ARIA-EAACI statement on asthma and COVID-19 (June 2, 2020)

Non peer reviewe

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Gestión estratégica del diseño para proyectos culturales. La cultura como estrategia de desarrollo sostenible en comunidades artesanales

La cultura, no sólo conserva su carácter fundamental para la identidad de un país y su contribución esencial a la cohesión social sino que, como efecto de la globalización, es percibida cada vez más nítidamente como sinónimo de la imagen de identidad de un espacio en el escenario global; más aún, la imparable combinación de la cultura con el desarrollo de las tecnologías y de las telecomunicaciones, se convierte no ya en un contenido con valor añadido, sino en el elemento clave para el desarrollo sostenible. Se trata entonces de soslayar la degradación de la identidad simbólica manifiesta (u organización cultural) mediante la gestión o revaloración estratégica reproduciendo los valores de uso y de cambio –valor mercantil– en valor simbólico como valor integral para la lograr sustentabilidad de la cultura y sus manifestaciones tradicionales inherentes. Finalmente, esta aproximación teórica de la gestión cultural debe ser susceptible a los rasgos propios de la práctica social de administración pública, entre las que se encuentran las relaciones con instituciones públicas y privadas, empresas públicas y privadas, ONG’s, entre otras, cuyas políticas públicas o asistenciales son fundamentales para el desarrollo integral de la producción artesanal sustentable.Se pretende saber la manera en que se pueda lograr que los diversos públicos disfruten distintos tipos de obras que se generan en México, la manera en que se disfruten obras de teatro, cine mexicano, museos de arte y arte popular, libros, entre muchos otros, que permiten “recuperar los fragmentos de su propia memoria“. Ésta es la labor del diseñador en la gestión cultural, desde variopintas trincheras pero con fines iguales, la democratización y sustentabilidad de la cultura y el arte, esto es, el desarrollo de procesos de administración cultural, el quehacer artístico, las promoción de la cultura, el trabajo en instituciones culturales, la planeación de espectáculos, la docencia, la investigación, la difusión de grupos artísticos, el trabajo con la creación