhancing Industrial Heritage Tourism. It aims to explore the influence of perceived authenticity in the future intentions of the local community, concerning a heritage tourism destination. Data was collected from Sao Joao da Madeira residents, Portugal, and the sample consisted of 389 respondents. The statistical technique applied was the structural equation model (SEM). Our findings suggest that perceived heritage plays a significant role in residents' attitudes towards tourism development support, their own participation ideals, and their attachment to the place. These findings will contribute to both practical and theoretical research, as they aim to enhance current knowledge on residents' perceived authenticity, being an understudied approach;furthermore, it offers a valuable opportunity to consider residents in the management and planning of an industrial tourism destination. This study analyses the outcomes of the obtained results. Additionally, it presents the main limitations, suggests future lines of research, and provides practical and theoretical data for both public and private entities, aiming at future improvements in the development of industrial heritage tourism.

DCcov: Repositioning of drugs and drug combinations for SARS-CoV-2 infected lung through constraint-based modeling.

The 2019 coronavirus disease (COVID-19) became a worldwide pandemic with currently no approved effective antiviral drug. Flux balance analysis (FBA) is an efficient method to analyze metabolic networks. Here, FBA was applied on human lung cells infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to reposition metabolic drugs and drug combinations against the virus replication within the host tissue. Making use of expression datasets of infected lung tissue, genome-scale COVID-19-specific metabolic models were reconstructed. Then, host-specific essential genes and gene pairs were determined through in silico knockouts that permit reducing the viral biomass production without affecting the host biomass. Key pathways that are associated with COVID-19 severity in lung tissue are related to oxidative stress, ferroptosis, and pyrimidine metabolism. By in silico screening of Food and Drug Administration (FDA)-approved drugs on the putative disease-specific essential genes and gene pairs, 85 drugs and 52 drug combinations were predicted as promising candidates for COVID-19 (https://github.com/sysbiolux/DCcov).