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      Physical activity: academic stress regulator in time of covid-19 pandemic. Covid-19 and academic stress Translated title: Actividad física: regulador de estrés académico en tiempos de pandemia Covid-19. Covid-19 y estrés académico

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          Abstract

          Abstract Introduction. The pandemic derived from the presence of the SARS-CoV-2 virus, forced the population to adopt measures for biosecurity purposes, such as: healthy distance and confinement, the tasks that were normally carried out outside the home were temporarily stopped, triggering with this a series of stressors. Objective. The objective of this work was to analyze the relationship between physical activity and perceived academic stress during the SARS-CoV-2 pandemic in students of the Faculty of Medicine and Surgery of the Universidad Regional del Sureste. Methods. It was a descriptive-cross-sectional study, the sample was determined conveniently since the surveys were applied to secondand third-year students, through the Moodle platform of the advisor of this project, surveying 6 groups, the Cognitivist Systemic Inventory was applied to study academic stress (SISCO) and the International Physical Activity Questionnaire (IPAQ). Results. 84% refer to physical activity on a daily basis, in addition to the fact that 65.4% of students consider themselves to be under moderate stress, 16.6% do not present stress, 15.5% with mild stress and only 2.5% with severe stress, this perhaps derived from individual personalities and levels of selfdemand. Conclusions. The main stressors are related to the self-directed study and the characteristics of the complementary activities of self-directed learning. The manifestations of stress are varied and of multifactorial origin, the most common being chronic fatigue, anxiety and headache. The practice of regular physical activity is related to greater physical and psycho-emotional well-being.

          Translated abstract

          Resumen Introducción. La pandemia derivada de la presencia del virus SARS-CoV-2, obligó a la población a adoptar medidas con fines de bioseguridad, tales como: distancia sana y confinamiento, las tareas que normalmente se realizaban fuera del hogar fueron detenidas temporalmente, desencadenando con esto una serie de factores estresantes. Objetivo. El objetivo de este trabajo fue analizar la relación entre la actividad física y el estrés académico percibido durante la pandemia SARS-CoV-2 en estudiantes de la Facultad de Medicina y Cirugía de la Universidad Regional del Sureste. Métodos. Se trató de un estudio descriptivo-transversal, la muestra se determinó convenientemente ya que las encuestas se aplicaron a estudiantes de segundo y tercer año, a través de la plataforma Moodle del asesor de este proyecto, encuestando a 6 grupos, para el estudio del estrés académico se aplicó el Inventario Cognitivista Sistémico (SISCO) y el Cuestionario Internacional de Actividad Física (IPAQ). Resultados. el 84% refiere realizar actividad física en el día a día, además de que el 65,4% de los estudiantes se considera bajo estrés moderado, el 16,6% no presenta estrés, el 15,5% con estrés leve y solo el 2,5% con estrés severo, esto quizás derivado de personalidades individuales y niveles de autoexigencia. Conclusiones. Los principales factores estresantes están relacionados con el estudio autodirigido y las características de las actividades complementarias del aprendizaje autodirigido. Las manifestaciones del estrés son variadas y de origen multifactorial, siendo las más frecuentes: fatiga crónica, ansiedad y dolor de cabeza. La práctica de actividad física regular está relacionada con un mayor bienestar físico y psicoemocional.

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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              Pathological findings of COVID-19 associated with acute respiratory distress syndrome

              Since late December, 2019, an outbreak of a novel coronavirus disease (COVID-19; previously known as 2019-nCoV)1, 2 was reported in Wuhan, China, 2 which has subsequently affected 26 countries worldwide. In general, COVID-19 is an acute resolved disease but it can also be deadly, with a 2% case fatality rate. Severe disease onset might result in death due to massive alveolar damage and progressive respiratory failure.2, 3 As of Feb 15, about 66 580 cases have been confirmed and over 1524 deaths. However, no pathology has been reported due to barely accessible autopsy or biopsy.2, 3 Here, we investigated the pathological characteristics of a patient who died from severe infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by postmortem biopsies. This study is in accordance with regulations issued by the National Health Commission of China and the Helsinki Declaration. Our findings will facilitate understanding of the pathogenesis of COVID-19 and improve clinical strategies against the disease. A 50-year-old man was admitted to a fever clinic on Jan 21, 2020, with symptoms of fever, chills, cough, fatigue and shortness of breath. He reported a travel history to Wuhan Jan 8–12, and that he had initial symptoms of mild chills and dry cough on Jan 14 (day 1 of illness) but did not see a doctor and kept working until Jan 21 (figure 1 ). Chest x-ray showed multiple patchy shadows in both lungs (appendix p 2), and a throat swab sample was taken. On Jan 22 (day 9 of illness), the Beijing Centers for Disease Control (CDC) confirmed by reverse real-time PCR assay that the patient had COVID-19. Figure 1 Timeline of disease course according to days from initial presentation of illness and days from hospital admission, from Jan 8–27, 2020 SARS-CoV-2=severe acute respiratory syndrome coronavirus 2. He was immediately admitted to the isolation ward and received supplemental oxygen through a face mask. He was given interferon alfa-2b (5 million units twice daily, atomisation inhalation) and lopinavir plus ritonavir (500 mg twice daily, orally) as antiviral therapy, and moxifloxacin (0·4 g once daily, intravenously) to prevent secondary infection. Given the serious shortness of breath and hypoxaemia, methylprednisolone (80 mg twice daily, intravenously) was administered to attenuate lung inflammation. Laboratory tests results are listed in the appendix (p 4). After receiving medication, his body temperature reduced from 39·0 to 36·4 °C. However, his cough, dyspnoea, and fatigue did not improve. On day 12 of illness, after initial presentation, chest x-ray showed progressive infiltrate and diffuse gridding shadow in both lungs. He refused ventilator support in the intensive care unit repeatedly because he suffered from claustrophobia; therefore, he received high-flow nasal cannula (HFNC) oxygen therapy (60% concentration, flow rate 40 L/min). On day 13 of illness, the patient's symptoms had still not improved, but oxygen saturation remained above 95%. In the afternoon of day 14 of illness, his hypoxaemia and shortness of breath worsened. Despite receiving HFNC oxygen therapy (100% concentration, flow rate 40 L/min), oxygen saturation values decreased to 60%, and the patient had sudden cardiac arrest. He was immediately given invasive ventilation, chest compression, and adrenaline injection. Unfortunately, the rescue was not successful, and he died at 18:31 (Beijing time). Biopsy samples were taken from lung, liver, and heart tissue of the patient. Histological examination showed bilateral diffuse alveolar damage with cellular fibromyxoid exudates (figure 2A, B ). The right lung showed evident desquamation of pneumocytes and hyaline membrane formation, indicating acute respiratory distress syndrome (ARDS; figure 2A). The left lung tissue displayed pulmonary oedema with hyaline membrane formation, suggestive of early-phase ARDS (figure 2B). Interstitial mononuclear inflammatory infiltrates, dominated by lymphocytes, were seen in both lungs. Multinucleated syncytial cells with atypical enlarged pneumocytes characterised by large nuclei, amphophilic granular cytoplasm, and prominent nucleoli were identified in the intra-alveolar spaces, showing viral cytopathic-like changes. No obvious intranuclear or intracytoplasmic viral inclusions were identified. Figure 2 Pathological manifestations of right (A) and left (B) lung tissue, liver tissue (C), and heart tissue (D) in a patient with severe pneumonia caused by SARS-CoV-2 SARS-CoV-2=severe acute respiratory syndrome coronavirus 2. The pathological features of COVID-19 greatly resemble those seen in SARS and Middle Eastern respiratory syndrome (MERS) coronavirus infection.4, 5 In addition, the liver biopsy specimens of the patient with COVID-19 showed moderate microvesicular steatosis and mild lobular and portal activity (figure 2C), indicating the injury could have been caused by either SARS-CoV-2 infection or drug-induced liver injury. There were a few interstitial mononuclear inflammatory infiltrates, but no other substantial damage in the heart tissue (figure 2D). Peripheral blood was prepared for flow cytometric analysis. We found that the counts of peripheral CD4 and CD8 T cells were substantially reduced, while their status was hyperactivated, as evidenced by the high proportions of HLA-DR (CD4 3·47%) and CD38 (CD8 39·4%) double-positive fractions (appendix p 3). Moreover, there was an increased concentration of highly proinflammatory CCR6+ Th17 in CD4 T cells (appendix p 3). Additionally, CD8 T cells were found to harbour high concentrations of cytotoxic granules, in which 31·6% cells were perforin positive, 64·2% cells were granulysin positive, and 30·5% cells were granulysin and perforin double-positive (appendix p 3). Our results imply that overactivation of T cells, manifested by increase of Th17 and high cytotoxicity of CD8 T cells, accounts for, in part, the severe immune injury in this patient. X-ray images showed rapid progression of pneumonia and some differences between the left and right lung. In addition, the liver tissue showed moderate microvesicular steatosis and mild lobular activity, but there was no conclusive evidence to support SARS-CoV-2 infection or drug-induced liver injury as the cause. There were no obvious histological changes seen in heart tissue, suggesting that SARS-CoV-2 infection might not directly impair the heart. Although corticosteroid treatment is not routinely recommended to be used for SARS-CoV-2 pneumonia, 1 according to our pathological findings of pulmonary oedema and hyaline membrane formation, timely and appropriate use of corticosteroids together with ventilator support should be considered for the severe patients to prevent ARDS development. Lymphopenia is a common feature in the patients with COVID-19 and might be a critical factor associated with disease severity and mortality. 3 Our clinical and pathological findings in this severe case of COVID-19 can not only help to identify a cause of death, but also provide new insights into the pathogenesis of SARS-CoV-2-related pneumonia, which might help physicians to formulate a timely therapeutic strategy for similar severe patients and reduce mortality. This online publication has been corrected. The corrected version first appeared at thelancet.com/respiratory on February 25, 2020
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                Author and article information

                Journal
                jonnpr
                Journal of Negative and No Positive Results
                JONNPR
                Research and Science S.L. (Madrid, Madrid, Spain )
                2529-850X
                2021
                : 6
                : 6
                : 872-880
                Affiliations
                [2] Oaxaca Oaxaca orgnameInstituto Tecnológico de Oaxaca orgdiv1Division of Postgraduate Studies and Research, Tecnológico Nacional de México Mexico
                [1] Oaxaca orgnameUniversidad Regional del Sureste orgdiv1Faculty of Medicine and Surgery Mexico
                Article
                S2529-850X2021000600872 S2529-850X(21)00600600872
                10.19230/jonnpr.4188
                67c29a3c-b8f8-430e-8910-3ffe1a4473a3

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 08 March 2021
                : 06 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 9
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                SciELO Spain

                Categories
                Original

                estrés,COVID-19,Undergraduate students,physical activity,pandemic,stress,Estudiantes de pregrado,actividad física,pandemia

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