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Introduction: Patients with chronic kidney disease (CKD) have a higher risk for infection caused by the new coronavirus (COVID-19). The COVID-19 pandemic and social isolation contributed to the adaptation to new health promotion and education tools, including virtual methods. The aim of this study is to analyze the guidelines made through the Renal Health profile on Instagram during the COVID-19 pandemic to patients with CKD. Method(s): This is a quantitative, descriptive study, with the analysis of posts, comments and likes, carried out on the Renal Health (@renal_health) Instagram profile, an educational project based in Brazil, initiated as part of an ISN Clinical Research Program Project, which addresses kidney health, from February 2020 to May 2022, during the COVID-19 pandemic. Result(s): Currently, the Renal Health Instagram profile (https://www.instagram.com/renal_health/) has 1333 publications and more than 10,000 followers. It is a profile administered by a nurse, a nephrologist and a team of public health researchers at the University of Fortaleza, Brazil. A total of 106 posts about COVID-19 were analyzed, covering news about the pandemic, guidelines on prevention and vaccination, association between COVID-19, CKD and transplantation, among others. There were 13,815 likes and 1,068 comments. The most liked post (n = 696) was a photo with a news item: "InCor discharges Covid patient with transplanted lung". Among the comments, it was possible to observe several compliments, reports of patients with CKD and kidney transplants, as well as doubts, which were answered by the team that maintains the profile. The most commented post was also a news item: "Hospital denies transplant to unvaccinated patients", with 146 comments. Conclusion(s): The general population's interest in the association between COVID-19 and kidney disease is evident. It is important to point out the role of the profile as an online educational tool that helps in clarifying doubts about the new coronavirus, in addition to acting as an easy and practical way to acquire knowledge from reliable sources, regarding the risks that patients with kidney diseases have when contracting the virus, as well as many other relevant subjects, always emphasizing the relevance of preventive measures, including vaccination. From the study, it is noticeable that, during the pandemic, there were a large number of clarified doubts, as well as positive feedbacks about the platform. Therefore, the Renal Health profile proved to be an important health education mechanism during the pandemic. No conflict of interestCopyright © 2023
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Introduction: Endothelial dysfunction and coagulopathy have been reported as the basis of severe Acute Kidney Injury (AKI) associated with COVID-19. Endothelial biomarkers can detect kidney damage early and allow the adoption of efficient measures to prevent the progression of the disease and its complications. This finding could facilitate the follow-up of patients at higher risk, as well as provide early diagnosis strategies and promote the rational use of resources. The aim of this study is to assess the role of vascular biomarkers to predict the need for hemodialysis in critically ill patients with COVID-19. Method(s): This is a prospective study with 58 patients critically ill due to COVID-19 infection admitted to a tertiary hospital in Fortaleza, Northeast Brazil, from 2020 to 2021. General laboratory tests and vascular biomarkers such as VCAM-1, Syndecan-1, ACE-2, ICAM-1, Angiopoietin-1 and Angiopoietin-2 were quantified on admission to the intensive care unit (ICU). Result(s): There was a 40% mortality rate. VCAM and the Ang-2/Ang-1 ratio at ICU admission were associated with the need for hemodialysis. Vascular biomarkers (VCAM-1, Syndecan-1, angiopoietin-2/anogiopoietin-1 ratio) and thrombocytopenia were predictors of dialysis, and their cutoff values were useful to stratify patients with worse prognosis in the Kaplan-Meier analysis. In the cox multivariate regression analysis with models adjusted according to the presence or absence of platelets, VCAM-1 [O.R. 1.13 (95% CI: 1.01 - 1.27);p=0.034] was an independent predictor of dialysis in all models, and the Ang-2/Ang-1 ratio [O.R. 4.87 (95% C.I.: 1.732 - 13.719);p=0.003] was associated with the need for dialysis in the model without platelet input. Conclusion(s): Vascular biomarkers, mainly VCAM-1 and Ang-2/Ang-1 ratio, and coagulation disorders showed important predictive value for the need for hemodialysis in critically ill patients with COVID-19. No conflict of interestCopyright © 2023
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This systematic review integrates the data available in the literature regarding the biological activities of the extracts of endophytic fungi isolated from Annona muricata and their secondary metabolites. The search was performed using four electronic databases, and studies' quality was evaluated using an adapted assessment tool. The initial database search yielded 436 results; ten studies were selected for inclusion. The leaf was the most studied part of the plant (in nine studies); Periconia sp. was the most tested fungus (n = 4); the most evaluated biological activity was anticancer (n = 6), followed by antiviral (n = 3). Antibacterial, antifungal, and antioxidant activities were also tested. Terpenoids or terpenoid hybrid compounds were the most abundant chemical metabolites. Phenolic compounds, esters, alkaloids, saturated and unsaturated fatty acids, aromatic compounds, and peptides were also reported. The selected studies highlighted the biotechnological potentiality of the endophytic fungi extracts from A. muricata. Consequently, it can be considered a promising source of biological compounds with antioxidant effects and active against different microorganisms and cancer cells. Further research is needed involving different plant tissues, other microorganisms, such as SARS-CoV-2, and different cancer cells.
Subject(s)
Annona , COVID-19 , Annona/chemistry , Annona/microbiology , Antioxidants/pharmacology , Fungi , Humans , Plant Extracts/chemistry , SARS-CoV-2 , TerpenesABSTRACT
In this paper, we discuss the impact of COVID-19 on Brazilian families, considering socioeconomic data from before and during the outbreak. The coronavirus threatens Brazil's entire population. Since May 2020, Brazil is considered the pandemic epicenter, presenting high rates of infections and deaths at least up to the end of August 2020. Families in which members may have lost their jobs or are living from informal work face the challenge of protecting themselves from COVID-19, but also of maintaining financial conditions despite the risk. Access to healthcare has proven to be more precarious for the poor, Indigenous, Black, street population, women, and LGBTQI+. Impacts on the mental health of family members who comply with social isolation and are overburdened with domestic duties, home office and their children's education by digital media are increased by stress, anxiety, and uncertainties about the future. Due to the great impact COVID-19 has provoked on Brazilian families, already existing socioeconomic iniquities increased during the pandemic. Unemployment, bad basic sanitation conditions and a high rate of informal work contrast with the situation of high-income families. The post-pandemic period will be decisive for Brazil to prioritize the recovery of its already existing public policies. We suggest the proposed initiatives be organized around the goal of mitigating adverse effects on mental health aggravated by COVID-19.
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Objective: describe the adaptations that occurred in healthcare referral services regarding the care for individuals living with HIV/ Aids in the covid-19 pandemic scenario. Method: the research is of a quantitative exploratory descriptive nature. The research was authorized by the ethics and research committee (Comite de etica e Pesquisa) under the protocol CAAE 46795521.5.0000.5013. Results: a total of 32 interviews were performed. The main modifications that occurred in the scenarios where data was collected were the distribution of supplies and materials to prevent contamination from SARS-CoV-2, bigger intervals between consultations and the expansion of the time in months for the dispensing of medications. Conclusion: it is evident that the pandemic brought diverse impacts to HIV healthcare referral services, as well as its users. Such scenario created challenges that may be overcome with interdisciplinary teamwork and institutional support, as well as collaboration and engagement of patients in the modifications proposed.