Correlación entre dos metodologías para la medición de anticuerpos contra la proteína spike del coronavirus del Síndrome Respiratorio Agudo Grave 2 / Correlation between two methodologies for the measurement of antibodies against the spike protein of coronavirus of the Severe Acute Respiratory Syndrome 2

Resumen El coronavirus del Síndrome Respiratorio Agudo Grave 2 (SARS-CoV-2) posee diversas proteínas estructurales que incluyen la proteína spike (S), principal blanco de las vacunas actuales. Existen diversas metodologías para la medición de anticuerpos contra ésta que brindan información acerca de la respuesta inmune frente a la vacunación. El objetivo de este trabajo fue determinar la correlación entre quimioluminiscencia (CLIA) y enzimoinmunoanálisis de adsorción (ELISA) para la medición de anticuerpos IgG anti-proteína S (IgG anti-S). Se recolectaron resultados serológicos de 169 individuos y se determinaron los niveles de anticuerpos por ambas metodologías. Del total de muestras, 106 arrojaron un resultado positivo por ambas metodologías y 15 resultaron discordantes (CLIA+, ELISA-), con índice Kappa de 0,80. La correlación entre ambas metodologías fue buena. Este estudio podría aportar al manejo y seguimiento de la población vacunada, con la finalidad de obtener un valor de corte para evaluar la aplicación de una dosis adicional.

Abstract Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has several structural proteins including the spike (S) protein, which is the main target of current vaccines. There are various methodologies for the measurement of antibodies against it that provide information about the immune response to vaccination. The objective of this study was to determine the correlation between chemiluminescence (CLIA) and enzyme-linked immunoassay (ELISA) for the measurement of IgG anti-S protein (IgG anti-S) antibodies. Serological results were collected from 169 individuals and antibody levels were determined by both methodologies. Out of the total samples, 106 were positive by both methodologies and 15 were discordant (CLIA+, ELISA-), with a Kappa index of 0.80. The correlation between both methodologies was good. This study could contribute to the management and follow-up of the vaccinated population, in order to obtain a cut-off value to evaluate the application of an additional dose.

Resumo O coronavírus da Síndrome Respiratória Aguda Grave 2 (SARS-CoV-2) possui várias proteínas estruturais, incluindo a proteína spike (S), principal alvo das vacinas atuais. Existem várias metodologias para medir anticorpos contra ela que fornecem informações sobre a resposta imune diante da vacinação. O objetivo deste trabalho foi determinar a correlação entre quimioluminescência (CLIA) e enzimoimunoanálise de absorção (ELISA) para a medição de anticorpos IgG anti-proteína S (IgG anti-S). Foram coletados resultados sorológicos de 169 indivíduos e os níveis de anticorpos foram determinados por ambas as metodologias. Do total de amostras, 106 deram resultados positivos nas duas metodologias e 15 foram discordantes (CLIA+, ELISA-), com índice Kappa de 0,80. A correlação entre as duas metodologias foi boa. Este estudo poderia contribuir para a gestão e seguimento da população vacinada, visando a obter um valor de corte para avaliar a aplicação de uma dose adicional.

Evolución del paciente diagnosticado de sindrome respiratorio agudo severo por coronavirus tipo 2 en función de la comorbilidad de la población adscrita al Centro de Salud Zona VI de Albacete / Risk factors for severity and mortality in adults testing positive for COVID-19 in the VI Health Area of Albacete

Objetivos: La bibliografía consultada, en su mayoría estudios descriptivos, establece asociación entre factores de riesgo para la salud, en su mayoría cardiovasculares, y la mala evolución de la COVID-19. Este estudio pretende mostrar dicha asociación entre la población perteneciente al área de salud zona vi de Albacete (España). Método: Estudio de cohortes de carácter retrospectivo. Mediante muestreo consecutivo se ha obtenido una muestra de 372 pacientes, mayores de 14 años, con diagnóstico confirmado de COVID-19. Los grupos se han dividido entre buena y mala evolución, entendiendo esta última como ingreso en UCI y/o muerte. Los datos obtenidos mediante la explotación de historias clínicas han sido analizados obteniendo frecuencias, Chi cuadrado con intervalo de confianza al 95% y ajustando por factores de confusión.ResultadosPor edad los pacientes con mala evolución tenían una media de 76 años, frente a los 48,7 años de los pacientes que evolucionaron favorablemente.Los pacientes con HTA presentaron peor evolución; siendo la Chi cuadrado <0,001 y la OR, para un intervalo de confianza del 95%, estuvo entre 3,97 y 21,42.En los paciente con DM también se relacionó la mala evolución de la enfermedad, siendo la Chi cuadrado <0,001 y la OR, para un intervalo de confianza del 95%, entre 2.766 y 12.690. Los pacientes que presentaban DM+HTA tenían un riesgo 5 veces superior de mala evolución respecto a los que solo presentaban una de las enfermedades.Nuestro estudio no pudo encontrar diferencias estadísticamente significativas entre el IMC, el sexo y los hábitos tóxicos (consumo de alcohol, tabaco y drogas) y la mala evolución de la COVID-19. Conclusiones: Los pacientes de mayor edad tuvieron un peor desenlace de la enfermedad, así como los hipertensos y diabéticos. No se encontró relación entre la evolución y la distribución por sexos. No se pudo establecer relación entre el IMC y hábitos tóxicos y la mala evolución.(AU)

Objectives: There are several retrospective studies that establish a relationship between some risk factors (cardiovascular risks mainly) and the development of COVID-19 and a severe outcome. Thus, our aim with this study is to find out the former relationship among the population within our basic health area. Method: Cohort study. The study sample consisted of 372 patients aged 14 or older who had tested positive for COVID-19 in our health centre by consecutive sampling. Data collected from medical records will be analysed using Frequencies, X2 with a Confidence interval of 95% and those carrying out the study will have prior experience/training in research and will be specifically trained for the aim of this research. Results: A worse outcome in patients aged 76 years old on average was found versus patients aged 48.7. Regarding high blood pressure patients, X2 was<.001 and OR between 3.975 and 21.425 with confidence interval of 95%, finding a worse outcome in these patients. With regard to Diabetes Mellitus (DM), X2 was<.001 and OR rated between 2.766 and 12.690 with a confidence interval of 95%, also resulting in a worse outcome in these patients. No significant differences regarding a worse outcome were found in Body Mass Index, gender, or toxic habits. Conclusions: Older patients had a worse outcome from COVID- 19, as well as patients with high blood pressure or DM. We found no differences regarding gender and neither could we find any differences regarding BMI.(AU)

Boletim Epidemiológico dos Casos de Covid-19 no Estado do Rio de Janeiro 2020 - 2021 / Epidemiological Bulletin of Covid-19 Cases in the State of Rio de Janeiro 2020 - 2021

Esta edição do boletim apresenta a análise do total de casos confirmados de COVID-19 de residentes no estado do Rio de Janeiro e suas nove regiões de saúde, incluindo os casos de Síndrome Gripal (SG) ou casos leves, as internações ou casos de Síndrome Respiratória Aguda Grave (SRAG) e os óbitos, ocorridos desde o início da pandemia em 2020 até 26 de fevereiro de 2022 (8ª Semana Epidemiológica).

Respiratory viral infections during pregnancy: effects of SARS-CoV-2 and other related viruses over the offspring.

Little is known about the consequences of viral infection for pregnant woman or for the fetus. This issue became important with the appearance of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The infection with SARS-CoV-2 causes a respiratory syndrome known as COVID-19. The fast spreading around the world and the fact that without a treatment or vaccine humans are completely exposed, converts emerging viral diseases in a significant risk for pregnant women and their infants. At this time, during SARS-CoV-2 pandemics pregnant women are not considered as a risk population and little is known about the effects of viral infections over the offspring although the amount of emerging evidence showing detrimental effects for the mother and the fetus. This issue highlights the importance to understand the effects of viral infections during pregnancy. In this work, we analyze the effects of viral infections, like SARS-CoV-2 and other related viruses during pregnancy over the mother and the consequences for the offspring.

Neurocognitive Outcome Following Recovery from Severe Acute Respiratory Syndrome - Coronavirus-1 (SARS-CoV-1).

OBJECTIVE: Severe acute respiratory syndrome (SARS) is a highly contagious viral respiratory illness associated with hypoxia and dyspnea. Many of those who contracted and recovered from SARS during the 2002-2003 outbreak reported persistent physical, psychological, and cognitive difficulties. Here, we investigated the residual influences of SARS on cognition for a subset of healthcare professionals who recovered and were referred for neuropsychological evaluation through their workplace insurance. METHOD: Twenty-eight healthcare professionals were evaluated on neuropsychological and mood functioning approximately 1.5 years post-recovery from a severe respiratory illness. Test scores were compared with age-matched normative data, and correlations were examined between mood, self-report memory scales, subjective complaints (e.g., poor concentration, pain, fatigue), illness severity (i.e., length of hospitalization, oxygen use during hospital stay), and cognitive performance. RESULTS: Participants performed within age expectations on the majority of cognitive measures including overall memory ability. Although processing speed was generally within normal limits, 43% showed significant speed-accuracy trade-offs favoring accuracy over maintaining speed. Deficits were observed on measures of complex attention, such as working memory and the ability to sustain attention under conditions of distraction. Participants endorsed poorer memory ability than same-age peers on a meta-memory measure and mild to moderate depression and anxiety symptoms. Objective test performance was largely uncorrelated with self-reports, mood, or illness severity, except for moderate correlations between complex attention and participants' subjective ratings of Everyday Task-Oriented Memory. CONCLUSIONS: These findings demonstrate specific long-term cognitive deficits associated with SARS and provide further evidence of the cognitive effects of hypoxic illnesses.

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.

Perfil de internações e óbitos hospitalares por síndrome respiratória aguda grave causada por COVID-19 no Piauí: estudo descritivo, 2020-2021 / Perfil de ingresos y fallecimientos hospitalarios por síndrome respiratorio agudo grave por COVID-19 en Piauí, Brasil: estudio descriptivo, 2020-2021 / Profile of hospital admissions and deaths due to severe acute respiratory syndrome caused by COVID-19 in Piauí, Brazil: a descriptive study, 2020-2021

Objetivo: Descrever o perfil e a variação temporal de internações e óbitos hospitalares por síndrome respiratória aguda grave (SRAG) por COVID-19 no Piauí, Brasil, segundo local de internação. Métodos: Estudo descritivo sobre dados do Sistema de Informação da Vigilância Epidemiológica da Gripe de 2020 a 2021. Calculou-se a letalidade entre registros hospitalares com desfecho e respectivos intervalos de confiança de 95% (IC95%). Resultados: Foram incluídos 12.649 indivíduos majoritariamente do sexo masculino (57,1%), negros (61,2%), com uma ou duas comorbidades (30,5%). No interior, entre registros hospitalares com desfecho, a letalidade para internados (44,1%; IC95% 42,0;46,3), admitidos em unidades de terapia intensiva (82,3%; IC95% 79,7;84,8) e indivíduos submetidos a ventilação mecânica invasiva (96,6%; IC95% 94,9;97,8) foi maior do que na capital do estado. Conclusão: O estudo permitiu a caracterização do perfil das internações devidas a SRAG por COVID-19 no Piauí e demonstrou elevada letalidade entre registros hospitalares com desfechos, mantendo-se alta no período estudado, sobretudo no interior.

Objetivo: Describir el perfil y variación temporal de los ingresos y fallecimientos hospitalarios por síndrome respiratorio agudo grave (SRAG) causado por COVID-19 en Piauí, Brasil, según el lugar de ingreso. Métodos: Estudio descriptivo con datos del Sistema de Información de Vigilancia Epidemiológica de la Gripe de 2020 a 2021. Se calculó la letalidad entre los registros hospitalarios con desenlace con intervalo de confianza del 95% (IC95%). Resultados: Se incluyeran 12.649 individuos que eran en su mayoría del sexo masculino (57,1%), negros (61,2%) y tenían una o dos comorbilidades (30,5%). La letalidad entre los registros hospitalarios con desenlace fue mayor en el interior, con proporciones de 44,1% (IC95% 42,0;46,3) en individuos hospitalizados, 82,3% (IC95% 79,7;84,8) en unidades de cuidados intensivos y 96,6% (IC95% 94,9;97,8) de los sometidos a ventilación mecánica invasiva. Conclusión: El estudio permitió caracterizar el perfil de hospitalizaciones por SRAG por COVID-19 en Piauí y mostró una alta letalidad entre los registros hospitalarios con desenlace, que se mantuvo alta durante el período de estudio, especialmente en el interior.

Objective: To describe the profile and temporal variation of hospital admissions and deaths due to severe acute respiratory syndrome (SARS) caused by COVID-19 in Piauí, Brazil, according to place of hospitalization. Methods: We performed a descriptive study using data from the Influenza Surveillance Information System between 2020 and 2021. Case fatality ratio among hospital records with outcome and respective 95% confidence intervals (95%CI) were calculated. Results: We included 12,649 individuals who were mostly male (57.1%), Black (61.2%) and had one or two comorbidities (30.5%). Case fatality ratio among hospital records with outcome was higher in the state's interior region than in its capital, with proportion of 44.1% (95%CI 42.0;46.3) for those who were hospitalized, 82.3% (95%CI 79.7;84.8) for those admitted to intensive care units and 96.6% (95%CI 94.9;97.8) for those undergoing invasive mechanical ventilation. Conclusion: The study enabled characterization of the profile of SARS hospitalizations due to COVID-19 in Piauí and demonstrated high case fatality ratio, among hospital records with outcome, which remained high during the study period, especially in the interior of the state.

Aula 1 - Covid-19: Características da SRAG e Manejo de Vias Aéreas

O vídeo apresenta informações com relação a terapia e tratamento da SRAG e a conduta médica,fisioterapeuta e da enfermagem com relação a condução dos pacientes acometidos pela SRAG e COVID-19, bem como também a atuação da Atenção Primária no enfrentamento a COVID-19.

Signaling pathways in the regulation of cytokine release syndrome in human diseases and intervention therapy.

Cytokine release syndrome (CRS) embodies a mixture of clinical manifestations, including elevated circulating cytokine levels, acute systemic inflammatory symptoms and secondary organ dysfunction, which was first described in the context of acute graft-versus-host disease after allogeneic hematopoietic stem-cell transplantation and was later observed in pandemics of influenza, SARS-CoV and COVID-19, immunotherapy of tumor, after chimeric antigen receptor T (CAR-T) therapy, and in monogenic disorders and autoimmune diseases. Particularly, severe CRS is a very significant and life-threatening complication, which is clinically characterized by persistent high fever, hyperinflammation, and severe organ dysfunction. However, CRS is a double-edged sword, which may be both helpful in controlling tumors/viruses/infections and harmful to the host. Although a high incidence and high levels of cytokines are features of CRS, the detailed kinetics and specific mechanisms of CRS in human diseases and intervention therapy remain unclear. In the present review, we have summarized the most recent advances related to the clinical features and management of CRS as well as cutting-edge technologies to elucidate the mechanisms of CRS. Considering that CRS is the major adverse event in human diseases and intervention therapy, our review delineates the characteristics, kinetics, signaling pathways, and potential mechanisms of CRS, which shows its clinical relevance for achieving both favorable efficacy and low toxicity.

Post-COVID syndrome: pulmonary complications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worlwide and caused a pandemic that is still ongoing. The virus can cause a disease named as COVID-19, which is composed of multi systemic manifestations with a pulmonary system predominance. As the time passes, we are dealing more and more with a wide variety of effects and complications of the disease in survivors as far as with concerns about the clinical outcome and the timeline of symptoms in different patients. Since the lungs are the most involved organs and the post-COVID prolonged and persistent effects are mainly related to the pulmonary system, it is crucial to define and predict the outcome and to determine the individuals that can progress to fibrosis and loss of function of lungs. This review summarizes the current literature regarding the pulmonary complications in post-COVID syndrome and the management of these conditions.

The risk of pancreatic adenocarcinoma following SARS-CoV family infection.

COVID 19 disease has become a global catastrophe over the past year that has claimed the lives of over two million people around the world. Despite the introduction of vaccines against the disease, there is still a long way to completely eradicate it. There are concerns about the complications following infection with SARS-CoV-2. This research aimed to evaluate the possible correlation between infection with SARS-CoV viruses and cancer in an in-silico study model. To do this, the relevent dataset was selected from GEO database. Identification of differentially expressed genes among defined groups including SARS-CoV, SARS-dORF6, SARS-BatSRBD, and H1N1 were screened where the |Log FC| ≥ 1and p < 0.05 were considered statistically significant. Later, the pathway enrichment analysis and gene ontology (GO) were used by Enrichr and Shiny GO databases. Evaluation with STRING online was applied to predict the functional interactions of proteins, followed by Cytoscape analysis to identify the master genes. Finally, analysis with GEPIA2 server was carried out to reveal the possible correlation between candidate genes and cancer development. The results showed that the main molecular function of up- and down-regulated genes was "double-stranded RNA binding" and actin-binding, respectively. STRING and Cytoscape analysis presented four genes, PTEN, CREB1, CASP3, and SMAD3 as the key genes involved in cancer development. According to TCGA database results, these four genes were up-regulated notably in pancreatic adenocarcinoma. Our findings suggest that pancreatic adenocarcinoma is the most probably malignancy happening after infection with SARS-CoV family.

High Levels of the Cleaved Form of Galectin-9 and Osteopontin in the Plasma Are Associated with Inflammatory Markers That Reflect the Severity of COVID-19 Pneumonia.

Numbers of patients with coronavirus disease 2019 (COVID-19) have increased rapidly worldwide. Plasma levels of full-length galectin-9 (FL-Gal9) and osteopontin (FL-OPN) as well as their truncated forms (Tr-Gal9, Ud-OPN, respectively), are representative inflammatory biomarkers. Here, we measured FL-Gal9, FL-OPN, Tr-Gal9, and Ud-OPN in 94 plasma samples obtained from 23 COVID-19-infected patients with mild clinical symptoms (CV), 25 COVID-19 patients associated with pneumonia (CP), and 14 patients with bacterial infection (ID). The four proteins were significantly elevated in the CP group when compared with healthy individuals. ROC analysis between the CV and CP groups showed that C-reactive protein had the highest ability to differentiate, followed by Tr-Gal9 and ferritin. Spearman's correlation analysis showed that Tr-Gal9 and Ud-OPN but not FL-Gal9 and FL-OPN, had a significant association with laboratory markers for lung function, inflammation, coagulopathy, and kidney function in CP patients. CP patients treated with tocilizumab had reduced levels of FL-Gal9, Tr-Gal9, and Ud-OPN. It was suggested that OPN is cleaved by interleukin-6-dependent proteases. These findings suggest that the cleaved forms of OPN and galectin-9 can be used to monitor the severity of pathological inflammation and the therapeutic effects of tocilizumab in CP patients.

The presence of headache at onset in SARS-CoV-2 infection is associated with long-term post-COVID headache and fatigue: A case-control study.

OBJECTIVE: To investigate the association of headache during the acute phase of SARS-CoV-2 infection with long-term post-COVID headache and other post-COVID symptoms in hospitalised survivors. METHODS: A case-control study including patients hospitalised during the first wave of the pandemic in Spain was conducted. Patients reporting headache as a symptom during the acute phase and age- and sex-matched patients without headache during the acute phase participated. Hospitalisation and clinical data were collected from medical records. Patients were scheduled for a telephone interview 7 months after hospital discharge. Participants were asked about a list of post-COVID symptoms and were also invited to report any additional symptom they might have. Anxiety/depressive symptoms and sleep quality were assessed with the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index. RESULTS: Overall, 205 patients reporting headache and 410 patients without headache at hospitalisation were assessed 7.3 months (Standard Deviation 0.6) after hospital discharge. Patients with headache at onset presented a higher number of post-COVID symptoms (Incident Rate Ratio: 1.16, 95% CI: 1.03-1.30). Headache at onset was associated with a previous history of migraine (Odd Ratio: 2.90, 95% Confidence Interval: 1.41-5.98) and with the development of persistent tension-type like headache as a new post-COVID symptom (Odd Ratio: 2.65, 95% CI: 1.66-4.24). Fatigue as a long-term symptom was also more prevalent in patients with headache at onset (Odd Ratio: 1.55, 95% CI: 1.07-2.24). No between-group differences in the prevalence of anxiety/depressive symptoms or sleep quality were seen. CONCLUSION: Headache in the acute phase of SARS-CoV-2 infection was associated with higher prevalence of headache and fatigue as long-term post-COVID symptoms. Monitoring headache during the acute phase could help to identify patients at risk of developing long-term post-COVID symptoms, including post-COVID headache.

[Post-COVID-19 syndrome: epidemiology, diagnostic criteria and pathogenic mechanisms involved]. / Síndrome post-COVID-19: epidemiología, criterios diagnósticos y mecanismos patogénicos implicados.

INTRODUCTION: Many patients with mild or severe COVID-19 do not make a full recovery and have a wide range of chronic symptoms for weeks or months after infection, often of a neurological, cognitive or psychiatric nature. The epidemiological evidence, diagnostic criteria and pathogenesis of post-COVID-19 syndrome are reviewed. DEVELOPMENT: Post-COVID-19 syndrome is defined by persistent clinical signs and symptoms that appear while or after suffering COVID-19, persist for more than 12 weeks and cannot be explained by an alternative diagnosis. The symptoms can fluctuate or cause relapses. It is a heterogeneous condition that includes post-viral chronic fatigue syndrome, sequelae in multiple organs and the effects of severe hospitalisation/post-intensive care syndrome. It has been reported in patients with mild or severe COVID-19 and irrespective of the severity of the symptoms in the acute phase. Between 10% and 65% of survivors who had mild/moderate COVID-19 present symptoms of post-COVID-19 syndrome for 12 weeks or more. At six months, subjects report an average of 14 persistent symptoms. The most common symptoms are fatigue, dyspnoea, anxiety, depression, and impaired attention, concentration, memory and sleep. The underlying biological mechanisms are unknown, although an abnormal or excessive autoimmune and inflammatory response may play an important role. CONCLUSIONS: Clinical manifestations are diverse, fluctuating and variable, although fatigue and neurocognitive complaints predominate. There is no defined consensus on post-COVID-19 syndrome and its diagnostic criteria have not been subjected to adequate psychometric evaluation.

TITLE: Síndrome post-COVID-19: epidemiología, criterios diagnósticos y mecanismos patogénicos implicados.Introducción. Numerosos pacientes con COVID-19 leve o grave no tienen una recuperación completa y presentan una gran variedad de síntomas crónicos durante semanas o meses tras la infección, con frecuencia de carácter neurológico, cognitivo o psiquiátrico. Se revisan las evidencias epidemiológicas, los criterios diagnósticos y la patogenia del síndrome post-COVID-19. Desarrollo. El síndrome post-COVID-19 se define por la persistencia de signos y síntomas clínicos que surgen durante o después de padecer la COVID-19, permanecen más de 12 semanas y no se explican por un diagnóstico alternativo. Los síntomas pueden fluctuar o causar brotes. Es una entidad heterogénea que incluye el síndrome de fatiga crónica posvírica, la secuela de múltiples órganos y los efectos de la hospitalización grave/síndrome poscuidados intensivos. Se ha descrito en pacientes con COVID-19 leve o grave y con independencia de la gravedad de los síntomas en la fase aguda. Un 10-65% de los supervivientes que padeció COVID-19 leve/moderada presenta síntomas de síndrome post-COVID-19 durante 12 semanas o más. A los seis meses, los sujetos relatan un promedio de 14 síntomas persistentes. Los síntomas más frecuentes son fatiga, disnea, alteración de la atención, de la concentración, de la memoria y del sueño, ansiedad y depresión. Se desconocen los mecanismos biológicos que subyacen, aunque una respuesta autoinmunitaria e inflamatoria anómala o excesiva puede tener un papel importante. Conclusiones. Las manifestaciones clínicas son diversas, fluctuantes y variables, aunque predominan la fatiga y las quejas neurocognitivas. No existe un consenso definido sobre el síndrome post-COVID-19 y sus criterios diagnósticos no se han sometido a una evaluación psicométrica adecuada.

SARS-CoV 2 Infection (Covid-19) and Cardiovascular Disease in Africa: Health Care and Socio-Economic Implications.

The current pandemic of SARS-COV 2 infection (Covid-19) is challenging health systems and communities worldwide. At the individual level, the main biological system involved in Covid-19 is the respiratory system. Respiratory complications range from mild flu-like illness symptoms to a fatal respiratory distress syndrome or a severe and fulminant pneumonia. Critically, the presence of a pre-existing cardiovascular disease or its risk factors, such as hypertension or type II diabetes mellitus, increases the chance of having severe complications (including death) if infected by the virus. In addition, the infection can worsen an existing cardiovascular disease or precipitate new ones. This paper presents a contemporary review of cardiovascular complications of Covid-19. It also specifically examines the impact of the disease on those already vulnerable and on the poorly resourced health systems of Africa as well as the potential broader consequences on the socio-economic health of this region.

Recent Findings on Cell-Based Therapies for COVID19-Related Pulmonary Fibrosis.

COVID-19 has spread worldwide, including the United States, United Kingdom, and Italy, along with its site of origin in China, since 2020. The virus was first found in the Wuhan seafood market at the end of 2019, with a controversial source. The clinical symptoms of COVID-19 include fever, cough, and respiratory tract inflammation, with some severe patients developing an acute and chronic lung injury, such as acute respiratory distress syndrome (ARDS) and pulmonary fibrosis (PF). It has already claimed approximately 300 thousand human lives and the number is still on the rise; the only way to prevent the infection is to be safe till vaccines and reliable treatments develop. In previous studies, the use of mesenchymal stem cells (MSCs) in clinical trials had been proven to be effective in immune modulation and tissue repair promotion; however, their efficacy in treating COVID-19 remains underestimated. Here, we report the findings from past experiences of SARS and MSCs, and how SARS could also induce PF. Such studies may help to understand the rationale for the recent cell-based therapies for COVID-19.

SARS-CoV-2 and other coronaviruses negatively influence mitochondrial quality control: beneficial effects of melatonin.

Coronaviruses (CoVs) are a group of single stranded RNA viruses, of which some of them such as SARS-CoV, MERS-CoV, and SARS-CoV-2 are associated with deadly worldwide human diseases. Coronavirus disease-2019 (COVID-19), a condition caused by SARS-CoV-2, results in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) associated with high mortality in the elderly and in people with underlying comorbidities. Results from several studies suggest that CoVs localize in mitochondria and interact with mitochondrial protein translocation machinery to target their encoded products to mitochondria. Coronaviruses encode a number of proteins; this process is essential for viral replication through inhibiting degradation of viral proteins and host misfolded proteins including those in mitochondria. These viruses seem to maintain their replication by altering mitochondrial dynamics and targeting mitochondrial-associated antiviral signaling (MAVS), allowing them to evade host innate immunity. Coronaviruses infections such as COVID-19 are more severe in aging patients. Since endogenous melatonin levels are often dramatically reduced in the aged and because it is a potent anti-inflammatory agent, melatonin has been proposed to be useful in CoVs infections by altering proteasomal and mitochondrial activities. Melatonin inhibits mitochondrial fission due to its antioxidant and inhibitory effects on cytosolic calcium overload. The collective data suggests that melatonin may mediate mitochondrial adaptations through regulating both mitochondrial dynamics and biogenesis. We propose that melatonin may inhibit SARS-CoV-2-induced cell damage by regulating mitochondrial physiology.