Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19.

OBJECTIVE: This study aimed to synthesize the existing evidence on biomarkers related to coronavirus disease 2019 (COVID-19) patients who presented neurological events. METHODS: A systematic review of observational studies (any design) following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Collaboration recommendations was performed (PROSPERO: CRD42021266995). Searches were conducted in PubMed and Scopus (updated April 2023). The methodological quality of nonrandomized studies was assessed using the Newcastle‒Ottawa Scale (NOS). An evidence gap map was built considering the reported biomarkers and NOS results. RESULTS: Nine specific markers of glial activation and neuronal injury were mapped from 35 studies published between 2020 and 2023. A total of 2,237 adult patients were evaluated in the included studies, especially during the acute phase of COVID-19. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) biomarkers were the most frequently assessed (n = 27 studies, 77%, and n = 14 studies, 40%, respectively). Although these biomarkers were found to be correlated with disease severity and worse outcomes in the acute phase in several studies (p < 0.05), they were not necessarily associated with neurological events. Overall, 12 studies (34%) were judged as having low methodological quality, 9 (26%) had moderate quality, and 9 (26%) had high quality. CONCLUSIONS: Different neurological biomarkers in neurosymptomatic COVID-19 patients were identified in observational studies. Although the evidence is still scarce and conflicting for some biomarkers, well-designed longitudinal studies should further explore the pathophysiological role of NfL, GFAP, and tau protein and their potential use for COVID-19 diagnosis and management.

Avaliação de extratos de quebra- pedra (Phyllanthus sp) frente à patógenos causadores de infecções no trato urinário / Evaluation of Phyllanthus sp extracts in face of Pathogen Causers of Urinary Treat Infections

RESUMO O trato urinário normalmente é estéril, no entanto, pode ser contaminado por agentes etiológicos provenientes da microbiota intestinal, dentre os mais comuns pode-se destacar a Escherichia coli. Os microrganismos estão se tornando cada vez mais resistentes a múltiplos antimicrobianos. É notória, portanto, a necessidade de encontrar novas substâncias com propriedades antimicrobianas. Portanto, foram avaliados diferentes extratos de Phyllanthus sp, frente a microrganismos causadores de infecções no trato urinário e comparadas as técnicas de hole-plate e disco difusão. Para ambas as técnicas avaliadas, o extrato de 72 horas mostrou melhor atividade antimicrobiana, na técnica de disco difusão, a bactéria mais sensível foi o Staphylococcus saprophyticcus, que apresentou CMI (Concentração Mínima Inibitória) de 15,84 mg/mL. Com a utilização da técnica de hole-plate, a bactéria mais sensível observada foi Staphylococcus aureus, com valor de CMI igual ao reportado anteriormente. Foi observado que os extratos alcoólicos obtiveram maior eficiência em relação às infusões, que a técnica de hole-plate revelou ser mais eficiente que a técnica de disco difusão e que os cocos Gram positivos foram mais susceptíveis quando comparadas aos bacilos Gram negativos e fungos.

ABSTRACT Commonly, the urinary treat is sterile, but it can also be contaminated by etiological agents from the intestinal treat, of which the Escherichiacoli is the most common one. These microorganisms are increasingly becoming more resistant to multiple antibiotics. It became necessary to find new substances with antimicrobial properties, so the purpose of this paper is to evaluate different Phyllanthus sp extracts- in face of microorganisms which cause the urinary treat infections- and compare it to the hole-plate and disk diffusion techniques. The 72 hours extraction showed better antimicrobial activity in both methods. Using disk diffusion, the most sensitive bacterium was the Staphylococcus saprophyticcus, with the MIC of 15,84 mg/mL. While using the technique of hole-plate, the most sensitive bacterium was the Staphylococcus aureus, with the same MIC of the previous cited bacterium. This study showed that the alcoholic extracts were more efficient than the infusions. It can also be observed that the hole-plate technique seems to be more efficient than the disk diffusion one, and the Gram positive cocci bacteria were more sensitive than the Gram negative bacilli and fungi.