ABSTRACT
Long COVID-19 is defined as persistency of symptoms, such as exertional dyspnea, twelve weeks after recovery from SARS-CoV-2 infection;its pathophysiology still needs to be fully understood. We investigated exercise tolerance and ventilatory efficiency using cardiopulmonary exercise testing (CPET) in patients with long COVID-19. Methods. One hundred patients admitted to our hospital from March to August 2020 for a moderate to critical COVID-19 were enrolled in our long COVID-19 program. Medical history, physical examination and chest HRCT were obtained at hospitalization (T0), at 3 (T3) and 15 months (T15). All HRCTs were revised using a semiquantitative CT severity score (Pan, F. et al. Radiology 2020;295(3):715-721). Pulmonary function tests (PFTs) were obtained at T and T . CPET was performed at T15 in twenty patients (10 male/10 female;mean age 62 years) with residual respiratory symptoms (e.g., exertional dyspnea) and/or an impairment in PFTs, DLCO and/or KCO . Results. At CPET, peak oxygen uptake (VO2 -peak) and ventilatory efficiency (VE /VCO2 slope) were 95.9+/-18.4 SD %pred and 31.4+/-3.9 SD, respectively. Of notice, significant correlations between VE/V'CO2 slope and CT score (T0 ) (r=0.403;p=0.039), CT score (T3) (r=0.453;p=0.022) and DLCO (T3 ) (r=-0.465;p=0.019) were observed. Conclusions. At fifteen-months from COVID-19 pneumonia, a significant number of subjects (20%) still complains of exertional dyspnea. At CPET this may be explained by reduced ventilatory efficiency (i.e., increase in VE/VCO2), possibly related to the degree of lung parenchymal involvement in the COVID-19 acute phase, likely reflecting a damage in the interstitial/pulmonary capillary structure.
ABSTRACT
This article aims to study the possibility of the Brazilian Government having incurred a crime of responsibility, by imposing the treatment by hydroxochloroquine. The new protocol implemented by the Ministry of Health expanded the recommendations with the drug to initial and prophylactic phases of the disease. The considerations on the possible of crime will be made based on public differences between the Brazilian entities, especially the ANVISA. In this attempt, it was decided to analyze details of Brazilian legislation and scientific studies, in order to identify the legal violation possible. For this, a method of comparative, historical and scientific approach was used, seeking to identify possible of irregularities in the performance of the Government through the Ministry of Health in Brazil.