Convergence model of AI and IoT for virus disease control system.

Recently, virus diseases, such as SARS-CoV, MERS-CoV, and COVID-19, continue to emerge and pose a severe public health problem. These diseases threaten the lives of many people and cause serious social and economic losses. Recent developments in information technology (IT) and connectivity have led to the emergence of Internet of Things (IoT) and Artificial Intelligence (AI) applications in many industries. These industries, where IoT and AI together are making significant impacts, are the healthcare and the diagnosis department. In addition, by actively communicating with smart devices and various biometric sensors, it is expanding its application fields to telemedicine, healthcare, and disease prevention. Even though existing IoT and AI technologies can enhance disease detection, monitoring, and quarantine, their impact is very limited because they are not integrated or applied rapidly to the emergence of a sudden epidemic. Especially in the situation where infectious diseases are rapidly spreading, the conventional methods fail to prevent large-scale infections and block global spreads through prediction, resulting in great loss of lives. Therefore, in this paper, various sources of infection information with local limitations are collected through virus disease information collector, and AI analysis and severity matching are performed through AI broker. Finally, through the Integrated Disease Control Center, risk alerts are issued, proliferation block letters are sent, and post-response services are provided quickly. Suppose we further develop the proposed integrated virus disease control model. In that case, it will be possible to proactively detect and warn of risk factors in response to infectious diseases that are rapidly spreading worldwide and strengthen measures to prevent spreading of infection in no time.

Covid-19 imaging: A narrative review.

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) imaging data is dispersed in numerous publications. A cohesive literature review is to be assembled. OBJECTIVE: To summarize the existing literature on Covid-19 pneumonia imaging including precautionary measures for radiology departments, Chest CT's role in diagnosis and management, imaging findings of Covid-19 patients including children and pregnant women, artificial intelligence applications and practical recommendations. METHODS: A systematic literature search of PubMed/med line electronic databases. RESULTS: The radiology department's staff is on the front line of the novel coronavirus outbreak. Strict adherence to precautionary measures is the main defense against infection's spread. Although nucleic acid testing is Covid-19's pneumonia diagnosis gold standard; kits shortage and low sensitivity led to the implementation of the highly sensitive chest computed tomography amidst initial diagnostic tools. Initial Covid-19 CT features comprise bilateral, peripheral or posterior, multilobar ground-glass opacities, predominantly in the lower lobes. Consolidations superimposed on ground-glass opacifications are found in few cases, preponderantly in the elderly. In later disease stages, GGO transformation into multifocal consolidations, thickened interlobular and intralobular lines, crazy paving, traction bronchiectasis, pleural thickening, and subpleural bands are reported. Standardized CT reporting is recommended to guide radiologists. While lung ultrasound, pulmonary MRI, and PET CT are not Covid-19 pneumonia's first-line investigative diagnostic modalities, their characteristic findings and clinical value are outlined. Artificial intelligence's role in strengthening available imaging tools is discussed. CONCLUSION: This review offers an exhaustive analysis of the current literature on imaging role and findings in COVID-19 pneumonia.

Machine learning-based diffusion model for prediction of coronavirus-19 outbreak.

The coronavirus pandemic has been globally impacting the health and prosperity of people. A persistent increase in the number of positive cases has boost the stress among governments across the globe. There is a need of approach which gives more accurate predictions of outbreak. This paper presents a novel approach called diffusion prediction model for prediction of number of coronavirus cases in four countries: India, France, China and Nepal. Diffusion prediction model works on the diffusion process of the human contact. Model considers two forms of spread: when the spread takes time after infecting one person and when the spread is immediate after infecting one person. It makes the proposed model different over other state-of-the art models. It is giving more accurate results than other state-of-the art models. The proposed diffusion prediction model forecasts the number of new cases expected to occur in next 4 weeks. The model has predicted the number of confirmed cases, recovered cases, deaths and active cases. The model can facilitate government to be well prepared for any abrupt rise in this pandemic. The performance is evaluated in terms of accuracy and error rate and compared with the prediction results of support vector machine, logistic regression model and convolution neural network. The results prove the efficiency of the proposed model.

A smart healthcare framework for detection and monitoring of COVID-19 using IoT and cloud computing.

Coronavirus (COVID-19) is a very contagious infection that has drawn the world's attention. Modeling such diseases can be extremely valuable in predicting their effects. Although classic statistical modeling may provide adequate models, it may also fail to understand the data's intricacy. An automatic COVID-19 detection system based on computed tomography (CT) scan or X-ray images is effective, but a robust system design is challenging. In this study, we propose an intelligent healthcare system that integrates IoT-cloud technologies. This architecture uses smart connectivity sensors and deep learning (DL) for intelligent decision-making from the perspective of the smart city. The intelligent system tracks the status of patients in real time and delivers reliable, timely, and high-quality healthcare facilities at a low cost. COVID-19 detection experiments are performed using DL to test the viability of the proposed system. We use a sensor for recording, transferring, and tracking healthcare data. CT scan images from patients are sent to the cloud by IoT sensors, where the cognitive module is stored. The system decides the patient status by examining the images of the CT scan. The DL cognitive module makes the real-time decision on the possible course of action. When information is conveyed to a cognitive module, we use a state-of-the-art classification algorithm based on DL, i.e., ResNet50, to detect and classify whether the patients are normal or infected by COVID-19. We validate the proposed system's robustness and effectiveness using two benchmark publicly available datasets (Covid-Chestxray dataset and Chex-Pert dataset). At first, a dataset of 6000 images is prepared from the above two datasets. The proposed system was trained on the collection of images from 80% of the datasets and tested with 20% of the data. Cross-validation is performed using a tenfold cross-validation technique for performance evaluation. The results indicate that the proposed system gives an accuracy of 98.6%, a sensitivity of 97.3%, a specificity of 98.2%, and an F1-score of 97.87%. Results clearly show that the accuracy, specificity, sensitivity, and F1-score of our proposed method are high. The comparison shows that the proposed system performs better than the existing state-of-the-art systems. The proposed system will be helpful in medical diagnosis research and healthcare systems. It will also support the medical experts for COVID-19 screening and lead to a precious second opinion.

Sexual Behavior Change Among Gay and Bisexual Men During the First COVID-19 Pandemic Wave in the United States.

BACKGROUND: After decades of navigating HIV and other sexually transmitted infections, gay and bisexual men are responding to new and uncertain risks presented by the coronavirus (COVID-19) pandemic by adapting their sexual behavior. METHODS: This paper uses data from a national sample of 728 gay and bisexual men collected from April 10 to May 10, 2020, to examine changes to sexual behavior in response to the first wave of the pandemic in the USA. We also assess whether behavior modifications are associated with exposure to statewide public health measures, including Stay-at-Home orders. RESULTS: Sexual minority men report significant changes to their sexual behavior and partner selection during the first wave. Nine out of 10 men reported having either one sexual partner or no sexual partner in the last 30 days at the time of interview, a decrease compared to just before the pandemic for nearly half of men surveyed. Reporting no sexual partners in the last 30 days was significantly predicted by increased exposure to a Stay-at-Home order. Sexual minority men also reduced interactions with casual partners, increased no-contact sexual behaviors (e.g., masturbation and virtual sex), and engaged in new strategies to reduce their risks of infection from partners. HIV-positive men were particularly likely to adopt strategies including avoiding casual partners and avoiding public transportation to meet sexual partners. CONCLUSION: Sexual minority men's behavior changes during the first wave may have reduced the impact of the coronavirus pandemic on their communities. Despite substantial changes in sexual behavior for most men in our sample during the initial first wave, we identify some concerns around the sustainability of certain behavioral changes over time and nondisclosure of COVID-19 symptoms to partners.

Knowledge, Attitude, Practice and Preparedness toward COVID-19 Pandemic among Healthcare Workers in Designated COVID Hospitals of a North-Eastern State of India.

The knowledge, attitude, and practice (KAP) of healthcare workers (HCW) toward the COVID-19 pandemic influence their preparedness to accept the preventative measures. This study investigates KAP toward COVID-19 among the HCWs working in two designated COVID hospitals. It was a cross-sectional study. The overall KAP scores were calculated, and the difference in mean scores among various demographic and other variables was tested using t-test and one-way ANOVA. The participants were knowledgeable about transmission modes and disease symptoms and were aware of the preventive measures like hand sanitisations for 96% and 91% for wearing masks. Among the knowledgeable group, 87% were aware of the control measures of COVID-19 infection like isolation and treatment of the infected; quarantine of their close contacts; and 92% had the acquaintance about the avoidance of public transport and crowded places as a safety measure. The HCWs also showed a positive attitude toward keeping distance and staying at home (81.13% strongly agreed) and regularly washing hands (agreed 91%). The mean knowledge, attitude, and practice scores of the study participants were 19.67(±1.85), 27.95(1.81) and 4.61(0.51), respectively. Nurses were found to have significantly better knowledge, attitude, and practice toward COVID-19 than laboratory technicians and pharmacists. HCWs having higher education levels were also found to have better knowledge about COVID-19. The majority of the HCWs who participated in the study also strongly agreed that the referred hospitals are well prepared for infection prevention and control (IPC). Better knowledge, attitude and practices toward COVID-19 may considerably decrease the risk of getting the disease.

Arterial Thrombosis and Acute Limb Ischemia as a Complication of COVID-19 Infection.

COVID-19 refers to viral respiratory infections and is the predisposing factor for the development of venous and arterial thrombotic events due to a pronounced inflammatory response, platelet activation, endothelial dysfunction, and stasis. Recent studies have confirmed a high incidence of thromboembolic events, especially in the group of patients with severe coronavirus pneumonia. There have been an increasing number of reports of peripheral arterial thrombosis as well. Most cases of arterial thrombosis are noted in critical ill patients in intensive care setting. However, an increase of adverse arterial events was also noted in cases of asymptomatic or mild forms of COVID-19. Herein, we report a case of patient with asymptomatic SARS-CoV-2 infection, who developed a threatening lower limb ischemia. Our own clinical observation suggests that COVID-19-associated arterial thrombosis can be successfully treated by embolectomy, administration of in-hospital parenteral anticoagulation, and continuation of antithrombotic therapy with a "vascular" dose of rivaroxaban after discharge.

Impact of the Coronavirus (COVID-19) Pandemic on the Care of Pediatric Acute Appendicitis.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency in children. With the rise of the Coronavirus-19 pandemic, quarantine measures have been enforced to limit the viral transmission of this disease. The purpose of this study was to identify differences in the clinical presentation and outcomes of pediatric acute appendicitis during the Coronavirus-19 pandemic. METHODS: A single-institution retrospective assessment of all pediatric patients (<18 years old) with acute appendicitis from December 2019 to June 2020 was performed at a tertiary care children's hospital. Patients were divided into two groups: (1) the Pre-COVID group presented on or before March 15, 2020, and (2) the COVID group presented after March 15, 2020. Demographic, preoperative, and clinical outcomes data were analyzed. RESULTS: 45 patients were included with a median age of 13 years [IQR 9.9 - 16.2] and 35 males (78%). 28 patients were in the Pre-COVID group (62%) and 17 in the COVID group (38%). There were no differences in demographics or use of diagnostic imaging. The COVID group did have a significantly delayed presentation from symptom onset (36 vs 24 hours, P < .05), higher Pediatric Appendicitis Scores (8 vs 6, P = .003), and longer hospital stays (2.2 vs 1.3 days, P = .04). There were no significant differences for rates of re-admission, re-operation, surgical site infection, perforation, or abscess formation. CONCLUSION: During the Coronavirus-19 pandemic, the incidence of pediatric acute appendicitis was approximately 40% lower. These children presented in a delayed fashion with longer hospital stays. No differences were noted for postoperative complications.

Accelerating drug repurposing for COVID-19 treatment by modeling mechanisms of action using cell image features and machine learning.

The novel coronavirus disease, COVID-19, has rapidly spread worldwide. Developing methods to identify the therapeutic activity of drugs based on phenotypic data can improve the efficiency of drug development. Here, a state-of-the-art machine-learning method was used to identify drug mechanism of actions (MoAs) based on the cell image features of 1105 drugs in the  LINCS database. As the multi-dimensional features of cell images are affected by non-experimental factors, the characteristics of similar drugs vary considerably, and it is difficult to effectively identify the MoA of drugs as there is substantial noise. By applying the supervised information theoretic metric-learning (ITML) algorithm, a linear transformation made drugs with the same MoA aggregate. By clustering drugs to communities and performing enrichment analysis, we found that transferred image features were more conducive to the recognition of drug MoAs. Image features analysis showed that different features play important roles in identifying different drug functions. Drugs that significantly affect cell survival or proliferation, such as cyclin-dependent kinase inhibitors, were more likely to be enriched in communities, whereas other drugs might be decentralized. Chloroquine and clomiphene, which block the entry of virus, were clustered into the same community, indicating that similar MoA could be reflected by the cell image. Overall, the findings of the present study laid the foundation for the discovery of MoAs of new drugs, based on image data. In addition, it provided a new method of drug repurposing for COVID-19. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11571-021-09727-5.

SARS-CoV-2 effects on male reproduction: should men be worried??

The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has placed a global challenge on both healthcare and society. So far, studies have shown that men are more prone to become ill than women and are more likely to die compared to female patients. Higher rates of positive cases and fatality in men than women have drawn the attention of scientists to investigate the possible impacts of SARS-CoV-2 on the male reproductive system. In this review, we tried to summarise so far findings on the effect of the SARS-CoV-2 on the male reproductive function to further assess the potential risks of this novel coronavirus on male reproductive health.

Evaluation of the COVID-19 Infection Rate in the Perioperative Period of Elective Surgeries of the Hand and Microsurgery.

BACKGROUND: After the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (coronavirus disease 2019 [COVID-19]), the world started reducing the number of elective surgeries to reduce the transmission of the coronavirus. Some priority elective surgeries were performed, and there was no increase in contagion rates due to safety protocols and protection measures. The study aims to present the coronavirus infection rate of elective hand surgeries and microsurgery performed during pandemics. METHODS: A retrospective study evaluating 188 patients submitted to elective surgical procedures. The exclusion criteria were patients infected by COVID-19 before the surgery and patients who submitted to trauma surgery. Only 108 patients were eligible for this study. The mean age was 47.8 years (range: 15 days-81 years). There were 63 females and 45 males. They were divided into 2 groups: outpatient (n = 49) and inpatient (n = 59) procedures. RESULTS: The overall COVID infection rate was 6.48%. The outpatient infection rate was 2.08%, whereas the inpatient infection rate was 10.17% (Student t test: P = .089). The main factor correlated with infection in the postoperative period was the number of postoperative outpatient visits (Student t test: P = .089). No statistical differences were observed between the variables studied, but there was a tendency for patients who submitted to inpatient surgery to get infected by COVID-19 (P = .089). The statistical power was 0.8 (Cohen's d test), showing that large samples are needed to analyze the correlation better. CONCLUSION: We concluded that the safety of performing elective hand surgery during the pandemic remains unclear, and more studies with larger samples are needed.

A Resilient Care of the Patient With COVID-19: A Phenomenological Study.

This study a utilized phenomenological hermeneutic design. Fourteen Iranian family caregivers of patients with COVID-19 who were isolated at home were included in the study using purposive sampling. In-depth unstructured interviews were conducted via WhatsApp. Sampling continued until data saturation. Interviews were transcribed and analyzed using Van Manen's approach. Three primary themes and eight subthemes emerged. The primary themes included: "captured in a whirlpool of time", "resilient care' and "feeling helpless". It seems that the families of patients with COVID-19 attempt to resist the pressures of this disease with religious practices and problem solving. However, due to the nature of the disease and its severity, they sometimes feel ashamed or lonely and are afraid of losing their loved ones. It is recommended that psychiatric nurses should develop programs in the form of comprehensive spiritual care packages or psychological support and utilize multiple media channels to deliver these.

The Role of the Immune System on the Cardiac Complications Observed in SARS-CoV-2

Abstract An acute respiratory syndrome caused by SARS-CoV2 was declared a pandemic by the World Health Organization. Current data in the world and in Brazil show that approximately 40% of patients who died have some type of cardiac comorbidity. There are also robust reports showing an increase in IL-6 / IL-1B / TNF-alpha and the presence of lymphopenia in patients with COVID-19. Our team and others have shown that increased cytokines are the link between arrhythmias/Left ventricular dysfunction and the immune system in different diseases. In addition, it has been well demonstrated that lymphopenia can not only be a good marker, but also a factor that causes heart failure. Thus, the present review focused on the role of the immune system upon the cardiac alterations observed in the SARS-CoV2 infection. Additionally, it was well described that SARS-CoV-2 is able to infect cardiac cells. Therefore, here it will be reviewed in deep.

Minor psychiatric disorders among nursing workers during the pandemic: a multicenter study / Distúrbios psíquicos menores entre trabalhadores de enfermagem durante a pandemia: estudo multicêntrico / Disturbios psíquicos menores en trabajadores de enfermería durante la pandemia: estudio multicéntrico

Resumo Objetivo Analisar os fatores associados à presença de Distúrbios Psíquicos Menores entre trabalhadores de enfermagem que atuam na pandemia da COVID-19. Métodos Estudo transversal multicêntrico, realizado em quatro instituições hospitalares, no Estado do Rio Grande do Sul, com 845 trabalhadores de enfermagem. Utilizou-se um formulário eletrônico composto por questões sociodemográficas, laborais, de condições de saúde e pelo Self-Reporting Questionnaire-20. Aplicaram-se testes de Mann-Whitney, Qui-Quadrado e Regressão de Poisson expressa na Razão de Prevalência (IC 95%). Resultados A prevalência de Distúrbios Psíquicos Menores (49,3%) foi associada ao aumento do consumo de álcool (RP = 1,2; IC95% = 1,1-1,4), não praticar atividade física (RP = 1,5; IC95% = 1,3-1,8), iniciar o uso de medicação na pandemia (RP = 1,5; IC95% = 1,3-1,7), não possuir um turno de trabalho fixo (RP = 1,4; IC95% = 1,1-1,9) e sentir medo frente à exposição ao risco de contaminação (RP = 1,2; IC95% = 1,1-1,3) Conclusão Na atual pandemia, os Distúrbios Psíquicos Menores mostram-se associados ao consumo de bebida alcoólica, falta de atividade física, uso de medicamento, turno de trabalho e medo de contaminar-se.

Resumen Objetivo Analizar los factores asociados con la presencia de disturbios psíquicos menores en trabajadores de enfermería que trabajan en la pandemia de COVID-19. Métodos Estudio transversal multicéntrico, realizado en cuatro instituciones hospitalarias, en el estado de Rio Grande do Sul, con 845 trabajadores del área de enfermería. Se utilizó un formulario electrónico compuesto por cuestiones sociodemográficas, laborales, de condiciones de salud y por el Self-Reporting Questionnaire-20. Se aplicaron las pruebas de Mann-Whitney, Ji Cuadrado y de Regresión de Poisson expresada en la Razón de Prevalencia (IC 95 %). Resultados La prevalencia de disturbios psíquicos menores (49,3 %) estuvo asociada al aumento del consumo de alcohol (RP = 1,2; IC95 % = 1,1-1,4), a no practicar actividades físicas (RP = 1,5; IC95 % = 1,3-1,8), al comiendo del uso de medicación durante la pandemia (RP = 1,5; IC95 % = 1,3-1,7), a no tener un turno de trabajo fijo (RP = 1,4; IC95 % = 1,1-1,9) y a sentir miedo frente a la exposición al riesgo de contaminación (RP = 1,2; IC95 % = 1,1-1,3) Conclusión En la actual pandemia, los disturbios psíquicos menores demostraron estar asociados al consumo de bebida alcohólica, falta de actividad física, uso de medicamentos, turnos de trabajo y miedo a contaminarse.

Abstract Objective To analyze the factors associated with the presence of minor psychiatric disorders among nursing workers working in the COVID-19 pandemic. Methods A multicenter cross-sectional study was conducted in four hospitals in the state of Rio Grande do Sul, Brazil, with 845 nursing workers. An electronic form composed of sociodemographic, labor, health conditions and Self-Reporting Questionnaire-20 was used. Mann-Whitney, chi-square and Poisson Regression tests, expressed in Prevalence Ratio (95% CI), were applied. Results The prevalence of minor psychiatric disorders (49.3%) was associated with increased alcohol consumption (PR = 1.2; 95% CI = 1.1-1.4), not practicing physical activity (PR = 1.5; 95% CI = 1.3-1.8), starting the use of medication in the pandemic (PR = 1.5; 95% CI = 1.3-1.7), not having a fixed work shift (PR = 1.4; 95% CI = 1.1-1.9) and feeling afraid of exposure to the risk of contamination (PR = 1.2; 95% CI = 1.1-1.3) Conclusion In the current pandemic, minor psychiatric disorders are associated with alcohol consumption, lack of physical activity, use of medication, work shift and fear of contamination.

Professional nursing practice environment from students' perspective in COVID-19 / Ambiente de prática profissional em enfermagem na perspectiva de estudantes na COVID-19 / Ambiente de práctica profesional de enfermería por la perspectiva de estudiantes en el COVID-19

Resumo Objetivo Avaliar o ambiente da prática profissional em enfermagem na perspectiva de estudantes no contexto da pandemia da COVID-19. Métodos Estudo transversal, realizado com amostra por conveniência de 43 estudantes da última série do bacharelado em Enfermagem de uma universidade federal, localizada no município de São Paulo, SP, Brasil. Variáveis de caracterização: gênero, etnia, idade, local de estágio e um questionamento se já trabalharam e/ou realizam estágio extracurricular na área. Aplicou-se o Instrumento Practice Environment Scale - versão brasileira validada, composto de 24 itens e 5 subescalas. Os dados foram analisados com estatística descritiva e inferencial por meio dos testes: Kruskal Wallis, ANOVA, Tukey, t-student e Mann Whitney. Foi realizada a análise de regressão logística. Considerou-se como nível de significância de p<0,005. Resultados A Subescala 3 "adequação da equipe e de recursos" foi a única que apresentou média desfavorável (53,49%). A variável "ter trabalhado e/ou realizado estágio extracurricular" mostrou-se estatisticamente significante na Subescala 2 "habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem" (p=0,003). Na média geral, os estudantes avaliaram o ambiente como favorável (p<0,001). Conclusão Apesar do contexto, a maioria dos estudantes avaliaram o ambiente como favorável. A variável "ter trabalhado e/ou realizado estágio extracurricular" foi estatisticamente significativa. A capacitação das lideranças, o fortalecimento de programas de educação continuada e o envolvimento dos enfermeiros nas atividades, resoluções de problemas e comissões internas da instituição, são considerados preâmbulos para ofertar uma assistência qualificada dentro de um ambiente de prática profissional próximo do favorável.

Resumen Objetivo Evaluar el ambiente de la práctica profesional de enfermería por la perspectiva de estudiantes en el contexto de la pandemia del COVID-19. Métodos Estudio transversal, realizado con muestra por conveniencia de 43 estudiantes del último año del grado de Enfermería de una universidad federal, ubicada en el municipio de São Paulo, São Paulo, Brasil. Variables de caracterización: género, etnia, edad, lugar de la pasantía y un interrogante sobre si ya trabajaron o realizan una pasantía extracurricular en el área. Se aplicó el Instrumento Practice Environment Scale - versión brasileña validada, compuesto por 24 ítems y 5 subescalas. Los datos fueron analizados con estadística descriptiva e inferencial por medio de las pruebas: Kruskal Wallis, ANOVA, Tukey, t-student y Mann Whitney. Se realizó el análisis de regresión logística. Se consideró un nivel de significación de p<0,005. Resultados La Subescala 3 "adecuación del equipo y de recursos" fue la única que presentó un promedio desfavorable (53,49 %). La variable "haber trabajado o realizado una pasantía extracurricular" se mostró estadísticamente significante en la Subescala 2 "habilidad, liderazgo y suporte de los coordinadores/supervisores de enfermería a los enfermeros/equipo de enfermería" (p=0,003). En el promedio general, los estudiantes evaluaron al ambiente como favorable (p<0,001). Conclusión Pese al contexto, la mayoría de los estudiantes evaluaron al ambiente como favorable. La variable "haber trabajado o realizado una pasantía extracurricular" fue estadísticamente significante. La capacitación de los liderazgos, el fortalecimiento de programas de educación continua y la participación de los enfermeros en las actividades, resoluciones de problemas y comisiones internas de la institución, son considerados preámbulos para brindar una asistencia calificada dentro de un ambiente de práctica profesional próxima a lo favorable.

Abstract Objective To assess the professional nursing practice environment from the perspective of students in the context of the COVID-19 pandemic. Methods Cross-sectional study conducted with a convenience sample of 43 students attending the last grade of the Nursing Undergraduate course at a federal university located in the city of São Paulo, SP, Brazil. Characterization variables: sex, ethnicity, age, place of internship and a question on whether they have worked and/or did an extracurricular internship in the area. The Practice Environment Scale - Brazilian validated version, consisting of 24 items and five subscales, was applied. Data were analyzed using descriptive and inferential statistics with the following tests: Kruskal Wallis, ANOVA, Tukey, t-student and Mann Whitney. Logistic regression analysis was performed. A significance level of p<0.005 was considered. Results Subscale 3 "Staffing and resource adequacy" was the only one with an unfavorable mean (53.49%). The variable "having worked and/or done an extracurricular internship" was statistically significant in Subscale 2 "Nurse manager ability, leadership and support of nurses" (p=0.003). On overall mean, students rated the environment as favorable (p<0.001). Conclusion Despite the context, most students rated the environment as favorable. The variable "having worked and/or done an extracurricular internship" was statistically significant. The training of leaders, the strengthening of continuing education programs and involvement of nurses in activities, problem solving and internal committees of the institution are considered preambles to offer qualified care within a close to favorable environment of professional practice.

Depression and generalized anxiety disorder in older adults by the COVID-19 infodemic / Depressão e transtorno de ansiedade generalizada em idosos pela infodemia de COVID-19 / Depresión y trastorno de ansiedad generalizada en adultos mayores por la infodemia de COVID-19

Resumo Objetivo Analisar os impactos da infodemia de COVID-19 nos sintomas sugestivos de depressão e transtorno de ansiedade generalizada (TAG) em idosos que utilizam as mídias digitais. Método Dados coletados por web-based survey, de julho a dezembro de 2020, na população acima de 60 anos (n=103.636) residente no município de Juiz de Fora, interior de Minas Gerais, Brasil. Foram analisadas variáveis sociodemográficas, de exposição a informações sobre COVID-19 e a associação a sintomas de depressão e TAG . Para o rastreio de depressão e de TAG foram utilizados a Escala de Depressão Geriátrica (EDG) e o Inventário de Ansiedade Geriátrica (GAI-BR), respectivamente. Para análise bivariada utilizou-se o teste do qui-quadrado e, posteriormente, a regressão de Poisson, controlada por possíveis fatores de confusão (RP ajustada) na análise múltipla, com intervalo de confiança de 95%. Resultados Dos 470 idosos respondentes, 26,1% apresentou sintomas de depressão e 18,4% TAG. Mostraram-se associados a sintomas de depressão: tempo de exposição nas redes sociais, sentir-se afetado pelas informações sobre COVID-19 veiculadas nas redes sociais e na televisão, e apresentar rastreio positivo para sofrimento psíquico causado e/ou agravado pela exposição às informações sobre COVID-19. Já para TAG, além do rastreio positivo para sofrimento psíquico, as variáveis que permaneceram associadas foram: respostas geradas pela divulgação de notícias falsas nas redes sociais e de medo relacionado à COVID-19 veiculadas no rádio. Conclusão Todas as variáveis associadas aos desfechos se referiam à exposição às informações sobre COVID-19, indicando o evidente impacto da infodemia nos sintomas de depressão e TAG em idosos.

Resumen Objetivo Analizar los impactos de la infodemia de COVID-19 en los síntomas sugestivos de depresión y trastorno de ansiedad generalizada (TAG) en adultos mayores que utilizan los medios digitales. Métodos Datos recopilados por web-based survey, de julio a diciembre de 2020, en la población de más de 60 años (n=103.636) domiciliados en el municipio de Juiz de Fora, interior de Minas Gerais, Brasil. Se analizaron variables sociodemográficas, de exposición a información sobre COVID-19 y su relación con síntomas de depresión y TAG. Para el rastreo de depresión y de TAG se utilizó la Escala de Depresión Geriátrica (EDG) y el Inventario de Ansiedad Geriátrica (GAI-BR), respectivamente. Para el análisis bivariado se utilizó la prueba de Ji cuadrado y, posteriormente, la regresión de Poisson, controlada por posibles factores de confusión (RP ajustada) en el análisis múltiple, con intervalo de confianza del 95 %. Resultados De los 470 adultos mayores que lo respondieron, el 26,1 % presentó síntomas de depresión y el 18,4 % TAG. Se mostraron asociados a síntomas de depresión los factores: tiempo de exposición en las redes sociales, sentirse afectado por la información sobre COVID-19 difundida en redes sociales y televisión, y presentar un rastreo positivo de sufrimiento psíquico causado o agravado por la exposición a la información sobre COVID-19. Por otro lado, las variables que permanecieron asociadas al TAG, además del rastreo positivo de sufrimiento psíquico, fueron: respuestas generadas por la divulgación de noticias falsas en las redes sociales y del miedo relacionado con el COVID-19 difundidas en la radio. Conclusión Todas las variables asociadas a los desenlaces mencionaron la exposición a información sobre COVID-19, lo que indica el evidente impacto de la infodemia en los síntomas de depresión y TAG en adultos mayores.

Abstract Objective To analyze the impacts of the COVID-19 infodemic on symptoms suggestive of depression and generalized anxiety disorder (GAD) in older adults who use digital media. Method Data collected by web-based survey, from July to December 2020, in the population over 60 years old (n=103,636) residing in the municipality of Juiz de Fora, in the countryside of Minas Gerais, Brazil. Sociodemographic variables, exposure to information about COVID-19 and the association with symptoms of depression and GAD were analyzed. The Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI-BR) were used to screen for depression and GAD, respectively. For bivariate analysis, the chi-square test was used and, later, Poisson regression, controlled for possible confounding factors (adjusted PR) in the multiple analysis, with a 95% confidence interval. Results Of the 470 older adults who responded, 26.1% had symptoms of depression, and 18.4%, GAD. They were associated with symptoms of depression: time of exposure on social media; feeling affected by information about COVID-19 transmitted on social media and TV; and presenting positive screening for psychological distress caused and/or aggravated by exposure to information about COVID-19. For GAD, in addition to the positive screening for psychological distress, the variables that remained associated were: responses generated by dissemination of fake news on social media; and fear COVID-19-related fear published on the radio. Conclusion All variables associated with outcomes referred to exposure to information on COVID-19, indicating the evident infodemic impact on symptoms of depression and GAD in older adults.

Impact of COVID-19 on nursing work in emergency units / Impacto da COVID-19 no trabalho de enfermagem em unidades de urgência/emergência / Impacto del COVID-19 en el trabajo de enfermería en unidades de urgencia/emergencia

Resumo Objetivo Analisar o impacto da pandemia da Coronavirus Disease 2019 (COVID-19) no trabalho de enfermagem em unidades de urgência e emergência. Métodos Pesquisa de abordagem qualitativa realizada entre profissionais de enfermagem atuantes em unidades de urgência e emergência no estado do Rio de Janeiro, Brasil. Dados coletados via online por meio de formulário semiestruturado e submetidos à análise lexicográfica no software Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires (IRAMUTEQ). Resultados Participaram 31 profissionais de enfermagem. O aproveitamento do corpus textual foi de 94,9% mediante a geração de seis classes de segmentos de textos, que possibilitou identificar que os profissionais que atuam nessas unidades têm vivenciado sobrecarga no desenvolver laboral, dada a carga horária de trabalho exaustiva, bem como a falta de infraestrutura, de equipamentos de proteção e de recursos humanos. Ainda, evidenciaram-se desgastes físicos e mentais, com ênfase para o estresse e a exaustão, além do sentimento de medo pelo receio de contaminação. Conclusão A pandemia da COVID-19 promoveu impactos diretos no trabalho de enfermagem em unidades de urgência e emergência no que tange a aspectos relacionados a recursos humanos e materiais e infraestrutura, além da assistência prestada aos pacientes em condições graves.

Resumen Objetivo Analizar el impacto de la pandemia de Coronavirus Disease 2019 (COVID-19) en el trabajo de enfermería en unidades de urgencia y emergencia. Métodos Investigación de enfoque cualitativo realizada entre profesionales de enfermería que actúan en unidades de urgencia y emergencia en el estado de Rio de Janeiro, Brasil. Datos recopilados en línea a través de formulario semiestructurado y presentados para análisis lexicográfico en el software Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires (IRAMUTEQ). Resultados Participaron 31 profesionales de enfermería. El aprovechamiento del corpus textual fue del 94,9 % mediante la producción de seis clases de segmentos de textos, lo que posibilitó identificar que los profesionales que actúan en esas unidades han vivido una sobrecarga en el quehacer laboral, considerando la duración de la jornada de trabajo agotadora, como también la ausencia de infraestructura, de equipos de protección y de recursos humanos. Además, se evidenciaron desgastes físicos y mentales, con énfasis en el estrés y el agotamiento, además del sentimiento de miedo por el temor a la contaminación. Conclusión La pandemia de COVID-19 ocasionó impactos directos en el trabajo de enfermería en unidades de urgencia y emergencia en lo que se refiere a aspectos relacionados con recursos humanos y materiales y con la infraestructura, además de la atención brindada a los pacientes en condiciones graves.

Abstract Objective To analyze the impact of the Coronavirus Disease 2019 pandemic (COVID-19) on nursing work in emergency units. Methods A qualitative research conducted among nursing professionals operating in emergency units in the state of Rio de Janeiro, Brazil. Data collected online through a semi-structured form and submitted to lexicographic analysis in the software Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires (IRAMUTEQ). Results Thirty-one nursing professionals participated. The use of the text corpus accounted for 94.9%, through the generation of six classes of text segments, which made it possible to identify that professionals working in these units have experienced overload in developing work, given the exhausting workload, as well as the lack of infrastructure, protective equipment and human resources. Also, physical and mental exhaustion was evidenced, with emphasis on stress and exhaustion, in addition to the feeling of fear for fear of contamination. Conclusion The COVID-19 pandemic promoted direct impacts on nursing work in emergency units regarding aspects related to human and material resources and infrastructure, in addition to the care provided to patients in severe conditions.

Pityriasis rosea as a cutaneous manifestation associated with SARS-CoV-2 infection: case report / Pitiriasis rosada como manifestación dermatológica de infección por SARS-CoV-2: a propósito de un caso

Las manifestaciones cutáneas relacionadas a la infección por el coronavirus SARS-CoV-2, causante de COVID-19, se han descrito entre el 0,2% y 20,4% de las personas que cursan con esta enfermedad. Las más frecuentemente descritas son: lesiones maculopapulares (47%), lesiones acrales eritematosas con vesículas o pústulas (pseudoperniosis) (19%), urticariales (19%), lesiones vesiculosas (9%) y livedo/necrosis (6%). En particular, la pitiriasis rosada es una dermatosis autolimitada de etiología desconocida, sin embargo, se ha visto asociada a la infección por SARS-CoV-2, con algunos reportes de casos en la literatura. El mecanismo fisiopatológico de las lesiones cutáneas en COVID-19 no es claro, y se han planteado algunas teorías, entre las cuales está el papel que juega la enzima convertidora de angiotensina 2 (ACE2) utilizada por el virus para infectar las células, los infiltrados linfocíticos, los depósitos de factores del complemento en la piel, y la reactivación de virus latentes como los herpes virus humanos. Se presenta el caso de una paciente con pitiriasis rosada asociada a COVID-19 y se describen los casos reportados hasta la fecha

SARS-CoV-2 from a hematological perspective / SARS-CoV-2 desde una perspectiva hematológica

La infección viral respiratoria causada por el SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) produce la enfermedad por coronavirus 2019 o COVID-19. Hasta el 20% al 50% de los pacientes hospitalizados con COVID-19 tienen alteraciones de la coagulación (dímero D elevado, tiempo de protrombina prolongado, trombocitopenia y fibrinógeno bajo). Esta condición se caracteriza por eventos trombóticos más que hemorrágicos. De otro lado, se presenta disfunción endotelial, lo cual explica los niveles elevados de trombina, de dímero D y de otros productos de degradación de fibrina, la trombocitopenia y la prolongación de los tiempos de coagulación; estos cambios terminan por originar hipoxia, oclusión microvascular y congestión pulmonar mediada por trombosis [1]. Se ha demostrado que el tratamiento anticoagulante inicial con heparinas de bajo peso molecular reduce la mortalidad un 48% a los 7 días y un 37% a los 28 días, y logra una mejoría significativa del cociente presión arterial de oxígeno/fracción inspirada de O2 (PaO2/FiO2), al mitigar la formación de microtrombos y la coagulopatía pulmonar asociada, disminuyendo además la inflamación [2]. En el artículo titulado "Alteraciones hematológicas como consecuencia de COVID-19 y sus vacunas", se abordan las anormalidades en la coagulación como la trombocitopenia trombótica inmune inducida por las vacunas contra el SARS-CoV-2. Es importante anotar, que hoy en día la comunidad científica está de acuerdo en que sin la vacunación hubiera sido imposible lograr el control actual que se tiene de la pandemia, pero a la vez se debe tener en cuenta que cualquier inmunización tiene también efectos adversos que por lo general son leves, pero que en raras ocasiones se pueden presentar complicaciones de mayor magnitud