Risk factors for acute kidney injury in patients hospitalized with COVID-19 / Fatores de risco para lesão renal aguda em pacientes hospitalizados com COVID-19

Abstract Introduction: Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. Methods: A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Results: Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02-1.04), male sex (OR 2.13; 95% CI 1.49-3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04-2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06-4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00-1.03), ICU admission (OR 1.81; 95% CI 1.04-3.16), and vasopressor support (OR 7.46; 95% CI 3.34-16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84-0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98-0.99) could be protective factors. Conclusions: A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes.

RESUMO Introdução: Lesão renal aguda (LRA) ocorre frequentemente em pacientes com COVID-19 e associa-se a maior morbidade e mortalidade. Conhecer riscos da LRA permite a identificação, prevenção e tratamento oportuno. Este estudo teve como objetivo identificar fatores de risco associados à LRA em pacientes hospitalizados. Métodos: Realizou-se estudo descritivo, retrospectivo, transversal e de componente analítico de pacientes adultos hospitalizados com COVID-19 de 1º de março a 31 de dezembro, 2020. Definiu-se a LRA pelos critérios de creatinina das diretrizes KDIGO-LRA. Informações sobre fatores de risco foram obtidas de prontuários eletrônicos. Resultados: Dos 934 pacientes, 42,93% desenvolveram LRA, 60,59% KDIGO-1 e 9,9% necessitaram de terapia renal substitutiva. Pacientes com LRA apresentaram maior tempo de internação, maior mortalidade e necessitaram de mais internações em UTIs, ventilação mecânica e suporte vasopressor. A análise multivariada mostrou que idade (OR 1,03; IC 95% 1,02-1,04), sexo masculino (OR 2,13; IC 95% 1,49-3,04), diabetes mellitus (DM) (OR 1,55; IC 95% 1,04-2,32), doença renal crônica (DRC) (OR 2,07; IC 95% 1,06-4,04), proteína C reativa (PCR) (OR 1,02; IC 95% 1,00-1,03), admissão em UTI (OR 1,81; IC 95% 1,04-3,16) e suporte vasopressor (OR 7,46; IC 95% 3,34-16,64) foram fatores de risco para LRA, e que bicarbonato (OR 0,89; IC 95% 0,84-0,94) e índice de pressão parcial de oxigênio arterial/fração inspirada de oxigênio (OR 0,99; IC 95% 0,98-0,99) poderiam ser fatores de proteção. Conclusões: Documentou-se alta frequência de LRA em pacientes com COVID-19, com diversos preditores: idade, sexo masculino, DM, DRC, PCR, admissão em UTI e suporte vasopressor. LRA ocorreu mais frequentemente em pacientes com maior gravidade da doença e associou-se a maior mortalidade e piores desfechos.

Seroincidencia de anticuerpos IgG del SARS-CoV-2 y factores de riesgo en trabajadores sanitarios asintomáticos del hospital Departamental de Villavicencio

Objetivo: Estimar la seroincidencia acumulada de inmunoglobulinas (Ig) clase G (IgG) anti-SARS-CoV-2 en trabajadores de la salud asintomáticos y su asociación epidemiológica dentro de las áreas funcionales del Hospital Departamental de Villavicencio (HDV). Metodología: Se llevó a cabo un estudio observacional analítico longitudinal de una cohorte de trabajadores, donde cada 21 días, en tres oportunidades, se midieron IgG anti-SARS-CoV-2 en suero sanguíneo, a través de ELISA indirecto, en una muestra representativa aleatoria (n= 105) de trabajadores sanitarios del hospital (N= 756). Como instrumento de recolección de datos se utilizó una encuesta, donde cada trabajador sanitario declaró no haber sido diagnosticado con COVID-19, e igualmente registró la información sobre las variables independientes: sexo, edad, condición laboral, área funcional y comorbilidades. Resultados: La prevalencia inicial para SARS-CoV-2 entre los trabajadores sanitarios asintomáticos del HDV fue de 9,52 % (IC 95 % 5,25-16,65). La seroincidencia acumulada durante 42 días fue de 12,38 % (IC 95 % 7,38-20,04). El riesgo relativo (RR) se utilizó para establecer los factores de riesgo asociados a las variables independientes. El sexo masculino (RR ajustado = 3,34, IC 95 % 1,98-5,86), obesidad (RR ajustado = 10,98, IC 95 % 1,41-85,98) y sexo femenino (RR ajustado = 2,15, IC 95 % 1,12-4,31) en las áreas funcionales de Hospitalización, Medicina Crítica y Urgencias, respectivamente, son factores de riesgo en el HDV. Conclusión: Un total de 13 de 105 trabajadores sanitarios del hospital seroconvirtieron positivamente para SARS-CoV-2 y fueron asintomáticos durante 42 días de seguimiento epidemiológico. Además, existen factores de riesgo importantes en su exposición a este virus en el HDV.

Objective: To estimate the cumulative seroincidence of antisars-CoV-2 immunoglobulin (Ig) class G (IgG) in asymptomatic health care workers and its epidemiological association within the functional areas of the Villavicencio Departmental Hospital (HDV). Methodology: A longitudinal analytical observational study of a cohort of workers was conducted in which anti- SARS-CoV-2 IgG levels in blood serum were measured every 21 days on three occasions using an indirect ELISA in a random representative sample (n = 105) of hospital health workers (N = 756). The data collection tool was a survey in which each healthcare worker indicated that they had not been diagnosed with COVID-19 and provided information on the independent variables: sex, age, job status, functional area, and comorbidities. Results: The baseline prevalence for SARS-CoV-2 among asymptomatic HDV healthcare workers was 9.52% (CI 95% 5.25-16.65). Cumulative seroincidence over 42 days was 12.38% (CI 95% 7.38-20.04). Relative risk (RR) was used to establish the risk factors associated with the independent variables. Male sex (adjusted RR 3.34, CI 95% 1.98-5.86), obesity (adjusted RR 10.98, CI 95% 1.41- 85.98) and female sex (adjusted RR 2.15, CI 95% 1.12-4.31) in the functional areas of Hospitalization, Critical Medicine and Emergency, respectively, are risk factors in the HDV. Conclusion: During 42 days of epidemiological follow-up, 13 out of 105 hospital healthcare workers seroconverted positively for SARS-CoV-2 and remained asymptomatic. Additionally, significant risk factors are associated with their exposure to this virus in the HDV.

Objetivo: Estimar a incidência zero acumulada de imunoglobulinas (Ig) classe G (IgG) anti-SARS-CoV-2 em profissionais de saúde assintomáticos e sua associação epidemiológica dentro das áreas funcionais do Hospital Estadual de Villavicencio (HDV). Metodologia: Foi realizado um estudo observacional analítico longitudinal de uma coorte de profissionais, no qual a cada 21 dias, em três ocasiões mediram-se IgG anti-SARS-CoV-2 em soro sanguíneo, através de ELISA indireto, em uma amostra representativa aleatória (n = 105) de profissionais de saúde do hospital (N =756). Como instrumento de recolecção de dados foi usada uma pesquisa, onde cada profissional de saúde declarou não ter sido diagnosticado com COVID-19, e igualmente registrou a informação sobre as variáveis independentes: sexo, idade, condições de trabalho, área de atuação e comorbidades. Resultados: A prevalência inicial para SARS-CoV-2 entre os profissionais de saúde assintomáticos do HDV foi de 9,52% (IC 95% 5,25-16,65). A incidência zero acumulada durante 42 dias foi de 12,38% (IC 95% 7,38-20,04). O risco relativo (RR) foi utilizado para estabelecer os fatores de risco associados às variáveis independentes. O sexo masculino (RR ajustado 3,34, IC 95% 1,98-5,86), obesidade (RR ajustado 10,98, IC 95% 1,41-85,98) e sexo feminino (RR ajustado 2,15, IC 95% 1,12-4,31) nas áreas funcionais de Internação, Unidade de Terapia Intensiva e Urgências, respectivamente, são fatores de risco no HDV. Conclusão: Um total de 13 de 105 profissionais de saúde do hospital foram detectados positivamente para SARS-CoV-2 e foram assintomáticos durante 42 dias de seguimento epidemiológico. Além disso, existem importantes fatores de risco na sua exposição a este vírus no HDV.

Do diagnóstico institucional ao apoio interdisciplinar: a psicologia hospitalar durante a Covid-19 / From institutional diagnosis to interdisciplinary support: hospital psychology during the Covid-19 / Del diagnóstico institucional al apoyo interdisciplinario: la psicología hospitalaria frente a Covid-19

The crisis generated by the coronavirus disease 2019 (Covid-19) pandemic changed health care routines and the dynamics of hospitals and impacted health professionals. This experience report presents an interdisciplinary institutional support intervention, led by the psychology service of a pediatric hospital. Based on the hospital management's demand for the care of the employees' mental health, an institutional diagnosis was made and an interdisciplinary action of guidance, support and reception to employees was structured, which collected and organized into 11 categories concerns and obstacles to the functioning of the hospital during the pandemic. Hence, it was possible to realign care flows and offer psychological support to professionals, highlighting the interdisciplinary quality of mental health care. We verified emotional rebalancing, strengthening of professional identity, and better occupational performance. The transformation process that was fostered helped to overcome difficulties and promote an environment of resilience and better coping with the situation, indicating the need to maintain the attention that the crisis demanded.

A pandemia provocada pela Covid-19 alterou as rotinas assistenciais hospitalares e impactou os profissionais de saúde. Este relato de experiência apresenta uma intervenção interdisciplinar de apoio institucional, liderada pelo Serviço de Psicologia de um hospital pediátrico, e a constatação da possibilidade de encontrar soluções inovadoras, sistematizadas e fundamentadas para novos problemas. A partir da demanda da direção da instituição de cuidado destinado à saúde mental dos colaboradores, realizou-se um diagnóstico institucional e estruturou-se a ação interdisciplinar de orientação, apoio e acolhimento aos colaboradores, revelando preocupações e entraves do hospital durante a pandemia. A partir daí, foi possível realinhar a ação, ressaltando a qualidade interdisciplinar do cuidado com a saúde mental. Constataram-se reequilíbrio emocional, fortalecimento da identidade profissional e melhor desempenho ocupacional. Esse resgate fomentou um processo de transformação que consistiu em colaborar para a superação de dificuldades, promover um ambiente de resiliência e melhor enfrentamento da situação, e indicar a necessidade de manutenção da atenção que a crise oportunizou.

La crisis generada por la pandemia de la coronavirus disease 2019 (Covid-19) cambió las rutinas de atención médica y la dinámica de los hospitales y impactó los profesionales de la salud. Presenta-se una intervención interdisciplinaria de apoyo institucional, dirigida por el servicio de psicología de un hospital pediátrico. Con base en las demandas de la administración del hospital para el cuidado de la salud de los empleados, se realizó un diagnóstico institucional y se estructuró una acción interdisciplinaria de orientación, apoyo y acogida a los empleados que recopiló y organizó en 11 categorías inquietudes y obstáculos para el funcionamiento del hospital durante la pandemia. Los flujos de atención han sido reordenados, destacando la calidad interdisciplinaria de la atención en salud mental. Verificamos reequilibrio emocional, fortalecimiento de la identidad profesional y mejor desempeño ocupacional. El proceso de transformación que se impulsó ayudó a superar las dificultades y promover un ambiente de resiliencia y mejor enfrentamiento a la situación, indicando la necesidad de mantener la atención que demandaba la crisis.

Mortalidade por COVID-19 Comparada: Brasil, Rio de Janeiro, Campos dos Goytacazes, Macaé, Cabo Frio e Rio das Ostras / Comparative Analysis of COVID-19 Mortality in Brazil, Rio de Janeiro, Campos dos Goytacazes, Macaé, Cabo Frio ando Rio das Ostras

Objetivos: analisar quantitativa e comparativamente os óbitos por COVID-19 nos quatro maiores municípios do Norte Fluminense (Campos dos Goytacazes e Macaé) e Baixada Litorânea do Rio de Janeiro (Cabo Frio e Rio das Ostras), situando-os no contexto estadual e nacional. Métodos: usamos dados do Registro Civil e informações demográficas para elaborar um quadro geral da pandemia até a 41a semana epidemiológica sob vários aspectos. Resultados: caracterizamos a evolução da pandemia, diferenciando os padrões conforme localidade. Encontramos uma dependência universal exponencial do coeficiente de mortalidade com a idade e uma maior letalidade na população masculina em relação à feminina, variável entre os municípios. O recorte racial também é examinado e discutido. Determinamos que a COVID-19 representa fração importante das causas de morte em 2020, estando associada à significativo excesso de óbitos em relação à 2019 e à alteração dos padrões de mortalidade por outras causas, com implicações relevantes para a saúde pública. Conclusões: a mortalidade é um indicador efetivo e poderoso para a compreensão da infecção pelo SARS-CoV-2 e sua pandemia, sendo sua análise local um instrumento indispensável para a construção de políticas públicas para o enfrentamento da pandemia e gestão da saúde pública.

COVID-19 pandemic and blood transfusion services: The impact, response and preparedness experience of a tertiary care blood center in southern Karnataka, India

Abstract Introduction With the outbreak of COVID-19 and its containment measures, blood centers faced a huge challenge in balancing blood demand and supply and devising a preparedness plan to withstand the uncertain situation. This study assesses the effect of the COVID-19 pandemic on blood transfusion services and discusses the appropriate mitigation strategies adopted. Methods We analyzed our center's blood transfusion services during the first half-period of the pandemic (Y3) and non-pandemic years 2018(Y1) and 2019(Y2) in two-quarters Q1 (pre-lockdown), from January to March and Q2 (post-lockdown), from April to June. The blood donation variables, the packed red blood cells (PRBCs) demand and the utilization pattern were compared between pandemic (Y3) and non-pandemic years (Y1 and Y2) in each quarter. The mitigation strategy adopted at every step of the transfusion service is highlighted. Results During post-lockdown (Q2) of the pandemic year (Y3), the blood donation was majorly by repeat donors (83%) from the in-house site (82.5%). Furthermore, the proportion of outdoor donation, deferral, blood collection, demand and issue demonstrated a significant drop of 50%, 32.6%, 33%, 31.8% and 32.3%, respectively, in comparison to Q2 of the non-pandemic years (Y1 and Y2), with a statistically significant difference for surgical and hemorrhagic indications (p < 0.05). Coping strategies, such as blood donor education and motivation using e-platforms emphasizing eligibility during the pandemic, staggering of donor in-flow, postponement of elective surgeries and donor and staff' COVID-19 safety assurance, were followed. Conclusion The timely adoption of coping strategies played a crucial role in the better handling of shortcomings at our center's blood transfusion services caused by the COVID-19 pandemic.

COVID-19 pandemic and blood transfusion services: The impact, response and preparedness experience of a tertiary care blood center in southern Karnataka, India.

INTRODUCTION: With the outbreak of COVID-19 and its containment measures, blood centers faced a huge challenge in balancing blood demand and supply and devising a preparedness plan to withstand the uncertain situation. This study assesses the effect of the COVID-19 pandemic on blood transfusion services and discusses the appropriate mitigation strategies adopted. METHODS: We analyzed our center's blood transfusion services during the first half-period of the pandemic (Y3) and non-pandemic years 2018(Y1) and 2019(Y2) in two-quarters Q1 (pre-lockdown), from January to March and Q2 (post-lockdown), from April to June. The blood donation variables, the packed red blood cells (PRBCs) demand and the utilization pattern were compared between pandemic (Y3) and non-pandemic years (Y1 and Y2) in each quarter. The mitigation strategy adopted at every step of the transfusion service is highlighted. RESULTS: During post-lockdown (Q2) of the pandemic year (Y3), the blood donation was majorly by repeat donors (83%) from the in-house site (82.5%). Furthermore, the proportion of outdoor donation, deferral, blood collection, demand and issue demonstrated a significant drop of 50%, 32.6%, 33%, 31.8% and 32.3%, respectively, in comparison to Q2 of the non-pandemic years (Y1 and Y2), with a statistically significant difference for surgical and hemorrhagic indications (p < 0.05). Coping strategies, such as blood donor education and motivation using e-platforms emphasizing eligibility during the pandemic, staggering of donor in-flow, postponement of elective surgeries and donor and staff' COVID-19 safety assurance, were followed. CONCLUSION: The timely adoption of coping strategies played a crucial role in the better handling of shortcomings at our center's blood transfusion services caused by the COVID-19 pandemic.

Aprendizajes de estudiantes del área de la salud en tiempos de Covid-19: una revisión integrativa / Learning Process of Health Care Student in Times of Covid-19: An Integrative Review / Aprendizagem do discente na área da saúde em tempo de Covid-19: uma revisão integrativa

Objetivo: caracterizar la producción científica relacionada con los aprendizajes de los estudiantes de salud en tiempos de pandemia por COVID-19. Metodología: revisión integrativa por medio de la búsqueda y análisis de literatura en nueve bases de datos científicas de acceso libre. Se incluyeron cuarenta artículos de investigación teniendo en cuenta los Descriptores en Ciencias de la Salud (DeCs) para su búsqueda, no se limitó el periodo de publicación al tratarse de un tema emergente. La investigación se realizó entre diciembre de 2020 y marzo de 2021. Resultados: se identifica la tendencia a estudiar el tema en el nivel de pregrado y específicamente, en la profesión de medicina. El abordaje metodológico con enfoque cuantitativo se presentó más en Asia. Las tendencias temáticas fueron: 1) percepción de los estudiantes en relación con el entorno de aprendizaje en línea y 2) factores para un entorno de aprendizaje. Conclusión: parece haber un acuerdo en la necesidad de un aprendizaje significativo en la educación virtual, sin embargo, todavía se discute cómo y para qué hacerlo.

Objective: to characterize the scientific production related to health students' learning in times of COVID-19 pandemic. Methodology: integrative review by means of literature search and analysis in nine open access scientific databases. Forty research articles were included taking into account the Descriptors in Health Sciences (DeCs) for their search, the period of publication was not limited as it was an emerging topic. The research was conducted between December 2020 and March 2021. Results: the tendency to study the topic at the undergraduate level and specifically in the medical profession is identified. The methodological approach with a quantitative focus was more present in Asia. The thematic trends were: 1) students' perception of the online learning environment and 2) factors for a learning environment. Conclusion: there seems to be an agreement on the need for meaningful learning in virtual education, however, how and for what to do it is still discussed.

Objetivo: caracterizar a produção científica relacionada à aprendizagem dos discentes da área da saúde em tempo de pandemia por COVID-19. Metodologia: revisão integrativa por meio da busca e análise da literatura em nove bases de dados científicas de acesso livre. Incluíram-se quarenta artigos de pesquisa considerando Descritores em Ciências da Saúde (DeCs) para sua busca, não se limitou o período de publicação por se tratar de um tema emergente. A pesquisa foi realizada entre dezembro de 2020 e março de 2021. Resultados: Foi identificada a tendência a estudar o tema no nível de graduação e especificamente na profissão de medicina. A abordagem metodológica com enfoque quantitativa apresentou-se mais na Ásia. As tendências temáticas foram: 1) percepção dos alunos em relação ao ambiente de aprendizagem online e 2) fatores para um ambiente de aprendizagem. Conclusão: parece haver consenso sobre a necessidade de uma aprendizagem significativa na educação virtual, porém, como e por que fazê-lo ainda está sendo discutido.

Response to Commentary: Fungal Infections of Oral Cavity: Diagnosis, Management, and Association with COVID-19.

This letter is a response to commentary by Ambadasu et al. on a review article by Santosh et al. on "Fungal Infections of Oral Cavity: Diagnosis, Management, and Association with COVID-19." In their commentary, Ambadasu et al. mentioned that in the list of COVID-19 associated fungal infections, mucormycosis should be added. In this response, we provide our thoughts on including mucormycosis in COVID-19 associated fungal infections of the oral cavity. We conclude that mucormycosis surge was more prevalent during the second wave of COVID-19 infection. Majority of published reports on oral fungal infections during the years 2019 and 2020 was focused on Oral Candidiasis, whereas mucormycosis appears to be re-emerging opportunistic entry of fungal infection among COVID-19 infection due to associated risk factors. Thus, Physicians and Dentists must be cautioned that other listed opportunistic fungal infections of oral cavity may also be seen among severe COVID-19 patients.be seen among severe COVID-19 patients.

Sleep in Older Adults and Its Possible Relations With COVID-19.

Since the beginning of the COVID-19 pandemic, older adults have been found to be a highly vulnerable group, with a higher prevalence of severe cases and negative outcomes. Research has focused on the reasons why older adults are at greater risk; Sleep-related factors have been suggested as one possible explanation for this. An individual's sleep pattern undergoes significant changes over the course of their life. In older adults a specific sleep profile can be observed, one characterized by advanced sleep timing, a morningness preference, longer sleep-onset latency, shorter overall sleep duration, increased sleep fragmentation, reduced slow-wave sleep and, increased wake time after sleep onset. Additionally, an increased prevalence of sleep disorders can be observed, such as obstructive sleep apnea and insomnia. Previous research has already linked sleep disorders (especially sleep apnea) with COVID-19, but few studies have focused specifically on the older population. We believe that the intrinsic sleep patterns of older adults, and the prevalence of sleep disorders in this population, may be important factors that could explain why they are at a greater risk of negative COVID-19 outcomes. In this review, we discuss the relationship between sleep and COVID-19 among older adults, focusing on three different aspects: (1) Sleep-related issues that might increase the likelihood of getting infected by SARS-COV-2; (2) Sleep disturbances that might increase the predisposition to worse COVID-19 prognosis and outcomes; and (3) COVID-19-related aspects affecting community-dwelling older adults, such as social isolation, quarantine, and home confinement, among others, that might impact sleep.

Manifestaciones orales y disfunción olfativa y gustativa en el síndrome respiratorio agudo severo por corona virus 2 (VIRUS SARS-COV-2): una revisión sistemáticaA / Oral Manifestations and Olfactory and Gustatory Dysfunction in Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCov-2 Virus) Disease: A Systematic Review

La enfermedad del corona virus 2 del síndrome respiratorio agudo severo (virus SARS-CoV-2) apareció por primera vez en diciembre de 2019 en Wuhan, China, y desde entonces se ha extendido rápidamente por todo el mundo. Desde entonces, el brote de esta grave enfermedad viral se ha convertido en una amenaza global para la humanidad. El diagnóstico precoz y el aislamiento son las medidas más importantes necesarias para prevenir su propagación. La evidencia anecdótica reciente ha sugerido manifestaciones orales con o sin deterioro olfativo y gustativo en asociación con la enfermedad por coronavirus (COVID-19). La enzima convertidora de angiotensina-2 (ECA-2) se expresa en la mucosa oral en grandes cantidades y, por tanto, puede contribuir a las primeras manifestaciones de esta enfermedad viral mortal. Las manifestaciones bucales de la enfermedad por coronavirus pueden presentarse en forma de lesiones ulcerativas irregulares en relación con diferentes partes de la cavidad oral y, en particular, en relación con la mucosa adherida en la región del paladar duro, así como inflamación y posterior atrofia de las diversas papilas de la lengua. La disfunción olfativa y gustativa asociada también puede conducir a una pérdida parcial y / o incluso completa de la capacidad para oler y saborear en las primeras etapas del inicio de la enfermedad. La evidencia también ha sugerido la presencia de ácido nucleico del SARS-CoV-2 en la saliva humana, lo que la convierte en portadora de la enfermedad viral infecciosa y ayuda en su diagnóstico. Hemos buscado sistemáticamente la base de datos médica para el mismo y hemos revisado toda la literatura disponible hasta el 29 de junio de 2020

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease had first appeared in December 2019 in Wuhan, China and has been spreading quickly throughout the world since then. Since then, the outbreak of this severe viral disease has become a global threat to humanity. An early diagnosis and isolation are the most significant measures required to prevent its spread. Recent anecdotal evidence has suggested oral manifestations with or, without olfactory and gustatory impairment in association with corona virus disease (COVID-19). Angiotensin converting enzyme-2 (ACE-2) is expressed in oral mucosa in large amounts and can, thus, contribute in the early manifestations of this deadly viral disease. The oral manifestations of corona virus disease can occur in the form of irregular ulcerative lesions in relation to different parts of the oral cavity and particularly, in relation to the attached mucosa in the hard palate region as well as inflammation and subsequent, atrophy of the various tongue papilla. The associated olfactory and gustatory dysfunction can, also, lead to partial and/or, even a complete loss of the ability to smell and taste in the early stages of the disease onset. Evidence has, also, suggested the presence of SARS-CoV-2 nucleic acid in human saliva making it the carrier of the infectious viral disease as well as aiding in its diagnosis. We have systemically searched medical database for the same and have reviewed all the literature available up to 29th of June 2020.

Are vanadium complexes druggable against the main protease Mpro of SARS-CoV-2? - A computational approach.

In silico techniques helped explore the binding capacities of the SARS-CoV-2 main protease (Mpro) for a series of metalloorganic compounds. Along with small size vanadium complexes a vanadium-containing derivative of the peptide-like inhibitor N3 (N-[(5-methylisoxazol-3-yl)carbonyl]alanyl-l-valyl-N1-((1R,2Z)-4-(benzyloxy)-4-oxo-1-{[(3R)-2-oxopyrrolidin-3-yl] methyl }but-2-enyl)-l-leucinamide) was designed from the crystal structure with PDB entry code 6LU7. On theoretical grounds our consensus docking studies evaluated the binding affinities at the hitherto known binding site of Chymotrypsin-like protease (3CLpro) of SARS-CoV-2 for existing and designed vanadium complexes. This main virus protease (Mpro) has a Cys-His dyad at the catalytic site that is characteristic of metal-dependent or metal-inhibited hydrolases. Mpro was compared to the human protein-tyrosine phosphatase 1B (hPTP1B) with a comparable catalytic dyad. HPTP1B is a key regulator at an early stage in the signalling cascade of the insulin hormone for glucose uptake into cells. The vanadium-ligand binding site of hPTP1B is located in a larger groove on the surface of Mpro. Vanadium constitutes a well-known phosphate analogue. Hence, its study offers possibilities to design promising vanadium-containing binders to SARS-CoV-2. Given the favourable physicochemical properties of vanadium nuclei, such organic vanadium complexes could become drugs not only for pharmacotherapy but also diagnostic tools for early infection detection in patients. This work presents the in silico design of a potential lead vanadium compound. It was tested along with 20 other vanadium-containing complexes from the literature in a virtual screening test by docking to inhibit Mpro of SARS-CoV-2.

Physical exercise effects on the brain during COVID-19 pandemic: links between mental and cardiovascular health.

The current pandemic was caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The quarantine period during corona virus disease 19 (COVID-19) outbreak might affect the quality of life leading thousands of individuals to diminish the daily caloric expenditure and mobility, leading to a sedentary behavior and increase the number of health disorders. Exercising is used as a non-pharmacological treatment in many chronic diseases. Here, we review the molecular mechanisms of physical exercise in COVID-19 pandemic on mental health. We also point links between exercise, mental, and cardiovascular health. The infection caused by SARS-CoV-2 affects host cells binding to angiotensin-converting enzyme-2 (ACE2), which is the receptor for SARS-CoV-2. If there is not enough oxygen supply the lungs and other tissues, such as the heart or brain, are affected. SARS-CoV-2 enhances ACE2 leading to inflammation and neuronal death with possible development of mood disorders, such as depression and anxiety. Physical exercise also enhances the ACE2 expression. Conversely, the activation of ACE2/Ang 1-7/Mas axis by physical exercise induces an antiinflammatory and antifibrotic effect. Physical exercise has beneficial effects on mental health enhancing IGF-1, PI3K, BDNF, ERK, and reducing GSK3ß levels. In addition, physical exercise enhances the activity of PGC-1α/ FNDC5/Irisin pathway leading to neuronal survival and the maintenance of a good mental health. Thus, SARS-CoV-2 infection leads to elevation of ACE2 levels through pathological mechanisms that lead to neurological and cardiovascular complications, while the physiological response of ACE2 to physical exercise improves cardiovascular and mental health.

Application of green synthesised copper iodide particles on cotton fabric-protective face mask material against COVID-19 pandemic.

Microorganisms cause variety of diseases that constitutes a severe threat to mankind. Due to the upsurge of many infectious diseases, there is a high requirement and demand for the development of safety products finished with antimicrobial properties. The study involves the antimicrobial activity of natural cotton coated with copper iodide capped with Hibiscus rosa-sinensis L. flower extract (CuI-FE) which is rich in anthocyanin, cyanidin-3-sophoroside by ultrasonication method. The coated and uncoated cotton fabric was characterised through XRD, SEM, AFM, tensile strength and UV-Visible spectroscopic techniques. XRD confirmed the formation of CuI particles, SEM showed that CuI-FE was prismatic in shape. The average size of CuI-FE particles was found to be 552.45 nm. Anti-bacterial studies showed copper iodide particles to be a potent antimicrobial agent. AFM images confirmed the rupture of bacterial cell walls in the presence of prismatic CuI-FE. In-vitro cytotoxicity investigation of CuI-FE was performed against cancer and spleen cell lines to evaluate the cell viability. Cytotoxicity analysis revealed the IC50 value of 233.93 µg/mL in the presence of CuI-FE. Molecular docking study was also carried out to understand the interaction of CuI-FE with COVID-19 main protease. This paper has given an insight on the usage of CuI-FE coated on the cotton fabric that has proved to have strong inhibition against the nano ranged bacterial, cancerous cell line and a strong interaction with the COVID-19 protease. Such eco-friendly material will provide a safe environment even after the disposable of medical waste from the infectious diseases like influenza and current pandemic like COVID-19.

A gestão da qualidade dos alimentos nos serviços de gastronomia na cidade de São Paulo durante a pandemia de Covid 19 / Food quality management in gastronomy services in the city of São Paulo during the Covid 19 pandemic

Devido ao risco da pandemia COVID 19, foram adotadas estratégias para reduzir as taxas de contágio das populações e tentar evitar crise no sistema de saúde. A categoria de bares e restaurantes busca adequar-se a essas estratégias, mantendo a qualidade e higiene de seus serviços para colaboradores e cliente. Neste trabalho o objetivo foi realizar o levantamento e análise sobre as ações direcionadas à prevenção da transmissão da COVID 19 em serviços de alimentação. A metodologia adoada foi a revisão bibliográfica por meio de dados disponíveis em bases de dados científicos como: Scielo, PubMed e Órgãos do Governo, nos últimos 43 anos. O período de busca se deu entre dezembro de 2020 e fevereiro de 2021 e resultou em 28 artigos. O Governo de São Paulo determinou fases de acordo com o avanço da pandemia e cada uma delas apresenta restrições para bares e restaurantes, além disso, outros autores desenvolveram orientações para que eles pudessem seguir o padrão das boas práticas de higiene nos serviços de alimentação. Concluiu-se que há necessidade de manter a qualidade higiênico sanitária em serviços de gastronomia de São Paulo, também é importante que os clientes sejam ouvidos e que funcionários tenham treinamentos para evitar a contaminação da COVID 19 e manter as pessoas sadias.(AU)

Due to the risk of the COVID 19 pandemic, strategies were adopted to reduce the contagion rates of populations and try to avoid a crisis in the health system. The category of bars and restaurants seeks to adapt to these strategies, maintaining the quality and hygiene of its services for employees and customers. In this work, the objective was to carry out a survey and analysis of actions aimed at preventing the transmission of COVID 19 in food services. The adopted methodology was a bibliographic review using data available in scientific databases such as: Scielo, PubMed and Government Agencies, in the last 43 years. The search period took place between December 2020 and February 2021 and resulted in 28 articles. The Government of São Paulo determined phases according to the progress of the pandemic and each one of them presents restrictions for bars and restaurants, in addition, other authors developed guidelines so that they could follow the standard of good hygiene practices in food services. It was concluded that there is a need to maintain the hygienic and sanitary quality in gastronomy services in São Paulo, it is also important that customers are heard and that employees have training to avoid contamination of COVID 19 and keep people healthy.(AU)

A Novel Frequency Based Feature Extraction Technique for Classification of Corona Virus Genome and Discovery of COVID-19 Repeat Pattern

Abstract Genome sequence regulates the life of all living organisms on earth. Genetic diseases cause genomic disorders and therefore early prediction of severe genetic diseases is quite possible by Genome sequence analysis. Genomic disorders refer to the mutation that is rearrangement of bases in the Genome of an organism. Genome sequence analysis and mutation identification can help to classify the diseased genome which can be accomplished using Machine Learning techniques. Feature Extraction plays a crucial role in classification as it is used to convert the Genome sequences into a set of quantitative values. In this article, we propose a novel feature extraction technique called Frequency based Feature Extraction Technique which extracts 120 features from genome sequences for classification. In the current scenario, COVID-19 is the pandemic disease and Corona virus is the source of this disease. So, in this research work, we tested the proposed feature extraction technique with 1000 samples of Genome sequences of Corona virus affected patients across the world. The extracted features were classified using both Machine Learning and Deep Learning techniques. From the results, it is evident that the proposed feature extraction technique performs well with Convolutional Neural Network classifier giving an accuracy of 97.96%. The proposed technique also helps to find the most repeat patterns in the genome sequences. It is discovered that the pattern "TTGTT" is the most repeat pattern in COVID-19 genome.

Boas práticas de fabricação de alimentos no contexto da Covid-19 / Good food manufacturingpractices in the Covid-19 context

Introdução: Após o início da pandemia ocasionada pelo novo coronavírus, o mundo se deparou com a necessidade do isolamento social. Todos os serviços não considerados essenciais tiveram a orientação de permanecerem fechados por tempo indeterminado. Nesse cenário, os serviços de alimentação puderam continuar funcionando, porém, com uma gama de alterações em suas rotinas e nas boas práticas de fabricação. Objetivo: Este trabalho teve como objetivo analisar as principais mudanças ocorridas nas boas práticas de fabricação de Unidades de Alimentação, após o início da pandemia do novo coronavírus. Método: Foi realizado um estudo qualitativo, com produção de dados por meio de entrevistas on-line, com gestores de Unidades de Alimentação. O questionário utilizado foi desenvolvido especialmente para este projeto, sendo segmentado em três etapas: dados pessoais, dados da unidade e alterações realizadas devido à pandemia. Resultado: Ao total, a pesquisa obteve 70 respostas, provenientes de profissionais que atuam na cidade de Curitiba- PR. Dentre as medidas mais citadas, destaca-se a aquisição de novos equipamentos de proteção, redução da capacidade do refeitório e aumento no uso de produtos de limpeza e álcool em gel. Conclusão: O fortalecimento das boas práticas e a implantação de medidas de segurança adicionais podem contribuir para a redução da transmissão do novo coronavírus, mas é fundamental que os profissionais adotem unicamente medidas baseadas nas legislações vigentes e nas orientações dos principais órgãos de saúde, a fim de evitar a disseminação de informações dúbias e errôneas

Introduction: After the start of the pandemic caused by the new coronavirus, the world was faced with the need for social isolation. All services not considered essential were instructed to remain indefinitelyclosed. In this scenario, food services were able to continue working, however, with a range of changes in their routines and good manufacturing practices. Objective: This study aimed to analyze the main changes that occurred in the good manufacturing practices of Food Units, after the beginning of the new coronavirus pandemic. Method: A qualitative study was carried out, with data production through online interviews with managers of Food Units. The questionnaire used was developed especially for this project, being divided into three stages: personal data, unit data and changes made due to the pandemic. Result: In total, the survey obtained 70 responses, from professionals who work in the city of Curitiba, PR. Among the actions most often mentioned, we highlight the acquisition of new protective equipment, reduction of cafeteria capacity and increase in the use of cleaning products and alcohol gel. Conclusion: The development of good practices and the implementation of additional safety measures can contribute to reducing the transmission of the new coronavirus, but it is essential that professionals adopt only measures based on current legislation and guidelines of the top health organizations, in order to avoid the dissemination of dubious and erroneous information.

Pregnant women and COVID-19: isolation as a physical and psychic impact factor / Gestantes e COVID-19: isolamento como fator de impacto físico e psíquico

Abstract This research aims to reflect upon the inherent impacts of social isolation caused by the new coronavirus (COVID-19) pandemic on the health of pregnant women. It brings up a survey on both physical and psychological aspects of this period on a woman's life, such as physiological and emotional changes. It also raises questions about how these aspects can be directly or indirectly affected by periods of isolation, considering recent research and guidance from health reference organizations.

Resumo Esse texto tem como objetivo refletir sobre os impactos inerentes do isolamento social proveniente da pandemia do novo corona vírus (COVID-19) na saúde das gestantes. Traz um levantamento tanto sobre os aspectos físicos como psíquicos específicos desse período da vida da mulher, como as alterações fisiológicas e emocionais. Bem como, levanta questões de como esses aspectos podem ser afetados direto ou indiretamente em um momento de isolamento, apresentando reflexões sobre pesquisas atuais e orientações de órgãos de referência na saúde.

Essential Oils as Antiviral Agents. Potential of Essential Oils to Treat SARS-CoV-2 Infection: An In-Silico Investigation.

Essential oils have shown promise as antiviral agents against several pathogenic viruses. In this work we hypothesized that essential oil components may interact with key protein targets of the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A molecular docking analysis was carried out using 171 essential oil components with SARS-CoV-2 main protease (SARS-CoV-2 Mpro), SARS-CoV-2 endoribonucleoase (SARS-CoV-2 Nsp15/NendoU), SARS-CoV-2 ADP-ribose-1″-phosphatase (SARS-CoV-2 ADRP), SARS-CoV-2 RNA-dependent RNA polymerase (SARS-CoV-2 RdRp), the binding domain of the SARS-CoV-2 spike protein (SARS-CoV-2 rS), and human angiotensin-converting enzyme (hACE2). The compound with the best normalized docking score to SARS-CoV-2 Mpro was the sesquiterpene hydrocarbon (E)-ß-farnesene. The best docking ligands for SARS-CoV Nsp15/NendoU were (E,E)-α-farnesene, (E)-ß-farnesene, and (E,E)-farnesol. (E,E)-Farnesol showed the most exothermic docking to SARS-CoV-2 ADRP. Unfortunately, the docking energies of (E,E)-α-farnesene, (E)-ß-farnesene, and (E,E)-farnesol with SARS-CoV-2 targets were relatively weak compared to docking energies with other proteins and are, therefore, unlikely to interact with the virus targets. However, essential oil components may act synergistically, essential oils may potentiate other antiviral agents, or they may provide some relief of COVID-19 symptoms.

La Psicología en la prevención y manejo del COVID-19: aportes desde la evidencia inicial / Psychology in the prevention and management of COVID-19: contributions from the initial evidence

Resumen En diciembre de 2019, se informaron casos de neumonía potencialmente mortal en Wuhan, provincia de Hubei, China (COVID-19). Esta enfermedad se ha extendido rápidamente por todo el mundo con miles de casos confirmados y muertes, transformándose en pandemia y desafiado los sistemas de salud pública. No existe aún vacuna ni tratamiento científicamente probado, sin embargo, se ha identificado los comportamientos exactos que pueden evitar el contagio y propagación. El presente artículo sistematiza información disponible inicial sobre psicología y COVID-19. Se discute que gran parte del problema de la enfermedad se puede evitar cambiando los comportamientos de las personas y que la psicología puede ayudar a explicar, prevenir e intervenir para su solución. La psicología cuenta con evidencia científica disponible que explica todos estos fenómenos, evidencia que debe ser puesta en relieve por los mismos actores de las disciplinas a disposición de otras áreas del conocimiento y sobre todo para los tomadores de decisión.

Abstract In December 2019, highly lethal cases of pneumonia were reported in Wuhan, Hubei Province, China (COVID-19). This disease has spread rapidly around the world with thousands of confirmed cases and deaths, becoming a pandemic and challenging public health systems. There is no vaccine or scientifically proven treatment yet, but the exact behaviours that can prevent transmission and spread have been identified. This article systematizes initial available information on psychology and COVID-19. It is discussed that much of the problem of the disease can be avoided by changing people's behaviors and that psychology can help explain, prevent and intervene to solve it. Psychology has scientific evidence available that explains all these phenomena, evidence that should be highlighted by the same actors in the disciplines available to other areas of knowledge and especially for decision makers.