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1.
Caries research ; 09, 2023.
Article in English | EMBASE | ID: covidwho-2194331

ABSTRACT

AIM: to evaluate changes in the frequency of use of minimum interventions (MI) techniques for caries management during the COVID-19 pandemic. MATERIALS AND METHODS: a questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of non-invasive, micro-invasive, minimally invasive, and mixed interventions, non-aerosol, or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test and the effect size (ES) was calculated. An alpha = 0.05 was adopted. RESULT(S): a total of 781 dentists answered the questionnaire;most of them were female (76.4%), with 30's (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the non-invasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p<0.01;ES=0.11). The frequency of sealants to repair defective restorations were the only micro invasive technique that increased during the pandemic (p<0.01;ES=0.03). Among the minimally invasive techniques the use of atraumatic restorative treatment (ART) increased significantly (p<0.01;ES=0.06), while the use of air abrasion decreased (p=0.02;ES=0.04) during COVID-19 pandemic. Moreover, non-restorative cavity control (mixed intervention) increased during pandemic period (p<0.001;ES=0.11). CONCLUSION(S): Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period. Copyright S. Karger AG, Basel.

2.
Neuropsychology ; 2023.
Article in English | PubMed | ID: covidwho-2185599

ABSTRACT

OBJECTIVES: (a) To characterize the frequency of objective cognitive deficits and self-perceived cognitive difficulties and (b) to explore demographic and clinical predictors of cognitive dysfunction and cognitive complaints. METHOD: One hundred and ten adults diagnosed with COVID-19 between March and November 2020, aged ≤ 74 years underwent a brief neuropsychological evaluation 12 months after infection, which included: Brief Visuospatial Memory Test-Revised, California Verbal Learning Test, and Symbol Digit Modalities Test. T scores < 38 were considered abnormal performance;cognitive dysfunction was defined as ≥ 2 abnormal tests. Participants also completed Broadbent's Cognitive Failure Questionnaires (CFQ), Hospital Anxiety and Depression Scale, Modified Fatigue Impact Scale, and Short-Form Health Survey. CFQ ≥ 43 was considered indicative of cognitive complaints. RESULTS: Twenty participants (18.2%) had cognitive dysfunction and 36 (33.3%) had cognitive complaints. Cognitive dysfunction was related to lower education, preinfection history of headache/migraine, and acute COVID-19 symptoms of headache and sleep disturbance. Cognitive complaints were more likely to occur in women, those with fewer years of education, and acute COVID-19 symptoms of headache and sleep disturbance. Cognitive complaints were also significantly related to symptoms of anxiety, depression, and fatigue. Sex and psychopathology were not significant predictors of cognitive dysfunction. Modest associations were found between CFQ total score and cognitive test performance. DISCUSSION: A subset of individuals develops cognitive difficulties in the context of post-COVID syndrome. Results may support the protective effect of education, a known proxy of cognitive reserve. COVID-19 infection symptoms of headache and sleep disturbance appear to be risk factors for long-term cognitive difficulties. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

5.
Eur Arch Paediatr Dent ; 2022 Jul 13.
Article in English | MEDLINE | ID: covidwho-1930614

ABSTRACT

BACKGROUND: Chemical-mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries removal. AIM: Characterize the worldwide scientific literature about CMCR products, over the years, by means of a critical review. DESIGN: Electronic search was performed on Medline/PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, and Embase up to November 2020. Year, journal, country of authors, and type of study were the data extracted from the retrieved studies. Additional data of the clinical studies and systematic reviews were investigated. RESULTS: 2221 records were identified, 397 selected. 2011-2020 period concentrates higher number of publications (n = 169), in the Journal of Dental Research (n = 51), developed in Brazil (n = 45) and India (n = 44). Most studies were in vitro (n = 211) and clinical trials (n = 101). Carisolv™ (n = 48) and Papacarie Duo Gel™ (n = 33) were the most used products, prescript in isolated usage (n = 101), and compared with drills (n = 77). CMCR were more studied in primary teeth (n = 78), receiving glass ionomer cement (GIC) (n = 51) as restorative material. The most evaluated outcomes were time spent (n = 48) and pain (n = 41). Clinical application of CMCR takes more time than other techniques, but can also reduce patient anxiety, pain, and need for anesthesia. CONCLUSION: In vitro and clinical studies with CMCR products have been increasing, mostly carried out in developing countries, evaluating Carisolv™ and Papacarie Duo Gel™. Clinical studies tend to evaluate the time spent and pain compared to drills for removing caries in primary teeth, posteriorly restored with GIC. CMCR clinical application reduces anxiety, pain, and need for anesthesia, despite increase treatments' time.

6.
Progress in Palliative Care ; 30(1):1-3, 2022.
Article in English | EMBASE | ID: covidwho-1758509
8.
Revista Cientifica Multidisciplinar RECIMA21 ; 2(5), 2021.
Article in Portuguese | CAB Abstracts | ID: covidwho-1319983

ABSTRACT

COVID-19 has represented a global challenge to health systems, expanding at an increasing rate of deaths. Methods to control the spread of the disease such as social isolation and tracing of case contacts have been used around the world. With the emergence of COVID-19, it was necessary to expand applications and adopt Telehealth technologies.

9.
European Journal of Neurology ; 28(SUPPL 1):291, 2021.
Article in English | EMBASE | ID: covidwho-1307719

ABSTRACT

Background and aims: Neurological symptoms are reported in over 30% of COVID-19 hospitalized patients. However, systematic studies reporting these manifestations in ambulatory patients are still missing. We aim to characterize and compare neurological phenotypes in hospitalized and ambulatory COVID-19 patients. Methods: Retrospective study in patients with laboratory confirmation of SARS-CoV-2 infection in a tertiary hospital in the North of Portugal, between March 1st and April 30th. Data from hospitalized patients was collected through electronic medical records;ambulatory patients' data was collected using a structured telephonic survey. Results: From a total of 283 patients hospitalized in this period with COVID-19, 116 (40.9%) had at least one neurological manifestation. Mean age was 64 years (20- 100) and 58.6% were women (n=68). The most frequent manifestation was headache (24.7%), followed by myalgia (15.5%) and hyposmia (10.6%). Other neurological manifestations were reported in <10%. In this period, from 488 ambulatory patients infected with COVID-19, all but one reported at least one neurological manifestation (n=487). Mean age was 50.3 years (18-93) and 63% were women (n=307). Myalgia was the most frequent symptom (71.1%), followed by anosmia (65.4%), disgeusia (62.9%) and headache (58.4%). EPR302 Sleep disorders and cognitive complaints were also frequent (39.9% and 17.4%). Hypertension, diabetes, cardiovascular, lung and kidney disease were more prevalent in hospitalized patients. Conclusion: In the 1st systematic evaluation of neurological symptoms in outpatient COVID-19 patients we found an extremely high rate of neurological manifestations, suggesting neurological involvement is not dependent on COVID-19 disease severity. Host susceptibility and viral characteristics may drive the neurological phenotype.

10.
European Journal of Neurology ; 28(SUPPL 1):158, 2021.
Article in English | EMBASE | ID: covidwho-1307712

ABSTRACT

Background and aims: COVID-19 related acute neurological phenotypes have been reported in over 30% of hospitalized patients. However, multicentric studies providing a population-based overview are still lacking. Methods: We conducted a retrospective multicentric study in five hospitals in Northern Portugal, between March 1st and June 30th 2020. Patient e-records were systematically revised using a standardized form to identify neurological manifestations stratified by type and severity. Results: From a total of 13,144 persons diagnosed with COVID-19 in the northern region, 2,795 (21.3%) required hospitalization. We reviewed a sample of 1,261 (45.1%) hospitalized patients and found a rate of 362 neurological manifestations per 1000 admitted COVID-19 patients, estimating a total of 1009 hospitalized patients with a neurological manifestation in the Northern Region. Patients with neurologic manifestations were younger (p=0.002), and the most frequent neurological symptoms were headache (13.4%), delirium (10.1%) and impairment of consciousness (9.7%). We observed a rate of 7.8 severe neurological events per every 1000 COVID-19 infected patients, including stroke, seizures, Guillain-Barre syndrome and myelopathy. The fatality among patients with neurological manifestations was 19.8%, and 15.6% had a modified Rankin Scale of 4-5 at hospital discharge. Conclusion: We characterized the population of hospitalized COVID-19 patients from the northern region of Portugal and found that neurological symptoms are common and associated with a high degree of disability. CNS involvement with criteria for in-hospital admission was observed in a significant proportion of patients. Neurology support is highly relevant in the multidisciplinary care of COVID-19 patients.

11.
Health Secur ; 19(5): 459-467, 2021.
Article in English | MEDLINE | ID: covidwho-1262059

ABSTRACT

Before the predicted March 2020 surge of COVID-19, US healthcare organizations were charged with developing resource allocation policies. We assessed policy preparedness and substantive triage criteria within existing policies using a cross-sectional survey distributed to public health personnel and healthcare providers between March 23 and April 23, 2020. Personnel and providers from 68 organizations from 34 US states responded. While half of the organizations did not yet have formal allocation policies, all but 4 were in the process of developing policies. Using manual abstraction and natural language processing, we summarize the origins and features of the policies. Most policies included objective triage criteria, specified inapplicable criteria, separated triage and clinical decision making, detailed reassessment plans, offered an appeals process, and addressed palliative care. All but 1 policy referenced a sequential organ failure assessment score as a triage criterion, and 10 policies categorically excluded patients. Six policies were almost identical, tracing their origins to influenza planning. This sample of policies reflects organizational strategies of exemplar-based policy development and the use of objective criteria in triage decisions, either before or instead of clinical judgment, to support ethical distribution of resources. Future guidance is warranted on how to adapt policies across disease type, choose objective criteria, and specify processes that rely on clinical judgments.


Subject(s)
COVID-19 , Triage , Cross-Sectional Studies , Health Care Rationing , Humans , Policy , Resource Allocation , SARS-CoV-2 , Ventilators, Mechanical
12.
Evaluation & the Health Professions ; 44(2):192-197, 2021.
Article in English | MEDLINE | ID: covidwho-1209074

ABSTRACT

Dentists are healthcare professionals who are at high risk of infection and transmission of the coronavirus disease-19 (COVID-19). The primary objective of the present study was to evaluate the changes in clinical practice made by Brazilian dentists during the COVID-19 pandemic. From June 22 to July 13, 2020, an online questionnaire was sent to dentists using Google Forms. After providing consent, 1,178 dentists answered questions regarding their knowledge and clinical experiences related to COVID-19. Data were analyzed using Chi-square, Fisher's exact, or Kruskal-Wallis tests, with a significance level of 5%. Brazilian dentists significantly changed their routine dental practices. Biosafety measures were added in their offices by 98% of the dentists, increasing operating costs for 88.3% of dentists. Greater discomfort due to the increase in personal protection equipment (PPE) worn during the pandemic was reported by 58.6%. Furthermore, 84.2% reduced heir hours of service. It was found that the dentists decreased their workload, used additional PPE, and took additional biosafety measures.

13.
Hepatology ; 72(1 SUPPL):278A-279A, 2020.
Article in English | EMBASE | ID: covidwho-986085

ABSTRACT

Background: The impact of SARS-CoV-2 infection on the liver and the possibility of chronic liver disease (CLD) as a risk factor for COVID-19 severity is not fully understood Our goal was to describe clinical outcomes of COVID-19 patients regarding the presence of abnormal liver tests (LTs) and CLD Methods: Retrospective analysis of clinical, analytical and imaging features of patients with SARS-CoV-2 infection, hospitalized in a tertiary care center in Portugal from March 2nd to May 4th, 2020 Studied outcomes were disease and hospitalization duration, COVID-19 severity, admission to intensive care unit (ICU) and mortality, analyzed by the presence of abnormal liver enzymes and CLD Results: We included 317 inpatients with a mean age of 70 4 years, 50 5% males COVID-19 severity was moderate to severe in 57 4% and critical in 12 9% Mean disease duration was 37 8 days, median hospitalization duration 10 0 days and overall mortality 28 6% At admission, 50 3% of the patients showed abnormal LTs and 41 5% showed elevated transaminase levels, from which the majority (75 4%) were mild (up to 2x the ULN) Male gender (62 3% vs 37 3%, p= 001) and age >65 years (71.3% vs 28.7%, p=.006) were associated with elevated transaminase levels Also, elevated transaminases at admission were associated with COVID-19 severity (34 4% vs 18 38%, p= 001), ICU admission (13 1% vs 5 92%, p= 034) and increased mortality (25 8% vs 13 3%, p= 007) In our cohort, 14 patients had baseline CLD (4 42%), 3 of them with cirrhosis Alcohol (n=6) and non-alcoholic fatty liver disease (n=6) were the most frequent etiologies CLD patients presented increased frequency of critical COVID-19 (21 4% vs 12 5%, p= 237), longer disease duration (36 6 vs 31 4 days, p= 291), hospitalization duration (11 5 vs 10 0 days, p= 447) and increased mortality (28 6% vs 22 5%, p= 595) Cirrhotic patients had longer inpatient duration (15 0 vs 10 0 days, p= 639), increased COVID-19 severity (66 6% vs 54 6%, p= 844) and higher mortality (66 7% vs 18 2%, p= 176) Conclusion: LTs abnormalities in COVID-19 patients were frequent but most commonly mild They were associated with worse clinical outcomes, such as COVID-19 severity, ICU admission and mortality Also, 4 41% of our COVID-19 patients presented CLD and a trend towards worse clinical outcomes.

14.
Eur J Neurol ; 27(9): 1727-1737, 2020 09.
Article in English | MEDLINE | ID: covidwho-968319

ABSTRACT

BACKGROUND AND PURPOSE: Although the main clinical features of COVID-19 infection are pulmonary, several associated neurological signs, symptoms and diseases are emerging. The incidence and characteristics of neurological complications are unclear. For this reason, the European Academy of Neurology (EAN) core COVID-19 Task Force initiated a survey on neurological symptoms observed in patients with COVID-19 infection. METHODS: A 17-question online survey was made available on the EAN website and distributed to EAN members and other worldwide physicians starting on 9 April 2020. RESULTS: By 27 April 2020, proper data were collected from 2343 responders (out of 4199), of whom 82.0% were neurologists, mostly from Europe. Most responders (74.7%) consulted patients with COVID-19 mainly in emergency rooms and in COVID-19 units. The majority (67.0%) had evaluated fewer than 10 patients with neurological manifestations of COVID-19 (neuro COVID-19). The most frequently reported neurological findings were headache (61.9%), myalgia (50.4%), anosmia (49.2%), ageusia (39.8%), impaired consciousness (29.3%) and psychomotor agitation (26.7%). Encephalopathy and acute cerebrovascular disorders were reported at 21.0%. Neurological manifestations were generally interpreted as being possibly related to COVID-19; they were most commonly recognized in patients with multiple general symptoms and occurred at any time during infection. CONCLUSION: Neurologists are currently and actively involved in the management of neurological issues related to the COVID-19 pandemic. This survey justifies setting up a prospective registry to better capture the prevalence of patients with neuro COVID-19, neurological disease characteristics and the contribution of neurological manifestations to outcome.


Subject(s)
Anosmia/etiology , COVID-19/complications , Headache/etiology , Myalgia/etiology , Psychomotor Agitation/etiology , Europe , Health Surveys , Humans , Neurology
15.
Eur J Neurol ; 28(1): 7-14, 2021 01.
Article in English | MEDLINE | ID: covidwho-861849

ABSTRACT

BACKGROUND AND PURPOSE: The recent SARS-CoV-2 pandemic has posed multiple challenges to the practice of clinical neurology including recognition of emerging neurological complications and management of coexistent neurological diseases. In a fast-evolving pandemic, evidence-based studies are lacking in many areas. This paper presents European Academy of Neurology (EAN) expert consensus statements to guide neurologists caring for patients with COVID-19. METHODS: A refined Delphi methodology was applied. In round 1, statements were provided by EAN scientific panels (SPs). In round 2, these statements were circulated to SP members not involved in writing them, asking for agreement/disagreement. Items with agreement >70% were retained for round 3, in which SP co-chairs rated importance on a five-point Likert scale. Results were graded by importance and reported as consensus statements. RESULTS: In round one, 70 statements were provided by 23 SPs. In round two, 259/1061 SP member responses were received. Fifty-nine statements obtained >70% agreement and were retained. In round three, responses were received from 55 co-chairs of 29 SPs. Whilst general recommendations related to prevention of COVID-19 transmission had high levels of agreement and importance, opinion was more varied concerning statements related to therapy. CONCLUSION: This is the first structured consensus statement on good clinical practice in patients with neurological disease during the COVID-19 pandemic that provides immediate guidance for neurologists. In this fast-evolving pandemic, a rapid response using refined Delphi methodology is possible, but guidance may be subject to change as further evidence emerges.


Subject(s)
COVID-19 , Nervous System Diseases/therapy , Pandemics , Patient Care Management , Consensus , Delphi Technique , Guidelines as Topic , Humans , Neurology
16.
Pain Physician ; 23(4 Special Issue):S353-S366, 2020.
Article in English | EMBASE | ID: covidwho-734672

ABSTRACT

Background: Chloroquine (CQ) and hydroxychloroquine (HCQ) are old drugs used against malaria, rheumatism, inflammation in the joints, lupus, among others. These drugs showed positive results in preliminary scientific research for treatment of the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Since the studies with CQ and HCQ are initial with small patient populations, it is not yet known whether there are adverse effects from the use of CQ and HCQ for patients infected with the coronavirus. Objectives: The aim of this study was to evaluate the evidence regarding the efficacy and safety of CQ and HCQ used against viral infection caused by SARS-CoV-2. Study Design: This is a narrative review of the traditional prescriptions of CQ and HCQ efficacy and adverse effects as well as their employment for coronavirus disease 2019 (COVID-19). Setting: In vitro and clinical studies comparing the antiviral efficacy and adverse effect profile of CQ and HCQ against COVID-19 in adult patients were evaluated. Methods: A systemic search of reviews, including in vitro and clinical trial studies in English focusing on CQ and HCQ effects and adverse effects against COVID-19 in the adult patient population from PubMed was performed. It included studies reporting chloroquine and hydroxychloroquine effects and adverse effects against COVID-19. Results: A total of 42 articles published between 2004 and April 2020 were reviewed for therapeutic use of CQ and HCQ. Both these drugs showed a significant in vitro potential against coronavirus. Many studies for clinical use of CQ and HCQ showed that patients presented adverse reactions on high doses. Limitations: Clinical studies have some methodology shortcomings, such as lack of information about the treatment and small number of experimental patients, leading to a misinterpretation of the data. Besides, there are few clinical studies with a limited sample size. Moreover, most of them did not present control groups, and some patients had died during these protocols. Discussion: Despite both CQ and HCQ in vitro antiviral evidence, clinically, both drugs, either alone or combined with other medications, may increase the risk of cardiac arrhythmias, leading to cardiac arrest and sudden death. Besides, a lot of uncertainty still remains, such as starting administration period, dose prescribed, length of treatment, patients’ condition, concomitant drug use, among others. Conclusion: From the studies reviewed, it is not possible to state the precise efficacy and safety of CQ and HCQ use in the treatment of COVID-19 at any time in the course of the disease. Future studies are warranted.

17.
Eur J Neurol ; 27(9): 1764-1773, 2020 09.
Article in English | MEDLINE | ID: covidwho-116448

ABSTRACT

The current coronavirus disease (COVID-19) outbreak, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has raised the possibility of potential neurotropic properties of this virus. Indeed, neurological sequelae of SARS-CoV-2 infection have already been reported and highlight the relevance of considering the neurological impact of coronavirus (CoV) from a translational perspective. Animal models of SARS and Middle East respiratory syndrome, caused by structurally similar CoVs during the 2002 and 2012 epidemics, have provided valuable data on nervous system involvement by CoVs and the potential for central nervous system spread of SARS-CoV-2. One key finding that may unify these pathogens is that all require angiotensin-converting enzyme 2 as a cell entry receptor. The CoV spike glycoprotein, by which SARS-CoV-2 binds to cell membranes, binds angiotensin-converting enzyme 2 with a higher affinity compared with SARS-CoV. The expression of this receptor in neurons and endothelial cells hints that SARS-CoV-2 may have higher neuroinvasive potential compared with previous CoVs. However, it remains to be determined how such invasiveness might contribute to respiratory failure or cause direct neurological damage. Both direct and indirect mechanisms may be of relevance. Clinical heterogeneity potentially driven by differential host immune-mediated responses will require extensive investigation. Development of disease models to anticipate emerging neurological complications and to explore mechanisms of direct or immune-mediated pathogenicity in the short and medium term is therefore of great importance. In this brief review, we describe the current knowledge from models of previous CoV infections and discuss their potential relevance to COVID-19.


Subject(s)
Brain/virology , COVID-19/virology , Endothelial Cells/virology , SARS-CoV-2/physiology , Animals , Humans , Models, Animal , Translational Research, Biomedical
18.
Non-conventional in English | WHO COVID | ID: covidwho-1372030

ABSTRACT

The objective of this work was to evaluate the relationship between factors associated with the COVID-19 pandemic and depression, anxiety, and stress (DAS) in dentists. Factors associated with the COVID-19 pandemic were evaluated using a questionnaire and scores of the Depression, Anxiety, and Stress Scales-21 were measured. The differences between the DAS scores based on the factors associated with the COVID-19 pandemic were tested through the successive application of multivariate analysis of variance (MANOVA, alpha = 0.05). After a sample size calculation, 998 participants with a mean age of 39.39 (+/- 11.69) years were included. The effect size indicated that changes in sleep quality (eta2 = 0.161), eating habits (eta2 = 0.057), and physical health (eta2 = 0.051) were the ones that most negatively affected DAS scores. The highest DAS scores were observed in professionals who lived with someone at high-risk for COVID-19 (p < 0.001) and in those who did not engage in leisure activities during the pandemic (p < 0.001). Dentists who worked on the frontline against COVID-19 had higher scores of anxiety and stress (p = 0.029). The highest scores for anxiety, depression, and/or stress were seen in dentists living with someone at high-risk for COVID-19, who acts on the frontline, who does not practice in leisure activities during the pandemic, who completely changed eating habits, quality of sleep and physical health during the pandemic. In general, DAS levels of dentists were associated with factors related to the COVID-19 pandemic.

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