COVID 19 repercussions in ophthalmology: a narrative review

Abstract

The outbreak of the new coronavirus (COVID-19) that started in Wuhan, China, has spread all over the world and has had a great impact on eye care. 1 It is a ribonucleic acid (RNA) virus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may have ocular manifestations in some patients. 2 This is a single-stranded RNA virus with a genome of about 30 kb in length. The RNA genome encodes its proteins. The proteins are spike protein S, membrane protein M, envelope protein E and nucleocapsid protein N. Protein S is responsible for attachment to host receptors; protein M helps to shape virus particles and their binding to the nucleocapsid; protein E acts in the assembly of particle release; and protein N acts on genome binding and replication. 3 The new coronavirus shows 96% genetic similarity to the bat-type coronavirus SARS BatCovRaTG13, and its spike surface protein (S) binds to angiotensin-converting enzyme 2 (ACE2) on the cell surface. ACE2 expression can be found in respiratory, intestinal, renal, cardiac and immune cells. Its main transmission routes are through respiratory droplets, fomites and fecal-oral routes. Some patients have had an episode of conjunctivitis before pneumonia, thus raising the hypothesis that the ocular mucosa is a possible transmission route for SARS-CoV-2, since the cornea and conjunctiva show expression of the ACE2 receptor, which is responsible for entry of the virus cells. 4 Presence of the ACE2 infection receptor in the aqueous humor of humans has also been described. 5 ACE2 is a crucial receptor for SARS-CoV-2 in vivo: in an experiment on mice, an injection of SARS-CoV spike worsened acute lung failure in vivo, which was then attenuated by blocking the renin-angiotensin pathway. 6,7 OBJECTIVEThe objective of this narrative review was to summarize the currently available evidence on COVID-19 with regard to its implications for ophthalmology.

Comportamento sedentário antes e durante a pandemia da COVID-19 entre professores da educação básica

“…O tempo despendido em frente às telas tem sido considerado importante indicador de atividades sedentárias e está associado a inúmeros problemas de saúde, que incluem o comportamento sedentário e o excesso de peso corporal 17 . A utilização do computador para trabalho e estudo estão vinculados às tarefas leitura, pesquisas e aulas, elaboração de atividades, participação em reuniões, debates e seminários, no qual faz parte de serviços dos professores e que estabelece o uso das tecnologias digitais no momento da pandemia, colaborando para o aumento do tempo sentado 16 .…”

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

“…Among the various symptoms presented, it is noteworthy that postural control can be highly susceptible to alterations as it depends on the coordinated integration of sensory systems (visual, vestibular, and somatosensory) and the musculoskeletal system, which can present important sequelae in the long COVID-19. Although the predominant ocular manifestation during the acute phase of SARS-CoV-2 infection is conjunctivitis, it is clear that other ophthalmologic manifestations are present in the long term ( 17 ), such as loss of corneal nerve fibers, and significant changes in the pupillary response to light and impairment of pupillary microcirculation have also been observed in long COVID-19 ( 18–21 ). Some authors have shown that SARS-CoV-2 infection can spread to the middle and inner ear, causing an inflammatory response or direct effect on the epithelium, resulting in symptoms related to hearing and balance ( 22–25 ).…”

A síndrome de Burnout no campo da saúde do trabalhador: uma reflexão na formação profissional

“…inversão, onde ocorre simultaneamente com os movimentos de inversão e adução do tornozelo em flexão plantar e isso gera danos tanto nos ligamentos laterais tendo como consequência rompimento de fibras ligamentares o qual pode ser dividida em lesão de primeiro, segundo e terceiro grau [5][6][7][8][9] De acordo com a epidemiologia ocorrem todos os dias uma entorse de tornozelo para cada 10.000 habitantes. Um estudo sobre o trauma no tornozelo foi concluído que as entorses mais frequentes são em jovens e a maioria do sexo masculino.…”