Molecular signatures of SARS-CoV2 in vitro infection of bronchial epithelium from CF, COPD and healthy subjects

Introduction: One of the major challenges of the SARS-CoV2 pandemic is to identify people most at risk of developing severe COVID-19. Patients with cystic fibrosis (CF) and COPD are at higher risk as alteration of their bronchial epithelium is a major target of SARS-CoV2 in triggering excessive inflammation. Aims and objectives: We aim to know whether the pathophysiological status of bronchial epithelium from CF and COPD patients could lead to specific responses to SARS-CoV2 infection. Method(s): Differentiated bronchial epithelium from controls, CF and COPD patients (N=4/group) were infected with SARS-CoV2 (24, 48 and 72h) as we previously described (Pizzorno, A. et al. Cell Rep Med, 2020). We compared its effect on epithelial integrity (transepithelial resistance), global gene expression (RNA sequencing) and inflammation (multiplex analysis). Result(s): SARS-CoV2 induces a stronger impairment of bronchial epithelial integrity and a greater number of deregulated genes in controls, compared to CF or COPD subjects. We identified specific transcriptomic signatures for each group, further characterized using in silico functional enrichment approaches. Although the magnitude of the responses differed, we identified common genes induced 72h post infection, including SOCS1, ZBP1 and CXCL10 (IP-10). Differential induction of CXCL10 was further validated at the protein level. Conclusion(s): We defined a common core signature of the bronchial epithelium response to SARS-CoV2, as well as specific differences according to the pathological context. This study may allow a better understanding of the underlying mechanisms related to COVID-19 severity and for identifying potential markers of interest.

Adaptación de los centros de atención primaria a la virtualidad

The COVID-19 pandemic has changed the scheme of care in order to protect our patients with chronic pathology, and to provide an adequate response to the acute care demand that reached the Health Centers. The non-face-to-face care can contribute to decongest the family doctor consultations. Primary Care professionals must lead and manage the transformation towards a mixed model where face-to-face and non-face-to-face care are part of the day-to-day consultation. Telemedicine or teleconsultation have become essential elements in our day-to-day care. For this process of transformation to be successful, we must answer three key questions: Why? For what? And for whom? It will be much easier to make this adaptation if we answer the three questions correctly. This transformation process must be sustained by organizational changes and the incorporation of new practices that add value. It should be based on the empowerment of all team members. We are in a unique moment for the change in the way primary care moving to a new paradigm where virtuality and presence fit: "let's aim for the moon, even if we miss, we'll land among the stars.”

HOW TO DEAL WITH HEALTHCARE WORKERS ALLERGIC TO COVID-19 MRNA VACCINE

The Occupational Risk and Prevention Service is notified the case of a 37-year-old nurse who reported watery rhinorrhea and generalized itching 10-15 minutes after first dose of the vaccine produced by BioNTech/Pfizer's administration. She presents: facial erythema, maxillary wheal and normal constants. How should the Occupational Risk and Prevention Service should deal with a health worker who suffers an allergic reaction to the mRNA vaccine against COVID-19? This clinical case draws attention to common preventive measures such as vaccination, but also to others such as collaboration between different hospital services, management and diagnosis by Allergology, follow-up by the Occupational Risk and Prevention Service and notification of adverse vaccine effects by Clinical Pharmacology. Coordination between these services is essential for the correct management of workers affected by adverse reactions to the first vaccine dose against COVID-19, being the workers able to be vaccinated and protected. Copyright © 2022, Accion Medica S.A. All rights reserved.

Covid-19 Lockdown Landslides: The Negative Impact of Subsequent Lockdowns on Loneliness, Wellbeing, and Mental Health of Australians

OBJECTIVE We previously reported on loneliness, depression, anxiety and stress of Australians living alone during the first COVID-19-related government enforced lockdown in Australia. At this time, those living alone were experiencing relatively low levels of emotional distress. Since then, one state, Victoria, underwent a second extended lockdown period and until now, it was unclear what impact this sequential lockdown might have had on the mental health and wellbeing of Victorian citizens. The current study aimed to add to the emerging literature on the lockdown experience in Australia by directly comparing the levels of anxiety, depression, stress, loneliness, and wellbeing between Victorians in the second extended lockdown and Australians in the first lockdown. DESIGN Data from our original study of 384 Australians was compared with cross-sectional surveys of 340 Victorians during the second lockdown period. SETTING An online survey was administered with people residing in Victoria self-selecting to complete the study. OUTCOME MEASURES Participants were asked to complete the Depression, Anxietyand Stress Scale (DASS-21), WHO-5 Wellbeing Scale, and the University of California Los Angeles (UCLA) Loneliness Scale. They were also invited to offer their insights into how the second extended lockdown experience had differed from the first. RESULTS Independent samples t-tests revealed that Australians were significantly more depressed, anxious, stressed, and lonely, and experienced reduced psychological wellbeing in the second lockdown compared to the first however overall, the levels indicated mild psychological distress. Qualitative insights revealed impact on mental health and a feeling of increased restrictions during lockdown two. CONCLUSIONS Participants demonstrated adaptation to the lockdowns, providing support for the measures the Australian government have adopted to physically protect Australians from COVID-19. Management of the negative psychological impact through attention to wellbeing practices is however recommended in light of the increase in mental health concerns and likelyfurther lockdown periods.

Forecasting the COVID-19 Space-time Dynamics in Brazil with Convolutional Graph Neural Networks and Transport Modals

One of the major challenges imposed by the SARS-CoV-2 pandemic is the lack of pattern in which the virus spreads, making it difficult to create effective policies to prevent and tackle the pandemic. Several approaches have been proposed to understand the virus behavior and anticipate its infection and death curves at country ans state levels, thus supporting containment measures. Those initiatives generalize well for general extents and decisions, but they do not predict so well the trajectory of the virus through specific regions, such as municipalities, considering their distinct interconnection profiles. Specially in countries with continental dimensions, like Brazil, too general decisions imply that containment measures are applied either too soon or too late. This study presents a novel scalable alternative to forecast the numbers of case and death by SARS-CoV-2, according to the influence that certain regions exert on others. By exploiting a single-model architecture of graph convolutional networks with recurrent networks, our approach maps the main access routes to municipalities in Brazil using the modals of transport, and processes this information via neural network algorithms to forecast at the municipal level ans for the whole country. We compared the performance in forecasting the pandemic daily numbers with three baseline models using Mean Absolute Error (MAE), Symmetric Mean Absolute Percentage Error (sMAPE) and Normalized Root Mean Square Error (NRMSE) metrics, with the forecasting horizon varying from 1 to 25 days. Results show that the proposed model overcomes the baselines when considering the MAE and NRMSE (p ˂0.01), being specially suitable for forecasts from 14 to 24 days ahead. Author

COVID-19: risk perception and coping strategy in workers

Introduction: COVID-19 has posed a challenge to labor activities in the world favoring the modality of online work, as an alternative to avoid being present and thus increasing the transmission of SARS-CoV-2. The social behaviors of workers and administrations are associated with the risk perception regarding COVID-19.

Highly efficient textile supercapacitors made with face masks waste and thermoelectric Ca3Co4O9-δ oxide

We studied the electrochemical performance of solid state supercapacitors (SCs) made with surgical face mask (FM) waste and blister packs recycled from paracetamol packaging. The Ca3Co4O9-δ (CaCo) oxide was also deposited on the SC electrodes to store charge by redox reactions. The CaCo microparticles had a plate-like morphology and had sizes in the range of 1–4 µm. They also presented a monoclinic phase according to the analysis by the X-ray diffraction. The electrochemical characterization of the face mask-based SCs was carried out and found maximum capacitance/energy density values of 1706.2 F g−1/208.4 Wh kg−1 and 816.8 F g−1/99.7 Wh kg−1 for the SCs made with and without CaCo, respectively. Thus, incorporating the CaCo into the SCs improved the energy density and capacitance by ≈108%. The best device made with CaCo also presented a moderate capacitance retention of 82.1% after 1500 cycles of charge/discharge and long discharge times of at least 10 h (at a maximum output voltage of 0.54 V). Additionally, the devices were subjected to pressing conditions by putting on them weights of 0.1–0.5 Kg and their capacitance retention was only reduced by 0.7–1.5%. The analysis by XPS, Absorbance and Raman measurements pointed out that the SCs made with CaCo presented extra redox species of Co2+/Co3+ and oxygen vacancies on their electrodes;therefore, they could store charge by redox reactions. Hence, the results presented here revealed that highly efficient SCs are possible to make from medical waste and this could help to decrease the environmental contamination by plastic residuals. © 2021 Elsevier Ltd

Adaptation of primary care centers to virtuality

The COVID-19 pandemic has changed the scheme of care in order to protect our patients with chronic pathology, and to provide an adequate response to the acute care demand that reached the Health Centers. The non-face-to-face care can contribute to decongest the family doctor consultations. Primary Care professionals must lead and manage the transformation towards a mixed model where face-to-face and non-face-to-face care are part of the day-to-day consultation. Telemedicine or teleconsultation have become essential elements in our day-to-day care. For this process of transformation to be successful, we must answer three key questions: Why? For what? And for whom? It will be much easier to make this adaptation if we answer the three questions correctly. This transformation process must be sustained by organizational changes and the incorporation of new practices that add value. It should be based on the empowerment of all team members. We are in a unique moment for the change in the way primary care moving to a new paradigm where virtuality and presence fit: "let's aim for the moon, even if we miss, we'll land among the stars.”

Vitamin D supplementation and COVID-19 risk: a population-based, cohort study.

PURPOSE: To analyze the associations between cholecalciferol or calcifediol supplementation, serum 25-hydroxyvitamin D (25OHD) levels and COVID-19 outcomes in a large population. METHODS: All individuals ≥ 18 years old living in Barcelona-Central Catalonia (n = 4.6 million) supplemented with cholecalciferol or calcifediol from April 2019 to February 2020 were compared with propensity score-matched untreated controls. Outcome variables were SARS-CoV2 infection, severe COVID-19 and COVID-19 mortality occuring during the first wave of the pandemic. Demographical data, comorbidities, serum 25OHD levels and concomitant pharmacological treatments were collected as covariates. Associations between cholecalciferol or calcifediol use and outcome variables were analyzed using multivariate Cox proportional regression. RESULTS: Cholecalciferol supplementation (n = 108,343) was associated with slight protection from SARS-CoV2 infection (n = 4352 [4.0%] vs 9142/216,686 [4.2%] in controls; HR 0.95 [CI 95% 0.91-0.98], p = 0.004). Patients on cholecalciferol treatment achieving 25OHD levels ≥ 30 ng/ml had lower risk of SARS-CoV2 infection, lower risk of severe COVID-19 and lower COVID-19 mortality than unsupplemented 25OHD-deficient patients (56/9474 [0.6%] vs 96/7616 [1.3%]; HR 0.66 [CI 95% 0.46-0.93], p = 0.018). Calcifediol use (n = 134,703) was not associated with reduced risk of SARS-CoV2 infection or mortality in the whole cohort. However, patients on calcifediol treatment achieving serum 25OHD levels ≥ 30 ng/ml also had lower risk of SARS-CoV2 infection, lower risk of severe COVID-19, and lower COVID-19 mortality compared to 25OHD-deficient patients not receiving vitamin D supplements (88/16276 [0.5%] vs 96/7616 [1.3%]; HR 0.56 [CI 95% 0.42-0.76], p < 0.001). CONCLUSIONS: In this large, population-based study, we observed that patients supplemented with cholecalciferol or calcifediol achieving serum 25OHD levels ≥ 30 ng/ml were associated with better COVID-19 outcomes.

Corticosteroids and tocilizumab reduce in-hospital mortality in severe COVID-19 pneumonia: a retrospective study in a Spanish hospital.

BACKGROUND: There is an urgent need to reduce mortality of COVID-19. We examined if corticosteroids and tocilizumab reduce risk for death in patients with severe pneumonia caused by SARS-CoV-2. METHODS: A retrospective cohort study was performed in a single university hospital. All adult patients admitted with confirmed severe COVID-19 pneumonia from 9 March to 9 April 2020 were included. Severe pneumonia was defined as multi-lobar or bilateral pneumonia and a ratio of oxygen saturation by pulse oximetry to the fraction of inspired oxygen (SpFi)<315. All patients received antiviral and antibiotic treatment. From March 26, patients also received immunomodulatory treatment with corticosteroids (methylprednisolone 250 mg/day for 3 days), or tocilizumab or both. In-hospital mortality in the entire cohort and in a 1:1 matched cohort sub-analysis was evaluated. RESULTS: 255 patients were included, 118 received only antiviral and antibiotic treatment while 137, admitted after March 26, also received immunomodulators. In-hospital mortality of patients on immunomodulatory treatment was significantly lower than in those without [47/137(34.3%) vs. 69/118(58.5%), (p < .001)]. The risk of death was 0.44 (CI, 0.26-0.76) in patients receiving corticosteroids alone and 0.292 (CI, 0.18-0.47) in those treated with corticosteroids and tocilizumab. In the sub-analysis with 202 matched patients, the risk of death was 0.356 (CI 0.179-0.707) in patients receiving corticosteroids alone and 0.233 (0.124-0.436) in those treated with the combination. CONCLUSIONS: Combined treatment with corticosteroids and tocilizumab reduced mortality with about 25% in patients with severe COVID-19 pneumonia. Corticosteroids alone also resulted in lower in-hospital mortality rate compared to patients receiving only antiviral and antibiotic treatment. Corticosteroids alone or combined with tocilizumab may be considered in patients with severe COVID-19 pneumonia.