COVID-19: Major Metabolic and Immunological Relationships in Obesity

Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There is a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of met inflammation

Major clinical outcomes of melatonin use in COVID-19 patients: a systematic review

Introduction: In the context of the Sars-Cov-2 (COVID-19) pandemic, as well as other viral infections, these viruses can lead to significant morbidity and mortality. Thus, in the context of melatonin science in viral infections such as influenza and COVID-19, there is a growing realization that the regulation of melatonin pathways, both pineal and systemic, may be an important aspect of the regulation of viruses in cellular functions. Objective: It was to list the main results of clinical studies of the use of melatonin in patients infected with Sars-Cov-2 through a systematic review. Methods: The rules of the Systematic Review-PRISMA Platform. The search was carried out from December 2021 to April 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: It was found 164 articles. A total of 86 articles were fully evaluated and 30 studies were developed in a systematic review. Melatonin is known as an anti-inflammatory agent and immune modulator that may address the progressive pathophysiology of coronavirus disease 2019 (COVID-19). According to the objective and results obtained in the present study that evaluated the treatment in patients with COVID-19, the use of melatonin can help reduce thrombosis, sepsis and mortality. Furthermore, the combination of 3.0 mg oral melatonin tablets and standard care can substantially improve sleep quality and blood oxygen saturation in hospitalized patients. Clinical symptoms such as cough, dyspnea and fatigue, as well as the polymerase chain reaction (PCR) level and lung involvement in patients receiving melatonin can improve significantly. Also, the mean time of patients' hospital discharge and return to initial health was significantly shorter in patients who received melatonin compared to the control group. There was evidence of benefit of sustained-release melatonin 2 mg in therapy in patients, as well as evidence that the use of melatonin was associated with a reduced probability of a positive SARS-CoV-2 test result compared to the use of blockers of the angiotensin II receptor or angiotensin-converting enzyme inhibitors

Injury profile of a soccer player training center: An epidemiological study

oai:ojs2.mednext.zotarellifilhoscientificworks.com:article/1Objective: To carry out an epidemiological analysis characterizing the type and location of the injury, severity based on recovery time, game position, and injury for hours of exposure. Methods: Data collection was carried out in the sub 15, sub 17, and sub 20 categories and verified records made by the medical team of the club, which was trained to use the F-MARC form (a form of the medical research center of the International Football Federation - FIFA) at the beginning of the season. To perform the data analysis, the GraphPad Prism software was used. All variables were analyzed using the Kolmogorov-Smirnov test. Results: In relation to the 129 athletes monitored during the season, 62 athletes presented some injury during the season, presenting 42.2 injuries for every 1000 hours of play, the Sub 15 category was the one with the highest incidence of injury, followed by the Sub17 and U20. The average time of leave after injury was 3.65 ± 4.2 weeks, the Defenders were the ones with the highest injury rate. There were 27 articular injuries (43.54%), 25 muscle injuries (40.32%), 9 bone injuries (15.41%), and one pathological injury (1.61%), and the most affected regions were ankle and knee. Conclusion: It is concluded that the moment of the game is the moment when the greatest number of injuries occurs, having a greater incidence in the athletes of the category Sub 15, the Defenders suffered more injuries and the Lower Limbs were more affected, mainly by articular traumas