Objetivo: determinar el efecto de la pronación consciente en la saturación de oxígeno (SaO2) en pacientes hospitalizados por COVID-19. Métodos: estudio de corte transversal analítico. La población estuvo conformada por los pacientes hospitalizados en uno de los pabellones por COVID-19 en el Hospital Nacional Hipólito Unanue durante el periodo junio a agosto del 2020. Se realizó un muestreo por conveniencia de tipo consecutivo de todos los pacientes comprendidos en el periodo de estudio. Se incluyó a pacientes hospitalizados mayores de 18 años, con el diagnóstico de neumonía por COVID-19. Fueron excluidos aquellos con algún grado de encefalopatía, post operados, gestantes, pacientes con inestabilidad hemodinámica. Se comparó la media de saturación arterial de oxígeno (SaO2) basal con la obtenida luego de una y dos horas de pronación. Asimismo, se evaluaron los factores asociados al cambio en la saturación. Resultados: de los 198 pacientes hospitalizados incluidos en el estudio, 144 (72.7%) fueron varones. El 31,8% eran mayores de 65 años y 30.3% menores de 49 años. La hipertensión arterial estaba presente en el 62,6%, siendo la comorbilidad más común seguida de la diabetes mellitus y la obesidad. La media de la SaO2 antes de la pronación fue de 89,4±0,24, incrementándose significativamente (p<0,001) a la hora posterior a la pronación a 95,6±0,30. A las dos horas, la media de SaO2 se incrementó a 96,7±0,30 (p < 0,001). En el análisis multivariado, el mayor recuento de linfocitos y plaquetas se asociaron en forma significativa a una mejor respuesta a la pronación, mientras que el antecedente de tuberculosis y los niveles de urea se asociaron a una menor respuesta. Conclusión: la pronación consciente se asocia a mejoras significativas en la SaO2 luego de una y dos horas de realizada la intervención. Esta intervención debe ser incluida en los protocolos de atención hospitalaria en el paciente con neumonía grave asociada a COVID-19.

Presentamos el caso de una mujer de 53 años con antecedentes de artritis reumatoide que, tras recuperarse de un cuadro de COVID-19grave, desarrolló hemorragia digestiva como manifestación de hipertensión portal e insuficiencia hepática progresiva. Basados en la serología y ecografía, se diagnosticó un síndrome overlap de hepatitis autoinmune y colangitis biliar primaria asociado a trombosis de vena porta. La respuesta a la corticoterapia y anticoagulación fue favorable. El compromiso hepático, inducido por el virus, está descrito en la COVID-19. Sin embargo, pueden desarrollarse enfermedades autoinmunes y fenómenos tromboembólicos, teniendo el hígado como órgano diana.

Introducción: El eritema pigmentado fijo ampolloso, es una forma de toxicodermia potencialmente grave. Se caracteriza por la aparición de lesiones cutáneas y/o mucosas, únicas o múltiples, pueden aparecer en cualquier zona, tras la administración de un fármaco u otra sustancia. Se presenta un varón de 73 años con diagnóstico de eritema pigmentado fijo ampolloso secundario a la ingesta de ivermectina. Es necesario que el medico sepa reconocer los efectos adversos de la automedicación con ivermectina contra el SARS CoV-2, a fin de realizar un diagnóstico temprano e iniciar un tratamiento oportuno.

Objetivo: Determinar factores asociados a mortalidad en pacientes con enfermedad grave por SARS-CoV-2. Material y métodos: Estudio retrospectivo en pacientes mayores de 18 años hospitalizados por enfermedad grave (saturación periférica de Oxígeno < 93% o compromiso radiológico pulmonar > 30%) y prueba molecular positiva en hisopado nasofaríngeo; en el hospital Rebagliati entre marzo y mayo de 2020. Se revisó historia clínica electrónica, resultados de análisis (de laboratorio y radiológicos) al ingreso y tratamiento recibido. Se realizó estadística bivariada y multivariada utilizando regresión de cox. Resultados: Se incluyeron 337 pacientes, de los cuales 215 fallecieron (63.8%). Fueron de sexo masculino 72.1%, edad promedio 63.6 años (DS 15.3), tiempo de enfermedad 7.4 días, estancia hospitalaria 10.3 días y 48.8% ingresó a ventilación mecánica invasiva. El análisis multivariado encontró significancia en edad > 60 años (HR 1.76, IC95% 1.26-2.45), antecedente de diabetes mellitus tipo 2 (HR 1.63, IC95% 1.14-2.32), compromiso radiológico pulmonar > 75% (HR 1.87, IC95% 1.37-2.56), leucocitosis > 14000 x mm3 (HR 1.59, IC95% 1.15-2.20), albúmina sérica < 4.0 g/dL (HR 2.49, IC95% 1.30-4.75) y lactato > 1.5 mmol/L (HR: 1.766 IC95% 1.25-2.49). Conclusiones: La edad mayor de 60 años, diabetes mellitus tipo 2, compromiso pulmonar severo, leucocitosis, albúmina baja y lactato elevado al ingreso hospitalario, son factores asociados a mortalidad en pacientes con enfermedad grave por SARS-CoV-2.

Introducción: La pandemia de la COVID-19 ha provocado aproximadamente 182 millones de casos y cerca de cuatro millones de muertes en todo el mundo, comprometiendo con mayor frecuencia a personas de 25 y 64 años de edad. Esta infección afecta principalmente al sistema respiratorio, pero otros órganos y sistemas pueden verse afectados a corto plazo como el neurológico. Una gran población de pacientes ha logrado superar la infección por el SARS-CoV-2, sin embargo, han comenzado a reportarse una serie de manifestaciones clínicas tardías, básicamente neuropsiquiátricas, dentro de ellas se ha referido a la ansiedad, depresión, deterioro del sueño, dolor muscular, mareos, cefaleas, fatiga, anosmia, entre otros; a este conjunto de manifestaciones tardías se le ha denominado síndrome neurológico post-Covid-19 y requiere por un lado, la atención de la comunidad médica para investigar las manifestaciones tardías o secuelas de esta enfermedad y por otro lado, una vigilancia médica ante la consulta de pacientes con estas manifestaciones.

CHARLES UNIVERSITY FACULTY OF SOCIAL SCIENCES Master of International Security Systems Anastasiya Neskoromna/Rieger Impact of COVID 19 on Security Policies of States in the Area of Cyber Security Abstract Prague 2022 Author: Ms. Anastasiya Neskoromna/Rieger Supervisor: prof. David Erkomashvile, Ph.D. Academic Year: 2021/2022 Abstract The SARS-Cov-19 or in different wording the global Covid pandemic outburst have created an unprecedented scenario for various organizations, agencies and structures. The COVID-19 pandemic in 2020 has become an extraordinary and shocking event for the world community and the global economy. On the part of the authorities, the COVID-19 pandemic is accompanied by sometimes harsh and ambiguous decisions, the consequences of which are felt by people in many countries of the world: movement between countries was stopped, businesses and enterprises were closed, the restriction was created, those who were sick or at risk of infection were isolated. There was also no possible assumption regarding how long such a mode of life will last. Many factors as a consequential chain of reactions from the pandemic in the aggregate have created a pleasant environment for altering and modifying the cybercrime landscape. This work aims to analyze the factorial presence of modification in the sphere...

The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) quickly reached pandemic proportions, and knowledge about this virus and coronavirus disease 2019 (COVID-19) has expanded rapidly. This review focuses primarily on mechanisms that contribute to acute cardiac injury and dysfunction, which are common in patients with severe disease. The etiology of cardiac injury is multifactorial, and the extent is likely enhanced by pre-existing cardiovascular disease. Disruption of homeostatic mechanisms secondary to pulmonary pathology ranks high on the list, and there is growing evidence that direct infection of cardiac cells can occur. Angiotensin converting enzyme 2 (ACE2) plays a central role in COVID-19 and is a necessary receptor for viral entry into human cells. ACE2 normally not only eliminates angiotensin II (Ang II) by converting it to Ang (1-7), but also elicits a beneficial response profile counteracting that of Ang II. Molecular analyses of single nuclei from human hearts have shown that ACE2 is most highly expressed by pericytes. Given the important roles that pericytes have in the microvasculature, infection of these cells could compromise myocardial supply to meet metabolic demand. Furthermore, ACE2 activity is crucial for opposing adverse effects of locally generated Ang II, so virus-mediated internalization of ACE2 could exacerbate pathology by this mechanism. While the role of cardiac pericytes in acute heart injury by SARS-CoV-2 requires investigation, expression of ACE2 by these cells has broader implications for cardiac pathophysiology.

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In early 2020 the World Health Organization (WHO) declared a COVID-19 pandemic outbreak. As of March 2023, the Kingdom of Saudi Arabia has reported over 829 thousand cases and over 9 thousand deaths. Due to the public health emergency, the wild-type SARS-CoV-2 genome was fully sequenced early on the pandemic course. Afterward, different viral variants emerged around the world. The variant prevalence fluctuates over time, with some strains presenting increased transmissibility, changes in disease severity, and decreased efficacy of containment measures. In this respect, genomic surveillance and timely data sharing to public repositories represent a tool to track and detect emerging changes that require addressing with public health measurements. However, the Kingdom's genome contribution to the GISAID database represents merely 0.27% of the reported cases. To address this gap, we incorporated whole genome sequencing and the available metadata, to track the circulating viral lineages and identify the variants of concern (VOC) and variants of interest (VOI) over 14 months, from December 2021 to January 2023. We sequenced 581 genomes using the MinION MK1C platform of Oxford Nanopore Technologies (ONT) and assigned the viral lineages, the data primarily derived from COVID-19-positive patients from the city of Jeddah. The VOC Omicron was the principal circulating variant in the country (~99%), which aligns with the global trend. Our report included the sublineages BA.2.75, BQ.1, CH.1.1, XBB, and XBB.1.5, which are under WHO monitoring. We also reported the VOC Delta and the recombinant strains XF, XZ, and XPB. Finally, to validate the use of ONT for genomic surveillance, we compared the data quality of 93 samples sequenced in both ONT MinION and Illumina NaovaSeq platforms. There was 90% correspondence in the Nextstrain clade assignment (84/93) and 78% correspondence in the Pangolin sublineage assignment (73/93). MinION offered a shorter turnaround time, while Illumina produced a consistently higher breadth of genome coverage. In conclusion, the continued viral evolution patterns are reflected in the Kingdom's variant prevalence, where only Omicron circulated by January 2023. Likewise, current Variants Under Monitoring (VUM) were already identified in KSA, highlighting the need for increased genomic surveillance.

<p> Over 40 years since the emergence of the AIDS epidemic and still no cure exists for AIDS or its causative HIV-1 infection. Protease inhibitors are an integral part of the most effective treatment regimen for HIV-1 infected patients known as combination antiretroviral therapy (cART), which is extremely effective at decreasing viral loads to nearly undetectable levels. One of the most alarming issues with current treatments is the emergence of multi-drug resistant strains. Even darunavir, which has shown exceptional activity against drug resistant strains, has experienced this issue. Herein we designed a novel series of heterocyclic based P2 ligand HIV-1 protease inhibitors based on kinase inhibitors such as imatinib and dasatinib. These inhibitors were designed to promote hydrogen bonding with the peptide backbone atoms of HIV-1 protease. Compounds were synthesized, biologically evaluated, and underwent X-ray structural studies. Inhibitors displayed activity as low as sub-nanomolar potency and low nanomolar antiviral activity. Important ligand-binding site interactions were determined through two X-ray crystal structures.</p> <p>Emergence of SARS-CoV-2 at the end of 2019 resulted in a global pandemic that has affected millions. Researchers all over the world turned their attention to developing drug therapies aimed at preventing and treating the viral infection. One such target became the main viral protease, or 3-chymotrypsin like protease (3CLpro). 3CLpro is an essential viral enzyme responsible for polypeptide cleavage during the viral replication cycle to produce 16 nonstructural proteins (nsps). Thus, it has been a highly researched area for effective SARS-CoV-2 drug therapies. Therefore, we designed, synthesized, and biologically evaluated a series of competitive reversible SARS-CoV-2 3CLpro inhibitors. </p>