Smartphone-based evaluation of static balance and mobility in long-lasting COVID-19 patients

BackgroundSARS-CoV-2 infection can lead to a variety of persistent sequelae, collectively known as long COVID-19. Deficits in postural balance have been reported in patients several months after COVID-19 infection. The purpose of this study was to evaluate the static balance and balance of individuals with long COVID-19 using inertial sensors in smartphones.MethodsA total of 73 participants were included in this study, of which 41 had long COVID-19 and 32 served as controls. All participants in the long COVID-19 group reported physical complaints for at least 7 months after SARS-CoV-2 infection. Participants were evaluated using a built-in inertial sensor of a smartphone attached to the low back, which recorded inertial signals during a static balance and mobility task (timed up and go test). The parameters of static balance and mobility obtained from both groups were compared.ResultsThe groups were matched for age and BMI. Of the 41 participants in the long COVID-19 group, 22 reported balance impairment and 33 had impaired balance in the Sharpened Romberg test. Static balance assessment revealed that the long COVID-19 group had greater postural instability with both eyes open and closed than the control group. In the TUG test, the long COVID-19 group showed greater acceleration during the sit-to-stand transition compared to the control group.ConclusionThe smartphone was feasible to identify losses in the balance motor control and mobility of patients with long-lasting symptomatic COVID-19 even after several months or years. Attention to the balance impairment experienced by these patients could help prevent falls and improve their quality of life, and the use of the smartphone can expand this monitoring for a broader population

Human T Lymphotropic virus and pulmonary diseases

Federal University of Pará. Tropical Medicine Center. Belém, PA, Brazil / State University of Pará. Center of Health and Biological Sciences. Belém, PA, Brazil.State University of Pará. Center of Health and Biological Sciences. Belém, PA, Brazil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Federal University of Pará. Tropical Medicine Center. Belém, PA, Brazil / State University of Pará. Center of Health and Biological Sciences. Belém, PA, Brazil.Federal University of Pará. Tropical Medicine Center. Belém, PA, Brazil / State University of Pará. Center of Health and Biological Sciences. Belém, PA, Brazil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Human T lymphotropic virus type 1 (HTLV-1) is the etiological agent of HTLV1-associated myelopathy, and adult T cell lymphoma/leukemia (ATL/L). Pulmonary complications such as alveolitis and bronchiectasis were found in individuals who develop TSP/HAM due to chronic inflammation. These individuals showed image anomalies in CT scans and changes in pulmonary function parameters distinctive of pulmonary disease. Furthermore, infected individuals have a greater susceptibility to pulmonary tuberculosis either due to changes in the innate immune response, in asymptomatic carriers, or to an opportunistic disease linked to immunodepression, in individuals who develop ATL/L. This summary addresses the general lack of knowledge regarding the relationship between HTLV-1 and pulmonary diseases and provides direction for future work

Doppler ultrasonography: A non‐invasive method used to diagnose and follow up patients with chronic hepatitis C

National Health and Medical Research Council (61856616.1.3001.5172)Universidade Federal do Pará. Núcleo de Medicina Tropical. Belém, PA, Brazil.Universidade Federal do Pará. Núcleo de Medicina Tropical. Belém, PA, Brazil / Santa Casa de Misericórdia. Belém, PA, Brazil.Universidade Federal do Pará. Núcleo de Medicina Tropical. Belém, PA, Brazil / Universidade do Estado do Pará. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Santa Casa de Misericórdia. Belém, PA, BrazilUniversidade Federal do Pará. Núcleo de Medicina Tropical. Belém, PA, Brazil / Universidade do Estado do Pará. Belém, PA, Brazil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Background and Aim: This study aimed to investigate the association between the findings of Doppler ultrasonography and transient elastography using FibroScan and to determine the cut-off points, sensitivity, and specificity of resistance indices, and pulsatility of the hepatic vessels to predict significant hepatic fibrosis. Methods: This is a transversal, observational, and analytical study that includes 30 patients with chronic hepatitis C who were admitted at a public referral hospital. Transient elastography and ultrasonographic data were collected, and the linear association between these methods was evaluated using the Pearson test. Various Doppler velocimetric indices were compared according to the presence/absence of significant (≥ F2) fibrosis. Results: There was a moderate-strong linear association between the FibroScan data and the Doppler velocimetric indices and splenic index in the hepatic vessels; the mean values of the indices differed between groups with absent/mild (F0/F1) and significant (≥ F2) hepatic fibrosis. There was an association between the monophasic and biphasic wave pattern of the suprahepatic veins and the stratification of hepatic fibrosis estimated by the values of kilopascal in FibroScan. Conclusion: Doppler ultrasonography is a non-invasive method used to evaluate liver fibrosis, and it presents acceptable sensitivity/specificity for the prediction of fibrosis ≥ F2 in patients with chronic hepatitis C

HTLV-I induces lesions in the pulmonary system: a systematic review

Federal University of Pará. Center for Tropical Medicine. Belém, PA, Brazil / State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.Federal University of Pará. Center for Tropical Medicine. Belém, PA, Brazil.State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.Federal University of Pará. Center for Tropical Medicine. Belém, PA, Brazil / Santa Casa de Misericórdia Foundation. Belém, PA, Brazil.State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.Federal University of Pará. Center for Tropical Medicine. Belém, PA, Brazil.State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil.Federal University of Pará. Center for Tropical Medicine. Belém, PA, Brazil / State University of Pará. Center for Biological and Health Sciences. Belém, PA, Brazil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.This study analyzed the relationship between infection by human T-cell lymphotropic virus type 1 (HTLV-1) and changes in the pulmonary system. Cohort and case-control study models that analyzed a causal association between HTLV-1 and changes in the pulmonary system were considered. There were no restrictions on language and publication period. The study was registered in the PROSPERO systematic analysis database (Protocol No. CRD42017078236) and was prepared according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The following databases were used: PubMed, BVS Regional Portal, Embase, CINAHL and Web of Science. We utilized the Newcastle-Ottawa Scale to assess the methodological quality of published studies and the Kappa coefficient to assess the agreement level between two reviewers. Of the total 1156 studies retrieved by the search strategy, 28 were considered potentially eligible (Kappa test = 0.928). Of the 28 studies, three fully met the inclusion criteria. These indicated that pulmonary lesions, such as bronchiectasis and bronchitis/bronchiolitis, were observed in patients with HTLV-1, with high-resolution computed tomography of the chest being the main method of diagnostic investigation. The analyzed cohort and case-control studies indicated an etiological relationship between HTLV-1 infection and the presence of lung lesions, with emphasis on bronchiectasis in the presence of high viral loads, as well as a higher mortality in these individuals compared with the general population

Data_Sheet_1_Smartphone-based evaluation of static balance and mobility in long-lasting COVID-19 patients.PDF

BackgroundSARS-CoV-2 infection can lead to a variety of persistent sequelae, collectively known as long COVID-19. Deficits in postural balance have been reported in patients several months after COVID-19 infection. The purpose of this study was to evaluate the static balance and balance of individuals with long COVID-19 using inertial sensors in smartphones.MethodsA total of 73 participants were included in this study, of which 41 had long COVID-19 and 32 served as controls. All participants in the long COVID-19 group reported physical complaints for at least 7 months after SARS-CoV-2 infection. Participants were evaluated using a built-in inertial sensor of a smartphone attached to the low back, which recorded inertial signals during a static balance and mobility task (timed up and go test). The parameters of static balance and mobility obtained from both groups were compared.ResultsThe groups were matched for age and BMI. Of the 41 participants in the long COVID-19 group, 22 reported balance impairment and 33 had impaired balance in the Sharpened Romberg test. Static balance assessment revealed that the long COVID-19 group had greater postural instability with both eyes open and closed than the control group. In the TUG test, the long COVID-19 group showed greater acceleration during the sit-to-stand transition compared to the control group.ConclusionThe smartphone was feasible to identify losses in the balance motor control and mobility of patients with long-lasting symptomatic COVID-19 even after several months or years. Attention to the balance impairment experienced by these patients could help prevent falls and improve their quality of life, and the use of the smartphone can expand this monitoring for a broader population.</p