Alpha 1-Acid Glycoprotein is Involved With Neutrophil Nets in COVID-19

Introduction: Orosomucoid also named Alpha-1 Acid Glycoprotein(AGP) is a major acute-phase protein and is increased in response to systemic injury and inflammation. AGP has been described as an inhibitor of neutrophil migration on sepsis, particularly its immunomodulation effects. The AGP biological functions are not understood in Coronavirus disease 2019 (COVID-19). Hypothesis: We hypothesize that plasmatic AGP is upregulated in severe Covid-19 patients and is involved in the regulation of netosis. Therefore, we sought to investigate the role of AGP in plasmatic from COVID-19 severe infection patients and neutrophils infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SarsCov-2). Method(s): Epidemiological data and AGP, interleukin-6 (IL-6), C-reactive protein (PCR), lactate, and other laboratorial parameters were measured in blood samples from 52 subjects hospitalized in the ICU with clinically SarsCov-2 infection confirmed by RT-PCR. To evaluate the role of AGP in netosis in neutrophils, blood samples from health patients (n=13) were collected, and neutrophils were separated and infected with Sars-Cov-2 (Moi=1). Those neutrophils were treated with AGP (10mug/ml) or vehicle for 18 hours and netosis was analyzed by flow cytometry (n=10) and immunofluorescence (IF;n=10). Early and late netosis, respectively, were characterized by negative or positive FVS and positive Sytox. The neutrophil extracellular traps (NETs) were investigated by myeloperoxidase (MPO), neutrophil elastase (NE), and DAPI by IF and quantified Netquant/Matlab software. This study was approved by Ethics Committee -CAAE: 30816620.0.0000.5440. Result(s): AGP increased in severe Covid-19 patients (p<0.05). A positive correlation between AGP with IL-6 and C-reactive protein (respectively, p=0.005, p=0.002) and a negative correlation between AGP and lactate (p=0.004) were found it. Together, AGP treatment downregulated early (35,7%) and late (43,5%) netosis in neutrophils infected with SarsCov-2. Confocal analysis by MPO, NE e DAPI showed NETs released by neutrophils infected with Sar-Cov-2 decreased when neutrophils were treated with AGP (p<0.05). Conclusion(s): Our data showed increased AGP in COVID-19 infection and contributed to netosis regulation.

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.

Lemierre's syndrome: case report of "the forgotten disease" in current COVID-19 pandemic.

Lemierre's syndrome refers to infectious thrombophlebitis of the internal jugular vein developed as complication of an oropharyngeal infection. It is a rare syndrome, affecting otherwise healthy young adults, which may lead to sepsis complicated by septic embolization. Although there is a characteristic clinical picture, many modern physicians are unaware of this syndrome, leading it to be termed 'the forgotten disease'. The authors report a case of late diagnosis due to initial suspicion of COVID-19 and highlight the pitfalls on its diagnosis.

Timber housing economy in Brazil: 2013 to 2022 scenarios and crises

Timber housing sector has several features and is essential for civil construction and forestry chains. In Brazil, the economy related to timber housing is still an unprecedented topic. Thus, the paper aimed to estimate scenarios to delimit the annual volume of this sector. Three years were studied from rare data available in the literature. From these national outcomes, projections for next years were developed. Multiple case approaches composed the literature-based methodology. As a result, the sector endured distinct internal and external economic instabilities, whose associated factors compiled political and sanitary crises, specially, with negative influences. The economy of timber housing reached an average about 500 million Dollars in 2014, being halved in 2015 due to the government crisis marked by the impeachment of the Brazilian president. From 2016 to 2019, small improvements were verified for this sector. In 2020, this favorable scenario was stagnated by the global Covid-19 pandemic. After 2021, a sectoral recovery is forecast based on positive expectations on the Brazilian economy. The two-year period of domestic presidential impeachment was more economically catastrophic than the current three-year phase of sanitary pandemic with global implications. From our economic forecasts, it was possible to attest that the Brazilian sector of timber houses is economically perceptible.

Delivery App workers: essentiality during Covid-19 and the lack of legislative and judicial protection

Delivery app services have expanded their activities during the Covid-19 pandemic. However, their workers have experienced even more social precarity. This paper investigates the relations between State action and the vulnerability faced by these workers during the pandemic context. It does so by following a two-fold methodological approach: based on research of legal documents and on literature review, the analysis ranges from the examination of concrete cases and norms to the consideration of underlying social theory concepts. In its first section, the paper analyses legislative and judicial documents and actions that conform delivery app workers' social precarity, so as to present the normative structure and the institutional dynamic that have operated in order to erode the incidence of social security rights, as well as of labor rights in contracts between delivery workers (contracted party) and digital platforms (contracting party). In the following section, the paper examines some theoretical categories - such as "espoliative contracts", "financialization" and "genocidal agenda" -, which allow a better understanding of the current patterns of relations between these parties. One may notice how, at the same time, delivery app workers are classified as "essential" but are continuously exposed to the sacrifice of themselves and their families, due to the lack of basic health and safety conditions at work.

Lemierre's Syndrome: Case Report Of 'The Forgotten Disease' In Current Covid-19 Pandemic

Introduction Lemierre's syndrome (LS) refers to infectious thrombophlebitis of the internal jugular vein (IJV) developed as a complication of an oropharyngeal infection. It is a serious condition which may lead to septicemia and septic embolization. LS is most frequently caused by the anaerobic Fusobacterium necrophorum. In the current post-antibiotic era, it is rare (annual incidence of 0.8 cases/million). Many clinicians are unaware of LS, leading it to be termed "the forgotten disease." Signs and symptoms include odynophagia, fever and easy fatigue simulating, among others, infection by COVID-19. Broad spectrum antibiotherapy should be started promptly. If a deep abscess is present, drainage is indicated. In cases of persistent sepsis or embolization, surgical ligation/excision of the IJV may be considered. Currently, the most controversial role in LS management is anticoagulation. Compared with pre-antibiotic era mortality has much improved (0-18%). Since 2004 there are only four cases of LS reported in Portugal (Medline).