Healthcare workers exposed to COVID-19 patients present an inflammatory status and Th2/Th17/Th22 immune profile: findings from before vaccine application in Brazil.

Healthcare workers present an increased risk of contagion for the SARS-CoV-2 virus due to their labor exposure. Here, we describe the clinical, laboratory, and immunological characteristics of healthcare workers, before vaccine application, exposed to SARS-CoV-2-infected patients. We collected sociodemographic, clinical, and laboratory information from 50 professionals who worked during the COVID-19 pandemic at the Clinical Hospital of the Northwest in Brazil. The results showed that most workers are women, over 50 years old, and worked as nursing technicians. Approximately 56% of workers were positive for a previous infection by RT-PCR and/or anti-SARS-CoV-2-immunoglobulin tests. Increased levels of hematocrit, neutrophils, NK lymphocytes, and fibrinogen, were found in positive healthcare workers, suggesting a light inflammatory status. The immunological findings showed an increase in IL-17 production and a Th2/Th17/Th22 profile followed by high serology for anti-SARS-CoV-2 IgM and IgG. Those data reveal the importance of studies with healthcare workers to investigate if the continuous exposition to the virus may result in chronic activation of the immune system and/or pulmonary inflammation in this target group.

Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19?

INTRODUCTION: A strong association between stroke and atrial fibrillation (AF) has been demonstrated. Anticoagulation for the prevention of stroke in high-risk patients has the benefit of improving the life expectancy, quality of life, autonomy and social functioning of the patient. The COVID-19 pandemic poses challenges for stroke patients because of the association between SARS-CoV-2 infection and thromboembolic risk. CASE DESCRIPTION: We describe the case of an 84-year-old female patient admitted due to an embolic stroke and non-anticoagulated AF. Her admission symptoms were sensory-motor aphasia and severe right limb paresis with an NIHSS score of 24. The diagnosis of embolic stroke (namely, total anterior circulation infarct; TACI) was made. Her stroke was extensive so she was not started on anticoagulation. During hospitalization, new embolic events occurred and a concomitant diagnosis of COVID-19 was made with progressive respiratory dysfunction followed by multiorgan failure. The patient died despite appropriate treatment. DISCUSSION: The prognosis of elderly patients with cardioembolic stroke depends on anticoagulation administration. The NIHSS score on admission of our patient meant anticoagulation therapy was not appropriate. The diagnosis of COVID-19 contributed to the patient's death. LEARNING POINTS: Anticoagulation should be considered in stroke patients with total infarction and atrial fibrillation.There is an association between COVID-19 and thromboembolic stroke.Elderly patients with stroke and COVID-19 are at higher risk of death.

The use and role of telemedicine in maternal fetal medicine around the world: an up-to-date.

Purpose: The aim of this narrative review is to sumarize data about the use and role of telemedicine in maternal fetal medicine (MFM). Methods: We searched pubmed and scopus to find articles about telemedicine in MFM by using the terms telmedicine or telehealth and maternal fetal medicine. Results: Telehealth has been widely used for several medical specialties. During the coronavirus disease 2019 (COVID-19) pandemic, telehealth has gained investment and further research. Even though telemedicine in MFM has not been frequently applied, from 2020 onwards it has increased in both implementation and acceptance worldwide. The need to screen the patients in overloaded centers in a pandemic scenario required telemedicine in MFM, which has exhibited consistently good results concerning health and budget. The aim of this study was to review the telehealth programs and research focused on MFM around the world. Few studies have been applied to MFM and even fewer in developing and undeveloped countries. The majority of studies were concentrated in the USA and in Europe. Conclusion: Further research is needed, especially in non-developed countries, to comprehend the potential role of telemedicine in MFM for improving the life quality of the patients, health professionals, and to be cost-efficient.

Evaluation of long-term stability of SARS-CoV-2 nucleic acid extracted from human nasopharyngeal samples.

The maintenance of SARS-Cov-2 RNA samples poses a new challenge for laboratories and researchers. In addition, it is a requirement in order to identify what strain of the new coronavirus is predominant in a region, for instance. Therefore, it is a must to keep the quality and viability of stored RNA to respond to this and other valid questions. In other to test the quality of our samples and storing protocols, we randomly checked RNA samples four different times over one year using a second RT-PCR assay after the first test. The virus genes, N1 and N2, showed no significant increase in the media of the CT value between the first assay and subsequent times with p > 0.05. However, the human RP gene showed differences in the first three times analyzed, but within the acceptable sample cut-off, according to the test manufacturer. After one year, the RNA extracted from human nasopharyngeal specimens are viable to detect the virus SARS-CoV-2 genes with minor changes.

Reflections on the extinction of the National Council for Food and Nutrition Security and the confrontation of Covid-19 in Brazil

ABSTRACT The Provisional Measure 870/2019, which amended the Organic Law on Food and Nutrition Security and extinguished the Conselho Nacional de Segurança Alimentar e Nutricional (National Council for Food and Nutrition Security), has brought serious consequences to the Brazilian population, especially for the most vulnerable. This scientific note brings reflections on the trajectory of the Conselho Nacional de Segurança Alimentar e Nutricional, the repercussions of its extinction in the last year, and the project to dismantle social protection policies in Brazil, with serious consequences at a time when the country is going through a crisis in public health due to the Covid-19 pandemic. The absence of the Conselho Nacional de Segurança Alimentar e Nutricional and the weakening of the set of policies for Food and Nutritional Security has mobilized the civil society to defend the human rights to food, food sovereignty, and to democracy itself. The resistance of the different social movements in order to maintain the spaces of civil participation related to Food and Nutrition Security public policies are still going to be long and arduous, demanding the continued vocalization and strengthening of partnership networks within the different movements of the organized civil society. Finally, we highlight the urgent need for restoration of the National System of Food and Nutritional Security (Sistema Nacional de Segurança Alimentar e Nutricional) with all its instances, and of other social policies, so that the negative consequences of the pandemic are avoided or mitigated and the State complies with its obligations to guarantee the rights of the Brazilian population. RESUMO A Medida Provisória nº 870/2019, que alterou a Lei Orgânica de Segurança Alimentar e Nutricional e extinguiu o Conselho Nacional de Segurança Alimentar e Nutricional, tem trazido graves consequências à população brasileira, em especial, àqueles em situação de maior vulnerabilidade. Esta nota científica traz reflexões sobre a trajetória do Conselho Nacional de Segurança Alimentar e Nutricional, as repercussões de sua extinção no último ano e o projeto de desmonte das políticas de proteção social no Brasil, com graves desdobramentos no momento em que o país atravessa uma crise de saúde pública em decorrência da pandemia da Covid-19. A ausência do Conselho Nacional de Segurança Alimentar e Nutricional e a fragilização do conjunto de políticas de Segurança Alimentar e Nutricional tem mobilizado a sociedade civil para a defesa do direito humano à alimentação, da soberania alimentar e da própria democracia. A resistência dos diferentes movimentos sociais para manutenção dos espaços de participação da sociedade civil nas políticas públicas de Segurança Alimentar e Nutricional ainda será longa e árdua, demandando a continuidade da vocalização e fortalecimento de redes de parceria nos diferentes movimentos da sociedade civil organizada. Por fim, destaca-se que a recomposição do Sistema Nacional de Segurança Alimentar e Nutricional, com todas as suas instâncias, e das demais políticas sociais, constitui uma necessidade premente para que as consequências negativas da pandemia sejam evitadas ou atenuadas e o Estado cumpra com as suas obrigações para a garantia dos direitos da população brasileira.

Reflections on the extinction of the National Council for Food and Nutrition Security and the confrontation of Covid-19 in Brazil / Reflexões sobre a extinção do Conselho Nacional de Segurança Alimentar e Nutricional e o enfrentamento da Covid-19 no Brasil

ABSTRACT The Provisional Measure 870/2019, which amended the Organic Law on Food and Nutrition Security and extinguished the Conselho Nacional de Segurança Alimentar e Nutricional (National Council for Food and Nutrition Security), has brought serious consequences to the Brazilian population, especially for the most vulnerable. This scientific note brings reflections on the trajectory of the Conselho Nacional de Segurança Alimentar e Nutricional, the repercussions of its extinction in the last year, and the project to dismantle social protection policies in Brazil, with serious consequences at a time when the country is going through a crisis in public health due to the Covid-19 pandemic. The absence of the Conselho Nacional de Segurança Alimentar e Nutricional and the weakening of the set of policies for Food and Nutritional Security has mobilized the civil society to defend the human rights to food, food sovereignty, and to democracy itself. The resistance of the different social movements in order to maintain the spaces of civil participation related to Food and Nutrition Security public policies are still going to be long and arduous, demanding the continued vocalization and strengthening of partnership networks within the different movements of the organized civil society. Finally, we highlight the urgent need for restoration of the National System of Food and Nutritional Security (Sistema Nacional de Segurança Alimentar e Nutricional) with all its instances, and of other social policies, so that the negative consequences of the pandemic are avoided or mitigated and the State complies with its obligations to guarantee the rights of the Brazilian population.

RESUMO A Medida Provisória nº 870/2019, que alterou a Lei Orgânica de Segurança Alimentar e Nutricional e extinguiu o Conselho Nacional de Segurança Alimentar e Nutricional, tem trazido graves consequências à população brasileira, em especial, àqueles em situação de maior vulnerabilidade. Esta nota científica traz reflexões sobre a trajetória do Conselho Nacional de Segurança Alimentar e Nutricional, as repercussões de sua extinção no último ano e o projeto de desmonte das políticas de proteção social no Brasil, com graves desdobramentos no momento em que o país atravessa uma crise de saúde pública em decorrência da pandemia da Covid-19. A ausência do Conselho Nacional de Segurança Alimentar e Nutricional e a fragilização do conjunto de políticas de Segurança Alimentar e Nutricional tem mobilizado a sociedade civil para a defesa do direito humano à alimentação, da soberania alimentar e da própria democracia. A resistência dos diferentes movimentos sociais para manutenção dos espaços de participação da sociedade civil nas políticas públicas de Segurança Alimentar e Nutricional ainda será longa e árdua, demandando a continuidade da vocalização e fortalecimento de redes de parceria nos diferentes movimentos da sociedade civil organizada. Por fim, destaca-se que a recomposição do Sistema Nacional de Segurança Alimentar e Nutricional, com todas as suas instâncias, e das demais políticas sociais, constitui uma necessidade premente para que as consequências negativas da pandemia sejam evitadas ou atenuadas e o Estado cumpra com as suas obrigações para a garantia dos direitos da população brasileira.