SARS-CoV-2 (COVID-19) is a new virus causing respiratory illness outbreak. Nowadays, COVID-19 has spread to several countries around the world and is presently a major global concern. It appears that ...no certain effective pharmaceutical agent is currently available for it. It seems that obesity is one of the biggest risk factors related to COVID-19 hospitalization and critical illness. The strengthening of the body systems by non-drug ways is very important especially in obese people. On the basis of some indirect evidence, it seems that moderate physical activity can be recommended as a non-pharmacological, inexpensive, and viable way to cope with corona. On the other hand, recommending higher intensity exercise needs further consideration to make final decision in this regard.
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•As a conservative approach, high intensity exercise is not recommended against COVID-19 virus.•It seems that moderate intensity exercise can be recommended as a way to cope with COVID-19.•The ‘open window’ theory and ‘J curve’ concept explain the effect of exercise intensity on immune system.
Justificativa e Objetivos: a hepatite B é uma doença infectocontagiosa provocada por um vírus da família hepadnaviridae, com distribuição mundial, e representa um grave problema de saúde global. A ...patologia pode ter sido afetada pela pandemia de COVID-19, provocada pelo vírus SARS-CoV-2, sendo possível a ocorrência de desfechos graves na sobreposição entre os dos tipos virais. Este estudo buscou descrever os níveis de evidências científicas de pesquisas realizadas sobre o tema, estabelecendo relação entre a infecção por vírus da hepatite B e a infecção por SARS-CoV-2. Conteúdo: revisão integrativa da literatura, com buscas realizadas nas bases de dados do Medical Literature Analysis and Retrieval System Online e Scientific Electronic Library Online, com análise centrada na descrição do delineamento metodológico e na classificação do nível de evidência. Conclusão: a produção científica sobre hepatite B associada a infecção por SARS-CoV-2 corresponde majoritariamente a pesquisas com baixo nível de evidência. As publicações selecionadas apresentaram limitações, como a ocorrência de estudos com número reduzido de amostras, falta de dados subsidiários de pacientes em tratamento e ocorrência de seleção não randomizada. Os resultados sugerem a necessidade de novas investigações para fins de incrementos tecnológicos, identificação de fatores de risco, intervenção terapêutica e investigação clínica avançada, de forma a fomentar práticas assistenciais em saúde baseadas em evidências.
Introdução: A memória imunológica para o SARS-CoV-2 fornece proteção a longo prazo, podendo ser adquirida por infecção natural ou por vacinação. As células T de memória oferecem suporte para produção ...de anticorpos (CD4) ou lise celular (CD8) em caso de nova infecção. A IL-15 é uma citocina crítica para a proliferação basal de células T. O polimorfismo rs2228059 T>G no gene IL15Rα foi estudado em diferentes populações por influenciar na formação do receptor de IL-15, podendo interferir na ativação e duração das células de memória, mas nenhum estudo incluiu indivíduos do sul do Brasil. O objetivo deste trabalho é estabelecer as frequências alélica e genotípica do polimorfismo rs2228059 T>G no gene IL15Rα em uma população de indivíduos oriundos do Biobanco do Hospital de Clínicas de Porto Alegre. Metodologia: Um total de 383 indivíduos com e sem infecção prévia por SARS-CoV-2 foram selecionados do Biobanco. Até o momento, o DNA extraído de sangue periférico de 97 indivíduos foi submetido à genotipagem por discriminação alélica utilizando a sonda TaqMan C1882528_10 (ThermoFischer Scientific, USA). Resultados: A frequência alélica observada para o alelo T foi 0,505 e para o alelo G foi 0,495. As frequências genotípicas foram: TT 0,289; GG 0,278 e TG 0,433. Entre as 33 (34%) amostras analisadas com histórico positivo para COVID-19, 36,4% (12/33) foram homozigotas GG, 48,5% (16/33) heterozigotas TG e 15,1% (5/33) homozigotas TT. Entre os 30 indivíduos negativos para COVID-19 (30,9%), o polimorfismo rs2228059 T>G foi identificado em 20% (6/30) em homozigose GG, 40% (12/30) em heterozigose TG e 40% (12/34) apresentaram o genótipo TT. Foram analisadas 34 amostras de indivíduos que não foram testados para COVID-19, e os resultados foram: 32,3% (11/34) apresentaram genótipo TT, 26,5% (9/34) homozigoto GG e 41,2% (14/34) heterozigoto TG. Conclusão: A frequência de heterozigotos para o polimorfismo rs2228059 T>G foi a mais elevada (0,433) na população analisada. A genotipagem dos demais indivíduos será realizada para determinar com maior confiabilidade a frequência deste polimorfismo em nossa população. Ademais, a quantificação de células de memória por citometria de fluxo e a genotipagem do polimorfismo serão realizados em uma população independente para avaliar a influência da variante rs2228059 T>G na manutenção de células T de memória. Essa informação pode guiar campanhas de vacinação em regiões em que a população possa ter menor manutenção de memória imunológica.
Introdução/Objetivo: Uma estratégia para compreender a forma grave da COVID-19 está voltada para avaliação de marcadores epidemiológicos, laboratoriais e clínicos capazes de predizer óbito. O ...presente estudo analisou marcadores epidemiológicos, biomarcadores clínicos e laboratoriais em participantes com COVID-19 grave internados em hospital de referência para tratamento da COVID-19 em Ilhéus/BA, com objetivo de determinar quais marcadores poderiam ser usados como preditores do óbito. Métodos: O estudo foi submetido ao CEP/UESC, aprovado sob CAAE n° 40671720.4.0000.5526. Realizado entre 11/06/2020 a 30/07/2021, onde foram coletados dados epidemiológicos, laboratoriais e clínicos dos prontuários de pacientes internados na UTI de um hospital de referência para COVID-19 em Ilhéus e cidades vizinhas, situadas no Sul da Bahia. Os dados foram registrados no software Epimed Monitor, passando por tratamento estatístico, respeitando categoria da variável: quantitativa ou categórica. As análises foram realizadas por softwares GraphPad Prism 9.0 e Statistical Package for Social Sciences 26.0. A classificação de sobreviventes e não sobreviventes foi analisada via curva ROC pelo método de Wilson/Brown. O estudo englobou 218 participantes com média de idade de 64,37SD± 15,16, 123 do sexo masculino e 95 do sexo feminino. 77 vieram a óbito. Resultados: As análises estatísticas evidenciaram idade superior a 65 anos (ponto de corte >66.5; p < 0,001) e sexo masculino(OR 2.73; IC95% 1.15-6.46; p < 0.022) como marcador epidemiológico para óbito, assim como biomarcadores clínicos insuficiência respiratória (OR 5.56; IC95% 3.05-10.15; p < 0.0001),vasopressores (OR 6.28; IC95% 3.08-12.56; p < 0.0001), cateteres (OR 79.30; IC95% 13.693-810.2; p < 0.0001) e dispositivos de ventilação mecânica invasivo (OR 5.56; IC95% 3.05-10.15; p < 0.0001) e não invasivo (OR 0.34; IC95% 0.18-0.60; p < 0.0003). A elevação de dosagem de ureia (ponto de corte de >40.5; p < 0,0001 e) e creatinina (ponto de corte de >0,895; p < 0,0001) nitrogênio ureico (ponto de corte >19.4; p < 0.0001), lactato sérico (ponto de corte >1.350, p = 0.0035.) dosagem de pH arterial (ponto de corte <7,4; p < 0,0003), presença de leucocitose (ponto de corte >10.03; p < 0,0001) e a longa permanência em UTI passando 11 dias (ponto de corte >11,5; p < 0,001) foram associados ao óbito, correlacionados a injúria sistêmica. Conclusão: Os marcadores epidemiológicos, laboratoriais e clínicos encontrados neste estudo podem ser usados pela equipe clínica como preditores para óbito em pacientes com COVID-19.
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•A new approach to simulate the airborne transmission of SARS-CoV-2 is proposed.•Guaranteeing reproduction number R0 < 1 needs reducing the crowding index.•The maximum exposure time ...for acceptable risks can be very short.•Applying the model to documented outbreaks confirmed the airborne transmission.•Outbreaks are not caused by superspreaders, but by “superspreading events”.
Airborne transmission is a recognized pathway of contagion; however, it is rarely quantitatively evaluated. The numerous outbreaks that have occurred during the SARS-CoV-2 pandemic are putting a demand on researchers to develop approaches capable of both predicting contagion in closed environments (predictive assessment) and analyzing previous infections (retrospective assessment).
This study presents a novel approach for quantitative assessment of the individual infection risk of susceptible subjects exposed in indoor microenvironments in the presence of an asymptomatic infected SARS-CoV-2 subject. The application of a Monte Carlo method allowed the risk for an exposed healthy subject to be evaluated or, starting from an acceptable risk, the maximum exposure time. We applied the proposed approach to four distinct scenarios for a prospective assessment, highlighting that, in order to guarantee an acceptable risk of 10−3 for exposed subjects in naturally ventilated indoor environments, the exposure time could be well below one hour. Such maximum exposure time clearly depends on the viral load emission of the infected subject and on the exposure conditions; thus, longer exposure times were estimated for mechanically ventilated indoor environments and lower viral load emissions. The proposed approach was used for retrospective assessment of documented outbreaks in a restaurant in Guangzhou (China) and at a choir rehearsal in Mount Vernon (USA), showing that, in both cases, the high attack rate values can be justified only assuming the airborne transmission as the main route of contagion. Moreover, we show that such outbreaks are not caused by the rare presence of a superspreader, but can be likely explained by the co-existence of conditions, including emission and exposure parameters, leading to a highly probable event, which can be defined as a “superspreading event”.
ISG15 is a ubiquitin-like modifier that also functions extracellularly, signaling through the LFA-1 integrin to promote interferon (IFN)-γ release from natural killer (NK) and T cells. The signals ...that lead to the production of extracellular ISG15 and the relationship between its two core functions remain unclear. We show that both epithelial cells and lymphocytes can secrete ISG15, which then signals in either an autocrine or paracrine manner to LFA-1-expressing cells. Microbial pathogens and Toll-like receptor (TLR) agonists result in both IFN-β-dependent and -independent secretion of ISG15, and residues required for ISG15 secretion are mapped. Intracellular ISGylation inhibits secretion, and viral effector proteins, influenza B NS1, and viral de-ISGylases, including SARS-CoV-2 PLpro, have opposing effects on secretion of ISG15. These results establish extracellular ISG15 as a cytokine-like protein that bridges early innate and IFN-γ-dependent immune responses, and indicate that pathogens have evolved to differentially inhibit the intracellular and extracellular functions of ISG15.
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•ISG15 is released from multiple cell types to signal to LFA-1-expressing lymphocytes•Mutational analysis separates ISG15 secretion from LFA-1 binding and ISGylation•Intracellular conjugation of ISG15 negatively modulates its secretion•Viral de-ISGylases, including SARS-CoV-2 PLpro, positively modulate ISG15 secretion
Swaim et al. characterize cell types and immune agonists that stimulate ISG15 secretion and signaling to lymphocytes. Intracellular conjugation of ISG15 is shown to inhibit secretion, whereas viral de-ISGylating enzymes, including SARS-CoV-2 PLpro, enhance ISG15 secretion, suggesting a potential role for ISG15 in pro-inflammatory responses associated with viral infections.
In the general population, the seroconversion rate after primary vaccination with two doses of an anti-SARS-CoV-2 mRNA vaccine reaches nearly 100%, with significantly higher antibody titers after ...mRNA-1273 vaccination compared to BNT162b2 vaccination. Here, we performed a systematic review and meta-analysis to compare the antibody response after two-dose mRNA-1273 versus BNT162b2 vaccination in solid organ transplant (SOT) recipients.
A systematic literature research was performed in Pubmed, Web of Science, and the Cochrane library and original research papers were included for a meta-analysis to calculate vaccine-specific seroconversion rates for each of the mRNA vaccines. Next, the pooled relative seroconversion rate was estimated.
Eight studies that described the development of antibodies against receptor-binding domain (RBD) and/or spike protein were eligible for meta-analysis. Two of these studies also reported antibody titers. The meta-analysis revealed lower seroconversion rates in SOT recipients vaccinated with two doses of BNT162b2 (44.3%; 95% confidence interval (CI): 34.1%-54.7%) as compared to such patients vaccinated with two doses of mRNA-1273 (58.4%; 95% CI: 47.2%-69.2%). The relative seroconversion rate amounted 0.795 (95% CI: 0.732-0.864).
This systematic review and meta-analysis indicates that, in SOT recipients, higher seroconversion rates were observed after vaccination with mRNA-1273 compared to BNT162b2.
Introducción. La pandemia de SARS-CoV-2/COVID-19 y las restricciones sanitarias afectaron la disponibilidad, acceso y consumo de alimentos, impactando la alimentación y el estado nutricional. ...Objetivo. Determinar el efecto de la pandemia SARS-CoV-2/COVID-19 sobre el cumplimiento de las Guías Alimentarias Basadas en Alimentos de Chile, en una comunidad universitaria, antes y durante la pandemia. Materiales y métodos. Estudio de cohorte retrospectiva con 427 participantes. Se aplicó una encuesta online con preguntas basadas en los mensajes de las GABA. La encuesta se validó por juicio de expertos y análisis psicométrico, evaluando la concordancia con el estadístico de Kappa (K=89,95) y la confiabilidad con el coeficiente Alfa de Cronbach (=0,97). Se fijó como período antes de la pandemia al tiempo anterior a marzo del año 2020, y durante la pandemia, entre marzo del 2020 y octubre del 2021. Para medir los cambios antes y durante la pandemia se aplicó el test de simetría considerando un p <0,05 con un intervalo de confianza del 95%, mediante el software estadístico STATA versión 16. Resultados. Se observaron cambios estadísticamente significativos antes y durante la pandemia en los mensajes relacionados con el estado nutricional (p=0,000), consumo semanal de: productos de pastelería (p=0,0040), cecinas y embutidos (p=0,0034), frituras (p=0,0070), legumbres (p=0,0000), aguas (p=0,0000) y lectura e información nutricional de los productos (p=0,0000). Conclusiones. La pandemia de SARS-CoV-2/COVID-19 generó cambios en la alimentación y estado nutricional respecto a los mensajes de las guías. Se precisan políticas alimentarias y estrategias educativas en alimentación y en nutrición para emergencias sanitarias.
Abstract
Background
Household transmission of SARS-CoV-2 is an important component of the community spread of the pandemic. Little is known about the factors associated with household transmission, ...at the level of the case, contact or household, or how these have varied over the course of the pandemic.
Methods
The Household Transmission Evaluation Dataset (HOSTED) is a passive surveillance system linking laboratory-confirmed COVID-19 cases to individuals living in the same household in England. We explored the risk of household transmission according to: age of case and contact, sex, region, deprivation, month and household composition between April and September 2020, building a multivariate model.
Results
In the period studied, on average, 5.5% of household contacts in England were diagnosed as cases. Household transmission was most common between adult cases and contacts of a similar age. There was some evidence of lower transmission rates to under-16s adjusted odds ratios (aOR) 0.70, 95% confidence interval (CI) 0.66–0.74). There were clear regional differences, with higher rates of household transmission in the north of England and the Midlands. Less deprived areas had a lower risk of household transmission. After controlling for region, there was no effect of deprivation, but houses of multiple occupancy had lower rates of household transmission aOR 0.74 (0.66–0.83).
Conclusions
Children are less likely to acquire SARS-CoV-2 via household transmission, and consequently there was no difference in the risk of transmission in households with children. Households in which cases could isolate effectively, such as houses of multiple occupancy, had lower rates of household transmission. Policies to support the effective isolation of cases from their household contacts could lower the level of household transmission.
•The proclamation of a global pandemic in March 2020 catalyzed immediate and imperative public health initiatives.•Biopharmaceutical and academic sectors rapidly focused on monoclonal antibodies, ...antiviral agents, and immunomodulatory therapies.•FDA iteratively updates regulations based on key findings for SARS-CoV-2 medication clinical trials on different patient populations.•This review provides a comprehensive examination of treatment development, regulatory approvals, mechanisms of action, and clinical data for COVID-19 crisis management.
Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020, which precipitated urgent public health responses. The causative agent, SARS-CoV-2, spreads primarily via respiratory droplets, necessitating precautions to mitigate transmission risks. Biopharmaceutical industries and academic institutions worldwide swiftly redirected their research endeavors towards developing therapeutic interventions, focusing on monoclonal antibodies, antiviral agents, and immunomodulatory therapies. The evolving body of evidence surrounding these treatments has prompted successive updates and revisions from the FDA, delineating the evolving landscape of COVID-19 therapeutics. This review comprehensively examines each treatment modality within the context of their developmental trajectories and regulatory approvals throughout the pandemic. Furthermore, it elucidates their mechanisms of action and presents clinical data underpinning their utility in combating the COVID-19 crisis.
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