[The Impact of the COVID-19 Pandemic on the Intensive Care Residency Program in Portugal]. / Impacto da Pandemia COVID-19 na Formação Especializada do Internato Médico de Medicina Intensiva em Portugal.

INTRODUCTION: In 2020, critical care departments underwent profound changes imposed by the COVID-19 pandemic. The aim of this study was to evaluate the impact of the pandemic on the intensive care residency program in Portugal. MATERIAL AND METHODS: The Association of Critical Care Residents (AIMINT) prepared a questionnaire using the Google Forms® tool, which was applied during August 2020 to the Critical Care residents in Portugal. A descriptive analysis was performed with the data collected. RESULTS: Eighty-five residents participated in the questionnaire, yieldinga response rate of 62%. Three-quarters of all participants provided care to COVID-19 patients. More than 80% of the surveyed participants were on rotations, and these were canceled in 59% of cases. Seventy-eight percent reported a workload greater than 40 hours per week. CONCLUSION: The COVID-19 pandemic had an impact on the Critical Care Residency program in Portugal. Most residents surveyed provided care to COVID-19 patients and not only saw their rotations suspended but also experienced difficulties in rescheduling them.

Introdução: No ano de 2020, os serviços de medicina intensiva sofreram profundas adaptações e reestruturações impostas pela pandemia de COVID-19. Este estudo teve como objetivo avaliar o impacto desta pandemia na formação especializada do internato médico de medicina intensiva em Portugal.Material e Métodos: A Associação de Internos de Medicina Intensiva elaborou um questionário usando a ferramenta Google Forms®, e que foi aplicado durante o mês de agosto de 2020 aos internos de formação especializada de medicina intensiva, em Portugal. Com base na informação recolhida realizou-se uma análise descritiva.Resultados: Oitenta e cinco médicos internos responderam ao questionário, perfazendo uma taxa de resposta de 62%. Três quartos dos participantes no estudo contactaram com doentes com COVID-19. Oitenta e seis por cento dos médicos internos inquiridos encontravam-se em estágios, tendo os mesmos sido cancelados em 59% dos casos. Setenta e oito por cento referiram uma carga assistencial superior a 40 horas semanais.Conclusão: A pandemia de COVID-19 teve impacto na formação especializada do internato médico de medicina intensiva em Portugal. A maioria dos internos inquiridos contactaram com doentes com COVID-19, com suspensão dos seus estágios e com prejuízo na remarcação dos mesmos.

Is the efficacy of remdesivir so different from that of lopinavir-ritonavir in severe COVID-19? The answer by real time-PCR: a narrative review.

This letter discusses the efficacy of current antiviral therapy used in severe COVID-19 infection. Since the first severe cases were documented, several antiviral options have been studied as adjuncts to standard supportive care [1, 2]. Firstly, the combination of lopinavir-ritonavir resurrected from SARS and MERS outbreaks and soon abandoned after the publication of several trials like the randomized controlled trial RECOVERY, which concluded that it was not associated with reductions in 28-day mortality, duration of hospital stay, or risk of progression to invasive mechanical ventilation or death [3]. Remdesivir is currently the only antiviral agent approved for the treatment of COVID-19. It is recommended for use in hospitalized patients who require supplemental oxygen. However, it is not routinely recommended for patients who require mechanical ventilation due to the lack of data showing any benefit at this advanced stage of the disease [4-6].