Physical activity and long COVID: findings from the Prospective Study About Mental and Physical Health in Adults cohort.

OBJECTIVES: The study investigated the longitudinal association between physical activity and the risk of long COVID in patients who recovered from COVID-19 infection. STUDY DESIGN: We analyzed longitudinal data of the Prospective Study About Mental and Physical Health cohort, a prospective cohort study with adults living in Southern Brazil. METHODS: Participants responded to an online, self-administered questionnaire in June 2020 (wave 1) and June 2022 (wave 4). Only participants who self-reported a positive test for COVID-19 were included. Physical activity was assessed before (wave 1, retrospectively) and during the pandemic (wave 1). Long COVID was assessed in wave 4 and defined as any post-COVID-19 symptoms that persisted for at least 3 months after infection. RESULTS: A total of 237 participants (75.1% women; mean age [standard deviation]: 37.1 [12.3]) were included in this study. The prevalence of physical inactivity in baseline was 71.7%, whereas 76.4% were classified with long COVID in wave 4. In the multivariate analysis, physical activity during the pandemic was associated with a reduced likelihood of long COVID (prevalence ratio [PR]: 0.83; 95% confidence interval [CI]: 0.69-0.99) and a reduced duration of long COVID symptoms (odds ratio: 0.44; 95% CI: 0.26-0.75). Participants who remained physically active from before to during the pandemic were less likely to report long COVID (PR: 0.74; 95% CI: 0.58-0.95), fatigue (PR: 0.49; 95% CI: 0.32-0.76), neurological complications (PR: 0.47; 95% CI: 0.27-0.80), cough (PR: 0.40; 95% CI: 0.22-0.71), and loss of sense of smell or taste (PR: 0.43; 95% CI: 0.21-0.87) as symptom-specific long COVID. CONCLUSION: Physical activity practice was associated with reduced risk of long COVID in adults.

Referral patterns of metastatic breast cancer patients to Palliative Care team at a Cancer Center in Brazil

Introduction: Breast cancer is the most common cancer in women and the leading cause of cancerrelated death in women worldwide. The high prevalence of physical and psychosocial suffering among breast cancer patients and their families justifies the need for an early interdisciplinary approach by a palliative care team. The effectiveness of early palliative care for patients with advanced cancer has been demonstrated in many studies. Early referral to outpatient palliative care services improves symptom control, reduces suffering and improves quality of end-of-life care. Aim(s): Evaluation of referral patterns of metastatic breast cancer patients to the outpatient embedded palliative care team. Method(s): We retrospectively retrieved data from electronic medical records of patients who were treated at a private community oncology practice in Brazil who died from metastatic breast cancer during the years of 2018 until 2021.We evaluated the patient's follow-up time by the palliative care team (follow-up > 12 weeks or not) and the year of referral to the service (pre-2020 vs 2020 and later) associated to the service referral type: Late referral (more than 8 weeks of metastatic diagnosis) or early referral. Each group was followed-up by cancer physicians and after referral was also followed-up by a palliative care multidisciplinary team who regularly evaluated cancer patients during their treatments at outpatient setting. During COVID-19 pandemic, some patients were evaluated by telemedicine appointments. We performed univariate comparisons analysis by Fisher's Exact Test. p < 0.1 was deemed as statistically significant. Result(s): Of the 211 patients whose data were assessed, 99 patients were referred to Palliative Care team before 2020 and 112 patients after 2020. 13.1% of patients pre-2020 received early palliative care versus 33.9% of patients in the post-2020 referral group, resulting in a 3.37-fold odds of an early palliative care integration after 2020 (OR 3.37, CI95: 1.61 - 7.45;p< 0.001). Overall, 30.4% of longer follow-up patients were an early referral versus 19.3% of the shorter follow-up, resulting in an 82% greater chance (OR 1.82, CI: 0.92-3.63;p< 0.1) of prolonged assistance with early referral. Conclusion(s): In this analysis, early palliative care integration for patients with metastatic breast cancer has increased after 2019 despite the COVID-19 pandemic, leading to prolonged time of accompaniment by the multidisciplinary palliative care team. This suggests that even in the face of this challenging moment, a mature and consolidated service is offered by the palliative care team. Also, according to previous data in literature, prematurely integration show signs of correlation with better quality of life and death, supporting early palliative care for this group of patients. However, further work is needed to examine the effect of this care model in our cohort.

Determinants of severe COVID-19 infection in Patients with Breast Cancer from a Community Oncology Practice in Brazil

Purpose: The SARS-CoV-2 pandemic was declared a global public health emergency. Determinants of mortality in the general population are now clear, but specific data on patients with breast cancer (BC) remain limited, particularly in developing nations. Material(s) and Method(s): We conducted a longitudinal, multicenter cohort study in patients with BC and confirmed SARS-CoV-2 infection. The primary end point was the proportion of patients on treatment for severe SARS-CoV-2 infection (defined as need for hospitalization) or early death (within 30 days of diagnosis). Data were evaluated sequentially in the following way: i) univariate Fisher's exact test;ii) multivariable logistic regression analysis;and iii) multivariable logistic regression. In items i and ii only those with P< 0.1 are considered significant and in stage iii only those with p< 0.05 were the final significant variables. We divided patients' data into three major variable domains: a) signs and symptoms;b) comorbidities;and c) tumor and treatment characteristics;in item ii each variable domain was tested separately, finally, in item iii the significant variables of all domains were tested together and we called it the integrative step. Result(s): From April 2020 to June 2021, 413 patients with BC and COVID-19 were retrospectively registered, of which 288 (70%) had an identified molecular subtype and 273 (66%) had stage information. Most patients were on active systemic therapy or radiotherapy (73.2%), most of them in the curative setting (69.5%). The overall rate of severe SARS-CoV-2 was 19.7% (95% CI, 15.3-25.1). In the integrative multivariate analysis, factors associated with severe infection were metastatic setting, chronic pain, acute dyspnea, and cardiovascular comorbidities. Recursive partitioning modeling used acute dyspnea, metastatic setting, and cardiovascular comorbidities to predict nonprogression to severe infection, yielding a negative predictive value of 84.9% (95% CI, 78.9%-88.3%). Conclusion(s): The rate of severe COVID-19 in patients with BC is influenced by prognostic factors that partially overlap with those reported in the general population. High-risk patients should be considered candidates to active preventive measures to reduce the risk of infection, close monitoring in the case of exposure or SARS-CoV-2 -related symptoms and prophylactic treatment once infected.

High efficacy of activated carbon fabric filters and masks developed to prevent the inhalation of microorganisms and particles associated with respiratory tract infections

As a major international public health emergency, COVID-19 has posed many challenges for healthcare professionals who have been heavily exposed to contamination. This article describes the development of a high-filtration capacity mask consisting of filter-element layers interspersed with super-activated carbon fiber fabric, non-woven polypropylene for dental–medical–hospital use and antiviral polyamide with nanostructured SiO2 thin film coating. The study found 98.18% particle filtration efficiency and determined 2.11 mmH2O/cm2 differential pressure, while fluid repellency complied with Brazilian standard NBR ABNT 15052:2004. © The Author(s) 2022.

Prospective cohort of elderly patients after hospitalization due to COVID-19: preliminary results

Background: Post Covid-19 syndrome is recognized as the maintenance of disease symptoms for weeks to months after the disease has healed. It is suspected that the involvement of the ACE enzyme and IL-6 may trigger an increased risk of dementia. Method(s): This is a cohort study that is evaluating over 12 months the functional status and cognition of elderly people after hospital discharge. One group is composed of elderly people admitted to the hospital for Covid-19 and the other group is composed of elderly people hospitalized for other clinical reasons. The groups are evaluated with The Mattis (DRS), AD8, IQCODE, ADCS-ADL, PCL-C, GDS-15, FIM, COPM, CFS, FSS, mMRC and SARC-calf. We will describe the preliminary results of the first 15 patients included in the COVID-19 group on functional status, cognition, mood and quality of life. Result(s): Fifteen patients with COVID-19 were evaluated three months after hospital discharge. One was excluded due to previous mental disorder and another due to a request to be excluded from the study. We found a mean age of 67.7 +/- 7.15 years, schooling 8.7 +/- 4.7 years, 61.5% female, Charlson Comorbidity Index 1.9 +/- 1.4, 69.2% with smoking history had incomplete vaccine protection for COVID-19. Considering cognition, 15.4% of the sample had no impairment, 53.9% had mild cognitive impairment (MCI) (30.8% amnestic MCI and 23.1% non-amnesic MCI) and 30.8% had dementia. 23.1% declared their health status and quality of life as fair or poor. Median CFS was 5 (3-5), mean GDS-15 was 4.7 +/- 2.9, FSS 32.9 +/- 18.9, PCL-c 32.6 +/- 12.5, SARC-calf 3.2 +/- 4.2. All had mMRC dyspnea classified between 2 and 4. Conclusion(s): There was a high prevalence of mild cognitive impairment and dementia among patients after three months of discharge, with a predominance of mild frailty due to CFS and the presence of fatigue. It is noteworthy that a quarter of the sample reported low quality of life. Copyright © 2022 the Alzheimer's Association.

Faceshield HUD: Extended Usage of Wearable Computing on the COVID-19 Frontline

Wearable Computing brings up novel methods and appliances to solve various problems in society’s routine tasks. Also, it brings the possibility of enhancing human abilities and perception throughout the execution of specialist activities. Finally, the flexibility and modularity of wearable devices allow the idealization of multiple appliances. In 2020, the world faced a global threat from the COVID-19 pandemic. Healthcare professionals are directly exposed to contamination and therefore require attention. In this work, we propose a novel wearable appliance to aid healthcare professionals working on the frontline of pandemic control. This new approach aids the professional in daily tasks and monitors his health for early signs of contamination. Our results display the system feasibility and constraints using a prototype and indicate initial restrictions for this appliance. This proposal also works as a benchmark for the aid in health monitoring in general hazardous situations. Copyright © 2021 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved.

Edge Computing Smart Healthcare Cooperative Architecture for COVID-19 Medical Facilities

Intelligent healthcare systems are a topic of interest in recent approaches due to novel possibilities created from edge hardware and software development. In 2020, the COVID-19 pandemic displayed the urge to speed up technological systems development to aid medical facilities. In this context, solutions must enhance the experience of both patients and healthcare professionals. Thus, we propose a novel cooperative architecture to improve healthcare facilities involved in pandemic control. On the one hand, this solution helps a faster recognition and link to the patients' data using reality augmentation resources. On the other hand, it helps monitor the conditions of medical professionals working in the facility and exposed to contamination danger.

Impact of the COVID-19 pandemic on stage at diagnosis of patients with breast cancer: An analysis of 11,752 patients from Oncoclínicas

Background: As a reaction to the COVID-19 pandemic, a nation-wide lockdown was enforced in Brazil in March 2020, cancer care was impacted, and cancer screening reduced. Therefore, an increase in cancer diagnoses at more advanced stages was expected. In this study, we extracted data from our nationwide real-world database to evaluate the impact of the COVID-19 pandemic on the stage at diagnosis of breast cancer (BC) cases. Methods: We explored curated electronic medical record data of female patients, over 18 years of age, diagnosed with BC and with established disease stage based on the AJCC 8th edition, who started treatment or follow-up in the Oncoclínicas (OC) between Jan 1, 2018, and Dec 31, 2021. The primary objective was to compare stage distribution at first visit during COVID- 19 pandemic (2020-2021) with a historical control cohort from a period prior to the pandemic (2018- 2019). We investigated stage distribution according to age at diagnosis and tumor ER/HER2 subtype in univariate models. Associations were considered significant if they had a minimum significance (P < 0.1 in Chi-square test). The historical numbers of patients with BC at OC make it possible to identify differences in the prevalence of stages in the order of 5% comparing pre and post pandemic periods with a statistical power greater than 80%. Results: We collected data for 11,752 patients with initial diagnosis of BC, with 6,492 patients belonging to the pandemic (2020-2021) and 5,260 patients to the pre-pandemic period (2018-2019). For both ER+/ HER2- and HER2+ tumors, there was a lower percentage of patients with early-stage (defined as stage I-II) in the years 2020-2021 vs 2018-2019 and a considerable increase in advanced-stage disease (defined as stage IV). For triple negative BC (TNBC), there was a significant higher percentage of patients with advanced-stage disease in the pandemic vs pre-pandemic period (table 1). Age over 50 years was associated with a greater risk of advanced stage at diagnosis after the onset of the pandemic, with an absolute increase of 7% (P twosided <0.01). Conclusions: We observed a substantial increase in cases of advanced-stage BC in OC institutions as a result of delays in BC diagnoses due to the COVID-19 pandemic. The impact appeared greater in older adults, potentially because of stricter confinement in this group.

Longitudinal study about the impact of COVID-19 pandemic in a southern Brazilian state: the PAMPA cohort

This study aimed to describe the effects of social distancing due to the COVID-19 pandemic on physical and mental health, chronic disease management, and economic situation in adults from a southern Brazilian state. Data from the baseline of the PAMPA (Prospective Study About Mental and Physical Health) cohort, a population-based, longitudinal study is presented. An online-based questionnaire was used to assess the variables pre- and during social distancing. Most of the respondents (N=2,321) were women (76.7%), white (90.6%), had at least university degree (66.7%), and were overweight or obese (53.3%). Nearly 40% were not able to work from home and 45.3% had monthly income reduced during social distancing. Moderate-to-severe symptoms of depression and anxiety increased 7.3x and 8.4x from before to during social distancing. Three quarters reported low back pain (74.2%;95%CI: 71.9%, 76.3%) during the same period while the prevalence of physical inactivity increased 31.2%. Managing chronic conditions was harder during social distancing for 28.5% of the participants. Roughly 40% reported that did not seek medical assistance even when necessary during this period. COVID-19 pandemic has disrupted the health of adults from a southern Brazilian state in several aspects.

ALTERAÇÕES NOS SUBTIPOS DE MONÓCITOS (CMO, IMO E NCMO) NA COVID-19 E SUA RELAÇÃO COM A GRAVIDADE DA DOENÇA

Objetivos: Este estudo teve como objetivo avaliar as frequências e números absolutos de monócitos e seus subtipos: clássico (cMo), intermediário (iMo) e não clássico (ncMo) em pacientes com COVID-19, a fim de esclarecer sua relação com as alterações do sistema imunológico periférico e a gravidade da doença. Material e métodos: Este estudo incluiu um total de 30 controles saudáveis (CS) e 157 pacientes com COVID-19. Os pacientes hospitalizados foram atendidos no Hospital Universitário Polydoro Ernani de São Thiago e Hospital Nereu Ramos. A gravidade da doença foi classificada como leve (n = 36), moderada (n = 30), grave (n = 32) e crítica (n = 59). Os monócitos foram subclassificados de acordo com a expressão de CD14 e CD16 em: cMo (CD14++CD16-), iMo (CD14+CD16+) e ncMo (CD14-/CD16+). Para analisar a expressão de HLA-DR nos subtipos de monócitos, a intensidade de fluorescência média (IFM) desse marcador foi avaliada. Em seguida, os valores das razões de IFM foram comparados entre os grupos. Resultados: Os pacientes com COVID-19 não apresentaram diferença significativa na contagem absoluta de monócitos quando comparados aos CS. Nos valores relativos, foi observada uma redução nos pacientes graves (p < 0,001). Já em relação aos subtipos de monócitos, foram encontradas diferenças significativas no valor percentual dentro do compartimento monocítico. Foi observado um aumento de cMo, principalmente nos casos de moderado a crítico (p < 0,001), no entanto, houve uma redução expressiva de ncMo, com redução de mais de 30× nos pacientes críticos quando comparado aos CS (p < 0,001). As frequências de iMo não apresentaram variação quando comparadas aos CS. Além disso, nos pacientes com quadro leve foi observado um aumento da expressão de HLA-DR pelos monócitos, quando comparados aos CS, que decai a partir dos pacientes moderados e reduz de forma mais expressiva nos pacientes graves e críticos (p < 0,001). Em relação aos subtipos de monócitos, esse padrão se repete, com um aumento de HLA-DR nos cMo, iMo e ncMo nos pacientes leves e uma redução significativa, principalmente nos quadros grave-crítico (p < 0,001). Essa redução ocorre principalmente nos cMo, o que levou a um aumento da razão HLA-DR iMo/cMo nos pacientes moderado-crítico (p < 0,001). Discussão: A COVID-19 é uma infecção respiratória causada pelo SARS-CoV-2, onde diversos estudos demonstram uma ligação entre a resposta imune do hospedeiro e a gravidade da doença. Nesse contexto, os monócitos circulantes possuem funções pró-inflamatórias e de resolução. Várias evidências indicam que essas células desempenham um papel importante na imunopatogênese da doença, uma vez que a resposta hiperinflamatória induzida pelo vírus parece ser a principal causa de gravidade da doença. Os resultados apresentados demonstram uma alteração no compartimento dos monócitos, com aumento de cMo e redução expressiva de ncMo, alterações que se mostram relacionadas com o aumento da gravidade da doença. Além disso, em pacientes com quadros mais severos, foi observada uma redução na expressão de HLA-DR, um MHC de classe II, o que indica um possível quadro de imunossupressão. Conclusão: Os resultados obtidos demonstram uma correlação dos subtipos de monócitos com a gravidade da doença, o que poderá servir como um possível marcador de prognóstico em pacientes com COVID-19.

IMPORTÂNCIA DA LAVAGEM DE MÃOS PARA PREVENIR A DISSEMINAÇÃO DA COVID-19

Introdução: Desde a percepção do novo coronavírus (SARS-CoV-2), responsável pela disseminação do surto descoberto pela primeira vez na cidade de Wuhan, China, em dezembro de 2019, a raça humana tem vivenciado um difícil problema sanitário global, arrodeadas de exatidão no que diz respeito aos caracteres epidemiológicos, sorológicos e sua facilidade de se disseminar. As infecções relacionadas à assistência à saúde têm ocorrência em várias em instituições assistenciais de saúde, tanto em países desenvolvidos como subdesenvolvidos, acometendo aproximadamente 1,4 milhões de pacientes em todo o mundo, resultando em altos números morbimortalidade, prolongamento do tempo de internação, resistência de microrganismos e óbitos. Apresentam diversas causas e tem várias relações multifatoriais. A higienização das mãos retrata a conduta apartada primordial como tática de minimização da incidência das infecções ambulatoriais e hospitalares. Objetivo: O objetivo deste estudo foi orientar os profissionais do setor de ambulatório de um centro de Hemoterapia no período de 10 a 26 de fevereiro de 2020, com intuito de melhorar os métodos de limpeza e higienização e prevenção acerca da COVID-19. Material e métodos: Foi realizado um treinamento teórico através do Google Met., que é um serviço de comunicação por vídeo desenvolvido pelo Google. O treinamento foi realizado em cinco módulos com carga horária 30h com os funcionários envolvendo o preenchimento do check-list, baseado no manual Segurança do Paciente em Serviços de Saúde, Higienização das Mãos da Agência Nacional de Vigilância Sanitária. Resultados: Dos 32 funcionários que executam suas atividades profissionais no setor de transfusão e ambulatório que responderam o instrumento de pesquisa, 75% (24) eram do sexo feminino e 25% (08) do sexo masculino. O nível de formação acadêmica variou entre os docentes: 9,3% (3) são Enfermeiros, Farmacêuticos 6,2 (02), Técnicos de Enfermagem 18,7% (06), Assistente administrativo 15,6% (05), Assistente social 3,1% (01), Psicóloga 3,1% (01), Fisioterapeuta 3,1% (01), Dentista 6,2% (02), Estagiários 34,3% (11). Discussão: Neste estudo observou-se que a higienização e o uso de luvas associaram-se a uma menor velocidade de contaminação das mãos durante cuidados rotineiros nos setores laboratoriais e no ambulatório evitando a contaminação da maioria dos profissionais de saúde. Conclusão: Esta ação deve ser constantemente desenvolvida na prática educacional, além de abordagem aprofundada referente à prevenção e controle de infecções como estratégia de promoção da segurança do paciente.

YOUTH AND ADULT EDUCATION (EJA) IN TIMES OF SOCIAL ISOLATION: CHALLENGES AND LIMITATIONS UNDER THE TEACHERS 'VIEWS

A reflection on Youth and Adult Education is presented, based on the recent isolation scenario caused by the Covid-19 pandemic. Based on the perceptions and positions of teachers working in public education in the Administrative Region of the Structural City, in the Federal District (DF), the objective was to reflect on the challenges and limitations imposed on the modality, as well as the possibilities of overcoming it. It is an exploratory research, based on bibliographic and documentary studies, and on the results expressed in an online questionnaire, applied to teachers. The work had as source: the related legislation, authors specialized in Youth and Adult Education and official data. The modality is considered to represent a State responsibility to its citizens. However, it appears that the obstacles imposed are even greater for the public of Youth and Adult Education, given the unfavorable social condition of the investigated context and the difficulties in accessing technological resources. Despite the uncertainties, there is hope of overcoming the difficulties and opening up for the implementation of viable alternatives.

Depression and anxiety symptoms remained elevated after 10 months of the COVID-19 pandemic in southern Brazil: findings from the PAMPA cohort.

OBJECTIVES: This study aimed to examine the changes in depression and anxiety symptoms among Brazilian adults over 10 months of the COVID-19 pandemic. STUDY DESIGN/METHODS: The present study used data from wave 1 (June/July 2020) and wave 2 (December 2020/January 2021) of the Prospective Study About Mental and Physical Health (PAMPA) Cohort, a state-level, ambispective longitudinal study with adults from southern Brazil. The frequency of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale. Anxiety and depressive symptoms before social distancing were retrospectively assessed during wave 1. RESULTS: Most of the 674 participants were classified as non-symptomatic for depressive (85.0%) and anxiety symptoms (73.2%) before the COVID-19 pandemic. At wave 1, there were increases in symptoms of depression (7.6% [95% confidence interval [CI]: 7.2%, 8.1%]) and anxiety (9.1% [95% CI: 8.6%, 9.5%]). These decreased at wave 2 (depression: 6.9% [95% CI: 6.5%, 7.2%]; anxiety: 7.4% [95% CI: 7.1%, 7.8%]) although they were still elevated compared with pre-COVID (depression: 4.5% [95% CI: 4.2%, 4.8%]; anxiety: 5.8% [95% CI: 5.5%, 6.1%]). Adults living alone (b = 0.44 [95% CI: 0.07, 0.82]) had a faster trajectory in anxiety symptoms than their counterparts. Cohort members who were living alone (b = 0.24 [95% CI: 0.06, 0.42]) and with diagnosed chronic disease (0.32 [95% CI: 0.18, 0.46]) had a faster increase in depressive symptoms than their respective counterparts. Participants aged ≥60 years showed a slower trajectory of depressive (b = -0.46 [95% CI: -0.73, -0.18]) and anxiety (b = -0.61 [95% CI: -1.20, -0.02) symptoms. CONCLUSIONS: During 10 months of COVID-19, anxiety and depression symptoms improved but were still higher than before COVID-19.

Photo-mediated and advanced oxidative processes applied for the treatment of effluents with drugs used for the treatment of early COVID-19: Review.

The COVID-19 pandemic is proving to be one of the most challenging health and social crises ever faced by humanity. Several drugs have been proposed as potential antiviral agents for the treatment of COVID-19 since the beginning of the health crisis. Among them are chloroquine (CQ), hydroxychloroquine (HCQ), ivermectin (IVM), and the combination of QC or HCQ and azithromycin (AZI). The use of these and several other drugs has grown sharply, even if there is proof of ineffectiveness in the early treatment or mild cases of COVID-19. Thus, there is great concern about the potential environmental impacts of the effluents released with the presence of these drugs. Therefore, this work aimed to carry out a literature review on wastewater treatment processes, focusing on removing these substances through advanced oxidation process. As the conventional effluent treatment processes do not have high efficiency for removal, it was concentrated in the literature that had as scope advanced and photo-mediated techniques to remove CQ, HCQ, IVM, and AZI. It is expected, with this work, to highlight the importance of conducting research that contributes to the control of pollution and contamination.

Association between specific types of physical activity during the COVID-19 pandemic and the risk of subjective memory decline: findings from the PAMPA Cohort.

OBJECTIVES: This study aimed to identify the effects of different physical activities practised during the time period when COVID-19 social distancing measures were in place on the risk of subjective memory decline in adults. STUDY DESIGN: Retrospective cohort study. METHODS: Data from the Prospective Study about Mental and Physical Health (PAMPA), a state-level (Rio Grande do Sul, Brazil), online-based cohort study, were analysed. Respondents were asked to rate their memory before COVID-19 social distancing measures were implemented (retrospectively) and on the day that the survey was completed. Subjective memory decline was defined as a perceived worsening of memory function during COVID-19 social distancing compared with the pre-pandemic period. The types of physical activity practised before and during COVID-19 social distancing measures were assessed. RESULTS: Data from 2319 adults were included. Out-of-home endurance, muscle strengthening, combined endurance and muscle strengthening, and stretching activities reduced the risk of subjective memory decline during the pandemic. In terms of physical activities practised at home, only muscle strengthening did not protect against subjective memory decline. Participants who sustained any type of physical activity at home during the COVID-19 pandemic showed a reduced risk for subjective memory decline. CONCLUSIONS: Physical activity, regardless of the type of activity and location performed, during the time period when COVID-19 social distancing measures were in place can mitigate the effects of the pandemic on subjective memory decline.

Machine learning prediction of COVID-19 mortality in cancer patients

Background: COVID-19 is a challenge for clinical decision-making in cancer patients and the allocation of healthcare resources. An accurate prognosis prediction to effectively triage patients is needed, especially in the community oncology practice. Methods:Nationwide cohort from Oncoclínicas Brazil was used to validate previously developed multivariable logistic regression (mLR) model (Ferrari et al, JCO GO 2021) and to construct a machine learning Random Forest (RF) algorithm as predictor of 30-day mortality after SARS-CoV-2 detection by RT-PCR in cancer patients diagnosed in an outpatient setting. To find the most important baseline clinical determinants of early COVID19-related death via Gini index, a RF with 100,000 trees was trained in 75% of the dataset, and the performance was assessed in the remaining 25%. We then compared the accuracy of different models in terms of sensitivity, specificity and area under the receiver operating characteristics curves (AUC). Results:From March to December 2020, 533 patients with COVID-19 were prospectively registered in the database. Median age was 60 years (19-93) and 67% were female. Most frequent cancers were breast in 34%, hematological in 16%, and gastrointestinal in 15%. Comorbidities were common (52%), as was current/former smoking history (17%). Most patients were on active systemic therapy or radiotherapy (84%) in the advanced or metastatic disease setting (55%). The overall mortality rate was 15% (CI95% 12%-18%). We validated the original mLR model trained in the first 198 patients: management in a noncurative setting (odds ratio [OR] 3.7), age ≥ 60 years (OR 2.3), and current/former smoking (OR 1.9) were significant predictors of death in the expanded cohort. Presence of comorbidities (OR 1.9) also defined poor outcome in the updated mLR model, which yielded low sensitivity (74%), specificity (68%) and AUC (0.78). With RF modeling, the most significant predictors of 30-day death after COVID-19 (in decreasing order) were older age, treatment of advanced or metastatic disease, tumor type (respiratory tract, brain and unknown primary cancers had higher mortality), COVID-related symptom burden at baseline evaluation and treatment regimen (immunotherapy combinations had higher mortality). The RF model demonstrated high sensitivity (89%), specificity (88%) and AUC (0.96). Conclusions:The results highlight the possibility that machine learning algorithms are able to predict early mortality after COVID-19 in cancer patients with high accuracy. The proposed prediction model may be helpful in the prompt identification of high-risk patients based on clinical features alone, without having to wait for the results of additional tests such as laboratory or radiologic studies. It can also help prioritize medical resources and redefine vaccination strategies. A web-based mortality risk calculator will be created for clinical decision support.

Perceptive changes in endurance athletes during social isolation due to COVID-19

Introduction: The COVID-19 pandemic has led to social isolation measures in different contexts. In endurance sports, competitions worldwide have been canceled, affecting behavioral, psychological, and physical aspects.