Severe acute psychosis significantly alters patient’s quality of life in patients with alcohol dependence. The aim of the investigation were examination value quality of the life patients with alcohol dependence who have recently suffered of acute psychotic disorder. The factor influencing the quality of life is the psychoorganic syndrome after acute psychosis.

120 patients with alcohol dependence who had recent history of acute psychosis were examined.

Psychopathological.

The psychorganic syndromes at these patients were investigated. The Index quality of the life in these patients was assessed due to type of the psychorganic syndromes. The dynamics of the Index quality of the life at patients with psychorganic syndrome during the treatment were described. The subjective assessment of their condition in patients with hard psychorganic syndrome was dissociated from the assessment of doctors and relatives. The explaining the characteristics of the consequences of the transferred psychotic disorder to the patients turned out to be important for overcoming anosognosia. The Index quality of the life in these patients was assessed repeatedly at the same time, there was a significant decrease in the difference in the assessment of the quality of life by patients with relatives.

The importance of value quality of the life from the point of the patient, relatives of the patient and physician was underlined. The assesment of Index quality of the life is important important to explain the peculiarities of the postpsychotic state to the patients and their relatives in order to develop rehabilitation programs and carrying out psychotherapeutic activities.

The high cognitive abilities named executive functions (EF) are responsible for emotional regulation and for goal-oriented behavior. EF are frequently disrupted in anxiety disorders and negatively affect daily function and quality of life (QoL). Nevertheless, EF evaluation is usually performed in the laboratory using neuro-psychological assessments that refer to specific components (such as working memory, inhibition), but lacks a comprehensive profile of EF and the expressions in real life context.

To elaborate the knowledge about EF in daily life of children/youth with psychiatric disorders, by comparing their EF to those of healthy controls, using an ecological measure that imitates daily life scenarios; To examine the relationship between EF and QoL in the study group.

Participants were 49 children and youth aged 8-18 years: 25 subjects with psychiatric (mainly anxiety) disorders and 24 healthy controls. The children’s parents completed a socio-demographic questionnaire, the Child Behavior Checklist (CBCL) to profile emotional difficulties; The Behavior Rating Inventory of Executive Functions (BRIEF) which examines EF components related to meta-cognition and behavioral regulation; and the Pediatric Quality of Life Inventory (Peds-QoL).

The study group had more EF difficulties [reduced behavioral regulation (F=31.81; p<.001) and metacognition (F=26.25; p<.001)], and lower QoL. In the study group, EF difficulties correlated with reduced physical, emotional, social, and school-related QoL.

EF should be evaluated in children/youth with psychiatric disorders, by ecological evaluation that reflect the difficulties in daily life. This may focus intervention on child’s specific needs and improve the outcomes in terms of better function, development and QoL.

The 48-item EPQR-S is a short version of EPQ-R widely used to assess neuroticism (N), extraversion (E), psychoticism (P) and Lie scale (L) for research purposes. The EPQR-S was chosen for the Arab population because it is a well-established Eysenck theory of personality.

To evaluate the psychometric properties of the Arabic EPQR-S.

The EPQ-R S, the Eysenck Personality Questionnaire (EPQ) and NEO Five-Factor Inventory (NEO–FFI-3) were administered to 1842 (538 males, 1304 females) Kuwait University undergraduates with a mean age = 20.42 ± 1.42. The internal consistency reliability, factor structure, and convergent validity of the EPQR-S with EPQ and NEO–FFI-3 were assessed.

Cronbach’s alpha was satisfactory for N (0.76), E (0.72), L (0.70) and low for P. (0.60). The results revealed significant gender differences in P & E with a favor for males and in N & L a favor with females. PCA showed that EPQR-S four factors explains 52.48% of the total variance. Moreover, the high correlations between the EPQR-S and EPQ scales, with coefficients of (0.92) for the N, (0.88) for the E, (0.78) for the L, and (0.76) for the P as the majority of items of the dimensions of the EPQR-S are the same with those of the EPQ. Furthermore, there were high correlations between the same scales of the EPQR-S and NEO–FFI-3, with coefficients of (0.67) for the N scales, and (0.52) for the E scales.

The findings support the psychometric properties N, E, L scales only.

No significant relationships.

Patients with severe mental illness die 10-20 younger from general population. In addition to suicide, preventable physical diseases cause most deaths. The mental illness itself and stigma keep the patients from adequate treatment for physical ilnesses.

We aimed to investigate medical consultations for inpatients with severe mental illnes.

We retrospectively evaluated medical records of patients diagnosed by schizophrenia, schizoaffective disorders, bipolar disorder, and depression between 1st Februrary 2018 and 30th January 2020. We excluded routine consultations before electroconvulsive treatment. Local ethichs committee approved the study.

Among total 475 consultations, %41.3 (n=196) was for male, and %58.7 (n=279) was for female patients. Mean age and standart deviation were 48.9 ± 13.9 for male, and 50.1 ± 13.7 for female (p>0.05). Comparing sexes oin terms of primer psychiatric diagnoses, the higher proportion was psychotic disorders for male, and for female it was mood disorders (p<0.05). The most consulted departments with percentage and number were: internal medicine %44.0 (n=209), neurology and neurosurgery %15.2 (n=72), physical medicine and rehabilitation %8.2 (n=39), dermatology %7.8 (n=37), cardiology %6.7 (n=32). We compared the proportions of consulted department between male and female. Male patients were consulted to dermatology more than female, and female patient were consulted to gynecology or urology more than male (p<0.05).

Awareness about physical diseases in paients with severe mental illness between healthcare workers, carries the potential to increase the patients’ quality of life and lifespan. For future interventions the focus should involve healthcare worker in internal medicine and neurology, as well as in psychiatry.

No significant relationships.

Adolescent online behavior is an urgent public health problem in different countries of the world due to the possibility of developing Internet addiction.

To study the prevalence of different types of online behavior and Internet addiction in Siberian adolescents, depending on gender and age.

During the period from January to May 2019, 2950 adolescents aged 11-18 years living in the urban area of Central Siberia (Krasnoyarsk) were examined, of them 1348 boys and 1602 girls. The Chen Internet Addiction Scale (CIAS) with a cut-off level of 65 points was used. Internet users are divided into three groups: Adaptive Internet Users (AIU) (27–42 points); maladaptive Internet users (MIU) (43–64 points); pathological Internet users (PIU) (score ≥ 65).

The AIU group comprised 50.3% (55.9% boys and 45.6% girls, p <0.001). The share of adolescents aged 11-14 is 52.0%, the share of adolescents aged 15-18 is 48.4% (p = 0.04). The MIU group constituted 42.9% (46.3% were girls and 38.9% boys, p <0.001). The share of adolescents aged 11-14 is 42.1%, and those aged 15-18 is 43.8%, p > 0.05. The PIU group constituted 6.8% (5.1% boys and 8.2% girls, p <0.001). The share of adolescents aged 11-14 is 5.9% and those aged 15-18 is 7.8% (p = 0.04).

Among adolescents in Central Siberia the prevalence of AIU consist 50.3%, MIU 42.9%, PIU 6.8%. The prevalence of PIU is more common in girls. The increase in PIU was marked in the older age group. The study was funded by RFBR project № 18-29-2203218.

The reported study was funded by RFBR project № 18-29-22032\18.

Poor maternal mental health during the perinatal period leads to serious complications, especially in humanitarian settings where both mothers and children have often been exposed to multiple stressful events. In those contexts, culturally relevant mental health and psychosocial interventions are required to support mother-infant dyads and ultimately to alleviate potential negative outcomes on child’s health and development.

This study aims at assessing the use of postnatal services by mothers and infants under 2 and its impact on maternal mental health.

A process evaluation of Baby Friendly Spaces (BFS) program was conducted in Nguynyel refugee camp (Ethiopia) and a prospective quantitative assessment was administered to lactating women at baseline and endline (2 months later) to measure maternal functional impairment (WHODAS 2.0), general psychological distress (Kessler scale-K6); depression symptoms (Patient Health Questionnaire-PHQ9) and post-traumatic stress symptoms (PTSD Checklist-PCL-6).

201 lactating women and their babies were enrolled between October 2018 and March 2019. Statistically significant reductions were observed in all mental health outcomes at follow-up. Total mean scores decrease by 19% (p<0.001) for general psychological distress and posttraumatic stress, by 23% (p<0.001) for the depression and by 15% (p<0.001) for the functional impairment. Examination of the compliance to the services revealed that mothers who dropped out early had statistically significantly lower depression scores (p=0.01), and functional impairment scores (p<0.001) than mothers who stayed in the program.

The integration of maternal mental health interventions within perinatal services is challenging but essential for identifying and treating maternal common mental disorders.

No significant relationships.

We present the case of a patient with schizophrenia who presents with restriction of intake, fear of gaining weight and alteration in the way of perceiving herself in which we ask ourselves if these behavioral alterations are secondary to her diagnosis of schizophrenia to an anorexia nervosa independent of previous diagnosis.

We propose to carry out a differential diagnosis of alterations in the perception of self-image in a patient with a diagnosis of schizophrenia. We suggest that these alterations may be secondary to alterations in the experience of the self present due to their psychosis.

In the differential diagnosis of the cause of alterations in self-image and fear of gaining weight, we rely on the psychiatric interview, the study of previous history and different scales: - Eating Disorders Inventory (EDI) - Gardner Body Image Assessment - Weight, body image and self-esteem scale E-PICA - IPASE scale

In this patient in whom the differential diagnosis of the cause of her dietary restrictions and weight loss is proposed, there does not seem to be any psychotic symptoms that produce these alterations.

In the alterations in self-image in those psychotic patients, there is a doubt as to whether these could be secondary to alterations in the perception of the self typical of psychotic diseases or, on the contrary, be secondary to the spectrum of Eating Disorders.

The COVID-19 pandemic and the need to fight it disrupt the balance between work and rest for health workers that can lead to a decrease in stress tolerance and emotional burnout appearance. The lifestyle and well-being of personal and family life can be both a “depletion” and a “resource” factor for health professionals when working under stressful conditions.

To study the presence/absence and severity of burnout symptoms in medical professionals in the COVID-19 pandemic context; to investigate the interaction between burnout severity and overall stress levels, family well-being, and the presence of children.

The author’s socio-demographic questionnaire, Stress Perception Questionnaire (Linville, 1987), modified Pandemic Perception Questionnaire (Broadbent et al.,2006), Maslach Burnout Inventory (Maslach et al.^1996), State-Trait Anxiety Inventory (Spielberger et al., 1983) were used. The study was conducted online from April 27 to October 26. It involved 249 medical workers, including 58 men and 191 women.

Health workers who have children show greater confidence in their professional competence(41.28±6.3vs39±7;p=0.007) and (at the trend level) have a lower level of exhaustion(34.53 ±9.2vs36.71±10.8;p=0.09) than their colleagues without children. Although health workers in both groups have approximately the same scores for perceived stress, however, those with children put less effort to counteract stress(9.31±2.5vs10.19±2.9;p=0.012). They describe the pandemic as less dangerous compared to colleagues who do not have children(15.4±5.7vs16.7±5.1;p=0.042).

Perhaps the very possibility of switching attention from a vitally dangerous topic to more positive aspects of life allows medical staff who have children to feel less exhausted and maintain faith in their own strength.

Autoimmune encephalitis (AE) refers to a newly described, heterogeneous group of rare diseases characterized by brain inflammation and circulating autoantibodies. Various AE have been described and each of them is linked to the presence of specific autoantibodies directed against synaptic and neuronal cell surface antigens. The clinical picture includes a wide array of neuropsychiatric symptoms and is correlated with the associated antibody subtype. Since pronounced psychiatric symptoms are relatively common at the onset, patients can be misdiagnosed and initially driven to psychiatric institutions, thus delaying the adequate diagnosis and management of AE.

We aim to review and summarize the psychiatric manifestations of AE that might dominate the clinical picture. We also aim to describe the clinical signs that should alert the psychiatrist to the possibility of these diagnoses.

We performed an updated review in the PubMed database using the terms “autoimmune”, “encephalitis” and “psychiatric manifestations”. The included articles were selected by title and abstract. We also consulted a reference textbook.

We summarize the reported psychiatric manifestations of AE and also include two situations that can be helpful in AE diagnosis in the psychiatric setting: symptoms that should alert the physician for the possibility of AE and symptoms that should prompt an antibody detection test.

AE are rare diseases that present very frequently with psychiatric symptoms as the first manifestation. Psychiatrists need to be aware of the most common psychiatric manifestations of AE since the early recognition and treatment of AE is fundamental for a good outcome.

Most mental disorders tend to relapse (severe or mild pathologies such as anxiety or dystima disorders), which are potentially recoverable and yet, tend to evolve poorly, persisting residual symptoms without achieving a complete recovery.

The objective of this paper is to analyze the factors that influence process of recurrence and chronification, among which are our own therapeutic interventions.

A bibliographic search was performed from different database (Pubmed, TripDatabase) about the iatrogenic potential of our intervention (psychopharmacological or psychotherapeutic), analyzing influence and mechanisms involved, and the way to prevent them.

Anxiety is a necessary element for the development of people, both from a biological perspective (natural and adaptive psychological response that allows us to respond adequately to possible threats); as an evolutionary psychological (element involved in conflict resolution, in turn necessary for personal development). It would be a mistake to consider it as pathological and try to eliminate it through medication or psychotherapy, since we could interfere with the natural recovery processes, contributing to its chronification and preventing possibility of change. At times, anxiety can be pathological when it occurs disproportionately and exceeds ability to adapt, but we must not eliminate it but to study origin and factors involved, to achieve complete resolution.

In conclusion, we must consider possible iatrogenesis of our therapeutic interventions in process of chronification of mental disorders and try to avoid them by adequately studying individual factors and characteristics, before intervening.

MIJ821 is a novel N-methyl-D-aspartate (NMDA) receptor antagonist, with a potentially low rate of the psychotomimetic side effects that limit the therapeutic utility of ketamine in treatment-refractory depression (TRD).

To assess efficacy and safety of MIJ821.

Adults with TRD (>2 prior treatment failures; Montgomery-Asberg Depression Rating Scale [MADRS], >24) were eligible and were randomized (n=70) to low versus high doses of MIJ821, with two dosing regimens of weekly or biweekly, versus ketamine versus placebo. The primary outcome was change in MADRS total score at 24 hours and final follow up was at 6 weeks.

At 24 hours, adjusted mean differences (ΔAM) versus placebo were –8.25 (p=0.001), –5.71 (p=0.019) and –5.67 (p=0.046) and at 48 h were –7.06 (p=0.013), –7.37 (p=0.013), –11.02 (p=0.019) in the pooled MIJ821 low dose, high dose, and ketamine groups, respectively. At 6 weeks, ΔAM (80% CI) versus placebo on MADRS were –6.46 (–11.8, –1.15); p=0.059 for low dose MIJ821, –5.42 (–10.8, –0.02); p=0.099) for high dose MIJ821, and –5.24 (–10.4, –0.06); p=0.097 for ketamine. Further details on dosing, efficacy, and safety outcomes will be provided.

In this proof-of-concept study, MIJ821 was effective and tolerable in TRD. This study was funded by Novartis. Clinical trial.gov: NCT03756129

Employee of Novartis.

Psychiatric emergency visits have been associated to several climate variables. However, the influence of relative humidity has been not well stablished.

The analyse the influence of relative humidity on emergency care visits.

Daily urgency visits were extracted from electronic medical records of Hospital Universitario La Paz from 1st January 2019 to 31st December 2019. Relative humidity data (%) was obtained from a local climate station. A negative binomial multivariate regression model was performed with relative humidity, weekday and month as covariates.

Relative humidity was not associated with number of psychiatric emergency department visits (IRR 1.00; 95%CI 0.99-1.00)

Relative humidity did not influence emergency help seeking for patients suffering from suicidal phenomena

No significant relationships.

Traumatic experiences has a key role on the mental health of individuals. Turkish Armed Forces has been involved in various combat in and out of the country over the years. Individuals who are able to find meaning after a negative life events are better overcome their issues and return to their positive functioning. Unhealthy attachment styles has been observed more in clinical samples than healthy attachment styles.

The aim of this study was to investigate the predictive role of attachment styles and meaning in life on psychiatric symptoms among wife of military personel who lost their lifes.

74 women who lost their husband in combat to the study. Their age was between 21 and 74, with the mean of 46.93. 60 (75.9%) participants had a child when they lost their husband. 63 (79.7%) of them hasn’t been married again. Brief Symptom Inventory, Meaning in Life Scale and Relationship Scales Questtionnare were used to collect the data. Five different regression analysis was conducted.

Finding meaning in life, dismissing and preoccupied attachment sytles predicted depression (R2= 51.8%). Finding meaning in life and fearful attachment styles predicted anxiety (R2= 46.2%). Finding meaning in life and fearful attachment styles predicted negative identity (R2= 51.1%). Finding meaning in life and dismissing attachment styles predicted hostility (R2= 50.4%) and somatization (R2= 57%).

Meaning in life has a protective role in the development of any psychopathologies whereas insecure attachment styles are risk factor.

No significant relationships.

Amnesia and palimpsests occurring and recurring in alcohol addicts due to alcohol intoxication (Ebrietas alcoholica) are accompanied by hazardous memory failures, gradual mental degradation and psychoorganic syndrome, which evidences urgent clinical, therapeutic and therapeutic issue in addictology, psychiatry, forensic medicine, sociology, medical psychology, etc. At EPA initiative (2019), research interest in non-invasive brain stimulation tools and methods for such populations was activated.

Development of a patentable method of treatment in addictology using pyracetam and nicotinic acid transcerebral electrophoresis (TCE).

Valid clinical-diagnostic, laboratory, biochemical, electrophysiological, psychological (scaling, testing), statistical methods for identification of alcohol dependence complicated by amnestic disorders.

The method of treatment of alcohol dependence complicated by amnestic disorders (Patent 141785 UA) provides complex pharmacological and drug-free therapy. Antiamnesic drugs are administered by TCE bilaterally; pyracetam 20% solution to the left orbit through active negative electrodes, and nicotinic acid 0.1% solution to the right orbit (positive electrode in the occipital fossa), current of 2-4 mA, 20-30 minutes exposure. The procedure was performed daily with a TCE device, for a 10-day course of treatment along with psychotherapeutic potentiation. TCE provides the ionic implementation of pharmacological agents in the brain and their physiological electrical stimulation.

In a representative clinical trial, using statistical methods and generated bank of patient-specific observations, significant potentiating effects of combined drug-free, non-invasive transcerebral electrical stimulation and electrophoretic implementation of pyracetam and nicotinic acid were demonstrated.

Antidepressants in older people have experienced their increase in medical prescriptions in recent decades whit comorbidity with other pathologies and drug polytherapies. With the use of antidepressants, can be observed side and unwanted effects (e.g. emotional blunting). Vortioxetine is a new antidepressant agent which promises fewer side effects.

To evaluate the clinical efficacy, safety, side effects (e.g emotional blunting) and cognitive profile

45 elderly patients affected by MDD (DSM-5) were recruited in our observational study. All patients were treated with vortioxetine for 12 months. Physiological and pathological parameters were collected at baseline (T0), after 3 months (T1), 6 months (T2); 12 months (T3). All patients were administered the following scales: GDS; MMSE; QLi; ODQ. The statistical data were processed with EZAnalyze.

33.33% of patients had a score in the “unlikely depression” GDS group. The ANOVA ODQ “Total” results indicate that at least two of the repeated measures differ significantly. Data of the “antidepressant as cause” dimension are interesting [T0 vs T3 (P-Unadjusted .000; P-Bonferroni .000; T-value 5.687. MMSE scores are indicative of one small but not significant difference. Mean QLIndex scores did not show statistically significant changes, but are indicative of positive changes from the baseline score

Vortioxetine resulted in partial reduction of depression. There was a moderate non-statistically significant increase in body weight, glycidic and lipid profiles. Overall data highlight the importance and role that vortioxetine can have in the management of depressive symptoms in elderly subjects. The handling, effectiveness and reduced side effects of the molecule are emphasized.

Establishing broad spectrum of new mental health services in whole Bosnia and Herzegovina (BH) existing mental health laws in both entities needed to be upgrade according positive results of the mental health reform in the country. Previous laws were exclusivelly oriented on protection of rights of the people with mental health disorders in (mainly) psychiatric institutions and were progressive and new in the period of their implementation (2001-2004).

Since 2010 main reform processes had direction to community mental health care and developed positive movement with implementing new services oriented to patients and their needs/continuity of care. For example case management and occupational therapy are part of daily work in whole country and standards established trough accreditation process lead to uniform approach in community work in the area of mental health.

Comparative analysis of laws in BH concerning mental health.

Carefuly and good preparation for pronounce of new Mental Health Law both in Republic of Srpska and Federation of BH were supported from both entities (task forces, drafts and proposition of the law and public discussion) and they are formaly supported in both entities parliaments in 2020 (prolonged since COVID-19 situation). In both laws is more emphasised role of commnity services, prevention, and post-hospital rehabilitation as continuity of care. Book of rules that follow the laws will be establish no longer than the end of 2020.

New mental health laws in BH are path to better protection of mental health of all population in BH and rights of our patients’ recovery.

Violence and crime committed by individuals with mental disorders has been the focus of growing interest among mental health professionals.Added to psychopathological disorders, individual, socio familial and therapeutic factors can be involved in the criminogenic risk.

To assess the characteristics of homicide in Tunisian patients with psychosis and to establish their sociodemographic, clinical and therapeutic characteristics.

We reported7cases of patients who attended Psychiatric department“A”at the Hedi Chaker university hospital in Sfax,Tunisia,between January2014 and September2019.They were hospitalized for committing homicide and penal irresponsibility was recognized.

The homicide acts were matricide in 3cases, parricide in one case and conjugal homicide in one case.The homicide was not premeditated, committed by using knife weapon in 3cases and a blunt object in 4cases.The crime was done in the family home in the majority of cases(71.42%). The average age of patients was 34years. They were in almost cases(85.71%) male. Six patients (85.71%) had very low educational and income levels. They were mostly unmarried(71.42%)and unemployed(71.42%).Alcohol consumption was observed in3patients.However, we did not found any substance use. According to DSM-5,six patients were diagnosed with schizophrenia and one case with schizoaffective disorder.The majority(85.71%) had previous psychiatric folow-up. Furthermore, interruption of treatment was the rule.Five patients had a previous record of violent behavior towards the victim.Judicial history was notified among one patient.The persecution and influence delusion were found among 6cases.

Homicidal behavior is extremely rare.Evaluation of different variables of homicide’s act and offender is a fundamental issue for developing preventive and therapeutic strategies to deal with such criminal behavior.

No significant relationships.

There is evidence that maternal perinatal depression is associated with adverse neurodevelopmental and mental health outcomes in children. No study has yet examined the association between maternal depressive symptoms during pregnancy and the postpartum period and the risk of oppositional-defiant disorder (ODD) in children and adolescents.

This study aimed to investigate whether there is an association between perinatal depressive symptoms and the risk of ODD in offspring from age 7 to 15 years.

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based prospective birth cohort study in the UK. Offspring ODD at the age of 7, 10, 13 and 15 years were assessed by using parental reports the Development and Well-Being Assessment (DAWBA). We applied Generalized Estimating Equation (GEE) modelling to examine associations across the four time points.

Maternal postnatal depressive symptoms were associated with more a two-fold increased risk of ODD overall. Third trimester depressive symptoms (measured at 32 weeks of gestation) increased risk of ODD by 72%. Offspring of mothers who had depressive symptoms both during pregnancy and in the first year of postpartum period have a four-fold increased risk of ODD over time (adjusted OR = 3.59 (1.98-6.52).

Offspring of mothers with perinatal depressive symptoms are at an increased risk of developing behavioural disorders.

During the COVID 19 epidemic, the isolation helped virtual psychoterapy sessions, not to break up therapeutic relationship in critical moments.

This paper points out the traditional setting modification and how the interpersonal relationship can affect the therapeutic dynamics.

The experience could support the possibility to design adequate plans to test possible relational potentiality/prospect to respond to the pandemic emergency. The computer screen represents a very important new and rich element as “Skype” seems to have been the most used remote support. The screen plays a filter and separation function but physically represents the related presence in a shared timeframe. It is also a “mutual mirror”, reflecting the exclusive duality and resending to “different” space and time where the therapeutic relationship acts.

In this way the “analysis room” loses its physical feature to move towards a new dimension where the subjective experience are communicated/lived/re-elaborated by the mean of shared visual, modifyng the codified space of a traditional setting.

The screen is not only a mere vehicle of verbal communication, but fully gets in “hic et nunc” in space relationship assuming however an allegoric value, that, in the individual subjective, could go really beyond its “simple” and usual technological function.

Covid-19 causes neuro/psychiatric problems by cerebral hypoxia.

My therapy could allow us to cross Covid-19 infection by minimizing both immediate and chronic lung damage and would avoid many deaths and neuro/psychiatric problems from cerebral hypoxia.

In the case of a Covid-19 lung infection, the virus infects type II alveolar cells which consequently reduce the production of pulmonary surfactant. The surfactant has the function of reducing the surface tension of the alveoli. The less pulmonary surfactant there is, the more the alveoli tend to collapse due to the increased surface tension of their surface. Consequently, the lung would tend to collapse, that is, to reduce its volume, but collapse is prevented by the muscular movement of inspiration, which instead increases its volume. This means that a “low-pressure area” is created in the interstitial space which attracts liquid and substances which are often inflammatory and which organize over time, giving rise to interstitial pneumonia.

I propose to administer the pulmonary surfactant to the patient Covid-19 in the presence of dyspnea and certainly during assisted ventilation. This technique is routinely used in preterm infants suffering from lack of pulmonary surfactant production due to the immaturity of type II alveolar cells, pending that once matured these cells produce it autonomously.

Similarly, the administration of surfactant during Covid-19 lung infection would allow the correct amount of surfactant to be maintained during the acute phase of the infection and would give time for type II alveolar cells to heal and independently resume surfactant production.

No significant relationships.