LIVIA MARIA LINDOSO LIMA

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  • article 8 Citação(ões) na Scopus
    Changes in Eating Habits and Sedentary Behavior During the COVID-19 Pandemic in Adolescents With Chronic Conditions
    (2021) MAZZOLANI, Bruna Caruso; SMAIRA, Fabiana Infante; ASTLEY, Camilla; IRAHA, Amanda Yuri; PINTO, Ana Jessica; MARQUES, Isabela Gouveia; AMARANTE, Milla Cordeiro; REZENDE, Nathalia Saffioti; SIECZKOWSKA, Sofia Mendes; FRANCO, Tathiane Christine; MIRANDA, Luana Cristina do Amaral; LINDOSO, Livia; HELITO, Alberto Carame; OBA, Jane; QUEIROZ, Ligia Bruni; PEREIRA, Rosa Maria R.; ROSCHEL, Hamilton; SILVA, Clovis Artur; GUALANO, Bruno
    Introduction: Among healthy adolescents, school closures and home confinement were shown to increase unhealthier eating habits and sedentary behavior. It remains unknown to which extent the pandemic has impacted the lifestyle of adolescents with chronic conditions. Thus, the aim of this study is to report on the impact of the COVID-19 outbreak on eating habits and sedentary behavior among adolescents with multiple chronic conditions (n = 347) from a tertiary, referral hospital vs. healthy peers.Methods: This observational study was conducted in Sao Paulo (Brazil) between July and October 2020, period in which a set of social distancing measures to contain the pandemic.Results: The main findings of this study were that adolescents with chronic conditions and health peers showed important changes in eating habits (e.g., more often cooking and eating in front of television than before quarantine). Also, 86.8% of adolescents with chronic conditions and 91.6% of healthy adolescents reported increasing screen time during pandemic. No major differences were observed between patients and controls.Conclusions: Adolescents with chronic conditions and healthy peers exposed to pandemic showed substantial changes in lifestyle, stressing the need for specific care to mitigate poor eating habits and excessive sedentary behavior for patients and healthy adolescents.
  • article 8 Citação(ões) na Scopus
    In-depth cardiovascular and pulmonary assessments in children with multisystem inflammatory syndrome after SARS-CoV-2 infection: A case series study
    (2022) ASTLEY, Camilla; PEREIRA, Maria Fernanda Badue; LIMA, Marcos Santos; BUCHPIGUEL, Carlos Alberto; CARNEIRO, Camila G.; SAPIENZA, Marcelo Tatit; LEAL, Gabriela Nunes; PRADO, Danilo Marcelo Leite do; PECANHA, Tiago; SIECZKOWSKA, Sofia Mendes; MATSUO, Olivia Mari; LINDOSO, Livia; MARQUES, Heloisa Helena; SILVA, Clovis Artur; GUALANO, Bruno
    We assessed PET-CT myocardial blood flow (MBF) using N-13 ammonia, brachial flow-mediated dilation, and cardiopulmonary exercise test in five post-discarged MIS-C survivors. None of the patients (median age: 9, range: 7-18 years; 3 females; 2 males) had preexisting pediatric chronic conditions. At the follow-up visit, two patients exhibited severe perfusion defect developed in the left ventricular cavity, suggesting extensive myocardial ischemia (MBF <2.0) and one patient showed persistent mild pericardial effusion. Others two patients demonstrated endothelial dysfunction. Nevertheless, all patients had lower predicted values in the VO2peak, VO2VAT, OUES, and O-2 Pulse (range: 35.2%-64.5%; 15.6%-38.2%; 1.0-1.3 L/min; 4-7 ml/beat), respectively. Our d suggested that previously health MIS-C patients had impaired MBF, endothelial dysfunction and lower cardiopulmonary capacity at follow-up analysis. Multidisciplinary further investigations should be conducted to reinforce these findings.
  • article 0 Citação(ões) na Scopus
    Impact of COVID-19 on physical and mental functioning in adolescents with disabilities in a sports nongovernmental organization
    (2023) LAURENTINO, Moises de Freitas; LINDOSO, Livia; ASTLEY, Camilla; LAVORATO, Sofia Simao Martins; IHARA, Bianca Pires; LIMA, Dandara Carvalho Casado de; GUALANO, Bruno; QUEIROZ, Ligia Bruni; PEREIRA, Rosa Maria Rodrigues; POLANCZYK, Guilherme Vanoni; CAMARGO, Olavo Pires de; SILVA, Clovis Artur; GRANGEIRO, Patricia Moreno
    Objective:This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0-10) vs. 5 (0-10), p=0.018] and prosocial [7 (0-10) vs. 9 (3-10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21-99) vs. 94 (67-100), p<0.001] and higher happiness scores in the PODCI scale [90 (65-100) vs. 80 (0-100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01-1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04-0.43, p=0.001) and screen time >= 3 h/day (OR=0.09; 95%CI 0.02-0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.
  • article 0 Citação(ões) na Scopus
    Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital (vol 76, e3511, 2021)
    (2022) FINK, Thais T.; MARQUES, Heloisa H. S.; GUALANO, Bruno; LINDOSO, Livia; BAIN, Vera; ASTLEY, Camilla; MARTINS, Fernanda; MATHEUS, Denise; MATSUO, Olivia M.; SUGUITA, Priscila; TRINDADE, Vitor; PAULA, Camila S. Y.; FARHAT, Sylvia C. L.; PALMEIRA, Patricia; LEAL, Gabriela N.; SUZUKI, Lisa; ODONE FILHO, Vicente; CARNEIRO-SAMPAIO, Magda; DUARTE, Alberto Jose S.; ANTONANGELO, Leila; BATISTTELLA, Linamara R.; POLANCZYK, Guilherme V.; PEREIRA, Rosa Maria R.; CARVALHO, Carlos Roberto R.; BUCHPIGUEL, Carlos A.; LATRONICO, Ana Claudia; SEELAENDER, Marilia; SILVA, Clovis Artur; PEREIRA, Maria Fernanda B.
  • article 9 Citação(ões) na Scopus
    Physical and mental health impacts during COVID-19 quarantine in adolescents with preexisting chronic immunocompromised conditions
    (2022) LINDOSO, Livia; ASTLEY, Camilla; QUEIROZ, Ligia Bruni; GUALANO, Bruno; PEREIRA, Rosa Maria Rodrigues; TANNURI, Uenis; CAMPOS, Lucia Maria Mattei de Arruda; LOURENCO, Benito; TOMA, Ricardo Katsuya; MEDEIROS, Karina; WATANABE, Andreia; GRANGEIRO, Patricia Moreno; BARROS, Vera da Penha Martellini Ferrari Rego; CASELLA, Caio Borba; FARHAT, Sylvia; POLANCZYK, Guilherme Vanoni; SILVA, Clovis Artur
    Objective: To evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions during coronavirus disease 2019 (COVID-19) quarantine. Methods: A cross-sectional study included 355 adolescents with chronic conditions and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine, and the quarantine impact on physical and mental health. The validated self-reported version of the Strengths and Difficulties Questionnaire (SDQ) was also applied. Results: The median of age [14 (10-18) vs. 15 (10-18) years, p = 0.733] and frequencies of female (61% vs. 60%, p = 0.970) were similar between adolescents with preexisting chronic conditions and healthy adolescents during quarantine of COVID-19 pandemic. The frequencies of abnormal total difficulties score of SDQ were similar in patients and controls (30% vs. 31%, p = 0.775). Logistic regression analysis showed that being female (OR = 1.965; 95% CI = 1.091-3.541, p = 0.024), fear of underlying disease activity/complication (OR = 1.009; 95%CI = 1.001-1.018, p = 0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework (OR = 0.449; 95% CI = 0.206-0.981, p = 0.045) and physical activity (OR = 0.990; 95% CI = 0.981-0.999, p = 0.030) were protective factors. Further analysis of patients with chronic immunocompromised conditions and previous diagnosis of mental disorders (9%) compared with patients without diagnosis showed higher median of total difficulties score (p = 0.001), emotional (p = 0.005), conduct (p = 0.007), peer problems (p = 0.001) and hyperactivity (p = 0.034) in the former group. Conclusion: Adolescents with preexisting chronic immunocompromised conditions during COVID-19 quarantine were not at higher risk of adverse health indicators. Being female, fear of underlying disease activity/complication, and household members working outside of the home were relevant issues for adolescents with preexisting chronic conditions. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during the pandemic. (C) 2021 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Pediatria.
  • article 6 Citação(ões) na Scopus
    Home-based exercise program for adolescents with juvenile dermatomyositis quarantined during COVID-19 pandemic: a mixed methods study
    (2021) ASTLEY, Camilla; SIECZKOWSKA, Sofia Mendes; MARQUES, Isabela Gouveia; IHARA, Bianca Pires; LINDOSO, Livia; LAVORATO, Sofia Simao Martins; CAMPOS, Lucia Maria Arruda; PEREIRA, Rosa Maria Rodrigues; ELIAS, Adriana Maluf; AIKAWA, Nadia Emi; KOZU, Katia; IRAHA, Amanda Yuri; FRANCO, Tathiane Christine; ROSCHEL, Hamilton; QUEIROZ, Ligia Bruni; POLANCZYK, Guilherme Vanoni; SILVA, Clovis Artur; GUALANO, Bruno
    Background Exercise has been suggested to prevent deterioration of health-related quality of life (HRQL) and overall health in pediatric rheumatologic diseases during the COVID-19 pandemic. Herein we describe the effects of a 12-week, home-based, exercise program on overall health and quality of life among quarantined patients with juvenile dermatomyositis (JDM). Method This prospective, quasi-experimental, mixed methods (qualitative and quantitative) study was conducted between July and December 2020, during the most restricted period of COVID-19 pandemic in Brazil. The home-based exercise program consisted of a 12-week, three-times-a-week, aerobic and strengthening (bodyweight) training program. Qualitative data were systematically evaluated. Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory (PedsQOL) and Pittsburgh Sleep Quality Index (PSQI) evaluate symptoms of mental health disorder, HRQL, and quality of sleep. Findings 11 patients (out of 27) met the inclusion criteria (91% female; mean +/- SD age: 13.5 +/- 3.2 years). Adherence to the intervention was 72.6%. Barriers to exercise involved poor internet connectivity, excessive weekly sessions, and other commitments. Even though not statistically significant, Self-report SDQ subscales Total Difficulties Score, Emotional Problems Score, and PedsQOL School Functioning Score improved after intervention (- 2.4; 95%confidence interval [CI] -5.1; 0.2, p = 0.06; - 1.0; 95%CI -2.2; 0.2, p = 0.09 and; 11.7; 95%CI -2.5; 25.8, p = 0.09, respectively). Remaining SDQ subscales were not altered. Six themes emerged from patients' and parents' comments (qualitative results). Patients engaged in exercise reported other health-related benefits including increased motivation, concentration and strength. Interpretation A home-based exercise program was associated with qualitative perceptions of improvements in overall health and HRQL by quarantined adolescents with JDM during COVID-19 pandemic. Lessons from this trial may help developing interventions focused on tackling physical inactivity in JDM.
  • article 30 Citação(ões) na Scopus
    Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
    (2021) FINK, Thais T.; MARQUES, Heloisa H. S.; GUALANO, Bruno; LINDOSO, Livia; BAIN, Vera; ASTLEY, Camilla; MARTINS, Fernanda; MATHEUS, Denise; MATSUO, Olivia M.; SUGUITA, Priscila; TRINDADE, Vitor; PAULA, Camila S. Y.; FARHAT, Sylvia C. L.; PALMEIRA, Patricia; LEAL, Gabriela N.; SUZUKI, Lisa; ODONE FILHO, Vicente; CARNEIRO-SAMPAIO, Magda; DUARTE, Alberto Jose S.; ANTONANGELO, Leila; BATISTTELLA, Linamara R.; V, Guilherme Polanczyk; PEREIRA, Rosa Maria R.; CARVALHO, Carlos Roberto R.; BUCHPIGUEL, Carlos A.; XAVIER, Ana Claudia L.; SEELAENDER, Marilia; SILVA, Clovis Artur; PEREIRA, Maria Fernanda B.
    OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
  • article 14 Citação(ões) na Scopus
    A home-based exercise program during COVID-19 pandemic: Perceptions and acceptability of juvenile systemic lupus erythematosus and juvenile idiopathic arthritis adolescents.
    (2022) SIECZKOWSKA, Sofia Mendes; ASTLEY, Camilla; MARQUES, Isabela Gouveia; IRAHA, Amanda Yuri; FRANCO, Tathiane Christine; IHARA, Bianca Pires; LAVORATO, Sofia Simao Martins; LINDOSO, Livia; SETOUE, Debora Narumi Demitrol; TANIGAVA, Nicolas Yamada; CAMPOS, Lucia Maria Arruda; PEREIRA, Rosa Maria Rodrigues; AIKAWA, Nadia Emi; ROSCHEL, Hamilton; QUEIROZ, Ligia Bruni; V, Guilherme Polanczyk; SILVA, Clovis Artur; GUALANO, Bruno
    Objectives To investigate the perceptions and acceptability of a home-based exercise intervention in systemic lupus erythematosus (JSLE) and juvenile idiopathic arthritis (JIA) adolescent patients during the COVID-19 pandemic, and to explore the effects of the intervention on health-related quality of life (HRQoL), sleep quality, and mental health conditions parameters. Methods This was a randomized controlled trial of a 12-week, home-based exercise training program conducted between October and December 2020. During this period, social distancing measures were in place in Brazil to contain the spread of COVID-19. Adolescent patients diagnosed with JSLE and JIA participated in the study. Health-related qualitative and quantitative data were collected before and after the follow-up. Results 21 JSLE patients and 30 JIA patients were analyzed. Six themes emerged from patients' feedback: 1) Suitability of the home-based format; 2) Appropriate trainer supervision, 3) Motivators and facilitators for the program; 4) Barriers to the program; 5) Health benefits; 6) Patients' suggestions to improve the program. Overall, data indicated that the intervention showed good acceptability and elicited improvements in the perceived HRQoL and fatigue in JIA and JSLE patients during the pandemic. However, further quantitative analyses with validated HRQoL, sleep quality, and mental health conditions instruments did not capture these benefits (p>0.05). Conclusion Our main findings based on in-depth qualitative assessments suggest that a home-based exercise training program was suitable and well-accepted by adolescents with JSLE and JIA during the COVID-19 pandemic. Nonetheless, adherence was not high, particularly among JIA patients, suggesting that facilitators and barriers identified in the current study should be explored to improve the quality of new home-based exercise programs implementation, particularly in a future emerging crisis.
  • article 0 Citação(ões) na Scopus
    Impaired cardiorespiratory fitness and endothelial function after SARS-CoV-2 infection in a sample of mainly immunocompromised youth
    (2023) ASTLEY, Camilla; PRADO, Danilo Marcelo Leite do; SIECZKOWSKA, Sofia Mendes; ESTEVES, Gabriel P.; SUGUITA, Priscila; FINK, Thais; LINDOSO, Livia; MATSUO, Olivia; MARTINS, Fernanda; BAIN, Vera; PEREIRA, Maria Fernanda Badue; MARQUES, Heloisa Helena; MALLUF, Adriana; LEAL, Gabriela Nunes; SILVA, Clovis Artur; ROSCHEL, Hamilton; GUALANO, Bruno
    This study aimed to compare cardiopulmonary fitness and endothelial function 6 months after hospital diagnosis in a sample mainly comprising immunocompromised patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection versus noninfected controls. Youth (n = 30; age: 14 yr; 60% females) with confirmed SARS-CoV-2 seen in a tertiary hospital of Sao Paulo, Brazil, were matched by propensity score based on BMI, age, sex, and pre-existing diseases with a control group who had not been tested positive for SARS-CoV-2 infection (n = 30; age: 15 yr; 50% females). Cardiopulmonary fitness (by means of a cardiopulmonary exercise test: CPET) and brachial flow-mediated dilation (%b-FMD) were assessed 3-6 mo after diagnosis. Patients were matched by propensity score based on BMI, age, sex and pre-existing diseases, if any, with a control group who had not been tested positive for SARS-CoV-2. Compared with controls, patients with COVID-19 showed reduced ventilatory anaerobic threshold (VAT) and peak exercise time and minute ventilation/maximum voluntary ventilation (V_E/MVV) (all P < 0.01). Brachial endothelial function variables were all adjusted for body surface area (BSA). Patients with COVID-19 had decreased %b-FMD (3.6 vs. 5.4; P = 0.03) mean and positive flow (P = 0.02 and P = 0.03, respectively) versus controls. Adjusted linear regression models exploring associations between CPET variables, %b-FMD and the potential predictors post-COVID-19 syndrome, number of symptoms, hospitalization, and COVID severity did not detect significant associations, except for total shear rate in hospitalization (coefficient: -65.07 [95%CI -119.5;-10.5], P = 0.02). Immunocompromised and previously healthy children and adolescents with COVID-19 presented with impaired exercise capacity and endothelial dysfunction when compared with their noninfected counterparts, but the mechanisms remain unknown.