Can SARS-CoV-2 induce hematologic malignancies in predisposed individuals? A case series and review of the literature

Abstract Introduction Coronavirus disease 2019 (COVID-19) may present with extrapulmonary manifestations, including hematologic changes. Previous studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) can interact with the renin-angiotensin system, ultimately causing increased production of angiotensin II. By reporting the cases of previously healthy young adults diagnosed with a hematologic malignancy after experiencing COVID-19, we raise the hypothesis that the SARS-Cov-2 infection could act as a trigger for leukemogenesis in predisposed individuals. Methods This was a case series performed through extraction of relevant clinical information from the medical records of three patients admitted to our Hematology unit between August 2020 and September 2020. Main Results Considering the relatively rapid development of cytopenias following recovery from COVID-19, it cannot be ruled out that SARS-Cov-2 played a role in leukemogenesis in those patients. Based on previous in vitro studies, the renin-angiotensin system imbalance induced by SARS-CoV-2 could potentially promote in vivo leukemogenesis through several mechanisms. Conclusion Despite the advances in pathophysiological and clinical characterization of COVID-19, the consequences of the pandemic to the incidence of hematologic diseases are still to be elucidated. In this context, future dissection of the status of the local bone marrow renin-angiotensin system in leukemogenesis is a clinically relevant basic research area.

Formação de cuidadores de idosos institucionalizados / Training of institutionalized elderly caregivers

Objetivo: analisar a formação dos cuidadores de idosos institucionalizados. Método: trata-se de um estudo qualitativo, descritivo e transversal. Realizou-se com dez cuidadores de instituição de longa permanência (ILP), utilizando-se um instrumento semiestruturado. Submeteram-se os dados coletados à Análise de Discurso. Resultados: registra-se que predominaram as cuidadoras do gênero feminino, casadas, com idade média de 42 anos, e que o período médio de atuação na área foi de 7,1 anos. Sabe-se que 90% tinham formação em cuidador de idoso e elencaram, como dificuldades, colocar a fralda, dar banho, a comunicação e as estratégias para interagir com a teimosia dos idosos, bem como as demandas dos idosos e a sobrecarga de peso e de trabalho. Conclusão: concluiu-se que há a necessidade de se qualificar bem e atualizar a formação do cuidador profissional para que este possa executar a sua práxis com segurança, efetividade, eficiência e atenção centrada no paciente.(AU)

Objective: to analyze the training of institutionalized elderly caregivers. Method: this is a qualitative, descriptive and cross-sectional study. It was carried out with ten caregivers of long-term institution (LTI), using a semi-structured instrument. The collected data were submitted to Speech Analysis. Results: it is recorded that the female carers, married, with a mean age of 42 years, predominated, and that the average period of performance in the area was 7.1 years. It is known that 90% had training in elderly caregivers and listed, as difficulties, putting diapers, bathing, communication and strategies to interact with the stubbornness of the elderly, as well as the demands of the elderly and the overload of weight and of work. Conclusion: it was concluded that there is a need to qualify well and update the training of the professional caregiver so that they can perform their praxis with safety, effectiveness, efficiency and patient-centered care.(AU)

Objetivo: analizar la formación de los cuidadores de ancianos institucionalizados. Método: se trata de un estudio cualitativo, descriptivo y transversal. Se realizó con diez cuidadores de institución de larga permanencia (ILP), utilizando un instrumento semiestructurado. Se sometieron los datos recogidos al Análisis de Discurso. Resultados: se registra que predominaron las cuidadoras del género femenino, casadas, con edad promedio de 42 años, y que el período promedio de actuación en el área fue de 7,1 años. Se sabe que el 90% tenía formación en cuidador de anciano y enumeró, como dificultades, colocar el pañal, bañar, la comunicación y las estrategias para interactuar con la terquedad de los ancianos, así como las demandas de los ancianos y la sobrecarga de peso y de trabajo. Conclusión: se concluyó que hay la necesidad de calificar bien y actualizar la formación del cuidador profesional para que éste pueda ejecutar su praxis con seguridad, efectividad, eficiencia y atención centrada en el paciente.(AU)