Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia

Background & objectives: The risk factors for clinically significant diffuse parenchymal lung abnormalities (CS-DPLA) persisting after severe coronavirus disease 2019 (COVID-19) pneumonia remain unclear. The present study was conducted to assess whether COVID-19 severity and other parameters are associated with CS-DPLA. Methods: The study participants included patients who recovered after acute severe COVID-19 and presented with CS-DPLA at two or six month follow up and control group (without CS-DPLA). Adults volunteers without any acute illness, chronic respiratory illness and without a history of severe COVID-19 were included as healthy controls for the biomarker study. The CS-DPLA was identified as a multidimensional entity involving clinical, radiological and physiological pulmonary abnormalities. The primary exposure was the neutrophil-lymphocyte ratio (NLR). Recorded confounders included age, sex, peak lactate dehydrogenase (LDH), advanced respiratory support (ARS), length of hospital stay (LOS) and others; associations were analyzed using logistic regression. The baseline serum levels of surfactant protein D, cancer antigen 15-3 and transforming growth factor-? (TGF-?) were also compared among cases, controls and healthy volunteers. Results: We identified 91/160 (56.9%) and 42/144 (29.2%) participants with CS-DPLA at two and six months, respectively. Univariate analyses revealed associations of NLR, peak LDH, ARS and LOS with CS-DPLA at two months and of NLR and LOS at six months. The NLR was not independently associated with CS-DPLA at either visit. Only LOS independently predicted CS-DPLA at two months [adjusted odds ratios (aOR) (95% confidence interval [CI]), 1.16 (1.07-1.25); P<0.001] and six months [aOR (95% CI) and 1.07 (1.01-1.12); P=0.01]. Participants with CS-DPLA at six months had higher baseline serum TGF-? levels than healthy volunteers. Interpretation and conclusions: Longer hospital stay was observed to be the only independent predictor of CS-DPLA six months after severe COVID-19. Serum TGF-? should be evaluated further as a biomarker.

Psicodrama público sp on-line durante a pandemia de covid-19 / Public psychodrama sp on-line during the covid-19 pandemic / Psicodrama público sp on-line durante la pandemia del covid-19

RESUMO O objetivo deste trabalho é apresentar reflexões sobre as sessões de Psicodrama Público SP On-line ocorridas entre agosto de 2020 e dezembro de 2021. O procedimento utilizado foi a análise qualitativa de entrevistas com a unidade funcional, o anfitrião e alguns participantes, gravadas após a realização dos psicodramas. Foram criadas quatro categorias a partir dos temas protagônicos apresentados. Foram identificados dois movimentos complementares: um em direção ao desequilíbrio e outro em direção à tentativa de restaurá-lo,além de uma retroalimentação entre as categorias e entre os períodos analisados. Observou-se que se instauraram novos processos de subjetivação no contexto grupal marcados pelos múltiplos sofrimentos vivenciados no período pandêmico da COVID-19, facilitados pela liberação da espontaneidade e criatividade.

ABSTRACT This paper aims to present reflections on the Psicodrama Público SP On-line sessions that took place between August 2020 and December 2021. The procedure used was the qualitative analysis of interviews, with the functional unit, the host and some participants, recorded after the realization of psychodramas. Four categories were created from the main themes presented. Two complementary movements were identified: one towards the imbalance and the other towards the attempt to restore it, in addition to a feedback between the categories and between the analyzed periods. It was observed that new processes of subjectivation were established in the group context marked by many sufferings in the pandemic period of COVID-19, facilitated by the release of spontaneity and creativity.

RESUMEN El objetivo de este trabajo es presentar reflexiones sobre las sesiones de Psicodrama Público SP On-line que se desarrollaron entre agosto de 2020 y diciembre de 2021. El procedimiento utilizado fue el análisis cualitativo de entrevistas, con la unidad funcional, el conductor y algunos participantes, grabadas después de la realización de psicodramas. Se crearon cuatro categorías a partir de los principales temas presentados. Se identificaron dos movimientos complementarios: uno hacia el desequilibrio y otro hacia el intento de restaurarlo, además de una retroalimentación entre las categorías y entre los periodos analizados. Se observó que se establecieron nuevos procesos de subjetivación en el contexto grupal marcado por los muchos sufrimientos en el período de pandemia por la COVID-19, facilitados por la liberación de la espontaneidad y la creatividad.

SARS-CoV-2-2019: emergência de uma pandemia / SARS-CoV-2-2019: emergence of a pandemic

A pandemia associada à emergência do vírus corona-2-2019 associado à síndrome respiratória aguda grave (SARS-CoV-2) representa um desafio imposto ao ser humano e sua sociedade, de forma planetária, com repercussões ainda por serem determinadas em todos os níveis da relação biopsicossocial cultural-espiritual. Constitui-se em um dos desafios mais graves já vividos pela humanidade, e sinaliza para a ocorrência de outras emergências e reemergências de doenças, em situações similares e episódicas, e que expressam a vulnerabilidade e imponderabilidade humanas, e requer reflexão sobre o autoconhecimento e o respeito aos limites da sua dignidade e da natureza. Esta revisão constitui-se em esforço para resumir de forma simples e prática a quantidade de aspectos significativos ao conhecimento que se apresenta de forma avassaladora que acompanha a virologia, epidemiologia, clínica, diagnóstico, terapêutica e prevenção da doença pelo SARS-CoV-2, para que possa ser entendida e facilitada sua abordagem.

The pandemic associated with the emergence of the SARS-CoV-2 represents a challenge imposed on human beings and their society, on a planetary basis, with repercussions yet to be determined at all levels of the biopsychosocial cultural-spiritual relationship. It represents one of the most serious challenges humankind has ever experienced, and signals the occurrence of other emergencies and reemergence's of diseases, in similar and episodic situations, which express human vulnerability and weightlessness, and requires reflection on self-knowledge and respect for limits of their dignity. This review is an effort to summarize in a simple and practical way the amount of significant aspects to the knowledge that is presented in an overwhelming way that accompanies the virology, epidemiology, clinic, diagnosis, therapy, and prevention of the disease by the SARS-CoV-2, so that its approach can be understood and facilitated.

Desinfección de Alicates de Ortodoncia. Actualización de Recomendaciones en Contexto de COVID- 19. Revisión de la Literatura

RESUMEN: El adecuado conocimiento de definiciones, normas, procedimientos, uso de antisépticos y desinfectantes, permite contar con las herramientas para evitar la diseminación de agentes infecciosos y proporcionar el conocimiento para el uso racional de estos. El objetivo de este trabajo es presentar de manera estructurada y ordenada la información disponible respecto de la desinfección de alicates de ortodoncia y proporcionar una guía para el control óptimo de infecciones. Se realizó una búsqueda mediante PubMed, MEDLINE y Google Scholar, sin importar idioma, desde el año 2000 a abril 2021. Se establecieron los desinfectantes más recomendados para la desinfección de alicates de ortodoncia y las consideraciones en su uso. Además, se determinaron los riesgos de corrosión y recomendaciones para evitarlas. Es importante contar con información actualizada que se pueda utilizar para desarrollar un programa óptimo de asepsia, sobre todo en el contexto actual de pandemía.

ABSTRACT: Adequate knowledge of definitions, norms, procedures, use of antiseptics and disinfectants, allows to avoid the spread of infectious agents and provides knowledge for proper use of these aides. The objective of this study is to present the information available regarding the disinfection of orthodontic pliers in a structured and organized manner, and to provide a guide for optimal infection control. A search was carried out using PubMed, MEDLINE and Google Scholar, regardless of language, from the year 2000 to April 2021. The most recommended disinfectants for the disinfection of orthodontic pliers and the considerations in their use were established. In addition, risks of corrosion and recommendations to avoid them were determined. It is important to have up-to-date information that can be used to develop an optimal asepsis program, especially in the present context of a pandemic.

Comparative study of confirmed and suspected undiagnosed cases of COVID-19 in Changning District， Shanghai / 上海预防医学

Objective:To analyze and compare the differences between the epidemiological data and clinical indicators of confirmed and suspected undiagnosed cases of COVID-19 in Changning District， Shanghai. Methods:A retrospective comparative study was conducted. We included 20 confirmed and 34 suspected but undiagnosed COVID-19 cases from January 20 to February 29， 2020. We analyzed the differences in epidemiological history， early clinical symptoms， blood routine indicators， and clinical imaging characteristics between the two groups. Results:The epidemic status of COVID-19 in Changning District of Shanghai was mainly imported， and most cases were promptly confirmed. Early clinical symptoms of confirmed and suspected undiagnosed cases often manifested as respiratory symptoms such as fever and dry cough. Compared with the confirmed cases， the cell counts of leukocytes， eosinophils， and neutrophils in suspected undiagnosed cases were significantly higher. Also， the concentration of serum C-reactive protein in suspected cases was higher than that in confirmed cases （P=0.230）. The clinical imaging manifestations of confirmed cases were mainly ground glass opacity （GGO） scattered in both lung leaves， while the suspected undiagnosed cases mainly manifested as plain patch opacity， and the distribution of GGO was more irregular. Conclusion:There exists significant difference in blood routine indicators and clinical imaging features between confirmed and suspected cases of COVID-19.

GICAcovid: aplicación web para gestionar la información en Centros de Aislamiento de pacientes con COVID-2019 / GICA-Covid: web application to manage the information in the Isolation Centers for COVID-19 patients

RESUMEN Introducción: en el combate actual que enfrenta Cuba contra la pandemia, se han desarrollado numerosos modelos matemáticos y aplicaciones informáticas. Estos instrumentos de análisis dependen de parámetros necesarios para estimar a partir de los datos que se generan y así obtener una información real del comportamiento de la enfermedad desde los entornos locales. Objetivo: desarrollar una aplicación web para la gestión de la información en los centros de aislamiento de pacientes con la COVID-19, en Pinar del Río. Métodos: investigación de desarrollo tecnológico para crear los procesos de análisis, diseño e implementación de una aplicación web de la información que se genera en los centros de aislamiento para atención a la pandemia. Se describen los métodos científicos utilizados durante el desarrollo de la investigación y se definen las tecnologías empleadas para la construcción de la aplicación. Resultados: se creó GICAcovid, aplicación web para la gestión de toda la información recibida en los centros de aislamiento designados en la provincia para combatir el Coronavirus. Registra datos de pacientes, acompañantes, los propios centros de aislamiento según su tipo, genera reportes y elabora gráficos que enriquecen las estadísticas que siguen el comportamiento de la enfermedad. Conclusiones: la aplicación web denominada GICAcovid favorece una gestión rápida para el estudio clínico y epidemiológico de la situación de la enfermedad en los centros de aislamiento de la provincia Pinar del Río, y la prontitud en la adopción de decisiones.

ABSTRACT Introduction: in the current battle that Cuba faces to deal with the pandemic, numerous mathematical models and computer applications have been developed. These analysis instruments depend on the necessary parameters to estimate from the data generated to obtain real-time information regarding the behavior of the disease from the local settings for the behavior of the disease and the implementation of editions. Objective: to develop a web application to manage the information in the Isolation Centers for COVID-19 patients in Pinar del Río province. Methods: technological development research, to create the processes of analysis, design and implementation of a web application of the information generated from the isolation centers for pandemic care. The scientific methods used during the development of the research are described and the technologies used to build the application are defined. Results: GICA-Covid was created, a web application for the management of all the information collected in the isolation centers opened in the province to fight Coronavirus. This web-application registers the data of patients and their companions; the isolation centers themselves according to their type, it also generates reports and creates graphs that improve the statistics that follow the behavior of the disease in Vueltabajo region. Conclusions: the development of the web application called GICA-covid favors a rapid management for the clinical and epidemiological study of the situation of the disease in the isolation centers of Pinar del Río province and timely decision-making.

Study on nursing emergency management strategy of general hospitals in non-epidemic areas under the outbreak of coronavirus disease 2019 / 上海交通大学学报（医学版）

Objective: To understand the implementation of the emergency management plan of nursing in the general hospitals in non-epidemic areas under the outbreak of coronavirus disease 2019 and propose strategies. Methods: Nine experts were interviewed by the method of focus group interviews method and the data were collected and analyzed by the method of Colaizzi data analysis method. Results: The important themes of nursing emergency management included the deployment and training of human resources, the development and implementation of material management system, and ward visiting system, the training and reserve of specialist nurses, as well as the psychological assistance and humanistic care. Conclusion: The emergency management of nursing in the general hospitals in non-epidemic areas is a systematic project. Nursing managers should further complete the construction of team and system for nursing emergency management, and improve the emergency nursing abilities and the mental health of nurses.

The interpretation of Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia / 解放军医学杂志

A coronavirus disease 2019 (COVID-19) outbreak has occurred in Wuhan, Hubei province since Dec. 2019. As of Feb. 10, 2020, more than 40,000 cases had been confirmed, nearly 30,000 cases in Hubei alone, and no inflection point in epidemiology appeared. Severe trauma may still occur during the outbreak of the COVID-19. In order to protect the medical personnel involved in emergency treatment and ensuring the timeliness of treatment for trauma patients, The Trauma Surgery Branch of Chinese Medical Doctors' Association (CMDA) organized the drafting of the present expert consensus. This paper interprets the main views of the expert consensus, emphasizes that the safety of health care staff and patients are equally important, and that the treatment strategies and procedures for severe trauma need to be adjusted during the COVID-19 outbreak. The consensus also recommends the use of CT scan, which plays both the role of screening COVID-19 and accurate assessment of trauma, and strengthening the protection of medical staff. The consensus states that medical personnel can be exempted from isolation if they wear standard three-level protective equipment and are not accidentally exposed during the operation. This expert consensus is the first one to systematically review, summarize and analyze the progress of COVID-19 from a surgeon's perspective. It may be used as a reference for medical institutions at all levels to treat patients with severe trauma and perform other kinds of operations during the COVID-19 outbreak.

Molecular mechanism of Bufei Huoxue Capsule on COVID-2019 based on network pharmacology and molecular docking / 中草药

Objective: To explore the potential mechanism of Bufei Huoxue Capsule (BHC) on coronavirus disease 2019 (COVID-19), and provide a theoretical basis for the clinical application of BHC. Methods: TCMSP, BATMAN-TCM, CNKI and Pubmed databases were used to search the compounds and targets of BHC and GeneCards database was used to search the targets of COVID-19; The intersection method was used to obtain the targets related to the therapeutic effect of BHC. Cytoscape 3.7.2 software was applied for the construction of CMM-compounds-targets network map. Protein-protein interaction (PPI) network was constructed by STRING database. Gene ontology (GO) functional enrichment analysis and KEGG pathway enrichment analysis were conducted by DAVID. AutoDock Tools 1.5.6 and AutoDock vina 1.1.2 were used for molecular docking. Results: A total of 32 potential active components were screened from BHC, corresponding to 203 targets. Among them, there were 11 core compounds and 52 core targets. PPI network analysis showed that there were 25 key targets intervening COVID-19 by BHC. A total of 251 biological processes (P < 0.05) and 93 pathways (P < 0.05) were obtained by GO analysis and KEGG analysis, respectively. The results of molecular docking showed that the key compounds had good affinity with SARS-CoV-2 3CL hydrolase and angiotensin converting enzyme II. Conclusion: The active compounds of BHC can target IL6, MAPK8, PTGS2, PTGS1 and NCOA2 to regulate multiple signal pathways, and play a therapeutic role in the recovery period of COVID-19.

Clinical points and experience in nucleic acid testing of SARS-CoV-2 / 国际检验医学杂志

The number of pneumonia cases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has risen rapidly since December 2019. Because the presence of viral nucleic acid in patients is the only basis for the diagnosis，and the positive rate of nucleic acid detection is generally not satisfactory in clinical practice，so there are high requirements for the laboratory conditions，inspectors of viral nucleic acid detection and other aspects of the detection process. This paper focuses on the current situation, the latest industry standards and the consensus contents of the SARS-CoV-2 nucleic acid testing, and probes into the difficult problems in clinical testing, so as to provide theoretical basis for the accurate diagnosis of the COVID-2019.

Nuevo coronavirus (COVID-19). Un análisis bibliométrico / Coronavirus disease (COVID-19). A bibliometric analysis

The new coronavirus pandemic (COVID-19) has spread to 180 countries, causing more than half a million confirmed cases and more than 40 thousand deaths. The main objective of this study was to analyze the world scientific production related to COVID-19. A literature search was performed using the Scopus database. A total of 547 published documents were identified, analyzing characteristics such as: type of publication, collaboration index, most productive countries, scientific journals, the institutions that are publishing the most on the subject and indicators of citations and impact. China was ranked first with 213 published documents (20.9%). Regarding the journals with the higher number of published documents, these were , and the . Likewise, was identified as the institution presenting the highest leadership regarding the number of publications. The total number of citations for all the publications was of 1.685. The h-index of the retrieved articles was of 42, and four articles were found with more than 100 quotations. This study offers a first approach to the global efforts aimed to this new area of research, which in only three months has substantially increased, and is expected to remain being prolific.

La pandemia del nuevo coronavirus (COVID-19) se ha extendido a 180 países, ocasionando más de medio millón de casos confirmados y más de 40.000 muertes. El objetivo principal de este estudio fue analizar la producción científica mundial relacionada con el COVID-19. Se realizó una búsqueda bibliográfica utilizando la base de datos Scopus. Se identificaron un total de 547 documentos publicados, analizándose características tales como: modalidad de publicación, los índices de colaboración, los países más productivos, las revistas científicas, las instituciones que más están publicando sobre el tema e indicadores de citación e impacto. Se identifica a China como el país que ocupa el primer lugar con 213 (20,9%) documentos publicados. Por su parte, , y el son las revistas con mayor número de documentos publicados. A su vez, se identifica a la como la institución que presenta mayor liderazgo respecto al número de publicaciones. El número total de citas de todas las publicaciones fue de 1.685, el índice h de los artículos recuperados fue de 42 y se ubican cuatro artículos con más de 100 citas. El presente estudio ofrece una primera aproximación a los esfuerzos globales dirigidos a esta nueva área de investigación, que en solo tres meses se ha incrementado de forma sustancial y que se estima continúe siendo prolífica.

Modelos estadísticos para las predicciones de la COVID-19 en Cuba

RESUMEN Introducción: Los estudios basados en modelos estadísticos juegan un papel importante para las predicciones sobre la COVID-19. Objetivo: Realizar un análisis de modelación estadística combinando 6 modelos de pronósticos para predecir la aparición de casos positivos diarios, activos y fallecidos por COVID-19 en Cuba. Métodos: Se utilizaron los datos reportados diariamente del 11 de marzo al 25 de mayo publicados en el sitio web CUBADEBATE. A los modelos propuestos se les calculó el desempeño mediante los estadísticos: MAE, RMSE, MAPE y ME así como el análisis de residuales. Resultados: Los modelos A y B dan una tendencia constante de 8 y 9 casos positivos respectivamente para el día 22 de julio. El modelo C indica una ligera disminución de los casos con 4 ese mismo día y el modelo D una tendencia al aumento con 19 casos. . El modelo E refleja un mínimo de 126 casos el día 3 de junio y luego un aumento de los casos hasta alcanzar el 22 de julio un valor de 374 casos activos hospitalizados. En el modelo F se apreció una tendencia a mantenerse constante el número de fallecidos por encima de 80 casos en la primera quincena de julio. Conclusiones: Los 6 modelos estudiados cumplen con las pruebas estadísticas, de desempeño y residuales. Sus datos proporcionan un pronóstico para la COVID-2019, representando una herramienta válida.

ABSTRACT Introduction: Studies based on statistical models play an important role for predictions about COVID-19. Objective: To carry out a statistical modeling analysis combining 6 forecast models to predict the appearance of daily positive cases, active and deceased by COVID-19 in Cuba. Method: Data reported daily from March 11 to May 25 from the CUBADEBATE website were used, which were processed and analyzed. The performance of the models was calculated: Mean absolute error (MAE), root of the mean square error (RMSE), percent of mean absolute error (MAPE) and the mean error (ME) as well as the residual analysis. Results: Models A and B gave a constant trend between 8 and 9 cases of until July 22. Model C indicated a decrease in cases with 4 that same day and model D indicated a raise to 19 cases. Model E indicated a minimum of 126 cases on June E and then a raise to 374 hospitalized cases. Deceases cases had a constant tendency in deceases numbers above of 80 cases in first 15 days of July. Conclusions: The 6 models studied meet the statistical , performance and residual tests. Their data provides a forecast for COVID2019, representing a valid tool.