The Impact of the COVID-19 Pandemic on the Brazilian Immigrant Community in the U.S: Results from a Qualitative Study.

While an increasing body of data suggests that marginalized groups have been disproportionately impacted by COVID-19, little has been published about the specific impact on Brazilian immigrants in the U.S. We conducted 15 key informant interviews, one of which included two participants (n = 16), with representatives from social service agencies, healthcare, and faith-based organizations serving Brazilian immigrants. Key informants were asked about the community's experiences with COVID-19 testing and treatment, responses to CDC (Centers for Disease Control) guidelines, perceptions about the virus, and the pandemic's impact on physical and mental health. Results suggest that COVID-19 has profoundly impacted Brazilian immigrants' mental and physical health. Key informants perceived that community members faced higher risk of COVID-19 infection due to overcrowded living conditions and over-representation in public-facing and informal (e.g., housecleaning) jobs. They reported barriers to COVID-19-related healthcare services including language, immigration status, and fear of deportation. Brazilian cultural norms surrounding hygiene practices, social distancing, and information distribution have shaped the community's pandemic response. The Brazilian community has faced extensive social, economic, and health ramifications due to the pandemic. While not unique to this community, pre-existing concerns about social disadvantage suggest a particular vulnerability of this population to the virus.

Inflammatory Cytokine Patterns Associated with Neurological Diseases in Coronavirus Disease 2019.

Patients with coronavirus disease 2019 (COVID-19) can present with distinct neurological manifestations. This study shows that inflammatory neurological diseases were associated with increased levels of interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12, chemokine (C-X-C motif) ligand 8 (CXCL8), and CXCL10 in the cerebrospinal fluid. Conversely, encephalopathy was associated with high serum levels of IL-6, CXCL8, and active tumor growth factor ß1. Inflammatory syndromes of the central nervous system in COVID-19 can appear early, as a parainfectious process without significant systemic involvement, or without direct evidence of severe acute respiratory syndrome coronavirus 2 neuroinvasion. At the same time, encephalopathy is mainly influenced by peripheral events, including inflammatory cytokines. ANN NEUROL 2021;89:1041-1045.

Isolated intracranial hypertension associated with COVID-19.

BACKGROUND: Headache is a frequent complaint in COVID-19 patients. However, no detailed information on headache characteristics is provided in these reports. Our objective is to describe the characteristics of headache and the cerebrospinal fluid (CSF) profile in COVID-19 patients, highlighting the cases of isolated intracranial hypertension. METHODS: In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. We reviewed clinical, imaging, and laboratory data of patients with refractory headache in the absence of other encephalitic or meningitic features. CSF opening pressures higher than 250 mmH2O were considered elevated, and from 200 to 250 mmH2O equivocal. RESULTS: Fifty-six COVID-19 patients underwent lumbar puncture for different neurological conditions. A new, persistent headache that prompted a CSF analysis was diagnosed in 13 (23.2%). The pain was throbbing, holocranial or bilateral in the majority of patients. All patients had normal CSF analysis and RT-qPCR for SARS-CoV-2 was negative in all samples. Opening pressure >200 mmH2O was present in 11 patients and, in six of these, > 250 mmH2O. 6/13 patients had complete improvement of the pain, five had partial improvement, and two were left with a daily persistent headache. CONCLUSIONS: In a significant proportion of COVID-19 patients, headache was associated to intracranial hypertension in the absence of meningitic or encephalitic features. Coagulopathy associated with COVID-19 could be an explanation, but further studies including post-mortem analysis of areas of production and CSF absorption (choroid plexuses and arachnoid granulations) are necessary to clarify this issue.

Cerebrospinal fluid findings in neurological diseases associated with COVID-19 and insights into mechanisms of disease development.

OBJECTIVES: To analyze the cerebrospinal fluid (CSF) of patients with SARS-CoV-2 infection and neurological manifestations to provide evidence for the understanding of mechanisms associated with central nervous system (CNS) involvement in COVID-19. METHODS: Patients (n = 58) were grouped according to their main neurological presentation: headache (n = 14); encephalopathy (n = 24); inflammatory neurological diseases, including meningoencephalitis (n = 4), acute myelitis (n = 3), meningitis (n = 2), acute disseminated encephalomyelitis (ADEM) (n = 2), encephalitis (n = 2), and neuromyelitis optica (n = 1); and Guillain-Barré syndrome (n = 6). Data regarding age, sex, cerebrovascular disease, and intracranial pressure were evaluated in combination with CSF profiles defined by cell counts, total protein and glucose levels, concentration of total Tau and neurofilament light chain (NfL) proteins, oligoclonal band patterns, and detection of SARS-CoV-2 RNA. RESULTS: CSF of patients with inflammatory neurological diseases was characterized by pleocytosis and elevated total protein and NfL levels. Patients with encephalopathy were mostly older men (mean age of 61.0 ± 17.6 years) with evidence of cerebrovascular disease. SARS-CoV-2 RNA in CSF was detected in 2 of 58 cases: a patient with refractory headache, and another patient who developed ADEM four days after onset of COVID-19 symptoms. Three patients presented intrathecal IgG synthesis, and four had identical oligoclonal bands in CSF and serum, indicating systemic inflammation. CONCLUSION: Patients with neurological manifestations associated with COVID-19 had diverse CSF profiles, even within the same clinical condition. Our findings indicate a possible contribution of viral replication on triggering CNS infiltration by immune cells and the subsequent inflammation promoting neuronal injury.

A contribution to understand the pharmaceutical industry in the financialized capitalist dynamics

Resumo A dominância financeira é um novo padrão sistêmico da riqueza que estabelece novas maneiras de definir, gerir e realizar a riqueza. As corporações não financeiras têm-se transformado em consonância com a dominância financeira, o que pode ocasionar desdobramentos na dinâmica produtiva e de inovação, assim como nas economias nacionais. Em meio à pandemia do coronavírus, a extrema necessidade do desenvolvimento tecnológico imputa a importância de um olhar retrospectivo para o setor farmacêutico. O objetivo do artigo é discutir as mudanças produzidas pela financeirização no âmbito da indústria farmacêutica. Para tanto, realizou-se revisão da literatura científica por busca e seleção sistematizadas. Os artigos, na maioria sobre empresas sediadas no RU e EUA, evidenciaram a dominância financeira pela concepção da empresa como ativo, participação dos fundos de alto risco, protagonismo dos ativos intangíveis, maximização do valor dos acionistas, desintegração vertical das atividades, intensificação de fusões e aquisições e encurtamento do horizonte de planejamento. Esses elementos não foram homogêneos em todos estudos demandando análises específicas por países e estudos de caso. A presente revisão contribuiu para a discussão do avanço tecnológico e aponta lacunas na produção cientifica no contexto de economias periféricas e articulada às políticas públicas e sistemas de saúde. Financial dominance is a new systemic pattern of wealth that establishes new ways to define, manage and realize wealth. Non-financial corporations have transformed themselves in line with financial dominance, which can cause developments in the productive and innovation dynamics, as well as in national economies. During the coronavirus pandemic, Covid-19, the extreme need for technological development imputes the importance of a retrospective look to the pharmaceutical sector. The article discusses the changes brought about by financialization in the scope of the pharmaceutical industry. To this end, a review of the scientific literature was carried out by systematic search and selection. The articles, mostly about companies based in the UK and the USA, showed financial dominance due to the company's conception as an asset, participation of high-risk funds, the role of intangible assets, maximization of shareholder value, vertical disintegration of activities, intensification of mergers and acquisitions and shortening the planning horizon. These elements were not homogeneous in all studies, requiring country-specific analyzes and case studies. This review contributed to the discussion of technological advances and points out gaps in scientific production in the context of peripheral economies and linked to public policies and health systems.

A contribution to understand the pharmaceutical industry in the financialized capitalist dynamics

Resumo A dominância financeira é um novo padrão sistêmico da riqueza que estabelece novas maneiras de definir, gerir e realizar a riqueza. As corporações não financeiras têm-se transformado em consonância com a dominância financeira, o que pode ocasionar desdobramentos na dinâmica produtiva e de inovação, assim como nas economias nacionais. Em meio à pandemia do coronavírus, a extrema necessidade do desenvolvimento tecnológico imputa a importância de um olhar retrospectivo para o setor farmacêutico. O objetivo do artigo é discutir as mudanças produzidas pela financeirização no âmbito da indústria farmacêutica. Para tanto, realizou-se revisão da literatura científica por busca e seleção sistematizadas. Os artigos, na maioria sobre empresas sediadas no RU e EUA, evidenciaram a dominância financeira pela concepção da empresa como ativo, participação dos fundos de alto risco, protagonismo dos ativos intangíveis, maximização do valor dos acionistas, desintegração vertical das atividades, intensificação de fusões e aquisições e encurtamento do horizonte de planejamento. Esses elementos não foram homogêneos em todos estudos demandando análises específicas por países e estudos de caso. A presente revisão contribuiu para a discussão do avanço tecnológico e aponta lacunas na produção cientifica no contexto de economias periféricas e articulada às políticas públicas e sistemas de saúde. Financial dominance is a new systemic pattern of wealth that establishes new ways to define, manage and realize wealth. Non-financial corporations have transformed themselves in line with financial dominance, which can cause developments in the productive and innovation dynamics, as well as in national economies. During the coronavirus pandemic, Covid-19, the extreme need for technological development imputes the importance of a retrospective look to the pharmaceutical sector. The article discusses the changes brought about by financialization in the scope of the pharmaceutical industry. To this end, a review of the scientific literature was carried out by systematic search and selection. The articles, mostly about companies based in the UK and the USA, showed financial dominance due to the company's conception as an asset, participation of high-risk funds, the role of intangible assets, maximization of shareholder value, vertical disintegration of activities, intensification of mergers and acquisitions and shortening the planning horizon. These elements were not homogeneous in all studies, requiring country-specific analyzes and case studies. This review contributed to the discussion of technological advances and points out gaps in scientific production in the context of peripheral economies and linked to public policies and health systems.

Peripheral facial nerve palsy associated with COVID-19.

COVID-19 pandemic revealed several neurological syndromes related to this infection. We describe the clinical, laboratory, and radiological features of eight patients with COVID-19 who developed peripheral facial palsy during infection. In three patients, facial palsy was the first symptom. Nerve damage resulted in mild dysfunction in five patients and moderate in three. SARS-Cov-2 was not detected in CSF by PCR in any of the samples. Seven out of eight patients were treated with steroids and all patients have complete or partial recovery of the symptoms. Peripheral facial palsy should be added to the spectrum of neurological manifestations associated with COVID-19.

Smell dysfunction in COVID-19 patients: More than a yes-no question.

Anosmia has been recognized as a prevalent and early symptom by many COVID-19 patients. However, most researchers have recorded smell dysfunction solely as present or absent and based on subjective evaluation by patients. We described the results of 57 consecutive COVID-19 patients seen at FIOCRUZ, Rio de Janeiro, Brazil, from April to May 2020. Data about the presence of smell loss, the onset of smell loss and other COVID-19 symptoms such as ageusia and nasal congestion or rhinorrhea were recorded. All patients at the initial consultation and 34 healthy controls underwent the Q-SIT, which is a quick disposable three-item smell identification test, by a trained physician. We compared three groups: healthy controls, COVID+ patients with reported smell loss (COVID w/ SL) and COVID+ patients without smell loss (COVID+ w/o SL). The mean age of patients was 41.4 years (SD ± 10.4), and 54.4% were women. Smell loss was reported by 40.4% of COVID-19 patients. We observed a gradual effect with higher Q-SIT scores in healthy controls, followed by COVID+ w/o SL and COVID+ w/ SL (medians = 3, 2 and 0; respectively, p < 0.001). Anosmia or severe microsmia (Q-SIT≤1) was present in 11.1% (CI: 3.1%-26.1%) of controls, 32.4% (CI: 17.4%-50.5%) of COVID-19 w/o SL and 87% (CI: 66.4%-97.2%) of COVID+ w/ SL (p < 0.001). This study provides evidence that olfactory dysfunction in COVID-19 is common and more prevalent than what is perceived by patients. Q-SIT is a quick and reliable screening test for the detection of smell dysfunction during the pandemics.

Patients with COVID-19 and neurological manifestations show undetectable SARS-CoV-2 RNA levels in the cerebrospinal fluid.

We report that patients with COVID-19 displaying distinct neurological disorders have undetectable or extremely low levels of SARS-CoV-2 RNA in the cerebrospinal fluid, indicating that viral clearance precede the neurological involvement. This finding points to the need for the development of more sensitive molecular tests and the investigation of other neurotropic pathogens to exclude concurrent neuroinfection.