COVID-19 Impact on Patients with Immune-Mediated Rheumatic Disease: A Comparative Study of Disease Activity and Psychological Well-Being Over Six Months (preprint)

Objectives: To compare the impact of COVID-19 on clinical status and psychological condition in patients with immune-mediated rheumatic diseases (IMRD) infected by SARS-CoV-2 with IMRD controls not infected, during a 6-month follow-up. Methods: The ReumaCoV Brasil is a longitudinal study designed to follow-up IMRD patients for 6 months after COVID-19 (cases) compared with IMRD patients no COVID-19 (controls). Clinical data, disease activity measurements and current treatment regarding IMRD, and COVID-19 outcomes were evaluated in all patients. Disease activity was assessed through validated tools at inclusion and at 3 and 6 months post-COVID-19. The FACIT-F (Functional Assessment of Chronic Illness Therapy) and DASS 21 (Depression, Anxiety and Stress Scale - 21 Items) questionnaires were also applied at 6 months after COVID-19 in both groups before large-scale vaccination. The significance level was set as p<0.05, with a 95% confidence interval. Results: A total of 601 patients were evaluated, being 321 cases (IMRD COVID-19+) and 280 controls (IMRD COVID-19 -), predominantly female with similar median age. No significant differences were noted in demographic data between the groups, including comorbidities, disease duration, and IMRD. Disease activity assessment over a 6-month follow-up showed no significant difference between cases and controls. While mean activity scores did not differ significantly, some patients reported worsened disease activity post-COVID-19, particularly in rheumatoid arthritis (RA) (32.2%) and systemic lupus erythematosus (SLE) (23.3%). Post-COVID-19 worsening in RA patients correlated with medical global assessment (MGA) and CDAI scores, with a moderate to large effect size. Diabetes mellitus showed a positive association (OR=7.15), while TNF inhibitors showed a protective effect (OR=0.51). Comparing SLEDAI pre- and post-COVID-19, a minority showed increased scores, with few requiring treatment changes. Fatigue, depression, anxiety, and stress were significantly higher in cases compared to controls. Worsening disease activity post-COVID correlated with worsened FACIT-F and DASS-21 stress scale in RA patients. No significant associations were found between COVID-19 outcomes and post-COVID-19 disease activity or psychological assessments. Conclusions: Post-COVID-19 IMRD patients show significant psychological well-being deterioration despite similar disease activity scores. The variability in reports on IMRD flares and the potential trigger of SARS-CoV-2 for autoimmune manifestations underline the need for detailed clinical assessment and a comprehensive approach to managing them.

Evaluation of effluent post-treatment by slow filtration and adsorption with activated carbon produced from spent coffee grounds in surfactant removal in sewage treatment

Environmental pollution is a worldwide concern, especially when caused by sewage dumping into water bodies. Many substances are present in industrial or domestic wastewater, causing contamination in superficial water collection. Surfactants stand out for being widely used both industrially and domestically. The use of detergents and many types of surfactants was increased during the Covid-19 pandemic period, a fact observed in the levels in the effluent sample analysis from a Sewage Treatment Plant (STP) - Vila City around 21 and 39 mg L-1 in this period. This work evaluated the surfactant concentrations in the primary and secondary treatment units of the Vila City STP, in the city of Paranavaí-PR.-Brazil. In addition, the use of a post-treatment by slow sand filtration and adsorption by activated carbon produced from spent coffee grounds in the complementary removal of surfactants was proposed. A mixed bed with sand and activated carbon columns was made on a pilot scale, and filtration/adsorption runs were performed simulating slow filtration with rates of approximately 15 m3 m-2 day-1. The parameters used for the efficiency removal evaluation in a pilot plant run were: turbidity (NTU) and surfactant concentrations. The removal of surfactant concentrations was about 9% and 7% in the Upflow Anaerobic Sludge Bed reactors (UASB-RALF) and in the secondary treatment, respectively, at the STP - Vila City units. In the post-treatment proposed by filtration/adsorption, bed columns on a pilot scale plant obtained a reduction of approximately 94% in terms of turbidity (NTU) and 95% in terms of surfactant removal.Alternate :Poluiçâo ambiental é uma preocupaçâo mundial, especialmente causada por despejos de esgotos nos coleçâo hídrica. Diversas substancias compöem os despejos e residuos industriais e esgotos domésticos. Os surfactantes destacam-se por serem amplamente usados tanto industrialmente como domesticamente. O consumo de detergentes e diversos tipos de tensoativos foi incrementado durante o período de pandemia da Covid-19, fato observado nos teores de surfactantes no efluente das Estaçöes de Tratamento de Esgoto (ETE) - Vila City entre 21 e 39 mg L-1 neste período de tempo. Este trabalho avaliou as concentraçöes de surfactantes em diferentes etapas da ETE da Vila City, na cidade de Paranavaí, PR.- Brasil. Além disso, propôs-se a utilizaçao de um pós-tratamento por filtraçâo/adsorçâo por carvão ativado produzido a partir da borra de café na remoçao complementar dos surfactantes. Foram confeccionadas colunas de adsorçao com meio filtrante de areia e carvão em escala piloto e realizados ensaios de filtração/adsorção simulando filtração lenta com taxas de aproximadamente 15 m3 m-2 dia-1. Os parámetros utilizados na aval