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1.
Life (Basel) ; 12(3)2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1732112

ABSTRACT

Staphylococcus epidermidis is more abundant in the anterior nares than internal parts of the nose, but its relative abundance changes along with age; it is more abundant in adolescents than in children and adults. Various studies have shown that S. epidermidis is the guardian of the nasal cavity because it prevents the colonization and infection of respiratory pathogens (bacteria and viruses) through the secretion of antimicrobial molecules and inhibitors of biofilm formation, occupying the space of the membrane mucosa and through the stimulation of the host's innate and adaptive immunity. There is a strong relationship between the low number of S. epidermidis in the nasal cavity and the increased risk of serious respiratory infections. The direct application of S. epidermidis into the nasal cavity could be an effective therapeutic strategy to prevent respiratory infections and to restore nasal cavity homeostasis. This review shows the mechanisms that S. epidermidis uses to eliminate respiratory pathogens from the nasal cavity, also S. epidermidis is proposed to be used as a probiotic to prevent the development of COVID-19 because S. epidermidis induces the production of interferon type I and III and decreases the expression of the entry receptors of SARS-CoV-2 (ACE2 and TMPRSS2) in the nasal epithelial cells.

3.
Rev Esp Cardiol ; 73(12): 985-993, 2020 Dec.
Article in Spanish | MEDLINE | ID: covidwho-878201

ABSTRACT

INTRODUCTION AND OBJECTIVES: Despite advances in treatment, patients with acute myocardial infarction (AMI) still exhibit unfavorable short- and long-term prognoses. In addition, there is scant evidence about the clinical outcomes of patients with AMI and coronavirus disease 2019 (COVID-19). The objective of this study was to describe the clinical presentation, complications, and risk factors for mortality in patients admitted for AMI during the COVID-19 pandemic. METHODS: This prospective, multicenter, cohort study included all consecutive patients with AMI who underwent coronary angiography in a 30-day period corresponding chronologically with the COVID-19 outbreak (March 15 to April 15, 2020). Clinical presentations and outcomes were compared between COVID-19 and non-COVID-19 patients. The effect of COVID-19 on mortality was assessed by propensity score matching and with a multivariate logistic regression model. RESULTS: In total, 187 patients were admitted for AMI, 111 with ST-segment elevation AMI and 76 with non-ST-segment elevation AMI. Of these, 32 (17%) were diagnosed with COVID-19. GRACE score, Killip-Kimball classification, and several inflammatory markers were significantly higher in COVID-19-positive patients. Total and cardiovascular mortality were also significantly higher in COVID-19-positive patients (25% vs 3.8% [P < .001] and 15.2% vs 1.8% [P = .001], respectively). GRACE score > 140 (OR, 23.45; 95%CI, 2.52-62.51; P = .005) and COVID-19 (OR, 6.61; 95%CI, 1.82-24.43; P = .02) were independent predictors of in-hospital death. CONCLUSIONS: During this pandemic, a high GRACE score and COVID-19 were independent risk factors associated with higher in-hospital mortality.Full English text available from:www.revespcardiol.org/en.

5.
EClinicalMedicine ; 27: 100518, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-730421

ABSTRACT

BACKGROUND: Most data on the clinical presentation, diagnostics, and outcomes of patients with COVID-19 have been presented as case series without comparison to patients with other acute respiratory illnesses. METHODS: We examined emergency department patients between February 3 and March 31, 2020 with an acute respiratory illness who were tested for SARS-CoV-2. We determined COVID-19 status by PCR and metagenomic next generation sequencing (mNGS). We compared clinical presentation, diagnostics, treatment, and outcomes. FINDINGS: Among 316 patients, 33 tested positive for SARS-CoV-2; 31 without COVID-19 tested positive for another respiratory virus. Among patients with additional viral testing (27/33), no SARS-CoV-2 co-infections were identified. Compared to those who tested negative, patients with COVID-19 reported longer symptoms duration (median 7d vs. 3d, p < 0.001). Patients with COVID-19 were more often hospitalized (79% vs. 56%, p = 0.014). When hospitalized, patients with COVID-19 had longer hospitalizations (median 10.7d vs. 4.7d, p < 0.001) and more often developed ARDS (23% vs. 3%, p < 0.001). Most comorbidities, medications, symptoms, vital signs, laboratories, treatments, and outcomes did not differ by COVID-19 status. INTERPRETATION: While we found differences in clinical features of COVID-19 compared to other acute respiratory illnesses, there was significant overlap in presentation and comorbidities. Patients with COVID-19 were more likely to be admitted to the hospital, have longer hospitalizations and develop ARDS, and were unlikely to have co-existent viral infections. FUNDING: National Center for Advancing Translational Sciences, National Heart Lung Blood Institute, National Institute of Allergy and Infectious Diseases, Chan Zuckerberg Biohub, Chan Zuckerberg Initiative.

6.
Front Neurol ; 11: 664, 2020.
Article in English | MEDLINE | ID: covidwho-658453

ABSTRACT

With the rapid pace and scale of the emerging coronavirus 2019 (COVID-19) pandemic, a growing body of evidence has shown a strong association of COVID-19 with pre- and post- neurological complications. This has necessitated the need to incorporate targeted neurological care for this subgroup of patients which warrants further reorganization of services, healthcare workforce, and ongoing management of chronic neurological cases. The social distancing and the shutdown imposed by several nations in the midst of COVID-19 have severely impacted the ongoing care, access and support of patients with chronic neurological conditions such as Multiple Sclerosis, Epilepsy, Neuromuscular Disorders, Migraine, Dementia, and Parkinson disease. There is a pressing need for governing bodies including national and international professional associations, health ministries and health institutions to harmonize policies, guidelines, and recommendations relating to the management of chronic neurological conditions. These harmonized guidelines should ensure patient continuity across the spectrum of hospital and community care including the well-being, safety, and mental health of the patients, their care partners and the health professionals involved. This article provides an in-depth analysis of the impact of COVID-19 on chronic neurological conditions and specific recommendations to minimize the potential harm to those at high risk.

7.
J Am Coll Cardiol ; 76(3): 268-276, 2020 07 21.
Article in English | MEDLINE | ID: covidwho-382030

ABSTRACT

BACKGROUND: Coronavirus disease-2019 (COVID-19) is caused by severe acute respiratory-syndrome coronavirus-2 that interfaces with the renin-angiotensin-aldosterone system (RAAS) through angiotensin-converting enzyme 2. This interaction has been proposed as a potential risk factor in patients treated with RAAS inhibitors. OBJECTIVES: This study analyzed whether RAAS inhibitors modify the risk for COVID-19. METHODS: The RASTAVI (Renin-Angiotensin System Blockade Benefits in Clinical Evolution and Ventricular Remodeling After Transcatheter Aortic Valve Implantation) trial is an ongoing randomized clinical trial randomly allocating subjects to ramipril or control groups after successful transcatheter aortic valve replacement at 14 centers in Spain. A non-pre-specified interim analysis was performed to evaluate ramipril's impact on COVID-19 risk in this vulnerable population. RESULTS: As of April 1, 2020, 102 patients (50 in the ramipril group and 52 in the control group) were included in the trial. Mean age was 82.3 ± 6.1 years, 56.9% of the participants were male. Median time of ramipril treatment was 6 months (interquartile range: 2.9 to 11.4 months). Eleven patients (10.8%) have been diagnosed with COVID-19 (6 in control group and 5 receiving ramipril; hazard ratio: 1.150; 95% confidence interval: 0.351 to 3.768). The risk of COVID-19 was increased in older patients (p = 0.019) and those with atrial fibrillation (p = 0.066), lower hematocrit (p = 0.084), and more comorbidities according to Society of Thoracic Surgeons score (p = 0.065). Admission and oxygen supply was required in 4.9% of patients (2 in the ramipril group and 3 in the control group), and 4 of them died (2 in each randomized group). A higher body mass index was the only factor increasing the mortality rate (p = 0.039). CONCLUSIONS: In a high-risk population of older patients with cardiovascular disease, randomization to ramipril had no impact on the incidence or severity of COVID-19. This analysis supports the maintenance of RAAS inhibitor treatment during the COVID-19 crisis. (Renin-Angiotensin System Blockade Benefits in Clinical Evolution and Ventricular Remodeling After Transcatheter Aortic Valve Implantation [RASTAVI]; NCT03201185).


Subject(s)
Angiotensin-Converting Enzyme Inhibitors/adverse effects , Coronavirus Infections/mortality , Pneumonia, Viral/mortality , Ramipril/adverse effects , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Coronavirus Infections/chemically induced , Female , Humans , Male , Pandemics , Pneumonia, Viral/chemically induced , Randomized Controlled Trials as Topic , Risk Factors , SARS-CoV-2 , Spain/epidemiology
8.
COVID-19, Insomnia, Depression, Anxiety |*Anxiety |*Insomnia |*Major Depression |*Physicians |*covid-19 |Medical Personnel |Pandemics |Test Construction |Sleep Quality |Impaired Professionals [3470] |Anxiety |Brazil |covid-19 |China |Cross-Sectional Studies |Depression |Female |Humans |SARS-CoV-2 |Sleep |Sleep Initiation and Maintenance Disorders |Surveys and Questionnaires |Human Male Female Adulthood (18 yrs & older) Young Adulthood (18-29 yrs) Thirties (30-39 yrs) Middle Age (40-64 yrs) ; 2021(Arquivos de Neuro-Psiquiatria)
Article in English | Feb | ID: covidwho-1760013

ABSTRACT

Introduction: Coronavirus pandemic began in China in 2019 (COVID-19), causing not only public health problems but also great psychological distress, especially for physicians involved in coping with the virus or those of the risk group in social isolation, and this represents a challenge for the psychological resilience in the world population. Studies showed that health professionals had psychological symptoms such as depression, anxiety, insomnia, stress, among others. Objectives: To investigate the quality of sleep and the prevalence rate of sleeping disorders among physicians during COVID-19 pandemic, and identify the psychological and social factors associated with the condition. Methods: A cross-sectional study of an online questionnaire was applied for physicians in Brazil. Among the 332 participants included, 227 were women. Sociodemographic assessment was used in the questionnaire, as well as the scale of impact on the events of modifications caused by COVID-19, assessment on sleep quality (PSQI), presence and severity of insomnia (ISI), depressive symptoms (PHQ-9), and anxiety (GAD-7). Results: Most physicians (65.6%) had changes in sleep. Poor sleep quality was reported by 73.1%, depressive symptoms were present in 75.8%, and anxiety in 73.4%. Conclusion: Our study found that more than 70% of the physicians assessed had impaired sleep quality, characterizing insomnia symptoms during COVID-19 outbreak. Related factors included an environment of isolation, concerns about COVID-19 outbreak and symptoms of anxiety and depression. Special interventions are needed to promote health professionals' mental well-being and implement changes in this scenario. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Abstract (Portuguese) Introducao: A pandemia de coronavirus iniciada na China em 2019 (COVID-19) nao so causou problemas de saude publica mas tambem trouxe grande sofrimento psiquico, principalmente aos medicos envolvidos no enfrentamento da doenca ou aqueles do grupo de risco em isolamento social, e representa um desafio para a resiliencia psicologica da populacao mundial. Estudos mostram que profissionais de saude apresentaram sintomas psicologicos como depressao, ansiedade, insonia, estresse, entre outros. Objetivos: Investigar a qualidade do sono e a taxa de prevalencia de transtornos do sono entre os medicos durante a pandemia do COVID-19, e identificar os fatores psicologicos e sociais associados ao quadro. Metodos: Estudo transversal com aplicacao de questionario on-line a medicos do Brasil e inclusao de 332 participantes, dos quais 227 eram mulheres. Foram utilizados questionarios com avaliacao sociodemografica, escala de impacto a eventos com modificacoes causadas pelo COVID-19, avaliacao da qualidade do sono (PSQI), presenca e gravidade da insonia (IGI), sintomas depressivos (PHQ-9) e ansiedade (TAG-7). Resultados: A maioria dos medicos (65,6%) apresentou alteracoes no sono, sendo a ma qualidade do sono reportada por 73,1%. Sintomas depressivos estiveram presentes em 75,8%, e ansiedade em 73,4%. Conclusao: Nosso estudo constatou que mais de 70% dos medicos avaliados apresentavam comprometimento da qualidade do sono, caracterizando sintomas de insonia durante o surto de COVID-19. Os fatores relacionados incluiram ambiente de isolamento, preocupacoes com o surto de COVID-19 e sintomas de ansiedade e depressao. Intervencoes especiais sao necessarias para promover o bem-estar mental dos profissionais de saude e implementar mudancas nesse cenario. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

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