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Objetivos: Em todo o mundo em 2020, havia 37,7 milhoes de pessoas vivendo com o virus da imunodeficiencia humana (HIV). O tratamento clinico utiliza uma combinacao de medicamentos antirretrovirais, sendo que, o paciente apos alguns meses pode alcancar a supressao viral, ficando com niveis indetectaveis de carga viral. Adicionalmente, pacientes com niveis indetectaveis de carga viral ha varios meses, nao transmitem o virus por via sexual. Dessa forma, torna-se importante o controle da carga viral para evitar novas transmissoes. Recentemente, a relacao neutrofilo/linfocito (RNL) e plaquetas/linfocitos (PLR) vem sendo estudadas quanto ao seu papel prognostico em diferentes infeccoes como preditor de gravidade e desfecho da doenca. Nesse contexto, nosso objetivo e avaliar se a RNL e PLR conseguem predizer carga viral detectavel em pessoas vivendo com HIV. Material e metodos: Estudo transversal com 651 pessoas vivendo com HIV atendidas pelo Servico de Atendimento Especializado (SAE) de Divinopolis/MG no ano de 2019. Foram coletados os dados sociodemograficos, resultados do hemograma e carga viral mais recentes nos prontuarios medicos. Os pacientes foram divididos em dois grupos: grupo 1 (n = 522) carga viral indetectavel e grupo 2 (n = 129) carga viral detectavel. A caracterizacao da carga viral indetectavel foi considerada abaixo de 50 copias/ml. A analise estatistica foi realizada usando o SPSS (ver.19.0). As comparacoes entre dois grupos foram realizadas pelo teste de Mann-Whitney. Para avaliar o desempenho da RNL e PLR como ferramenta para preditora de carga viral detectavel, a area sob a curva ROC foi calculada. O nivel de significancia foi de p < 0,05. Resultados: Dentre os pacientes com carga viral indetectavel, 310 (59%) eram do sexo masculino e 212 (41%) do sexo feminino, enquanto no grupo com carga viral detectavel 67 (52%) do sexo masculino e 62 (48%) do sexo feminino. Ao avaliar a RNL do grupo 2, a mediana foi significativamente maior, 1,69 (1,09 - 2,57), quando comparada com o grupo 1: 1,54 (1,07 - 2,04) (p = 0,020). A PLR tambem foi significativamente maior no grupo 2: 125 (88 - 175), enquanto no grupo 1: 111 (85 - 142) (p = 0,015). A curva ROC foi realizada para avaliar a performance da RNL e PLR em discriminar os dois grupos de estudo. A area sob a curva foi estatisticamente significativa (AUC= 0,566, p = 0,020) para a RNL e PLR (AUC= 0,569, p = 0,015). Discussao: A RNL e PLR vem sendo muito estudadas, de modo que muitos estudos foram realizados para avaliar o valor preditivo em diferentes infeccoes sendo uma delas a COVID-19. Ademais, a RNL e PLR sao de facil aquisicao e reproducao, alem de apresentar baixo custo, quando comparadas com o exame de analise de carga viral. Nesse estudo, a RNL e PLR mostraram-se elevadas em pacientes vivendo com HIV com carga viral detectavel, quando comparadas com aqueles com carga viral indetectavel, sugerindo uma provavel aplicabilidade clinica na avaliacao da carga viral. Conclusao: A RNL e PLR foram mais elevadas nos pacientes com carga viral detectavel, assim inferimos, que a determinacao de RNL e PLR pode ser util para auxiliar na avaliacao de carga viral em pacientes vivendo com HIV. Contudo, e importante ressaltar que se trata de um estudo piloto, dessa forma, sao necessarios estudos prospectivos para avaliar a RNL e PLR no controle de carga viral. Financiamento: CAPES, CNPq e FAPEMIG. Copyright © 2022
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Background: Some factors associated with severe COVID-19 outcomes have been identifed in patients with psoriasis (PsO) and infammatory/autoimmune rheumatic diseases, namely older age, male sex, comorbidity burden, higher disease activity, and certain medications such as rituximab. However, information about specifcities of patients with PsO, psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), including disease modifying anti-rheumatic drugs (DMARDs) specifcally licensed for these conditions, such as IL-17 inhibitors (IL-17i), IL-23/IL-12 + 23 inhibitors (IL-23/IL-12 + 23i), and apremilast, is lacking. Objectives: To determine characteristics associated with severe COVID-19 outcomes in people with PsO, PsA and axSpA. Methods: This study was a pooled analysis of data from two physician-reported registries: the Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection (PsoProtect), comprising patients with PsO/PsA, and the COVID-19 Global Rheumatology Alliance (GRA) registry, comprising patients with PsA/axSpA. Data from the beginning of the pandemic up to 25 October, 2021 were included. An ordinal severity outcome was defned as: 1) not hospitalised, 2) hospitalised without death, and 3) death. A multivariable ordinal logistic regression model was constructed to assess the relationship between COVID-19 severity and demographic characteristics (age, sex, time period of infection), comorbidities (hypertension, other cardiovascular disease [CVD], chronic obstructive lung disease [COPD], asthma, other chronic lung disease, chronic kidney disease, cancer, smoking, obesity, diabetes mellitus [DM]), rheumatic/skin disease (PsO, PsA, axSpA), physician-reported disease activity, and medication exposure (methotrexate, lefunomide, sulfasalazine, TNFi, IL17i, IL-23/IL-12 + 23i, Janus kinase inhibitors (JAKi), apremilast, glucocorticoids [GC] and NSAIDs). Age-adjustment was performed employing four-knot restricted cubic splines. Country-adjustment was performed using random effects. Results: A total of 5008 individuals with PsO (n=921), PsA (n=2263) and axSpA (n=1824) were included. Mean age was 50 years (SD 13.5) and 51.8% were male. Hospitalisation (without death) was observed in 14.6% of cases and 1.8% died. In the multivariable model, the following variables were associated with severe COVID-19 outcomes: older age (Figure 1), male sex (OR 1.53, 95%CI 1.29-1.82), CVD (hypertension alone: 1.26, 1.02-1.56;other CVD alone: 1.89, 1.22-2.94;vs no hypertension and no other CVD), COPD or asthma (1.75, 1.32-2.32), other lung disease (2.56, 1.66-3.97), chronic kidney disease (2.32, 1.50-3.59), obesity and DM (obesity alone: 1.36, 1.07-1.71;DM alone: 1.85, 1.39-2.47;obesity and DM: 1.89, 1.34-2.67;vs no obesity and no DM), higher disease activity and GC intake (remission/low disease activity and GC intake: 1.96, 1.36-2.82;moderate/severe disease activity and no GC intake: 1.35, 1.05-1.72;moderate/severe disease activity and GC intake 2.30, 1.41-3.74;vs remission/low disease activity and no GC intake). Conversely, the following variables were associated with less severe COVID-19 outcomes: time period after 15 June 2020 (16 June 2020-31 December 2020: 0.42, 0.34-0.51;1 January 2021 onwards: 0.52, 0.41-0.67;vs time period until 15 June 2020), a diagnosis of PsO (without arthritis) (0.49, 0.37-0.65;vs PsA), and exposure to TNFi (0.58, 0.45-0.75;vs no DMARDs), IL17i (0.63, 0.45-0.88;vs no DMARDs), IL-23/IL-12 + 23i (0.68, 0.46-0.997;vs no DMARDs) and NSAIDs (0.77, 0.60-0.98;vs no NSAIDs). Conclusion: More severe COVID-19 outcomes in PsO, PsA and axSpA are largely driven by demographic factors (age, sex), comorbidities, and active disease. None of the DMARDs typically used in PsO, PsA and axSpA, were associated with severe COVID-19 outcomes, including IL-17i, IL-23/IL-12 + 23i, JAKi and apremilast.
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Funding Acknowledgements Type of funding sources: Other. Main funding source(s): This work was financially supported by the project POCI-01-0145-FEDER-030011, funded by FEDER, through COMPETE2020-POCI, and by national funds, through FCT/MCTES (PTDC/MEC-CAR/30011/2017). CIAFEL, UnIC and UMIB are supported by national funds through Fundação para a Ciência e Tecnologia, I.P. [(UIDB/00617/2020), (UIDB/00051/2020 and UIDP/00051/2020), and (UIDB/00215/2020 and UIDP/00215/2020), respectively]. CS received an individual grant from CAPES [BEX 0554/14-6]. Introduction Cardiac rehabilitation (CR) is an evidence-based recommended treatment of heart failure (HF) patients. During the COVID-19 pandemic, the shutdown of CR centers was necessary to limit the infection risk among high-risk patients. The integration of a home-based CR (HBCR) program in CR units can help to improve the delivery of care and improve cardiovascular outcomes of HF patients. Purpose To assess the effectiveness of an HBCR program in HF patients. Methods This is a substudy of the EXercise InTervention in Heart Failure trial (EXIT-HF), which include forty-nine HF patients (preserved and reduced ejection fraction). The HBCR program consisted in 12-week combined exercise program (60%-80% of peak oxygen consumption (VO2 peak)), 2 training sessions per week, for a total of 24 sessions. Patients performed 4 supervised training sessions and the remaining sessions at home. All patients performed a cardiopulmonary exercise test (VO2 peak), the 6-minute-walking test (6MWT), collected blood analysis (plasma NT-proBNP), and answered the Minnesota Living with Heart Failure Questionnaire. Results Forty-two patients (86%) complete at least 80% of prescribed training sessions (age: 61.1±12;FEVE: 37.1±10.8). The HBCR program improve VO2 peak from 18.3 to 20.1ml/kg/min (+1.8 ml/kg/min;95%IC:1.4 to 2.4;p<0.001) and the walked distance at the 6MWT from 462 to 512 meters (+49 meters;95%IC: 38 to 60;p<0.001). In addition, overall quality of life was improved (-13 points;95%IC:-7.8 to -18.5;p<0.001), as well physical (-6.3 points;95%IC:-3.5 to -9;p<0.001) and emotional dimension of quality of life (-2.8points ;95%IC: -0.9 to -4.7;p=0.06). No significant change was found in NT-proBNP levels (820±1220 vs 674±903;p=0.285). Conclusions Our results showed that HBCR is feasible and can improve functional capacity and quality of life in HF patients.
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BACKGROUND AND AIMS: Antineutrophil cytoplasmatic antibody (ANCA) associated vasculitis (AAV) is a small vessel vasculitis hallmarked by the presence of antibodies against antigens in cytoplasmic granules of neutrophils. Vaccines per se stimulate the immune system, including the innate and the adaptive immune response. Therefore, it is possible that an excess of autoimmunity is observed after vaccine administration. Vaccination (notably influenza) is a recognized trigger for the relapse of ANCA-associated vasculitis. ANCA associated vasculitis and autoimmune reactions have been reported with COVID-19 infection and following vaccination. We report the case of a Caucasian, 62-year-old-man, with a previous history of type 2 diabetes mellitus, hypertension and atrial fibrillation. Blood analysis 1 year before presentation showed preserved renal function and normal urinalysis. He received the first dose of Pfizer-BioNTech COVID-19 vaccine and 2 weeks later routine blood analysis showed acute kidney injury with serum Creatinine 1.75 mg/dL with De novo hematuria, a protein-to-creatinine ratio (RPC) 1.1 mg/g and candersartan (4 mg twice daily) was started. The patient received the second dose of COVID-19 vaccine 21 days after the first injection. Two weeks later, he developed anorexia, nausea and De novo hematuria. He was admitted at the emergency department with deteriorating renal function with a sCr of 5.5 mg/dL, worsening hematuria with dysmorphic red blood cells and proteinuria (RPC 2.9 mg/g). Renal ultrasound was normal. Immunological studies revealed an elevated ANCA-MPO titer of 561. A kidney biopsy was performed and showed a crescentic necrotizing glomerulonephritis. Immunofluorescence confirmed pauci-immune glomerulonephritis. He was diagnosed with renal limited myeloperoxidase (MPO) ANCA AAV. He started three pulses of 500 mg I.V methylprednisolone followed by prednisolone 1 mg/kg/day after that. He also started rituximab (four doses of 500 mg I.V. once a week apart). Despite the immunosuppression, the patient never recovered renal function and remained dialysis dependent. CONCLUSION: Whether autoimmune diseases can be triggered after vaccination remains a matter of discussion among experts. ANCA-associated vasculitis and autoimmune reactions have been reported with COVID-19 infection and following vaccination, which prompts the question whether this response could be a direct reaction to the RNA present in the vaccine. While an association with De novo ANCA vasculitis and COVID-19 vaccine may be possible, further investigation is necessary.
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Introduction: The current COVID-19 pandemic has led to significant changes in physical and mental health and has become a major challenge for cardiac rehabilitation (CR) programs. CR is an essential component in the treatment of heart failure (HF), as it improves cardiorespiratory fitness and quality of life, as well as reducing hospitalization rates. COVID-19 pandemic increased social isolation, and the CR centers were closed. Center-based CR requires the patient to travel to the hospital, which increases the risk of SARS-CoV-2 infection in this high-risk population. In this context, home-based CR can be an excellent strategy to reduce the physical and mental consequences of the social isolation imposed by the COVID-19 pandemic. Objective: To test the effectiveness of a home-based CR program on cardiorespiratory fitness and anxiety and depression levels in individuals with HF during covid-19 pandemic. Methods: Forty-two individuals with HF (age: 61.3±12.0;LVEF: 37.5±11.2) were included in this study. The exercise training program consisted in 12 weeks of combined exercise training (2x/week;60min/day, 60-80% VO2peak), with 4 supervised exercise sessions in the hospital context and the remaining at home. Patients were monitored using a heart rate monitor and weekly phone calls. The following parameters were evaluated: cardiorespiratory fitness through the 6-minute walk test (6MWT) and anxiety and depression levels through the Hospital Anxiety and Depression Scale (HADS). Results: After the home-based CR program, there was a significant increase in the 6MWT of 49 meters (95%IC: 38 to 60;p<0.001) and a significant decrease in anxiety levels of -1.12 points (95%CI: - 2.163 to -0.075 p=0.036). No significant changes were found in depression levels (p=0.954). Furthermore, the improvements in cardiorespiratory fitness were significantly associated with the reduction in the levels of anxiety (r= -0.281;p=0.028) and depression (r=: -0.278;p=0.030). Conclusions: The home-based CR program was able to improve cardiorespiratory fitness and this improvement was associated with a decrease in anxiety and depression levels in individuals with HF. The results suggest that home-based CR can be an important strategy to minimize the physical and mental impact induced by social isolation imposed by COVID-19 pandemic in HF patients.
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Since the first description of the new Coronavirus disease 19 (COVID 19), the number of associated manifestations described in literature have increase exponentially. The spread of virus to extrapulmonary tissues, especially to central and peripheral nervous system, concerns the physicians and suspicious of disease even in the absence of respiratory symptoms had a major impact preventing it's spread. The authors report two cases of Bell's palsy in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), describing the clinical manifestations, evolution and treatments. Both patients had a mild course of COVID 19, without respiratory symptoms reported and complete resolution of facial palsy. The authors postulate an association between isolated facial palsy and SARS-CoV-2 infection reviewing the reported cases in literature and the mechanism of neuroinvasion. The authors highlights the importance of suspecting SARS-CoV-2 infection when a patient presents with isolated facial palsy.
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The challenges imposed on Physical Education teachers, in 2020, with the Covid-19 pandemic that forced the whole country to live a social distance, without in-person classes, are the problem of this article. The aim of this article is to identify how Physical Education teachers working in the west-central-west of Sao Paulo responded to the demands of remote activities during the period of the Covid-19 pandemic, analyzing the strategies used and the perceptions of these professionals facing this new context. For data collection, a semi-structured questionnaire with open and closed questions was prepared, sent to the teachers and analyzed. To contextualize the discussion, we approached: Distance Education, Remote Education and Hybrid Teaching. Some initial hypotheses were confirmed, for example, that this phenomenon caused anguish and apprehension in teachers. A surprise was that many teachers have hope and positivity in face of reality.
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Background: The COVID-19 pandemic has changed the paradigm when it comes to infection control. However, there are still many doubts about pregnancy and the perinatal period in this context, even though many studies suggest the benignity of infection in this phase. The present study took place in a Level II Hospital with differentiated perinatal care and describes the newborns whose mothers were infected with COVID-19 during pregnancy. We aim to understand the mother-newborn pattern of transmission and clinical, analytical and serologic follow-up. Methods: Prospective observational study from 1/4/2020 to 31/5/2021, using the clinical files of every SARS-COV-2 PCR-positive mother and their newborns. Among others, we evaluated the state of infection of the newborn at 12 and 48h and after 14 days with SARS-Cov-2 PCR tests. In the first three months, serologic and clinical evaluation were performed. Results: Of the 1684 live births, 60 (3,6%) mothers were infected with SARS-COV-2 during pregnancy, 43% of which were diagnosed in the screening performed during/before labour. The median value of gestational age was 39 weeks, and the average weight was 3171g. 81,7% of the newborns remained with their mother in the hospital ward, and 85% were breastfed. 7 newborns (11,7%) needed NICU, one of which was born at 32 weeks because the mother needed ICU support due to COVID-19. Of the 26 newborns whose mothers were positive in labour, 15 were tested for SARS-Cov-2 PCR in the first 12 h, and 21 within 48h: all of them were negative.16 were tested after 14 days. Only one of them (6,2%) tested positive but remained asymptomatic. Serologic anti-spike and anti-nucleocapsid analyses were performed in 32 babies: 10 of them (31.3%) showed positive antibodies. In these cases, 80% of the mothers were positive in the 3rd trimester and 20% in the 2nd trimester. The clinical follow-up showed a positive outcome in all of them. Conclusions: This study supports others that show the benignity of perinatal SARS-COV-2 infection. There were no more significant rates of prematurity or NICU need. None of the newborns tested positive in SARS-Cov-2 PCR tests in the first 48h, supporting the rarity of the vertical infection, and only one has been affected by horizontal transmission.
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In the context of the COVID-19 pandemic, mobile applications have been widely used and promoted to help prevent the spread of the pandemic. Many countries have proposed these applications with the aim of improving contact tracing and thus helping "flatten the curve"of infection case numbers. However, even though there were many campaigns to promote the use of these apps, their adoption was relatively low, which significantly affected their success. The success of COVID-19 contact tracing apps, in terms of its massive use and effectiveness, seems to have been deeply affected by issues associated with privacy and anonymity and the perception that its potential users have about the cost/benefit. In this paper, we analyze some applications for monitoring and contact tracing of infectious diseases to identify the most common approaches and features. We then proceed to discuss the challenges and risks that may influence the success of this type of applications, and we present some recommendations that can contribute to improve their acceptance. Considering the proposed recommendations, we describe the main features and the development of an app that includes additional functionalities alongside the contact tracing feature, in order to increase user perceived value from the use of the application. © 2021 AISTI.
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Objectives: To determine the main risk factors associated with COVID-19 in SLE patients. Methods: The Reuma CoV Brazil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. SLE adult patients according to SLE SLICC criteria classification (2012), with and without (control group-CG) COVID-19 diagnosis were matched. Demographic data, managing of COVID-19, comorbidities, clinical characteristics (disease activity: Patient Report Outcomes-PROs, Physician Global Assessment and SLEDAI-2 K)were collected. Results: From May 2020 to January 2021, 604 SLE patients were included, 317 (52.4%) with COVID-19 and 287 (47.6%) in the CG. Both groups were homogeneous and comparable regarding sex and comorbidities. SLE patients with COVID-19 declared a lower level of social isolation (49.5% vs. 61.9%;p = 0.002), worked more commonly in health professions (10.4% vs. 3.5%;p = 0.002), presented more frequently joint (32.5% vs. 22.0%;p = 0.004) and hematological manifestations (18.0% vs. 11.5%;p = 0.025). SLEDAI-2 K did not differ among groups prior and after COVID-19 infection. However, considering the mean duration of COVID-19 symptoms (12.1 ± 8.8 days), infected patients had more severe disease activity's PROs after resolution of COVID-19 symptoms (2.9 ± 2.9 vs. 2.3 ± 2.6;p = 0.031). The hospitalization rate was 20.5% (n = 65), of whom 23 (7.2%) needed intensive care unit and 14 (4.4%) patients died. Hypertension [5,26 (1,9714,07);p = 0.001] and recently cyclophosphamide pulses [39,21 (4,17-368,53);p = 0.001] were associated with hospitalization and patients who received telemedicine medical care presented 72% less chance of hospitalization [0.28 (0.09-0.83);p = 0.023). Conclusion: COVID-19 was associated with a lower level of declared social isolation and more severe disease activity perception after SARS-CoV-2 infection according to PROs. Hypertension and cyclophosphamide were associated with hospitalization and telemedicine can be a useful tool for SLE patients with COVID-19. These data should be considered to perform public health policy and national guidelines to manage SLE patients during the pandemic, as well as to prioritize some special groups for the immunization program.
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Local media are decisive for communities in the context of a global culture. In Portugal, communicating for a more geographically restricted area deals with permanent hazards, especially in the journalistic scope, from both structural and organizational points of view. Arguably weakened and lacking from institutional support, Portuguese local media, ranging from printed media, radio, and television to online broadcasts, still thrive on uncertainty. Also, from an academic point view, little is known about the audiences’ perceptions towards these local media. In doing so, this article presents the data collected from an online survey of 139 consumers of local media, thus concluding: traditional media (printed and FM) are still the most consumed formats, compared to the online scope;the COVID-19 pandemic was not decisive to increase local media consumption habits;seeking for information is the fundamental reason to follow local media;participants understand that websites and Facebook, mainly, are the most dynamic digital spaces that local media foster, thus giving them a very good evaluation;half of the sample have already interacted with broadcasters, especially to suggest ideas for journalistic approaches;in a global perspective, participants are pleased with the news coverage of local media towards local matters. Future research should implement complementary scientific approaches, based on in-depth perspectives to fully understand motivations to engage with local media and other social representations towards these mass media. © 2021, Bastas Publishing. All rights reserved.
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Na manhã de 10 de janeiro de 2020, no anfiteatro da Université de Toulouse (Jean Jaurès), com olhos e ouvidos bem abertos, estudantes da França, do Brasil e de outras nacionalidades assistiam à conferência do filósofo Vladimir Safatle, professor da Universidade de São Paulo. No púlpito, ele comentava o significado da estruturação psíquica paranoica, tal como descrita por Freud, e como ela ganharia status de normalidade em determinados contextos sociais e políticos que hoje não nos são nada estranhos. Nem sequer desconfiávamos, no âmbito daquele conjunto de Conferências sobre as alianças entre neoliberalismo e autoritarismo na política contemporânea, da iminente crise sanitária, econômica e humanitária que estava por vir com o Covid-19. © 2020, Revista de Filosofia: Aurora. All Rights Reserved.
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This study aims to highlight the efforts made by the Brazilian Courts of Accounts (CAs) during the COVID-19 pandemic to collaborate with its jurisdictional authorities, civil servants, and society to face its effects. Descriptive and qualitative research was carried out, analyzing the legislation issued by the CAs to evaluate their actions. Among the findings, it was observed that the CM took administrative and pedagogical measures to protect the public, such as the suspension or restriction of face-to-face service. Also, the courts suspended collective events, face-to-face meetings, and travel, adopted telework, limited expenditures and distance learning courses. Among the procedural measures, Plenary Sessions or Chambers, procedural deadlines, and remittance of accounts were suspended. Finally, the activities of guidance and monitoring were conducted under a series of guidelines and recommendations created collaboratively with other agencies and branches of government, guiding public spending, the acquisition and contracting of services with no bidding requirements, among other procedures. It is concluded that the set of measures implemented by the CAs shows a change in the traditional status of subsequent control of public accounts - which gives rise to punitive action - for prior and concurrent control, with recommendations, inspections, and monitoring, when the manager still has instruments to amend errors and avoid waste and misapplication of public resources.
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Rationale: COVID-19 is a rapidly evolving pandemic with many critically ill patients and no proven treatments except supportive care. Further, cytokine storm and hyperinflammatory state appears to be an emerging component of severe COVID-19 illness. There are few data about nutritional therapy interventions for COVID-19 critically ill patients. Methods: This study included a retrospective, single-center case series of 51 consecutively critically ill patients who received enteral feeding with confirmed COVID-19 at Hospital Israelita Albert Einstein in São Paulo, Brazil. We collected and analyzed demographic, nutritional parameters, and nutritional therapy data. We expressed the measurement data as mean ± standard deviation. Results: Of the 51 critically ill patients with COVID-19, the mean age was 66 years old (SD ± 14) and 37 (73%) were men;34 (66 %) are overweight or obese. It was observed a mean of 1.2g/Kg (SD ± 0.3) actual body weight protein delivered and mean of 21.3 Kcal/Kg (SD ± 4.2) actual body weight calories delivered. Despite a good tolerance to enteral nutritional therapy, 22% had diarrhea and 20% vomiting. The length of stay in the ICU was 18 (SD ± 11) days on average and 14 (27%) died. Conclusion: Nutritional therapy in covid-19 patients is still a new topic. Apparently, patients have good tolerance to enteral nutrition and it is possible to achieve nutritional goals. Disclosure of Interest: None declared
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Rationale: Overfeeding in critically ill patients is associated with many complications. Propofol provide non-nutritional calories, potentially causing overfeeding. Patients with COVID-19 in the ICU need a large amount of sedation and Propofol is one of the most widely used drug. Methods: We retrospectively studied 51 adult mechanically ventilated intensive care unit (ICU) patients with COVID-19 receiving enteral nutrition. We collected and analyzed demographic, nutritional parameters, and dosage of Propofol used. Descriptive data were reported as means and s.d. or median and interquartile range (IQR) in case of skewed distributions, frequencies and percentages or ranges (minimum–maximum). Results: Of the 51 critically ill patients with COVID-19, 76% of patients received propofol during hospitalization. The mean age was 66 years old (SD ± 14) and 37 (73%) were men;34 (66 %) are overweight or obese. An adequacy of 88% and 86% of protein and energy goals, respectively, were achieved. Among patients with propofol (N = 39) administration, median intake from propofol was 260 (IQR 20-594) kcal. The proportion of calories from propofol was 15% (SD± 8) and mean duration of use was 8 days (SD± 5.5). The length of stay in the ICU was 18 (SD ± 11) days on average and 14 (27%) died. Conclusion: The mean proportion of non-nutritional calories in patients who receive propofol is low. However, it can reach more than 500 kcal/ day in some patients. Patients must have close monitoring in order to prevent overfeeding. Disclosure of Interest: None declared