Introduction: SARS-Cov-2 virus pandemic causes serious emotional consequences. It has occurred widespread medical courses suspension, and graduations were anticipated. Field hospitals, set up to treat patients with mild to moderate COVID-19, were the main workplaces of newly graduated doctors. Objective: To assess the impact of SARS-Cov-2/COVID-19 pandemic on mental health of medical interns and newly graduated doctors. Method: This is a cross-sectional study performed using a digital platform. Links to forms were sent in two moments: moment 1 (M1), at the beginning of the pandemic, in the first half of April/2020 and moment 2 (M2), after six months of pandemic, in the second half of September/2020. All students from the medical internship and all doctors graduated since 2018 from the three medical schools in Sergipe-NE-Brazil were invited. Results: 335 forms were answered in April and 148 in September. In M1 88.9% considered themselves exposed to excess of information about COVID-19, which was associated with anxiety symptoms (p = 0.04). Long family physical distance was also associated with these symptoms, as increased appetite (p = 0.01), feeling shortness of breath (p = 0.003) and sweating (p = 0.007). Fear of acquire COVID-19 was reported as intense by almost half of participants, and of transmitting by 85.7% in M1. In M2 41.2% reported the death of friends or relatives. Psychiatric illness was described by 38.5% and psychotropic drugs use by 30.1% in M1, especially those who lived alone (p = 0.03) and the single ones (p = 0.01). Alcohol intake was reported by 54.3%, and among doctors graduated in 2020 it increased from 50% in M1 to 85% in M2 (p = 0.04). Conclusion: The pandemic had a negative impact on the mental health of medical students and newly graduated doctors. Exposure to excessive COVID-19 information and family physical distance were associated to anxiety symptoms. Among doctors graduated in 2020, alcohol intake increased during pandemic evolution.

Chronotropic incompetence is associated with ventricular dysfunction in peak exercise and critical right coronary artery lesions.

Background: Left bundle branch block (LBBB) has prognostic significance in patients with congestive heart failure. However, its influence is not well established in patients with preserved systolic ventricular function.

Objective: To analyze the clinical profile of obese patients with COVID-19 in ambulatory care during the first wave of the pandemic. Methods: A retrospective observational study conducted in an outpatient setting in Aracaju/SE, Brazil. The patients with COVID-19 received medical care in a referral center from April to August 2020 and were followed remotely. Clinical data was analyzed using Jamovi 1.2.27. Results: Of 1,134 patients with COVID-19, 288 (25.4%) were obese, 59.7% were women. Hypertension, diabetes, dyslipidemia, and chronic kidney disease were more frequent in the obese group. Dyspnea and diarrhea were more frequent in obese individuals, while odynophagia, nausea, and vomiting were more common in non-obese individuals. Attending physicians prescribed more antibiotics, ivermectin, corticosteroids, and heparin for obese patients. Hospital admission (6.6% vs. 3.1%; p=0.008) and use of oxygen therapy (5.1% vs. 2.1%; p=0.011) were more frequent in the obesity group. Obesity was independently associated with hospital admission in multivariate analysis (OR: 2.561, 95% CI 1.352 - 4.853; p=0.004). The lethality rate was higher in obese individuals (2.1% vs. 0.7%; p=0.049). Conclusion: In this outpatient cohort of COVID-19 patients, there were more comorbidities among obese individuals. Despite the low frequency of unfavorable outcomes overall, obesity increased the risk of hospital admission and there were more deaths among patients with obesity.

Resumo: Introdução: A pandemia de Covid-19 impactou negativamente a saúde mental de médicos e estudantes de Medicina. Muito tem sido discutido sobre as lições aprendidas, no que se refere a aspectos clínicos, de diagnóstico, tratamento e prevenção. Entretanto, os médicos são treinados para o cuidado dos pacientes, o que envolve técnica e humanidade. Objetivo: Este estudo apresenta e discute as lições e reflexões aprendidas por internos de Medicina e médicos recém-formados durante a pandemia de Covid-19. Método: Trata-se de um estudo quali-quantitativo realizado durante a segunda quinzena de setembro de 2020 (seis meses após o início da pandemia) por meio de formulário em plataforma digital. Todos os alunos do internato e todos os médicos formados desde 2018 nas três faculdades de Medicina de Sergipe foram convidados a participar da pesquisa. Resultado: Obtiveram-se 148 questionários respondidos, dos quais quatro não continham respostas nos campos abertos. Quanto ao estágio de formação universitária, 36,5% eram recém-formados (n = 54), dos quais 90,7% trabalharam na linha de frente do atendimento aos pacientes com Covid-19. Ao serem questionados sobre os principais aprendizados que a pandemia havia trazido, 41 respostas estiveram voltadas para a paciência, a imprevisibilidade do futuro e a resiliência no enfrentamento das adversidades. Aproximadamente 42% (n = 62) dos participantes conheciam ao menos uma pessoa que faleceu por Covid-19, e isso se associou à necessidade de aproveitar o tempo, a vida e as pessoas (p = 0,009). Um total de 34 respostas (23%) demonstrou uma atitude positiva de reaprendizado e esperança quando os participantes foram perguntados sobre como imaginavam o trabalho e o ensino médico após pandemia. A necessidade de um retorno cauteloso foi citada em 34 (23%) respostas. Conclusão: Os estudantes de Medicina e os médicos recém-formados relataram aprendizados relacionados à paciência e resiliência. A perda de familiares e amigos por Covid-19 esteve relacionada à necessidade de aproveitar o momento presente.