RESUMO
Since the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there have been challenges recognizing the clinical features of SARS-CoV-2 and identifying therapeutic options. This has been compounded by viral mutations that affect clinical response and primary epidemiological indicators. Multiple variants of SARS-CoV-2 have been identified and classified on the basis of nomenclature implemented by scientific organizations and the World Health Organisation (WHO). A total of five variants of concern (VOCs) have been identified to date. The present study aimed to analyse clinical and epidemiological features of each variant. Based on these characteristics, predictions were made about potential future evolution. Considering the time and location of SARS-CoV-2 VOC emergence, it was hypothesised that mutations were not due to pressure caused by the vaccines introduced in December 2020 but were dependent on natural characteristics of the virus. In the process of adapting to the human body, SARS-CoV-2 is expected to undergo evolution to become more contagious but less deadly. SARS-CoV-2 was hypothesized to continue spread through isolated epidemic outbreaks due to the unimmunized population, mostly unvaccinated children and adults, and for coronaviruses to continue to present a public health problem.
RESUMO
UNLABELLED: Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory affection of the whole lung, characterized by an accelerated loss of the pulmonary functions, that reduces the patients' independence and stops them from having a normal, active life. The medical rehabilitation is considered "Third class rehabilitation", after preventive medicine and pharmaceutical medicine, and the respiratory rehabilitation recovery represents a complex structure of service addressing to patients with chronic pulmonary illnesses whose aim is to optimize the physical performances, psycho-social and autonomy. AIM AND OBJECTIVES: The main objective of this study is to show the importance of respiratory rehabilitation that is correctly and timely made, based on the gravity and stage of the illness, the COPD patient's associated illnesses and their importance in improving the patient's mental and physical quality of life. Patients from the study were assigned a complex pulmonary rehabilitation regimen consisting of 10 physical exercise sessions and 10 educational sessions, for two weeks, followed by 3 physical education sessions and medical education per week, for six weeks. MATERIAL AND METHOD; The research included 35 COPD patients from the 5th medical Geriatric and Gerontology. Clinic during 1.03.2014-30.11.2014. Patients from the study were assigned a complex pulmonary rehabilitation regimen consisting of 10 physical exercise sessions and 10 educational session for two weeks, followed by 3 sessions a week for 6 weeks. The dyspnea evaluation was made by BORG and MRC dyspnea scales, the quality of life was measured by St. George and CAT questionnaires, and anxiety and anxiety and depression were quantified by Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS). RESULTS: The gradation of dyspnea on BORG scale was correlated with the variation of the expiratory capacity that varied at COPD patients, suggesting that hyperinflation has a major role in producing the dyspnea. The average score measurement was about 75.25 ± 5.9. the positive effects of rehab were validated by decreasing the St. George score by 16% to the initial value. Respiratory rehab was an important way of treatment due to effort tolerance increasing and the patient's independence. Depression was significantly more pronounced in women (Z = -1.876: p = 0.039). The little value of maximum respiratory volume per second (VEMS) was correlated to a bigger HARS and HDRS score. CONCLUSIONS: The prevalence and importance of symptoms of anxiety and depression in COPD patients requires a specific questionnaire as routine screening procedure, for detecting early symptoms and preventing their progress.
