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Abstract Anxiety and depression are prevalent mental disorders around the world. The etiology of both diseases is multifactorial, involving biological and psychological issues. The COVID-19 pandemic settled in 2020 and culminated in several changes in the routine of individuals around the world, affecting mental health. People infected with COVID-19 are at greater risk of developing anxiety and depression, and individuals previously affected by these disorders have worsened the condition. In addition, individuals diagnosed with anxiety or depression before being affected by COVID-19 developed the severe illness at higher rates than individuals without mental disorders. This harmful cycle involves several mechanisms, including systemic hyper-inflammation and neuroinflammation. Furthermore, the context of the pandemic and some previous psychosocial factors can aggravate or trigger anxiety and depression. Disorders are also risks for a more severe picture of COVID-19. This review discusses research on a scientific basis, which brings evidence on biopsychosocial factors from COVID-19 and the context of the pandemic involved in anxiety and depression disorders.

Neuroinflammation is closely related to the development of depression, since the latter is caused, among other factors, by inflammatory processes, mainly related to the activation of microglia and expression of specific genes, which occurs during the neuroinflammatory process. Thus, COVID-19 is an important risk factor for the development of depression, since in addition to generating the feeling of stress, which also increases the activity of the immune system, it is also the cause of pathological processes and physiological ones that lead to the development of neuroinflammation, microglial activation, gene expression dysfunction and decreased concentration of available serotonin. That said, drugs are being used to combat COVID-19 to reduce the oxidative stress presented in the disease. Thus, tramadol and fluoxetine are highlighted as drugs used, however, although they present some positive results, such as the reduction of pro-inflammatory cytokines, they are also associated with negative effects such as dependence, pulmonary, cardiac and brain impairment. From this, the purinergic system is highlighted in the literature as a possible therapeutic target. This is because its mechanisms are related to the regulation of microglia, astrocytes and the physiology of important neurotransmitters and hormones. Added to this, there is a modulation of inflammatory activity, especially with regard to the P2X7 receptors of this system. The latter is an important target for the treatment of depression and COVID-19, since positive results were obtained through the genetic exclusion of this receptor and the use of selective antagonists.

COVID-19 is associated with oxidative stress, peripheral hyper inflammation, and neuroinflammation, especially in individuals with a more severe form of the disease. Some studies provide evidence on the onset or exacerbation of major depressive disorder (MDD), among other psychiatric disorders due to COVID-19. Oxidative stress and neuroinflammation are associated conditions, especially in the more severe form of MDD and in refractoriness to available therapeutic strategies. Inflammatory cytokines in the COVID-19 hyper inflammation process can activate the hypothalamic-pituitary-adrenal (HPA) axis and the indoleamine-2,3-dioxygenase (IDO) enzyme. IDO activation can reduce tryptophan and increase toxic metabolites of the kynurenine pathway, which increases glial activation, neuroinflammation, toxicity, and neuronal death. This review surveyed a number of studies and analyzed the mechanisms of oxidative stress, inflammation, and neuroinflammation involved in COVID-19 and depression. Finally, the importance of more protocols that can help elucidate the interaction between these mechanisms underlying COVID-19 and MDD and the possible therapeutic strategies involved in the interaction of these mechanisms are highlighted.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has significantly impacted the world and has driven many researchers into the pathophysiology of COVID-19. In the findings, there is a close association between purinergic signaling and the immune response. Then, this study aimed to evaluate alterations in the purinergic signaling in COVID-19 patients according to range severity. We divided the COVID-19 patients into moderate and severe cases following the guideless of NIH and WHO, together with clinical characteristics. The blood samples were collected to obtain PBMCs and platelets. We analyzed the ectonucleotidase activities through ATP, ADP, AMP, Ado hydrolysis, E-NTPDase1 (CD39), and 5'-NT (CD73) expression by flow cytometry in total leukocytes. The extracellular ATP was measured by bioluminescence, and cytokines were analyzed by flow cytometry. We observed a decrease in ATP hydrolysis and increased AMP hydrolysis in PBMCs for both groups. In severe cases, ATP hydrolysis was raised for the platelets, while ADP and AMP hydrolysis have risen significantly in both groups. Additionally, there was a significant increase in ADP hydrolysis in severe cases compared to moderate cases. In addition, we observed an increase in the ADA activity in platelets of moderate patients. Moderate and severe cases showed increased expression of CD39 and CD73 in total leukocytes. To finalize the purinergic signaling, extracellular ATP was increased in both groups. Furthermore, there was an increase in IL-2, IL-6, IL-10, and IL-17 in moderate and severe groups. Thus, for the first time, our findings confirm the changes in purinergic signaling and immune response in COVID-19, in addition to making it more evident that the severity range directly impacts these changes. Therefore, the therapeutic potential of the purinergic system must be highlighted and studied as a possible target for the treatment of SARS-CoV-2 disease. KEY MESSAGES: COVID-19 patients exhibit alterations in purinergic system and immune response. High levels of extracellular ATP lead to different inflammatory responses. CD39 and CD73 expression were increased in COVID-19 patients. Cytokines IL-2, IL-6, IL-10, and IL-17 also were altered in these patients. The purinergic system may be a possibility target to SARS-CoV-2 treatments.

Major depressive disorder (MDD) etiology is still not completely understood, and many individuals resist the traditional treatments. Chronic exposure to stressful events can contribute to development and progression and be involved in biological changes underlying MDD. Among the biological mechanisms involved, inflammatory changes and oxidative balance are associated with MDD pathophysiology. Quetiapine, a second-generation antipsychotic, induces a better therapeutic response in individuals refractory to traditional treatments. The main objectives of this research were: To evaluate the effect of chronic mild stress (CMS) on depressive-like behaviors, oxidative stress, and inflammation in adult rats; to evaluate the possible antidepressant, antioxidant and anti-inflammatory effects of quetiapine. The animals were submitted to CMS protocols. At the end of the CMS, the animals were submitted to a chronic treatment for 14 days with the following drugs: quetiapine, imipramine, and escitalopram. At the end of the treatments, the animals were evaluated in the open field tests, anhedonia (splash test), and forced swimming. The animals were euthanized after the behavioral tests, and serum samples were collected. Myeloperoxidase (MPO) activity and interleukin-6 levels were analyzed. CMS induced an increase in depressive-like behaviors, and quetiapine significantly reduced these behaviors. MPO activity and IL-6 levels increased in the serum of animals submitted to CMS. Quetiapine significantly reduced MPO activity and IL-6 levels. These results corroborate other evidence, indicating that chronic stress is a relevant phenomenon in the etiology of depression and suggesting that quetiapine induces an antidepressant effect because it reduces oxidative and inflammatory mechanisms.

A idade da populacao vem aumentando de forma relevante no mundo e no Brasil. Com o aumento da idade da populacao, aumentam tambem as preocupacoes e cuidados com relacao aos riscos de suicidio, associados a fatores biopsicossociais envolvidos no avanco da idade. Este estudo teve como objetivo avaliar a prevalencia do risco de suicidio em uma populacao entre 60 e 79 anos. Metodo: Estudo transversal com base de dados populacionais, que avaliou 1.021 idosos. Foram realizadas entrevistas domiciliares com a versao em portugues do Mini International Neropsychiatric Interview (MINI), bem como coleta de dados sociodemograficos e clinicos. O risco foi classificado em ausente ou presente, e ainda em leve, moderado ou grave. Resultados: O risco de suicidio foi classificado como presente em 26 individuos (2,5% da amostra), 22 tinham risco leve e 4 foram classificados como risco moderado. A media de idade dos pacientes que apresentavam risco de suicidio foi superior ao dos que nao apresentavam. Os fatores de risco encontrados foram nao ter companheiro, transtorno de humor, ex-tabagista, comparado com quem nunca fumou, sendo que o tabagismo atual nao foi fator de risco. Nao tiveram associacao com risco de suicidio: genero, escolaridade, hipertensao arterial sistemica e infarto agudo do miocardio, colesterol total e transtorno de ansiedade. Conclusoes: Os dados demonstram que o risco de suicidio em idosos da comunidade e expressivo e esta em consonância com resultados de outras pesquisas no Brasil e sul do Brasil. O risco aumenta com a idade, ausencia de companheiro e transtorno de humor, corroborando dados da literatura cientifica nacional e internacional.

Major depressive disorder (MDD) is one of the disorders that most causes disability and affects about 265 million people worldwide, according to the World Health Organization (WHO). Chronic stress is one of the most prevalent factors that trigger MDD. Among the most relevant biological mechanisms that mediate stress and MDD are changes in the hypothalamic-pituitary-adrenal (HPA) axis function. Hypercortisolism is one of the relevant mechanisms involved in response to stress and is present in many people with MDD and in animals subjected to stress in the laboratory. This study aimed to investigate the levels of stress and cortisol in individuals diagnosed with MDD from the Basic Health Unit (BHU) in a small city in the western region of Santa Catarina, Brazil. Depression scores were assessed using Beck's inventory. For the investigation of stress, an adaptation with twenty-four questions of the Checklist-90-R manual was performed. The analysis of the cortisol levels in the individuals' serum was by the chemiluminescence method. Depression and stress scores were significantly higher in individuals with MDD than in control subjects (p < 0.001). Cortisol levels were also significantly higher in individuals with MDD (p < 0.05). Besides, depression scores were positively correlated with stress scores in individuals with MDD (Pearson's “r” = 0.70). Conclusion: Individuals with MDD had higher stress levels and cortisol than control subjects. The positive correlation between the levels of stress and depression in MDD individuals suggests that these conditions are related to a dysregulation of the HPA axis function.

The Aedes aegypti is the main vector of the transmission of diseases such as dengue, yellow fever, Chikungunya, and Zika. The agents used for the control of mosquito involve the use of synthetic compounds, which may cause toxicity and contamination environmental. Aiming to test the effectiveness of natural products, the aim of this study was to evaluate the larvicidal and repellent activity of extracts of Ateleia glazioveana Baill. (timbó) and essential oil of Ocimum basilicum L. (manjericão), against A. aegypti. The activities of hydroalcoholic (HEA) and dichloromethane (DEA) extracts from A. glazioveana against A. aegypti larvae were assessed after exposure for 24, 48, and 72 h, using water and Bacillus thuringiensis israelensis as negative and positive controls, respectively. For repellent evaluation, we investigated the sting attempts of A. aegypti in response to the application of HEA- and DEA-based body creams (5%), as well as an alcoholic spray based on the essential oil from O. basilicum. The repellency of these preparations was compared with negative (vehicle) and positive (DEET) controls. Although HEA showed no apparent larvicidal activity, DEA at concentrations of 150 to 500 mg/ml showed high larvicidal potential after 24 h, compared to the negative control group (p < 0.001). Moreover, the DEA-based cream and the alcoholic spray of O. basilicum based essential oil showed higher repellency compared with the vehicle (84.5% and 70.5%, respectively). Accordingly, it is possible to infer that extracts and preparations of A. glazioveana and O. basilicum exhibit larvicidal and repellent activity against A. aegypti. Aedes aegypti es el principal vector de transmisión de enfermedades como el dengue, la fiebre amarilla, el chikungunya y el zika. Los agentes utilizados para el control de mosquitos involucran el uso de compuestos sintéticos, sin embargo, estos pueden causar toxicidad y contaminación ambiental. Con el objetivo de probar la eficacia de los productos naturales, el objetivo de este estudio fue evaluar la actividad larvicida y repelente de los extractos de Ateleia glazioveana Baill. (timbó) y aceite esencial de Ocimum basilicum L. (mangericão), contra A. aegypti. Se evaluaron las actividades de los extractos hidroalcohólicos (HEA) y diclorometano (DEA) de A. glazioveana después de la exposición durante 24, 48 y 72 h, utilizando agua y Bacillus thuringiensis israelensis como controles negativos y positivos, respectivamente. Para la evaluación del repelente, se investigaron los intentos de picar A. aegypti en respuesta a la aplicación de cremas corporales a base de HEA y DEA (5%) y un spray alcohólico a base de aceite esencial de O. basilicum. La repelencia de estas preparaciones se comparó con controles negativos (vehículo) y positivos (DEET). Aunque HEA no mostró actividad larvicida aparente, DEA en concentraciones de 150 a 500 µg/ml mostró un alto potencial larvicida después de 24 h, en comparación con el grupo de control negativo (p < 0,001). Además, la crema a base de DEA y el spray de aceite esencial alcohólico a base de O. basilicum mostraron mayor repelencia en relación al vehículo (84,5% y 70,5%, respectivamente). Así, es posible inferir que los extractos y preparaciones de A. glazioveana y O. basilicum exhiben actividad larvicida y repelente contra A. aegypti. O Aedes aegypti é o principal vetor de transmissão de doenças como dengue, febre amarela, Chikungunya e Zika. Os agentes utilizados para o controle do mosquito envolvem o uso de compostos sintéticos contudo, estes podem causar toxicidade e contaminação ambiental. Visando testar a efetividade de produtos naturais, o objetivo deste estudo foi avaliar a atividade larvicida e repelente dos extratos de Ateleia glazioveana Baill. (timbó) e óleo essencial de Ocimum basilicum L. (manjericão), frente ao A. aegypti. As atividades dos extratos hidroalcoólico (HEA) e diclorometano (DEA) de A. glazioveana foram avaliadas após exposição por 24, 48 e 72 h, utilizando água e Bacillus thuringiensis israelensis como controle negativo e positivo, respectivamente. Para avaliação repelente, foi investigado as tentativas de picadas de A. aegypti em resposta à aplicação de cremes corporais à base de HEA e DEA (5%), além de um spray alcoólico à base de óleo essencial de O. basilicum. A repelência dessas preparações foi comparada com os controles negativo (veículo) e positivo (DEET). Embora HEA não tenha demonstrado atividade larvicida aparente, DEA nas concentrações de 150 a 500 mg/ml apresentou elevado potencial larvicida após 24 h, em comparação com o grupo de controle negativo (p < 0,001). Além disso, o creme à base de DEA e o spray alcoólico de óleo essencial à base de O. basilicum apresentaram maior repelência em relação ao veículo (84,5% e 70,5%, respectivamente). Assim, é possível inferir que extratos e preparações de A. glazioveana e O. basilicum exibem atividade larvicida e repelente frente A. aegypti.

Após a publicação da Política Nacional de Práticas Integrativas e Complementares, surge a necessidade de se criarem espaços de diálogo e divulgação das terapias holísticas para a implantação da referida política. Este trabalho relata uma experiência de extensão de atendimento com Medicina Tradicional Chinesa em uma unidade do SUS. Pelos resultados obtidos até o presente momento, pode-se inferir que a inserção das TIC, de forma contínua, nos serviços de atenção básica do SUS, pode ser importante ferramenta para o aumento do bem estar e da qualidade de vida dos usuários atendidos, contribuindo diretamente para as estratégias de promoção de saúde.