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Objective: to investigate factors associated with the SARS-CoV-2 infection among health professionals from university hospitals. Method: a multicenter, mixed approach study with concomitant incorporated strategy, carried out with 559 professionals in the quantitative stage, and 599 in the qualitative stage. Four data collection instruments were used, applied by means of an electronic form. The quantitative analysis was performed with descriptive and inferential statistics and the qualitative data were processed by means of content analysis. Results: the factors associated with the infection were as follows: performance of the RT-PCR test (p<0.001) and units offering care to COVID-19 patients (p=0.028). Having symptoms increased 5.63 times the prevalence of infection and adhering to social distancing most of the time in private life reduced it by 53.9%. The qualitative data evidenced difficulties faced by the professionals: scarcity and low quality of Personal Protective Equipment, work overload, physical distancing at work, inadequate processes and routines and lack of a mass screening and testing policy. Conclusion: the factors associated with the SARS-CoV-2 infection among health professionals were mostly related to occupational issues.
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Objetivo: investigar fatores associados a infeccao por SARS-CoV-2 entre profissionais da saude de hospitais universitarios. Metodo: estudo multicentrico, de abordagem mista com estrategia incorporada concomitante, realizado com 559 profissionais na etapa quantitativa, e 599 na etapa qualitativa. Foram utilizados quatro instrumentos de coleta de dados, aplicados via formulario eletronico. A analise quantitativa foi realizada com estatistica descritiva e inferencial e os dados qualitativos por meio de analise de conteudo. Resultados: os fatores associados a infecao foram: realizacao de teste "RT-PCR" (p<0,001) e unidades com atendimento a pacientes com COVID-19 (p=0,028). Ter sintomas aumentou em 5,63 vezes a prevalencia de infecao e aderir ao distanciamento social na maior parte do tempo na vida particular reduziu em 53,9%. Dados qualitativos evidenciaram dificuldades enfrentadas pelos profissionais: escassez e baixa qualidade de equipamentos de protecao individual, sobrecarga de trabalho, distanciamento fisico no trabalho, processos e rotinas inadequadas e ausencia de uma politica de triagem e testagem em massa. Conclusao: os fatores associados a infeccao por SARS-CoV-2 entre profissionais da saude foram em sua maioria relacionados a questoes ocupacionais.
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Infection by beta-coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coron-avirus-2) alters the homeostasis of the vascular endothelium, promoting an inflammatory state which causes damage and favors the prothrombotic state. The direct viral cytotoxicity induced by the SARS-CoV-2 leads to endothelial cell death;thus, altering the vessel functions. Moreover, SARS-CoV infection induces endothelial dysfunction (ED) and reduces the levels of nitric oxide (NO);thus, aggravating the vascular injuries, which promotes thrombotic events due to an altera-tion in the homeostasis. NO is a pleiotropic molecule that induces vasodilation, regulates the immune response, inhibits platelet aggregation, and decreases the cellular adhesion to vascular en-dothelium. Moreover, NO acts directly against invasive agents, exhibiting antibacterial, antiviral, and antifungal activity. High levels of NO result in an increase in the ED, causing an inflammatory amplification that aggravates the disease through undesirable positive feedback. The objective of this review was to present and discuss the involvement of NO on ED in SARS-CoV-2 infections. This review may also highlight new perspectives for therapeutic interventions through the supple-mentation of exogenous NO. The maintenance of homeostatic NO levels could represent a useful approach in the prevention of coronavirus-induced ED.Copyright © 2021 Bentham Science Publishers.
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The current COVID-19 pandemic presents one of the greatest challenges in human history. There is a consensus that the rapid and accurate diagnosis of COVID-19 directly affects procedures to avoid dissemination, promote treatments, and favor the prognosis of infected patients. This interdisciplinary study aims at designing new synthetic peptides inspired by the SARS-CoV-2 spike protein (SARS-CoV-2S) to produce rapid detection tests relying on nanomaterial-based colorimetric properties. Hence, in silico analyses of SARS-CoV-2S were performed using advanced bioinformatic simulation tools and algorithms. Five novel peptide sequences were proposed, and three were selected (P2, J4, and J5) based on their prospective reactivity against positive serum from naturally COVID-19-infected humans. Next, hyperimmune sera against the selected peptides were produced in rabbits. Concurrently, gold nanoparticles (AuNP) were synthesized using a green aqueous method under mild conditions through in situ reduction by trisodium citrate salt. They were extensively characterized by their morphological, physicochemical, and optical properties. The AuNPs demonstrated colloidal chemical stability in aqueous media, with an average size of approximately 29 nm (metallic core), and zeta potential before and after bioconjugation of −43 mV and −31 mV, respectively. Moreover, they presented an intense reddish-bluish color due to the surface plasmon resonance (SPR) effect, with maxima at λ = 525 nm and 536 nm, before and after bioconjugation, respectively, evidencing their applicability as colorimetric biomarkers for antigen–antibody immunoassay detection. To develop a rapid COVID-19 diagnosis test using lateral flow assay (LFA), semi-purified anti-SARS-CoV-2S sera against the three selected peptides were bioconjugated to the AuNPs as the highly optically sensitive agents using a considerably low antibody concentration (0.2 mg mL−1). All tested peptide sequences (P2, J4, and J5) induced antibodies capable of identifying the presence of SARS-CoV-2 virus inactivate suspensions (1 : 10, 1 : 100, or 1 : 1000 dilutions). For LFA positive test control, an anti-rabbit antibody was used. In summary, this research comprises several contributions and advances to the broad and multidisciplinary field of nanomaterials-based immunodiagnosis tools, encompassing: (a) the novelty of designing and synthesizing new immunogenic peptides inspired by SARS-CoV-2 virus epitopes using in silico bioinformatics;(b) the peptides induced the immune response in rabbit animal model producing hyperimmune serum;(c) the semi-purified hyperimmune serum rendered effective antibodies to detect SARS-CoV-2 virus in cell suspension;(d) colloidal gold nanoparticles were produced and bioconjugated to the antibodies for qualitative colorimetric detection. As the overall result of this study, it was designed, developed, produced, and validated a new simple, rapid, and sensitive LFA diagnostic test for the SARS-CoV-2 virus using a nanotechnology-based qualitative colorimetric assay, which can be envisioned as promising nanoplatforms for detecting other diseases. The current COVID-19 pandemic presents one of the greatest challenges in human history.
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mRNA has been touted as a therapeutic modality since 1990 and has demonstrated potential applications in oncology, protein replacement therapies, and infectious diseases. Since the first demonstration of direct injection of mRNA into muscle showing expression of the encoded protein, tremendous progress has been made to improve mRNA functionality, stability, and safety. Progress has also been made with the development of specialized drug delivery systems that enable delivery of mRNA to virtually any organ, tissue, and cells in the body. The rapid development and deployment of mRNA vaccines to address the COVID-19 global pandemic is a true testimony of the significant developments of mRNA technology in the past 30 years. In this book chapter, we will review design strategies used to improve mRNA functionality, stability, and safety and delivery strategies that have been used to deploy mRNA vaccines and provide an overview of manufacturing technologies and regulatory challenges. We will present our own perspective in these areas, gained through building an end-to-end mRNA discovery and development platform to evaluate therapeutic mRNA as a rapid response to pandemic threats and pandemic prevention. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Presently, several million people suffer from major depressive and bipolar disorders. Thus, the modelling, characterization, classification, diagnosis, and analysis of such mental disorders bears great significance in medical research. Electroencephalogram records provide important information to improve clinical diagnosis and are very useful in the scientific community. In this work, electroencephalogram records and patient data from the Hospital Virgen de la Luz in Cuenca (Spain) were processed for a correct classification of bipolar disorders. This work implemented an innovative radial basis function-based neural network employing a fuzzy means algorithm. The results show that the proposed method is an effective approach for discrimination of two kinds of classes, i.e., bipolar disorder patients and healthy persons. The proposed algorithm achieved the best performance compared with other machine learning techniques such as Bayesian linear discriminant analysis, Gaussian naive Bayes, decision trees, K-nearest neighbour, or support vector machine, showing a very high accuracy close to 97%. Therefore, the neural network technique presented could be used as a new tool for the diagnosis of bipolar disorder, considering the possibility of integrating this method into medical software.
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Introduction: The severe acute respiratory syndrome SARS-CoV-2 was identified in December 2019 in the city ofWuhan and soon became pandemic and already had cases worldwide. This worldwide dispersion has been widely studied and can be explained in several ways, including in an interdisciplinary way with high school content. Method: This study aimed to characterize the dispersion of COVID-19 in 102 municipalities in the state of Alagoas with a content learning perspective, through an interdisciplinary analysis using concepts of Biology and Physics, to understand from the first case record in each municipality, how the virus moved in the state and the speed at which the dispersion occurred. The work was carried out with the students of the 3rd grade of High School of the Basic Education School Virgem dos Pobres, Arapiraca - AL, to acquire competence for education as a whole, prioritizing the student as an agent of his knowledge. Results: The speed of the virus dispersion showed an oscillation, practically constant, presenting increasing and decreasing movements, configuring accelerated and decelerate movements, respectively, with values in an interval of 0.02 to 0.27 km/h and with an average of 0.09 km/h. Conclusions: It was possible, illustratively and in practice, to understand how school knowledge can be applied to everyday natural phenomena, in addition to offering a better understanding of the dispersion of the new Coronavirus.
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To reduce transmission of the coronavirus, the Brazilian government adopted containment measures to control the virus' spread, including limitations to the practice of physical activity. It was aimed to analyze the effects of COVID-19 quarantine on physical activity levels, energy expenditure, quality of life, and level of stress in a sample of the Brazilian population. The sample included 426 participants (7 to 80 years). The International Physical Activity Questionnaire, Short form survey-36 (SF-36), and Stress Perception Scale, were used to assess the level of physical activity, quality of life and stress, respectively. The anthropometric data was used to the assessment of body mass index and basal metabolic rate. Body weight increased significantly in all sample (p < 0.05). During the pandemic, 84% of the sample indicated a low level of physical activity. Furthermore, weekly energy expenditure decreased significantly in all age groups during the pandemic (children p < 0.0001;adolescents: p < 0.0001;adults p < 0.001, and elderly p < 0.0001). All aspects of quality of life, significantly reduced in both sexes in all age groups (p < 0.05). With the exception of children, stress levels increased significantly during the pandemic (adolescents: male: p=0.003, female: p < 0.05;adults: male: p=0.003, female: p=0.01, and elderly: male: p=0.02, female: p=0.03). Findings from the present study suggests that COVID-19 social isolation has negatively affected Brazilian' physical activity and quality of life.
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Myasthenia gravis (MG) is an autoimmune disease involving neuromuscular transmission and possible respiratory failure when concomitant with COVID-19. The aim of this study was to analyze the need for ventilatory support (VS), length of hospital stay (LOS) and mortality in patients diagnosed with MG and COVID-19. In this systematic review, PubMed, SciELO, LILACS, MEDLINE and IBECS databases were searched for primary studies published from January 2010 to March 2021, with no language restrictions. Fourteen eligible studies were identified. The main factor associated with the need for VS was the use of antibiotics other than azithromycin (AZM) for the treatment of COVID-19 (RR 1.60;95% CI 1.20-2.91;p = 0.009). Patients who used hydroxychloroquine (HCQ) and AZM had almost twice the risk of needing invasive ventilatory support (IVS) (RR 1.94;95% CI 1.07-3.52;p = 0.16). There were nonsignificant trends towards less need for IVS in patients who used intravenous immunoglobulin (IVIg) and corticosteroid therapy (RR 0.54;95% CI 0.09-3.26;p = 0.60). There was a trend towards shorter LOS in patients who received therapy with IVIg and corticosteroid therapy [8 (5 - 8) vs 19 (12.2-23.7);p = 0.007]. 10.3% (n = 4/39) died and 100% did not use IVIg or IVIg and prednisone. There was a non-significant trend towards higher mortality in patients who used AZM (RR 2.55;95% CI 0.26-30.02;p = 0.60). IVIg and corticotherapy presented themselves as a favorable alternative in relation to the outcomes. © 2021 Brazilian Society of Parasitology. All rights reserved.
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INTRODUCTION: This epidemiological household survey aimed to estimate the prevalence of the current and past SARS-CoV-2 infections in Ribeirão Preto, a municipality of southeast Brazil. METHODS: The survey was conducted in two phases using a clustered sampling scheme. The first phase spanned May 1-3 and involved 709 participants. The second phase spanned June 11-14, 2020, and involved 646 participants. RESULTS: During the first phase, RT-PCR performed on nasopharyngeal swabs was positive at 0.14%. The serological tests were positive in 1.27% of the patients during the first phase and 2.79% during the second phase. People living in households with more than five members had a prevalence of 10.83% (95%CI: 1.58-74.27) higher than those living alone or with someone other. Considering the proportion of the positive serological test results with sex and age adjustments, approximately 2.37% (95%CI: 1.32-3.42) of the population had been cumulatively infected by mid-June 2020, which is equivalent to 16,670 people (95%CI: 9,267-24,074). Considering that 68 deaths from the disease in the residents of the city had been confirmed as at the date of the second phase of the survey, the infection fatality rate was estimated to be 0.41% (95%CI: 0.28-0.73). Our results suggest that approximately 88% of the cases of SARS-CoV-2 infection at the time of the survey were not reported to the local epidemiological surveillance service. CONCLUSIONS: The findings of this study provide in-depth knowledge of the COVID-19 pandemic in Brazil and are helpful for the preventive and decision-making policies of public managers.
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OBJECTIVE: Residents and workers in long-term care facilities (LTCF) for older adults share the same space, and residents are more susceptible to COVID-19 complications. The aim of this study was to determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies as an indication of previous infection of both residents and workers in LTCFs, as well as associated factors. METHODS: This epidemiological survey was conducted in Ribeir..o Preto, Brazil, a medium-sized city. Stratified sampling was performed, with data collected on demographics, health, LTCF protective measures, activities of daily living, and cognition. A serological test was carried out on all selected individuals. RESULTS: The mean resident and worker ages were 80.62 (SD, 9.66) and 37.41 (SD, 12.42) years, respectively. The serological test was positive in 13.33% of the residents, who had 2.91 (SD, 1.28) chronic diseases and used 5.65 (SD, 2.79) medications. Dementia screening was negative in only 11.1%, and only 20% were independent in activities of daily living. The serological test results were positive in 25.93% of the workers, although SARS-CoV-2 had been previously detected in only 6.9%. The LTCF did not perform systematic screening of worker respiratory symptoms. CONCLUSIONS: There was a higher seroprevalence of SARS-CoV-2 among LTCF workers than residents. Systematic screening of worker symptoms before each shift was not regularly performed. The high prevalence of cognitive changes among LTCF residents can impede adherence to personal protection measures.
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OBJECTIVE: To know the perception of health professionals and their families about fake news related to the COVID-19 pandemic. METHOD: Descriptive-exploratory study with a qualitative approach. Twenty-eight individuals participated, including seven physicians, seven nurses, and 14 family members. Data collection took place between August and October 2020, with audio-recorded interviews. After transcription, the content was analyzed using Content Analysis, thematic modality. RESULTS: Three categories were identified: "Context of the occurrence and dissemination of fake news in times of pandemic";"Consequences of fake news on the experience of the pandemic";and "Coping strategies to contain/combat fake news". CONCLUSION: Sociocultural, political, educational, and technological aspects influence the occurrence and dissemination of fake news, which have consequences such as: misinformation, self-medication, worsening in the professional-patient relationship, increased need for additional research, and fear in the population. To face the current situation, greater control by the State is required, with investigation and punishment of people who disseminate fake news, as well as greater awareness among the population on the subject.