COVID-19 y medidas de protección adoptadas en comunidades rurales amazónicas durante los primeros meses de la pandemia / COVID-19 and protection measures adopted in rural amazon communities during the first months of the pandemic

RESUMEN Objetivos. Analizar la evolución del COVID-19 en poblaciones rurales de Loreto y Ucayali en la etapa temprana de la pandemia. Materiales y métodos. Se realizó un estudio observacional longitudinal a nivel de comunidades basado en dos rondas de encuestas telefónicas con autoridades locales de más de 400 comunidades rurales indígenas y no-indígenas en Loreto y Ucayali, en julio y agosto de 2020, para recopilar información sobre casos y muertes por COVID-19 en sus comunidades, medidas de protección adoptadas y la recepción de asistencia estatal en la etapa temprana de la pandemia. Estadísticas descriptivas permiten evaluar la evolución de la pandemia después del brote inicial y comparar las tendencias de las dos regiones, así como entre poblaciones indígenas y no-indígenas. Resultados. En julio de 2020, el COVID-19 había llegado al 91,5% de las comunidades, aunque se reportaron muertes por COVID-19 en 13,0% de las comunidades, siendo la mortalidad rural mayor en Ucayali (0,111%) que en Loreto (0,047%) y en comunidades no-indígenas. Para agosto, la prevalencia disminuyó de 44,0% a 32,0% de comunidades, pero se volvió más frecuente en las comunidades indígenas, y aquellas en Ucayali. Viajar a la ciudad para recibir bonos estatales y las dificultades para mantener el distanciamiento social contribuyeron al contagio. Conclusiones. Los hallazgos mostraron la evolución del COVID-19 en comunidades rurales y señalan áreas importantes de atención en futuras políticas públicas, para la adopción de medidas de protección y reconsiderar estrategias para la distribución de asistencia ante pandemias futuras.

ABSTRACT Objectives. To analyze the evolution of COVID-19 in rural populations of Loreto and Ucayali in the early stage of the pandemic. Materials and methods. A community-level longitudinal observational study was conducted and based on two rounds of telephone surveys with local authorities of more than 400 indigenous and non-indigenous rural communities in Loreto and Ucayali, in July and August 2020. We collected information on cases and deaths by COVID-19 in their communities, protective measures adopted and if state assistance was received in the early stage of the pandemic. Descriptive statistics allowed us to evaluate the evolution of the pandemic after the initial outbreak and compare the trends of the two regions, as well as between indigenous and non-indigenous populations. Results. In July 2020, COVID-19 had reached 91.5% of the communities, although deaths from COVID-19 were reported in 13.0% of the communities, with rural mortality being higher in Ucayali (0.111%) than in Loreto (0.047%) and in non-indigenous communities. By August, prevalence decreased from 44.0% to 32.0% of communities, but became more frequent in indigenous communities, and those in Ucayali. Traveling to the city to receive state bonuses and difficulties maintaining social distancing contributed to the spread. Conclusions. Our findings show the evolution of COVID-19 in rural communities and point to important areas of attention in future public policies, for the adoption of protective measures and reconsidering strategies for the distribution of assistance in the face of future pandemics.

Prone positioning in awake patients without ventilatory support does not alter major clinical outcomes in severe COVID-19: results from a retrospective observational cohort study, systematic review and meta-analysis.

OBJECTIVES: During the Coronavirus disease (COVID-19) pandemic, clinicians recommended awake-prone positioning (APP) to avoid the worst outcomes. The objectives of this study were to investigate if APP reduces intubation, death rates, and hospital length of stay (HLOS) in acute COVID-19. METHODS: We performed a retrospective cohort with non-mechanically ventilated patients hospitalized in a reference center in Manaus, Brazil, 2020. Participants were stratified into APP and awake-not-prone positioning (ANPP) groups. Also, we conducted a systematic review and performed a meta-analysis to understand if this intervention had different outcomes in resource-limited settings (PROSPERO CRD42023422452). RESULTS: A total of 115 participants were allocated into the groups. There was no statistical difference between both groups regarding time to intubation (HR: 0.861; 95CI: 0.474-1.1562; p=0.622) and time to death (HR: 1.666; 95CI: 0.939-2.951; p=0.081). APP was not significantly associated with reduced HLOS. A total of 86 articles were included in the systematic review, of which 76 (88,3%) show similar findings after APP. Also, low/middle, and high-income countries were similar regarding such outcomes. CONCLUSION: APP in COVID-19 does not present clinical improvement that affects mortality, intubation rate and HLOS. The lack of a prone position protocol, obtained through a controlled study, is necessary. After 3 years, APP benefits are still inconclusive.

SARS-CoV-2 egress from Vero cells: a morphological approach.

Despite being extensively studied because of the current coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interactions with mammalian cells are still poorly understood. Furthermore, little is known about this coronavirus cycle within the host cells, particularly the steps that lead to viral egress. This study aimed to shed light on the morphological features of SARS-CoV-2 egress by utilizing transmission and high-resolution scanning electron microscopy, along with serial electron tomography, to describe the route of nascent virions towards the extracellular medium. Electron microscopy revealed that the clusters of viruses in the paracellular space did not seem to result from collective virus release. Instead, virus accumulation was observed on incurved areas of the cell surface, with egress primarily occurring through individual vesicles. Additionally, our findings showed that the emission of long membrane projections, which could facilitate virus surfing in Vero cells infected with SARS-CoV-2, was also observed in non-infected cultures, suggesting that these are constitutive events in this cell lineage.

Alternative therapies for viral infections caused by SARS-Cov-2 / Terapias alternativas para infecções virais causadas pelo SARS-Cov-2

Abstract Introduction The relevance of the studied topic lies in the complexity of the treatment of infection caused by SARS-CoV-2. Objective To discuss the potential advantages and disadvantages of alternative treatments compared to conventional medical approaches, and to highlight the importance of collaborative communication between patients and healthcare providers in making informed decisions about alternative treatments of the SARS-CoV-2 virus. Methods The research methodology employed literature analysis methods, including bibliographic and bibliosemantic approaches. The study used theoretical, systematic, and statistical methods, including analysis, synthesis, generalization, interpretation, classification, and meta-analysis to explore alternative treatments for SARS-CoV-2 infections, their interrelationships, and statistical trends in incidence. Results The study identifies diverse alternative therapies for treating SARS-CoV-2 infections, highlighting herbal medicine, acupuncture, reflexology, biohacking, homoeopathy, and magnetotherapy. It underscores the potential benefits of herbal remedies like garlic, ginger, chamomile, and honeysuckle, as well as vitamins (C, D, B12) and minerals (zinc, selenium) in managing COVID-19 symptoms. Conclusion While of-fering holistic benefits, these therapies warrant cautious consideration due to limited scientific backing and potential interactions. Cultural understanding, patient-provider dialogue, and informed choices are key in harnessing the potential of alternative medicine along-side conventional approaches for managing COVID-19 challenges.

Resumo Introdução A relevância do tema estudado reside na comple-xidade do tratamento da infeção causada pelo SARS-CoV-2. Objetivo Discutir as potenciais vantagens e desvantagens dos tratamentos alternativos em comparação com as abordagens médicas convencionais e realçar a importância da comunicação colaborativa entre os doentes e os prestadores de cuidados de saúde na tomada de decisões informadas sobre os tratamentos alternativos do vírus SARS-CoV-2. Métodos A metodologia de investigação utilizou métodos de análise da literatura, incluindo abordagens bibliográficas e bibliosemânticas. O estudo utilizou métodos teóricos, sistemáticos e estatísticos, incluindo análise, síntese, generalização, interpretação, classificação e meta-aná-lise para explorar tratamentos alternativos para as infecções por SARS-CoV-2, suas inter-relações e tendências estatísticas da incidência. Resultados O estudo identifica diversas terapias alternativas para o tratamento das infecções por SARS-CoV-2, destacando a fitoterapia, a acupunctura, a reflexologia, o biohacking, a homeopatia e a magnetoterapia. Sublinha os potenciais benefícios dos remédios à base de plantas como o alho, o gengibre, a camomila e a madressilva, bem como das vitaminas (C, D, B12) e dos minerais (zinco, selénio) na gestão dos sintomas da COVID-19. Conclusão Embora ofereçam benefícios holísticos, estas terapias devem ser consideradas com cautela devido ao apoio científico limitado e às potenciais interações. A compreensão cultural, o diálogo paciente-prove-dor e as escolhas informadas são fundamentais para aproveitar o potencial da medicina alternativa juntamente às abordagens convencionais para gerir os desafios da COVID-19.

Percepción de estresores académicos antes y durante la pandemia de COVID-19 en estudiantes de Enfermería / Nursing Students' Perception of Academic Stress before and during de COVID-19 Pandemic

Introducción: Los estresores académicos tienen efectos negativos en la salud y el desarrollo académico de los estudiantes de educación superior. Objetivo: Identificar los estresores académicos de mayor prevalencia antes y durante la pandemia de COVID-19 y su relación con factores socioacadémicos. Métodos: Se realizó un estudio longitudinal correlacional. La muestra censal en el 2019 fueron 166 y en el 2021, 156 estudiantes de enfermería de una universidad pública andina (Huaraz, Perú). El instrumento fue el Inventario de Estrés Académico. Los análisis estadísticos incluyeron comparación de medias, correlación de Pearson y Rho de Spearman. Resultados: Fueron estresores académicos antes vs. durante la pandemia de COVID-19: sobrecarga académica (3,94vs. 3,51), falta de tiempo (3,75vs. 3,14), trabajos obligatorios (3,12vs. 2,98). Estos correlacionaron antes de la pandemia con: mayor número de cursos e insatisfacción con rendimiento académico y; durante la pandemia: sexo femenino e insatisfacción con situación económica. Las mujeres percibieron cuatro o siete estresores académicos y los varones dos o uno, antes o durante la pandemia de COVID-19, respectivamente. Conclusiones: Los estresores académicos en los estudiantes antes y durante la pandemia de COVID-19 fueron: sobrecarga académica, falta de tiempo para cumplir con las actividades académicas y realización de trabajos obligatorios para aprobar las asignaturas. Las mujeres presentaron más estresores académicos que los varones antes y durante la pandemia. Los estresores académicos correlacionaron con factores académicos antes de la pandemia; y con factores sociales durante la pandemia(AU)

Introduction: Academic stressors have negative effects on the health and academic development of higher education students. Objective: To identify the most prevalent academic stressors before and during the COVID-19 pandemic and their relationship with socio-academic factors. Methods: A longitudinal correlational study was carried out. The census sample in 2019 was 166; and, in 2021, 156 nursing students from an Andean public university (Huaraz, Peru). The instrument was the Academic Stress Inventory. Statistical analyzes included comparison of means, Pearson correlation and Spearman's rho. Results: The following were academic stressors before vs. during the COVID-19 pandemic: academic overload (3.94 vs. 3.51), lack of time (3.75 vs. 3.14), mandatory assignments (3.12 vs. 2.98). These were correlated, before the pandemic, with greater number of courses and dissatisfaction with academic performance; and, during the pandemic, with female sex and dissatisfaction with the economic situation. The women perceived four or seven academic stressors and the male perceived two or one, before or during the COVID-19 pandemic, respectively. Conclusions: The academic stressors in students before and during the COVID-19 pandemic were academic overload, lack of time to complete academic activities, and completing mandatory work to pass the subjects. The women presented more academic stressors than the male before and during the pandemic. Academic stressors were correlated with academic factors before the pandemic and with social factors during the pandemic(AU)

Efectos de la pandemia por COVID-19 en determinantes sociales de familias del área metropolitana de Bucaramanga

Introducción: La pandemia por COVID-19 trajo consigo grandes cambios a nivel socioeconómico, producto de las medidas tomadas para mitigar su expansión, que implicó cierre de colegios y dificultad para el acceso a servicios de salud. Sin embargo, no se cuenta con mucha información respecto al impacto que estas medidas han tenido en la salud y el bienestar de niños y adolescentes, por lo cual se desarrolló una encuesta virtual para conocer la dimensión de los efectos de la pandemia en el bienestar integral de los menores y sus familias. Metodología: Estudio observacional de corte transversal que se realizó mediante la aplicación de una encuesta en formato electrónico a padres de familia de niños y adolescentes del Área Metropolitana de Bucaramanga. Resultados: Se obtuvieron 960 respuestas. El 25,63 % de los encuestados refieren cancelación de citas médicas. El 98 % de los estudiantes pudo continuar las actividades académicas durante el aislamiento. El factor económico fue la principal causa de preocupación en el periodo de la encuesta. Discusión: Durante el periodo de aislamiento, los problemas de salud mental, las dificultades para el acceso a herramientas para la educación virtual y las barreras para la atención, propias de la emergencia sanitaria, causaron efectos significativos en la calidad de vida de los menores. Conclusiones: Ante emergencias sanitarias, se deben mantener los servicios de atención en salud de la misma forma que se hacía previo a la ocurrencia del evento, como los programas de vacunación, crecimiento y desarrollo, promoción y prevención, además de la continuidad de la escolaridad.

Introduction: The COVID-19 pandemic has brought great changes along with, some of those were at the socioeconomic level, as a result of the actions taken to mitigate the virus expansion, which involved the closure of schools and restriction in accessing to some health services. However, there is not much information regarding the impact that these measures have had on the health and well-being of children and adolescents, for this reason, a virtual survey was developed to find out the dimension of the pandemic's effect on the comprehensive welfare of minors and families. Methodology: Cross-sectional observational study, which was carried out by applying a survey in electronic format to parents of children and adolescents in the Metropolitan Area of Bucaramanga. Results: A total of 960 responses were obtained. Of those surveyed, 25,63% refer cancellation of medical appointments. The 98% of students were able to continue academic activities during isolation. The economic factor was the main cause of concern in the survey period. Discussion: During the isolation period, mental health problems, difficulties in accessing tools for virtual education and barriers to care, typical of the health emergency, caused a significant effects on the quality of life of youngsters. Conclusions: In the event of health emergencies, health care services should be maintained in the same way as before the occurrence of the event, such as vaccination, growth and development, promotion and prevention programs, in addition to the continuity of schooling.

Preocupación por el contagio de la COVID-19 y carga laboral como predictores del malestar psicológico durante la emergencia sanitaria en personal de salud de Perú

Introducción: Durante la emergencia sanitaria, preocupan las repercusiones en la salud mental que pudieran estar experimentando los trabajadores sanitarios peruanos, quienes representan la primera línea de atención contra la COVID-19. Objetivo: Determinar si la preocupación por la COVID-19 y la carga laboral predicen el malestar psicológico en personal de salud. Métodos: Estudio predictivo en 367 trabajadores (enfermeros, médicos, técnicos en enfermería, obstetras, odontólogos, psicólogos, nutricionistas, entre otros) de ambos sexos en 12 redes de salud de la región de Puno, seleccionados a través de un muestreo no probabilístico intencional. Los datos se recogieron a través de la Escala de malestar psicológico de Kessler, la Escala de preocupación por el contagio de la COVID-19 y la Escala de carga de trabajo (ECT). Resultados: Se encontró que no hay diferencias significativas entre varones y mujeres en el malestar psicológico, la preocupación por el contagio de la COVID-19 y la carga laboral; además, se hallaron correlaciones muy significativas entre las variables de estudio (p < 0,01). El análisis de regresión múltiple demostró un ajuste adecuado para el modelo (F = 94,834; p < 0,001), en el que la preocupación por la COVID-19 (ß =-0,436; p < 0,01) y la carga laboral (ß = 0,239; p < 0,01) son variables que predicen significativamente el malestar psicológico (R2 ajustado = 0,33). Conclusiones: La preocupación por la COVID-19 y la sobrecarga de trabajo predicen el malestar psicológico en el personal sanitario de la región de Puno.

Introduction: During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing. Objective: To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers. Methods: Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale. Results: It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (p <0.01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; p <0.001), where concern about COVID-19 (ß = -0.436; p <0.01) and workload (ß = 0.239; p <0.01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33). Conclusions: Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru / Hospitalização e mortalidade durante a pandemia em pacientes em hemodiálise crônica e na população em geral no Peru

ABSTRACT Background: Patients with chronic kidney disease have a higher risk of severe disease and mortality from COVID-19 than the general population. Objective: To compare hospitalization and mortality rates during the pandemic among chronic hemodialysis (HD) patients and the general population in Lima (Peru). Methods: This retrospective cohort included an assessment of the database of chronic HD patients of the health service providers of the social health insurance benefit networks of Lima and Callao between 2019 and 2021. Hospitalization and mortality rates were obtained for every 1,000 individuals, and variations in the percentages of COVID-19 cases and deaths were calculated. These rates were compared with those of the general population data and standardized by age and sex. Results: An average of 3,937 chronic HD patients were evaluated each month. Of these, 4.8% had COVID-19 and 64.97% were mild cases. The hospitalization rates per 1,000 patients were 19.5, 29.28, and 36.7 in 2019, 2020, and 2021, respectively. The mortality rates per 1,000 patients were 5.9, 9.74, and 11.49 in 2019, 2020, and 2021, respectively. When compared to the standardized general population, the peaks of both rates coincided with the plateaus of the waves during the pandemic. The hospitalization rate for COVID-19 was 12 times higher in HD patients than in the general population, and the mortality rate for COVID-19 was twice as high. Conclusion: HD patients had higher hospitalization and standardized mortality rates than the general population. Peaks in hospitalizations and mortality coincided with the plateaus of the first and second waves of the pandemic.

Resumo Histórico: Pacientes com DRC apresentam maior risco de doença grave e mortalidade por COVID-19 do que a população geral. Objetivo: Comparar taxas de hospitalização e mortalidade durante a pandemia entre pacientes em hemodiálise crônica (HD) e a população geral em Lima (Peru). Métodos: Esta coorte retrospectiva incluiu avaliação do banco de dados de pacientes em HD crônica dos prestadores de serviços de saúde das redes de benefícios do seguro social de saúde de Lima e Callao, entre 2019-2021. Obteve-se taxas de hospitalização e mortalidade para cada 1.000 indivíduos, e foram calculadas variações nas porcentagens de casos de COVID-19 e óbitos. Estas taxas foram comparadas com os dados da população geral e padronizadas por idade e sexo. Resultados: Uma média de 3.937 pacientes em HD crônica foram avaliados mensalmente. Destes, 4,8% tinham COVID-19, 64,97% eram casos leves. As taxas de hospitalização por 1.000 pacientes foram 19,5; 29,28; e 36,7 em 2019, 2020, e 2021, respectivamente. As taxas de mortalidade por 1.000 pacientes foram 5,9; 9,74 e 11,49 em 2019, 2020, e 2021, respectivamente. Quando comparados à população geral padronizada, os picos das taxas coincidiram com os platôs das ondas da pandemia. A taxa de hospitalização para COVID-19 foi 12 vezes maior em pacientes em HD do que na população geral e a taxa de mortalidade por COVID-19 foi duas vezes maior. Conclusão: Pacientes em HD apresentaram taxas de hospitalização e mortalidade padronizada mais elevadas do que a população geral. Os picos das hospitalizações e mortalidade coincidiram com os platôs da primeira e segunda ondas da pandemia.

Factores asociados con la intensidad de los síntomas ansiosos y depresivos en personal de salud de dos centros de referencia para la atención de pacientes con COVID-19 de Antioquia, Colombia. Un análisis de clases latentes / Factors Associated with the Intensity of Anxiety and Depression Symptoms in Health Workers of two Centres of Reference for COVID 19 Patient Care in Antioquia, Colombia-a Latent Class Analysis

RESUMEN Objetivo: Clasificar al personal de 2 instituciones de referencia para la atención de la COVID-19 en Antioquia según la intensidad de los síntomas ansiosos y depresivos y determinar los factores asociados con estas clases. Métodos: Estudio de corte transversal en el que se usaron las escalas GAD-7, PHQ-9, miedo a la COVID-19 y escala Burnout de Copenhague. Se hizo análisis de clases latentes para identificar las clases y se determinaron los factores asociados mediante regresión logística multinomial. Resultados: Participaron 486 personas. El modelo con mejor ajuste fue el de 3 clases. La I, con puntajes bajos en escalas; la II, con grados leves de ansiedad y depresión, e intermedios de miedo a la COVID-19 y estrés percibido; y la III, con grados moderados y graves de ansiedad, depresión y estrés percibido. Los factores asociados con pertenecer a la clase III fueron: edad (OR = 0,94; IC95%, 0,91-0,96), cambio de vivienda para no exponer a familiares (OR = 4,01; IC95%, 1,99-8,09), y antecedente de trastorno depresivo (OR = 3,10; IC95%, 1,27-7,56) y ansioso (OR = 5,5; IC95%, 2,36-12,90). Los factores asociados con la clase II fueron: edad (OR = 0,97; IC95%, 0,95-0,99), antecedente de trastorno depresivo (OR = 3,41; IC95%, 1,60-7,25), convivir con alguien con riesgo de muerte por COVID-19 (OR = 1,86; IC95%, 1,192,91), familiar personal de salud (OR = 1,58; IC95%, 1,01-2,47) y cambio de vivienda para no exponer a familiares (OR=1,99; IC95%, 1,11-3,59). 0034-7450/© 2021 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. Todos los derechos reservados. Conclusiones: Se obtuvieron 3 clases de participantes, 2 de ellas con síntomas ansiosos y depresivos. La menor edad y el antecedente de un trastorno mental fueron factores asociados con las 2 clases de pacientes sintomáticos; otros factores pueden ser causa o consecuencia de los síntomas. © 2021 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.

ABSTRACT Objective: To classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes. Methods: Cross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression. Results: 486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR = 0.94; 95%CI, 0.91-0.96), change of residence to avoid exposing relatives (OR = 4.01; 95%CI, 1.99-8.09), and a history of depressive disorder (OR = 3.10; 95%CI, 1.27-7.56), and anxiety (OR = 5.5; 95%CI, 2.36-12.90). Factors associated with class II were age (OR = 0.97; 95%CI, 0.95-0.99), history of depressive disorder (OR = 3.41; 95%CI, 1.60-7.25), living with someone at risk of death from COVID-19 (OR= 1.86; 95%CI, 1.19-2.91), family member being healthcare staff (OR = 1.58; 95%CI, 1.01-2.47), and change of residence to avoid exposing relatives (OR = 1.99; 95%CI, 1.11-3.59). Conclusions: Three classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.

Factors associated with the intensity of anxiety and depression symptoms in health workers of two centres of reference for COVID 19 patient care in Antioquia, Colombia - A latent class analysis.

OBJECTIVE: To classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes. METHODS: Cross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression. RESULTS: 486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR = 0.94; 95%CI, 0.91-0.96), change of residence to avoid exposing relatives (OR = 4.01; 95%CI, 1.99-8.09), and a history of depressive disorder (OR = 3.10; 95%CI, 1.27-7.56), and anxiety (OR = 5.5; 95%CI, 2.36-12.90). Factors associated with class II were age (OR = 0.97; 95%CI, 0.95-0.99), history of depressive disorder (OR = 3.41; 95%CI, 1.60-7.25), living with someone at risk of death from COVID-19 (OR = 1.86; 95%CI, 1.19-2.91), family member being healthcare staff (OR = 1.58; 95%CI, 1.01-2.47), and change of residence to avoid exposing relatives (OR = 1.99; 95%CI, 1.11-3.59). CONCLUSIONS: Three classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.

Concern about COVID-19 infection and workload as predictors of psychological distress during the health emergency in Peruvian healthcare personnel.

INTRODUCTION: During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing. OBJECTIVE: To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers. METHODS: Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale. RESULTS: It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (P < .01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; P < .001), where concern about COVID-19 (ß = -0.436; P < .01) and workload (ß = 0.239; P < .01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33). CONCLUSIONS: Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Exploring the perceptions and experiences of medical students in the care for patients diagnosed with COVID-19: A qualitative content analysis

Resumen Introducción: los estudiantes de medicina enfrentaron numerosos problemas para combatir la pandemia de COVID-19, en la que fueron los miembros del personal médico con menos experiencia. Conocer el impacto de esta pandemia en los estudiantes de medicina es fundamental para gestionar y controlar sus efectos adversos. Objetivo: este estudio tuvo como objetivo explorar las percepciones y experiencias de los estudiantes de medicina durante la pandemia de COVID-19. Métodos: realizamos un estudio cualitativo en mayo y junio del 2020, el cual involucró entrevistas telefónicas semiestructuradas con 19 estudiantes de medicina. Los datos fueron recolectados a través de entrevistas telefónicas en profundidad y analizados con el software MAXQDA 10. Se utilizó el análisis de contenido convencional propuesto por Graneheim y Lundman. Resultados: surgieron treinta subcategorías, seis categorías y tres temas del análisis de datos. Los temas incluían paradojas mentales y emocionales percibidas (sentimientos placenteros complicados por sentimientos y emociones negativas), enfrentarse a una catástrofe (enfrentarse a la falta de equipo y a una gestión desorganizada; trabajar en medio de la confusión) e intentar adaptarse a situaciones desagradables (esfuerzos individuales hacia el ajuste psicológico; intento de resiliencia como profesional). Conclusión: la pandemia del COVID-19 tuvo múltiples efectos emocionales, educativos y laborales, tanto positivos como negativos, en los estudiantes de medicina. Este estudio destacó estos efectos al explorar las experiencias de los estudiantes. Se recomienda el diseño de un plan de respuesta organizado ante una pandemia, el cual contemple varios aspectos de la educación de los estudiantes de medicina, así como la atención al paciente y las habilidades para afrontar futuras pandemias.

Abstract Introduction: Medical students faced numerous problems to combat the COVID-19 pandemic as the least experienced medical staff members. Awareness of the impact of the COVID-19 pandemic on medical students is essential to manage and control its adverse effects. Objective: This study aimed to explore medical students' perceptions and experiences during the COVID-19 pandemic. Methods: We conducted a qualitative study in May and June 2020 involving semi-structured phone interviews with 19 medical students. Data were collected through in-depth telephone interviews and analyzed with MAXQDA 10 software using the conventional content analysis proposed by Graneheim and Lundman. Results: Thirty subcategories, six categories, and three themes emerged from the data analysis. The themes included perceived mental and emotional paradox (pleasurable feelings complicated by negative feelings and emotions), encountering catastrophe (being confronted with a lack of equipment and disorganized management; working in turmoil), and attempting to adapt to unpleasant conditions (individual efforts toward psychological adjustment; attempting to resile as a professional). Conclusion: The COVID-19 pandemic had multiple positive and negative emotional, educational, and occupational effects on medical students. This study highlighted these effects by exploring the students' experiences. Design of an organized pandemic response plan for medical student is recommended in various aspects of education, patient care and coping skills for future pandemics.

Rare genetic variants involved in multisystem inflammatory syndrome in children: a multicenter Brazilian cohort study.

Introduction: Despite the existing data on the Multisystem Inflammatory Syndrome in Children (MIS-C), the factors that determine these patients evolution remain elusive. Answers may lie, at least in part, in genetics. It is currently under investigation that MIS-C patients may have an underlying innate error of immunity (IEI), whether of monogenic, digenic, or even oligogenic origin. Methods: To further investigate this hypothesis, 30 patients with MIS-C were submitted to whole exome sequencing. Results: Analyses of genes associated with MIS-C, MIS-A, severe covid-19, and Kawasaki disease identified twenty-nine patients with rare potentially damaging variants (50 variants were identified in 38 different genes), including those previously described in IFNA21 and IFIH1 genes, new variants in genes previously described in MIS-C patients (KMT2D, CFB, and PRF1), and variants in genes newly associated to MIS-C such as APOL1, TNFRSF13B, and G6PD. In addition, gene ontology enrichment pointed to the involvement of thirteen major pathways, including complement system, hematopoiesis, immune system development, and type II interferon signaling, that were not yet reported in MIS-C. Discussion: These data strongly indicate that different gene families may favor MIS- C development. Larger cohort studies with healthy controls and other omics approaches, such as proteomics and RNAseq, will be precious to better understanding the disease dynamics.

Cutaneous manifestations of COVID-19 patients in a Hospital in São Paulo, Brazil, and global literature review

Abstract Background: Since the beginning of the COVID-19 pandemic, a myriad of cutaneous manifestations have been described in association with this viral infection. However, in Latin America, this kind of data is still scarce. Objective: In this sense, the goal of this study was to describe the dermatological findings observed during SARS-CoV-2 infection, in a Brazilian Hospital. Methods: This is a cross-sectional, retrospective and descriptive study of 50 cases of new-onset dermatologic symptoms in patients with COVID-19, treated at Hospital Sírio-Libanês, from February to June 2020. Results: The patients (n = 50) were classified into 6 groups, according to the elementary lesions and the statistical analysis was performed. The most common cutaneous lesions were maculopapular eruptions (44%), necrosis, purpura, and livedo (32%), urticarial lesions (12%), pseudochilblains (4%) and papular-vesicular eruption (4%). In 46% of the patients the cutaneous lesions occurred in association with other symptoms, such as pruritus (38%), pain and burning sensation (8%). Lower limbs were affected in 44% of the cases, followed by the trunk (38%), upper limbs (24%) and face (14%). Cutaneous lesions were mostly found after other COVID-19 systemic symptoms, with a mean period between the viral syndrome and cutaneous signs of 5 days (SD = 6.1 days). Study limitations: It is a small sample, in a single-center study, with patients exclusively from a private Hospitals. Conclusions: Patients in Brazil have the same proportion of lesions as revealed in other studies in Europa. The compiled data is essential for a better understanding of cutaneous manifestations deemed secondary to COVID.

Validación de la reacción de polimerasa en cadena en tiempo real como herramienta diagnóstica en la aspergilosis asociada a COVID-19 en pacientes hospitalizados en Clínica Dávila de Santiago, Chile, durante los años 2020 y 2021 / Validation of real-time PCR as a diagnostic tool in aspergillosis associated with COVID-19 in patients hospitalized at Clínica Dávila at Santiago, Chile, during the years 2020 and 2021

INTRODUCCIÓN: Desde el inicio de la pandemia por COVID-19 se han registrado casos de infecciones de aspergilosis pulmonar asociada a esta infección, la cual tiene características diferentes a la aspergilosis pulmonar clásica y, por lo tanto, han significado un desafío diagnóstico. OBJETIVO: Validar una reacción de polimerasa en cadena (RPC) en tiempo real (sigla en inglés RT-PCR) comercial, como herramienta diagnóstica alternativa a la técnica de galactomanano (GM) en el diagnóstico de aspergilosis pulmonar asociada a COVID-19 (sigla en inglés CAPA). PACIENTES Y MÉTODO: Se analizaron resultados de RT-PCR de Aspergillus spp y GM en lavado bronco-alveolar (LBA) de 72 pacientes, hospitalizados por COVID-19 de Clínica Dávila entre los años 2020 y 2021. De estos pacientes, 33 presentaron CAPA. RESULTADOS: La RT-PCR de Aspergillus y GM presentaron una correlación positiva (r = 0,6351, valor p < 0,0001). La técnica de RT-PCR presentó una sensibilidad (S), especificidad (E), valor predictor positivo (VPP) y valor predictor negativo (VPN) de 100, 44, 66 y 100%, respectivamente, mientras que en GM fueron de 64, 89, 84 y 73%, respectivamente para LBA. Al utilizar ambas técnicas en combinación se obtuvo una S, E, VPP y VPN de 100, 82, 88 y 100%, respectivamente. CONCLUSIÓN: Este estudio concluyó que usar una técnica de RT-PCR de Aspergillus y GM en conjunto en LBA mejoraron los parámetros de desempeño de ambas técnicas usadas de manera individual para diagnosticar CAPA. Se requieren más estudios para evaluar el desempeño de técnicas combinadas en otros tipos de aspergilosis.

BACKGROUND: Since the beginning of the COVID-19 pandemic, there have been cases of pulmonary aspergillosis infections associated with this infection, which has different characteristics from classical pulmonary aspergillosis and therefore, have been diagnostic challenges. AIM: To validate a commercial real-time PCR (RT-PCR) method as an alternative diagnostic tool to the galactomannan (GM) technique in the diagnosis of COVID-19-associated pulmonary aspergillosis (CAPA). METHODS: Results of RT-PCR of Aspergillus spp and GM in broncho-alveolar lavage (BAL) of 72 patients hospitalized for COVID-19 at Clínica Dávila between 2020 and 2021 were analyzed. Of these patients, 33 presented CAPA. RESULTS: The RT-PCR for Aspergillus and GM showed a positive correlation (r = 0.6351, p-value < 0.0001). The RT-PCR for Aspergillus technique presented a sensitivity (S), specificity (S), positive predictive value (PPV) and negative predictive value (NPV) of 100, 44, 66 and 100% respectively, while the GM technique presented 64, 89, 84 and 73%, respectively for BAL. Using both techniques in combination a S, E, PPV and NPV of 100, 82, 88 and 100% were obtained respectively. CONCLUSION: This study concluded that using RT-PCR and GM techniques in combination in BAL improved the performance parameters of both techniques from those used individually to diagnose CAPA. Further studies are required to evaluate the performance of combined techniques in other aspergillosis focus.

Niveles de actividad física y peso corporal en una comunidad universitaria en la pandemia COVID-19

Objetivo: evaluar el nivel de actividad física, horas sedente e índice de masa corporal (IMC) en una comunidad universitaria asociados al aislamiento obligatorio decretado en razón a la pandemia por COVID-19. Metodología: estudio descriptivo, transversal en trabajadores, docentes y estudiantes con un rango de edad de 18 a 59 años, llevada a cabo entre febrero y abril del 2021 con un muestreo por conveniencia. Se determinó el índice de masa corporal y se aplicó el Cuestionario Internacional de Actividad Física versión corta avalado para Colombia. Resultados: se evaluaron un total de 52 personas, 35 mujeres (67,3 %) y 17 hombres (32,7 %), edad media de 37,6 años ± 11,4, IMC medio de 25,9 kg/ m² ± 3,8. El nivel del IMC mostró un exceso de peso en el 67,9 % del grupo de 39 años o más; en los menores solo el 4,2 % mostró niveles en obesidad. No se encontraron personas con nivel bajo peso. En el 57,7 % de los participantes se encontró bajo nivel de actividad física, 15,4 % en el nivel moderado y 26,9 % con un nivel de actividad física alta. Las horas sedentes de los mayores se encontró en 8,4 horas por día. Conclusiones: los cambios en el estilo de vida asociados al aislamiento obligatorio, impactaron de forma negativa en el nivel de actividad física, en el IMC y en número de horas sedente a los integrantes de la comunidad universitaria.

Objective: To evaluate the level of physical activity, sitting hours and Body Mass Index in a university community associated with the mandatory isolation decreed due to the COVID-19 pandemic. Method: Descriptive, cross-sectional study in workers, teachers and students with an age range of 18 to 59 years, carried out between February and April 2021 with convenience sampling. The body mass index was determined and the International Physical Activity Questionnaire, short version endorsed for Colombia, was applied. Results: A total of 52 people were evaluated, 35 women (67.3%) and 17 men (32.7%), mean age of 37.6 years ± 11.4, mean BMI of 25.9 kg/m² ± 3.8. The BMI level showed excess weight in 67.9% of the group aged 39 or over. In the younger group only 4.2% showed levels of obesity. People with low weight level were not found. A low level of physical activity was found in 57.7% of the participants, 15.4% showed a moderate level and 26.9% showed a high level of physical activity. The sitting hours of the elderly was found to be 8.4 hours per day. Conclusions: Changes in lifestyle associated with mandatory isolation had a negative impact on the level of physical activity, on the body mass index and on the number of hours sitting for the members of the university community.

Objetivo: avaliar o nível de atividade física, horas sem atividade física e índice de massa corporal (IMC) em uma comunidade universitária associados ao isolamento obrigatória decretado a causa da pandemia por COVID-19. Metodologia: estudo descritivo, transversal em trabalhadores, docentes e estudantes com uma média de idade de 18 a 59 anos, levada a cabo entre fevereiro e abril do 2021 com uma amostra por conveniência. Determinou-se o índice de massa corporal e se aplicou o Questionário Internacional de Atividade Física versão curta avaliada para a Colômbia. Resultados: avaliaram-se um total de 52 pessoas, 35 mulheres (67,3 %) e 17 homens (32,7 %), idade média de 37,6 anos ± 11,4, IMC médio de 25,9 kg/ m² ± 3,8. o nível do IMC amostrou um excesso de peso no 67,9 % do grupo de 39 anos o mais; nos menores só o 4,2 % amostrou níveis em obesidade. Não se acharam pessoas com nível baixo peso. No 57,7 % dos participantes se encontrou baixo nível de atividade física, 15,4 % no nível moderado e 26,9 % com um nível de atividade física alta. As horas sem atividade física nos maiores se achou em 8,4 horas por dia. Conclusões: os câmbios no estilo de vida associados ao isolamento obrigatório, impactaram de forma negativa no nível de atividade física, no IMC e no número de horas sem atividade física aos integrantes da comunidade universitária.

Headache in long COVID as disabling condition: A clinical approach.

Background and purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can exacerbate previous headache disorders or change the type of pain experienced from headaches. This study aimed to investigate the clinical features of Long COVID headaches. Method: This was a cross-sectional, descriptive, and analytical observational study that included 102 patients (with previous headache, n = 50; without previous headache, n = 52) with long COVID and headache complaints. The Migraine Disability Assessment Test and Visual Analog Pain Scale were used to collect participants' headache data according to a standardized protocol. Results: The patients in this study who reported experiencing headaches before COVID-19 had longer headache duration in the long COVID phase than that in the pre-long COVID phase (p = 0.031), exhibited partial improvement in headache symptoms with analgesics (p = 0.045), and had a duration of long COVID of <1 year (p = 0.030). Patients with moderate or severe disability and those classified as having severe headaches in the long COVID phase were highly likely to develop chronic headaches. Hospital admission [odds ratio (OR) = 3.0082; 95% confidence interval (95% CI): 1.10-8.26], back pain (OR = 4.0017; 95% CI: 1.13-14.17), insomnia (OR = 3.1339; 95% CI: 1.39-7.06), and paraesthesia (OR = 2.7600; 95% CI: 1.20-6.33) were associated with headache in these patients. Conclusion: Headache is a disabling condition in patients with long COVID-19, exacerbating the conditions of those with headaches prior to contracting COVID-19.

Cutaneous manifestations of COVID-19 patients in a Hospital in São Paulo, Brazil, and global literature review.

BACKGROUND: Since the beginning of the COVID-19 pandemic, a myriad of cutaneous manifestations have been described in association with this viral infection. However, in Latin America, this kind of data is still scarce. OBJECTIVE: In this sense, the goal of this study was to describe the dermatological findings observed during SARS-CoV-2 infection, in a Brazilian Hospital. METHODS: This is a cross-sectional, retrospective and descriptive study of 50 cases of new-onset dermatologic symptoms in patients with COVID-19, treated at Hospital Sírio-Libanês, from February to June 2020. RESULTS: The patients (n = 50) were classified into 6 groups, according to the elementary lesions and the statistical analysis was performed. The most common cutaneous lesions were maculopapular eruptions (44%), necrosis, purpura, and livedo (32%), urticarial lesions (12%), pseudochilblains (4%) and papular-vesicular eruption (4%). In 46% of the patients the cutaneous lesions occurred in association with other symptoms, such as pruritus (38%), pain and burning sensation (8%). Lower limbs were affected in 44% of the cases, followed by the trunk (38%), upper limbs (24%) and face (14%). Cutaneous lesions were mostly found after other COVID-19 systemic symptoms, with a mean period between the viral syndrome and cutaneous signs of 5 days (SD = 6.1 days). STUDY LIMITATIONS: It is a small sample, in a single-center study, with patients exclusively from a private Hospital. CONCLUSIONS: Patients in Brazil have the same proportion of lesions as revealed in other studies in Europa. The compiled data is essential for a better understanding of cutaneous manifestations deemed secondary to COVID.

Caracterización clínica y epidemiológica de la enfermedad COVID-19 en el municipio Sandino, año 2020 / Clinical and Epidemiological Characterization of COVID-19 Disease in Sandino Municipality, year 2020

Introducción: La COVID-19 fue declarada por la Organización Mundial de la Salud como pandemia el 11 de marzo de 2020 por su complejidad y rápida expansión mundial. El municipio de Sandino presentó su primer caso positivo el 6 de octubre de 2020. Objetivo: Caracterizar el comportamiento clínico-epidemiológico de la COVID-19 en Sandino, en el año 2020. Métodos: Se realizó una investigación descriptiva y transversal, del 11 de marzo al 31 de diciembre. Con la información obtenida de historias clínico-epidemiológicas, resultados virológicos, pesquisa domiciliaria y laboral, atenciones por infecciones respiratorias agudas en consultorios y policlínicos, y los partes diarios de la Dirección Municipal de Salud, se realizó un análisis estadístico cuya información fue depositada en base de datos en Excel. Resultados: La tasa de incidencia fue de 528,23 por 100 000 habitantes; sin fallecidos. La mayoría de los casos ocurrieron en la ciudad de Sandino. Hubo mayor frecuencia de afectados, entre 41 y 60 años de edad, y el sexo masculino, mientras el 55,73 por ciento, fueron asintomáticos al diagnóstico. Los síntomas más frecuentes fueron la tos, la fiebre y la congestión nasal. Se diagnosticaron entre uno y 13 casos por día durante los 63 días que hubo positividad. La transmisión familiar fue del 68,23 por ciento y la laboral del 50,52 por ciento de los casos. Conclusiones: La COVID-19 tuvo una alta incidencia en Sandino, y esta predominó en los lugares con mayor densidad poblacional con transmisión familiar y laboral intensa en un corto período de tiempo. Además, en el sexo masculino, el grupo etario en edad laboral y, en los asintomáticos(AU)

Introduction: COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020 due to its complexity and rapid global expansion. Sandino municipality presented its first positive case on October 6, 2020. Objective: To characterize the clinical-epidemiological behavior of COVID-19 in Sandino municipality, in 2020. Methods: A descriptive and cross-sectional research was conducted from March 11 to December 31, 2020. With the information obtained from clinical-epidemiological records, virological results, home and work screening, care for acute respiratory infections in clinics and polyclinics, and the daily reports of the Municipal Health Directorate, a statistical analysis was carried out whose information was inserted in an Excel database. Results: The incidence rate was 528.23 per 100 000 population; no deaths. Most of the cases occurred in the city of Sandino. There was a higher frequency of patients in the ages from 41 and 60, and the male sex; while 55.73 percent were asymptomatic at diagnosis. The most common symptoms were cough, fever and nasal congestion. Between one and 13 cases per day were diagnosed during the 63 days that there was positivity. Family transmission was 68.23 percent and occupational transmission was 50.52 percent of cases. Conclusions: COVID-19 had a high incidence in Sandino municipality, and this predominated in places with higher population density with intense family and work transmission in a short period of time; also, in the male sex, the age group in working ages, and in the asymptomatic patients(AU)

In vitro antiviral effect of silver nanoparticles against SARS-CoV-2

Resumen Introducción: la COVID-19 es una enfermedad aguda del tracto respiratorio causada por el coronavirus SARS-CoV-2. A pesar de que han surgido algunas opciones quimioprofilácticas, aún no existe un tratamiento efectivo contra esta enfermedad. Objetivo: investigar las propiedades antivirales de las nanopartículas de plata sintetizadas contra SARS-CoV-2 usando modelos in vitro. Metodología: en este estudio se sintetizaron AgNPs por medio de un método electroquímico. La caracterización de las AgNPs se realizó mediante técnicas físicoquímicas (ICP-OES, espectroscopía UV-Vis, y microscopía electrónica de transmisión). El efecto citotóxico y la actividad antiviral de las AgNPs contra SARS-CoV-2 se evaluó in vitro en células Vero E6. La viabilidad celular se evaluó en presencia de diluciones seriadas de AgNPs mediante el ensayo de MTT. Adicionalmente, el efecto antiviral contra el SARS-CoV-2 fue evaluado por ensayo de placa en células Vero E6 bajo la estrategia prepostratamiento. El diámetro de las AgNPs estuvo entre 2,6 y 30 nm. El tamaño promedio obtenido por los métodos electroquímicos fue de 6,2 nm. Resultados: el efecto citotóxico fue observado a concentraciones por encima de 0,07 ppm. Cuando se empleó la estrategia pre-postratamiento con las AgNPs se observó una reducción significativa del título de SARS-CoV-2 con porcentajes de inhibición del 96,5 %, 64,13 % y 74,72 % en las concentraciones de 0,03, 0,017 y 0,008 ppm, respectivamente. Conclusión: nuestros resultados sugieren que las AgNPs podrían reducir la replicación del SARS-CoV-2, con un bajo efecto citotóxico. Sin embargo, se requieren estudios adicionales tanto in vitro como in vivo para definir su potencial terapéutico en humanos.

Abstract Introduction: COVID-19 is an acute respiratory tract disease caused by the emerging coronavirus SARS-CoV-2. Although several options for chemoprophylaxis are under development, effective treatment for COVID-19 is not yet available. Objective: To investigate the antiviral properties of synthesized silver nanoparticles (AgNPs) against SARS-CoV-2 using in vitro models. Materials and methods: This work synthesized AgNPs using an electrochemical method and characterized them using physico-chemical techniques (ICP-OES, ultraviolet-visible spectroscopy, and transmission electron microscopy). AgNPs with diameter sizes ranging between 2.6 to 30 nm and an average size of 6.2 nm were obtained by the electrochemical method. The cytotoxic effect and the antiviral activity of prepared AgNPs against SARS-CoV-2 were evaluated in vitro using Vero E6 cells. Cell viability was evaluated by MTT assay in the presence of serial dilutions of AgNPs. The antiviral effect of AgNPs was evaluated before and after the infection of Vero E6 cells by plaque assay. Results: Cytotoxic effect was observed at concentrations above 0.07 ppm. AgNPs exhibit a significant reduction of SARS-CoV-2 viral titer after a prepost treatment strategy with inhibition of 96.5%, 64.13%, and 74.72% at 0.03, 0.017, and 0.008 ppm, respectively. Conclusion: Our results suggest that AgNPs could reduce SARS-CoV-2 replication with a low cytotoxic effect. Still, additional in vitro and in vivo studies are required to define its potential therapeutic application in humans.