ABSTRACT
Despite advances in knowledge about COVID-19, little is known about the course of the disease and its long-term outcomes. Therefore, post-pandemic research has focused on the sequelae and complications caused by the Coronavirus. Thus, the objective was to investigate symptomatological remains and their duration of discharged patients hospitalized for COVID-19 from three regional hospitals in Ceará. This is a descriptive, analytical cross-sectional study with a quantitative approach carried out from August to October 2021 through telesurvey. The final sample consisted of 49 patients in the first wave of the pandemic and 153 in the second, totaling 202 participants. Data were tabulated in an Excel® spreadsheet and analyzed according to descriptive statistics. There is a prevalence of male patients, 31 (63.3%) in the first period investigated, and 86 (56.2%) in the second wave. In the investigation of physical symptoms, fatigue/tiredness stood out, identified in 23 (46.9%) and 69 (45.1%) individuals according to the wave, followed by a lack of appetite in 13 (26.5%) and (40.5%). Shortness of breath was highlighted in the second period among 39 (25.5%) individuals. Symptoms such as memory loss, cough, and chest pain appear to be the most lasting, and were prevalent for up to 4 months after hospital discharge. While in the 2nd wave chest pain was cited lasting up to 6 months. In this context, this study exposes the main symptoms reported, pointing to the imminent need for public strategies for monitoring and intervention services with these patients. © 2022 Centro Universitario Sao Camilo. All rights reserved.
ABSTRACT
Introduction: Diabetes mellitus is associated with poorer outcomes in patients with coronavirus disease (COVID-19). The mechanisms for this association are not fully elucidated. We aimed to evaluate the clinical characteristics and outcomes of hospitalized patients with type 2 diabetes (T2DM) and COVID-19, as well as the impact of blood glucose control on mortality. Material and Methods: In this retrospective study, we included 97 patients (38 with T2DM, 59 without diabetes). We compared demographic characteristics, comorbidities, admission findings and outcomes between patients with and without diabetes. To assess glycaemic control, individual derived time in range (70-180 mg/dL) was derived as the proportion of values within range. Derived time above range was calculated as the proportion of values above range. Results: The fatality rate of patients with diabetes was 36.8%. Among these patients, nonsurvivors presented with higher Pneumonia Severity Index score (159 +/- 36 vs 109 +/- 30, p=0.001), a higher N-terminal brain natriuretic peptide (5521 [4256-15280] vs 1541 [288-2349] pg/mL, p=0.047), a lower PaO2/FiO2 ratio (214 [181-259] vs 300 [248-347], p=0.033) and were more likely to have bilateral lung involvement at admission (78.6% vs 29.2%, p=0.013). Rates of acute kidney injury (85.7% vs 33.3%, p=0.003), acute heart failure (57.1% vs 25.0%, p=0.048) and secondary bacterial infection (64.3 vs 26.1%, p=0.022) were higher in deceased patients. Nonsurvivors had a lower derived time in range (38% vs 73%, p=0.020) and a higher derived time above range (62% vs 27%, p=0.020). Conclusion: A poorer glucose control assessed by lower derived time in range during hospitalization was associated with in-hospital death.
ABSTRACT
The paper aims to evidence the impact of passenger traffic in the airports of major Brazilian tourist destinations and its relation to the spread of COVID-19 pandemic. To achieve this, the study performed a qualitative analysis based on secondary data obtained from official websites of regulatory authorities and a quantitative analysis through the use of multiple regression, cluster and discriminant analysis in order to measure a cause-and- effect relation between the variables observed. The tourist destinations addressed are the capitals of Brazilian federal states, the national capital (Brasilia), and the cities of Cannpinas, Foz do Iguagu, and Balneario Cannboriu - the choice was made based on the cities with the highest number of airport passenger traffic. The results indicate a strong correlation between passenger traffic in Brazilian capitals and the spread of COVID-19 cases.
ABSTRACT
Background and aims: Although it primarily damages the respiratory system, COVID-19 can also develops with neurological conditions such as stroke. This study aims to describe a case report of a patient with ischemic stroke related to COVID-19. Methods: Male, 44 years old, with untreated diabetes, admitted to emergency with left hemiplegia and dysarthria. Patient had flu-like symptoms 11 days ago and was diagnosed with COVID-19. Auscultation revealed bilateral bases rhonchi. Normotensive, oxygen saturation: 94%, glycemia: 241mg/dl, increased lactate and CRP;hemogram, D-Dimer and coagulogram unchanged. Brain CT demonstrated no evidence of hemorrhagic injury. Chest CT revealed bilateral lung involvement with ground-glass opacities. The patient remained hospitalized for 21 days and was discharged still with motor deficits. Results: The literature suggests that the mechanisms of ischemic stroke associated with COVID-19 are multiple, highlighting the cytokine storm and coagulation dysfunction. Increased lactate and CRP suggest an acute inflammatory activity;however, the patient did not exhibit high levels of D-dimer, platelet or coagulogram changes. Strokes associated with COVID-19 occur mainly in elderly patients and critically sick. Patients with mild clinical presentation of the disease have an incidence of strokes less than 1%. Although the patient does not have the risk factors mentioned above, diabetes may represent a predisposing factor of the neurological complication. Conclusion: Patients with mild respiratory conditions may present severe neurological complications, possibly due to the association between previous comorbidity and coagulopathy from COVID-19. The strokes associated with COVID-19 may present greater mortality and disability when compared to cases unrelated to COVID-19.
ABSTRACT
The reduction in trade takes into account both the economic slowdown and the interruption of production chains caused by social isolation measures or labour restrictions as mitigating measures, something that in the first months of the year was concentrated on China and is now spreading globally (WTO, 2020a). With the rise in numbers of the dead and infected, the country attempted to redesign its supply chains in order to attend its 210 million inhabitants and also create strategies to subsidise the anticipation of a possible collapse in its National Health Service (Sistema Único de Saúde-SUS), by looking to foreign companies that could provide the inputs for tackling the Covid-19. Today companies in a wide variety of segments are hard hit with lost revenue, reduced demand, broken supply chains, harm to entire chains, as in the case of local and global tourism;increasing risk aversion in financial markets, which is now causing a drop in the level of corporate and consumer confidence (Açikgoz & Gunay, 2020;OECD, 2020;Ivanov, 2020) and one of the main trading upsets in recent decades (Araz et al., 2020). Amidst the slowdown of the Chinese economy with disruptions in production, the operation of global supply chains was affected, a result of their key role as producers of intermediary goods, particularly computer hardware, electronic, pharmaceutical drugs, transport equipment and as a main source of demand for many commodities (OECD, 2020).
ABSTRACT
Unprecedented challenges have been imposed on global markets to minimise losses in the short and long supply chains. The purpose of this paper is to identify the impacts created by the Covid-19 pandemic on the short and long supply chains in Brazil. This paper analyses the short and long supply chains in Brazil, whose overriding data were consulted on the websites of supervisory bodies and agencies at home and abroad. Adopting a qualitative approach, the consultation of literature about short and long supply chains was to determine the impacts of the pandemic on them in Brazil, as well as the resilience adopted by many in the course of the outbreak of the new coronavirus. This study examines the resilience of the Brazilian supply chains when pointing out the impacts on them during the Covid-19 pandemic and the alternatives to continue operating. It was also found that short supply chain resilience plays a key role in the Brazilian food supply. The study is restricted to the context of Brazil and its particularities. Also, further studies are required to explore the economic and operating impacts on different sectors of the economy in the post-pandemic period.