Caracterización epidemiológica de pacientes con COVID-19 en la Región Sanitaria de Francisco Morazán, Honduras / Epidemiological characterization of patients with COVID-19 in the Sanitary Region of Francisco Morazán, Honduras

Antecedentes: La infección por el virus SARS- CoV-2 causa la enfermedad por coronavirus 2019 ( COVID-19). Objetivo: Caracterizar epidemiológicamente al paciente con COVID-19, Región Sanitaria Departamental de Francisco Morazán (RSDFM), Honduras, marzo 2020-enero 2021. Métodos: Estudio descriptivo retrospectivo. Incluyó n=11,401 usuarios a quienes se les realizó confirmación diagnóstica en la RSDFM. Se calculó incidencia general y mensual de COVID-19 como tasas por 10,000 habitantes, tasas de incidencia municipal (casos positivos/10,000) y tasa de letalidad (fallecidos/100 casos positivos). Resultados: Del total de 3,680 usuarios, el promedio de edad de los casos positivos fue 36.8 años (DS+/-17.9); sexo femenino 53.3% (1,962), procedencia Valle de Ángeles 20.4% (752). El nexo epidemiológico fue contacto con familiar o amigo positivo o fallecido por COVID-19 en 96.3% (3,544). La tasa general de incidencia fue 92.4/10,000. El municipio de Valle de Ángeles presentó la tasa de incidencia más elevada 366.1/10,000. La tasa de letalidad fue 1.8% (68/3680). Discusión: Los hallazgos de este estudio son compatibles con otros autores con respecto a las características epidemiológicas y sintomatología, identificando mayor riesgo de mortalidad en los individuos con edad ≥60 años (35/418 vs <60 años 32/3194; p=0.000, OR: 8.60, IC95%: 5.15-14.37), así como para el sexo masculino (48/1670 vs 20/1942; p=0.000, OR:2.79, IC95%: 1.61- 4.89). Los meses de mayor incidencia de casos en la RSDFM fueron los meses de junio a julio del 2020 y diciembre del 2020 a enero del 2021. Estudios de este tipo fortalecen el abordaje epidemiológico de las epidemias/pandemias...(AU)

Uso de métodos contraceptivos durante a pandemia da COVID-19 / Use of contraceptive methods during the COVID-19 pandemic

Objetivo: Análise do uso de métodos contraceptivos no período da pandemia. Método: Trata-se de um estudo transversal, descritivo, exploratório, aprovado pelo Comitê de Ética em Pesquisa envolvendo Seres Humanos (número 3.146.657). Foram entrevistadas via chamada telefônicas colaboradoras que retiraram contraceptivos em 01/01/2020 à 30/07/2020, excluídas os menores de 18 anos de idade; cadastro incompleto e residência fora da área de abrangência da Unidade Básica de Saúde Aquiles Stenghel (Londrina ­ Paraná). Resultados: Elaboraram-se tabelas descritivas com as respostas obtidas. Notou-se que quatro colaboradoras não usavam nenhum contraceptivo no momento da entrevista, e oito haviam trocado de métodos contraceptivos. Todas referiram conhecer pelo menos um contraceptivo e tê-lo utilizado em algum momento. Conclusão: O anticoncepcional injetável, apesar dos efeitos indesejáveis mencionados, continuou sendo o mais usado por entre a maioria delas, e observou-se um desuso da camisinha. Ficou evidente a necessidade de ampliar o olhar para as especificidades das mulheres, em especial as que estão em contexto de vulnerabilidades.(AU)

Objective: Analyze the use of contraceptive methods during the pandemic. Method: This is a cross-sectional, descriptive, exploratory study, approved by the Ethics Committee for Research involving Human Beings (number 3,146,657). Women, who collected contraceptives in the period between 01/01/2020 to 07/30/2020, over 18 years old, with complete registration and resident in the coverage area of the Basic Health Unit Aquiles Stenghel (Londrina ­ Paraná) were interviewed by the researchers by telephone. Results: Descriptive tables were created with the interview responses obtained. It was noted that four collaborators were not using any contraceptive at the time of the interview, and eight had changed contraceptive methods. All participants reported being familiar with at least one contraceptive and having used it at some point. Conclusion: Injectable contraceptives, despite the aforementioned undesirable effects, continued to be the most widely used method among the participants, and there was a lack of use of condoms. It is evident that women especially those who are in a vulnerability context need a bit more of pharmacy assistance in order to guarantee correct contraceptives use and its efficiency.(AU)

Objetivo: Análisis del uso de métodos anticonceptivos durante la pandemia. Método: Estudio transversal, descriptivo y exploratorio, aprobado por el Comité de Ética para la Investigación con Seres Humanos (número 3.146.657). Se entrevistó por llamada telefónica a mujeres que tomaron anticonceptivos entre el 01/01/2020 y el 30/07/2020; no se incluyeron menores de 18 años; registro incompleto y residencia fuera de la zona de captación de la Unidad Básica de Salud Aquiles Stenghel (Londrina ­ Paraná). Resultados: Con las respuestas obtenidas se elaboraron tablas descriptivas. Se observó que cuatro colaboradoras no utilizaban ningún anticonceptivo en el momento de la entrevista y ocho habían cambiado de método anticonceptivo. Todas declararon conocer al menos un anticonceptivo y haberlo utilizado en algún momento. Conclusión: El anticonceptivo inyectable, a pesar de los efectos indeseables mencionados, siguió siendo el más utilizado entre la mayoría de las colaboradoras, y se observó desuso del preservativo. Se puso de manifiesto la necesidad de profundizar en las particularidades de las mujeres, especialmente las que se encuentran en contextos vulnerables.(AU)

Surto de microorganismos em unidade hospitalar em época de pandemia da covid-19 / Outbreak of microorganisms in a hospital unit during the covid-19 pandemic / Estallido de microorganismos em uma unidad hospitalaria durante la pandemia covid-19

Objetivo: quantificar e investigar casos de microrganismos durante o primeiro ano da pandemia da COVID-19, em hospital da região sul do Brasil, referência para tratamento de sintomáticos da doença e, analisar os desfechos das infecções pelos microrganismos estudados. Métodos: estudo transversal realizado em unidade hospitalar de ensino da região dos Campos Gerais - Paraná. Analisouse os exames de cultura positivas coletadas após 48 horas de internação dos pacientes, juntamente com o perfil de sensibilidade destes microrganismos. Os dados correspondem ao período entre janeiro de 2020 a janeiro de 2021 e foram analisados descritivamente segundo microrganismo, sensibilidade e óbitos. Resultados: houve crescimento na detecção de microrganismos no intervalo de agosto/20 e janeiro/21, correspondente ao período pandêmico da COVID-19. Os microrganismos mais frequentes foram Klebsiella pneumoniae, Staphylococcus aureus e Escherichia coli. Também observou-se maior frequência de óbitos por infecções relacionadas à assistência à saúde nas unidades de terapia intensiva no mesmo período. Conclusão: verificou-se aumento da incidência de microrganismos associados a infecções relacionadas à assistência à saúde em paralelo ao crescimento da pandemia na região estudada e, uma maior frequência de óbitos por infecções relacionadas à assistência à saúde na ala de atendimento exclusivo COVID-19. (AU)

Objective: to quantify and investigate microorganisms associated with hospital healthcare-associated infections during the first year of the COVID-19 pandemic and analyze their outcomes. Methods: cross-sectional study carried out in a teaching hospital in the Campos Gerais region ­ Paraná. Positive culture tests collected after 48 hours of patient admission were analyzed, along with the sensitivity profile of these microorganisms. The data correspond to the period from January 2020 to January 2021 and were analyzed descriptively according to microorganism, sensitivity and deaths. Results: there was an increase in the detection of microorganisms in the interval from August 2020 and January 2021, corresponding to the COVID-19 pandemic period. The most frequent microorganisms were Klebsiella pneumoniae, Staphylococcus aureus, and Escherichia coli. There was also a higher frequency of deaths due to healthcare-associated infections in intensive care units in the same period. Conclusion: there was an increase in the incidence of microorganisms associated with healthcare-associated infections in parallel with the growth of the pandemic in the studied region and a higher frequency of deaths from healthcare-associated infections in the exclusive care ward for COVID-19. (AU)

Objetivo: cuantificar e investigar microorganismos asociados a las infecciones relacionadas con la asistencia sanitaria durante el primer año de la pandemia de COVID-19 y analizar sus resultados. Métodos: estudio transversal realizado en un hospital universitario de la región de Campos Gerais ­ Paraná. Se analizaron las pruebas de cultivo positivas recogidas 48 horas después del ingreso de los pacientes, junto con el perfil de sensibilidad de estos microorganismos. Los datos corresponden al período comprendido entre enero de 2020 y enero de 2021 y se analizaron descriptivamente según microorganismo, sensibilidad y muertes. Resultados: hubo un aumento en la detección de microorganismos en el intervalo entre agosto de 2020 y enero de 2021, correspondiente al período pandémico de COVID-19. Los microorganismos más frecuentes fueron Klebsiella pneumoniae, Staphylococcus aureus y Escherichia coli. También se notó una mayor frecuencia de muertes por infecciones asociadas a la asistencia sanitaria en unidades de cuidados intensivos en el mismo período. Conclusión: se observó un aumento en la incidencia de microorganismos asociados a las infecciones relacionadas con la asistencia sanitaria en paralelo con el crecimiento de la pandemia en la región estudiada y una mayor frecuencia de muertes por infecciones relacionadas con la asistencia sanitaria en el sector de atención exclusiva de COVID-19. (AU)

Estrés laboral y salud mental del personal de primera línea en la atención de la COVID-19 / Occupational stress and mental health on frontline healthcare workers during COVID-19 pandemic

El estrés laboral significó un riesgo importante para la presencia de alteraciones de salud mental en trabajadores de salud, durante la pandemia de Coronavirus 2019. Objetivo. Determinar la relación del nivel de estrés laboral y salud mental en el personal asignado en primera línea de atención contra el COVID-19. Metodología. Se realizó un estudio transversal analítico en las áreas de emergencias y hospitalización del Hospital Nacional San Juan de Dios de San Miguel, de septiembre a diciembre de 2020. Participaron en total 121 trabajadores. Se utilizaron las escalas de estrés laboral de la Organización Internacional del Trabajo y la escala de Gilbert abreviada. El análisis de correlación de variables se realizó por el coeficiente de Spearman. Resultados. El 59,5 % de los estudiados son mujeres y el 44,6 % era personal de enfermería. El 89,3 % tenía bajo nivel de estrés y 79,3 % nivel intermedio de alteración en salud mental con predominio de ansiedad (51,2 %), sobre depresión (8,3 %) en enfermeras y personal de servicios generales entre 21 a 40 años. El análisis de la correlación Spearman determinó una correlación positiva entre el estrés laboral y la presencia de alteración de salud mental (R2 0,218; p = 0,016) en el personal de primera línea. Conclusión. El estudio demostró un nivel de estrés laboral bajo e intermedio en salud mental; con relación positiva, lo que significa que el aumento de estrés puede favorecer la presencia de alteraciones al estado de salud mental del trabajador

Occupational stress posed a relevant risk for mental health disturbances in healthcare workers during the 2019 Coronavirus pandemic. Objective. To determine the relationship between the level of occupational stress and mental health in front-line healthcare personnel against COVID-19. Methodology. An analytical cross-sectional study was carried out in the emergency and hospitalization areas of the San Juan de Dios National Hospital in San Miguel, from September to December 2020. A total of 121 workers participated. The occupational stress scales of the International Labor Organization and the abbreviated Goldberg scale were used. Variable correlation analysis was performed using Spearman's coefficient. Results. 59.5 % were female and 44.6 % were the nursing staff. 89.3 % had a low level of stress and 79.3 % had an intermediate level of alteration in mental health with a predominance of anxiety (51.2 %) over depression (8.3 %) in nurses and general services personnel between 21 and 40 years. The analysis of the Spearman correlation determined a positive correlation between occupational stress and mental health disorders (R2 0.218; p = 0.016) in workers. Conclusion. The study showed a low and intermediate level of occupational stress in mental health; with a positive correlation, which means that the increase in stress can favor the presence of alterations in the mental health status of the worker

Antimalarials and macrolides: a review of off-label pharmacotherapies during the first wave of the SARS-CoV-2 pandemic

Abstract We critically analyzed clinical trials performed with chloroquine (CQ) and hydroxychloroquine (HCQ) with or without macrolides during the first wave of COVID-19 and discussed the design and limitations of peer-reviewed studies from January to July 2020. Seventeen studies were eligible for the discussion. CQ and HCQ did not demonstrate clinical advantages that justified their inclusion in therapeutic regimens of free prescription for treatment or prophylactic purposes, as suggested by health authorities, including in Brazil, during the first wave. Around August 2020, robust data had already indicated that pharmacological effects of CQ, HCQ and macrolides as anti-SARS-CoV-2 molecules were limited to in vitro conditions and largely based on retrospective trials with low quality and weak internal validity, which made evidence superficial for decision-making. Up to that point, most randomized and nonrandomized clinical trials did not reveal beneficial effects of CQ or HCQ with or without macrolides to reduce lethality, rate of intubation, days of hospitalization, respiratory support/mechanical ventilation requirements, duration, type and number of symptoms, and death and were unsuccessful in increasing virus elimination and/or days alive in hospitalized or ambulatory patients with COVID-19. In addition, many studies have demonstrated that side effects are more common in CQ-or HCQ-treated patients.

Alterações sistêmicas na assinatura do ciclo celular de pacientes com COVID-19 / Systemic changes in the cell cycle signature of patients with COVID-19

Com base nas perturbações fosfoproteômicas de moléculas associadas ao ciclo celular em células infectadas pelo coronavírus causador da síndrome respiratória aguda grave (SARSCoV)-2, a hipótese de inibidores do ciclo celular como uma terapia potencial para a doença de coronavírus 2019 (COVID-19) foi proposta. No entanto, o cenário das alterações do ciclo celular em COVID-19 permanece inexplorado. Aqui, realizamos uma análise integrativa de sistemas imunológicos de proteoma publicamente disponível (espectrometria de massa) e dados de transcriptoma (sequenciamento de RNA em massa e de célula única [scRNAseq]), com o objetivo de caracterizar mudanças globais na assinatura do ciclo celular de pacientes com COVID-19. Além de módulos de co-expressão de genes significativos enriquecidos associados ao ciclo celular, encontramos uma rede interconectada de proteínas diferencialmente expressas associadas ao ciclo celular (DEPs) e genes (DEGs) integrando dados moleculares de 1.480 indivíduos (974 pacientes infectados por SARS-CoV-2 e 506 controles [controles saudáveis ou indivíduos com outras doenças respiratórias]). Entre esses DEPs e DEGs estão várias ciclinas (CCNs), ciclo de divisão celular (CDCs), quinases dependentes de ciclinas (CDKs) e proteínas de manutenção de minicromossomos (MCMs). Embora os pacientes com COVID-19 compartilhem parcialmente o padrão de expressão de algumas moléculas associadas ao ciclo celular com outras doenças respiratórias, eles exibiram uma expressão significativamente maior de moléculas associadas ao ciclo celular relacionadas à gravidade da doença. Notavelmente, a assinatura do ciclo celular predominou nos leucócitos do sangue dos pacientes, mas não nas vias aéreas superiores. Os dados de scRNAseq de 229 indivíduos (159 pacientes com COVID- 19 e 70 controles) revelaram que as alterações das assinaturas do ciclo celular predominam nas células B, T e NK. Esses resultados fornecem uma compreensão global única das alterações nas moléculas associadas ao ciclo celular em pacientes com COVID-19, sugerindo novas vias putativas para intervenção terapêutica

Based on phosphoproteomics perturbations of cell cycle-associated molecules in severe acute respiratory syndrome coronavirus (SARS-CoV)-2-infected cells, the hypothesis of cell cycle inhibitors as a potential therapy for Coronavirus disease 2019 (COVID-19) has been proposed. However, the landscape of cell cycle alterations in COVID-19 remains mostly unexplored. Here, we performed an integrative systems immunology analysis of publicly available proteome (mass spectrometry) and transcriptome data (bulk and single-cell RNA sequencing [scRNAseq]), aiming to characterize global changes in the cell cycle signature of COVID-19 patients. Beyond significant enriched cell cycle-associated gene co-expression modules, we found an interconnected network of cell cycle-associated differentially expressed proteins (DEPs) and genes (DEGs) by integrating molecular data of 1,480 individuals (974 SARS-CoV- 2 infected patients and 506 controls [either healthy controls or individuals with other respiratory illness]). Among these DEPs and DEGs are several cyclins (CCNs), cell division cycle (CDCs), cyclin-dependent kinases (CDKs), and mini-chromosome maintenance proteins (MCMs). Although COVID-19 patients partially shared the expression pattern of some cell cycleassociated molecules with other respiratory illnesses, they exhibited a significantly higher expression of cell cycle-associated molecules associated with disease severity. Notably, the cell cycle signature predominated in the patients blood leukocytes but not in the upper airways. The scRNAseq data from 229 individuals (159 COVID-19 patients and 70 controls) revealed that the alterations of cell cycle signatures predominate in B, T, and NK cells. These results provide a unique global comprehension of the alterations in cell cycle-associated molecules in COVID-19 patients, suggesting new putative pathways for therapeutic intervention

Changes in the frequency of oral hygiene during the COVID-19 pandemic among teachers / Mudanças na frequência de higiene bucal durante a pandemia da COVID-19 entre professores

Aim: To verify changes in the frequency of oral hygiene among basic education teachers in Minas Gerais during the COVID-19 pandemic, according to gender. Methods: This is a web survey, epidemiological study. Data collection took place from August to September 2020 through digital form. The dependent variable was the frequency of oral hygiene during the pandemic, categorized as: remained the same, increased, and decreased. Multinomial Logistic Regression was performed. Results: In this study, 15,641 teachers participated, 81.9% of whom were women. Regarding the frequency of oral hygiene, 73.4% reported that it remained the same, 20.1% increased, and 6.5% decreased, with no significant difference between genders. The chances of a decrease in the frequency of oral hygiene were greater in women under 60 years of age, those without children, those who tested positive for COVID-19, those with a worsening health during the pandemic, those with an increased body weight during the pandemic, and those who were sad or depressed during the pandemic. Among men, the chances of reduction were greater among those who did not live with a spouse, those with a worsening health during the pandemic, those who were sad or depressed during the pandemic, and among smokers or ex-smokers. Conclusion: Although the prevalence of changes in the frequency of oral hygiene in the pandemic did not differ between men and women, the factors related to the increase and decrease in frequency were different for each sex.

Introdução: Cuidar da higiene bucal é fundamental para a manutenção da saúde. Objetivo: Verificar as mudanças na frequência de higienização bucal entre professores durante a pandemia da COVID-19, segundo sexo. Métodos: Trata-se de um estudo transversal, do tipo websurvey, realizado com professores da educação básica pública de Minas Gerais. A coleta de dados ocorreu em 2020. A variável dependente foi a frequência de higiene bucal durante a pandemia. Foi realizada Regressão Logística Multinomial. Resultados: Participaram do estudo 15.641 professores, sendo 81,9% mulheres. Em relação à frequência de higiene bucal, 73,4% relataram que permaneceu a mesma, 20,1% aumentou e 6,5% diminuiu, sem diferença significativa entre os sexos. As chances de diminuição da frequência de higienização bucal foram maiores em mulheres com menos de 60 anos, sem filhos, que testaram positivo para a COVID-19, com piora da saúde durante a pandemia, com aumento de peso corporal durante a pandemia e aquelas que estavam tristes ou deprimidas durante a pandemia. Entre os homens, as chances de redução foram maiores entre aqueles que não moravam com cônjuge, com piora da saúde durante a pandemia, aqueles que estavam tristes ou deprimidos durante a pandemia e entre os fumantes ou ex-fumantes. Conclusão: A frequência de higienização bucal na pandemia não apresentou diferenças significativas entre os sexos, no entanto, observou-se, em ambos os sexos, que variáveis referentes às características sociodemográficas, hábitos de vida e condições de saúde, foram associados ao aumento e diminuição da frequência de higienização bucal na pandemia.

The COVID-19 pandemic in sub-Saharan Africa: The significance of presumed immune sufficiency

A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China in 2019 and later ignited a global pandemic. Contrary to expectations, the effect of the pandemic was not as devastating to Africa and its young population compared to the rest of the world. To provide insight into the possible reasons for the presumed immune sufficiency to coronavirus disease 2019 (COVID-19) in Africa, this review critically examines literature published from 2020 onwards on the dynamics of COVID-19 infection and immunity and how other prevalent infectious diseases in Africa might have influenced the outcome of COVID-19. Studies characterising the immune response in patients with COVID-19 show that the correlates of protection in infected individuals are T-cell responses against the SARSCoV-2 spike protein and neutralising titres of immunoglobin G and immunoglobin A antibodies. In some other studies, substantial pre-existing T-cell reactivity to SARS-CoV-2 was detected in many people from diverse geographical locations without a history of exposure. Certain studies also suggest that innate immune memory, which offers protection against reinfection with the same or another pathogen, might influence the severity of COVID-19. In addition, an initial analysis of epidemiological data showed that COVID-19 cases were not severe in some countries that implemented universal Bacillus Calmette­Guerin (BCG) vaccination policies, thus supporting the potential of BCG vaccination to boost innate immunity. The high burden of infectious diseases and the extensive vaccination campaigns previously conducted in Africa could have induced specific and non-specific protective immunity to infectious pathogens in Africans.

Knowledge, fear, and willingness to accept covid-19 vaccine among residents of Gere lga, Borno state, Nigeria

Background: Coronavirus (COVID-19) which emerged from Wuhan, Hubei province, China has gained tremendous attention. It has caused huge morbidity and mortality as well as a visible psychological burden on communities across the globe. Knowledge, fear, and willingness to accept COVID-19 Vaccine are reported to be serious factors in the fight against the disease in many communities for which Jere LGA, Maiduguri, Borno State, may not be an exception. Objectives: To determine the Knowledge, fear, and willingness to accept the COVID-19 Vaccine among the residents of Jere LGA, Maiduguri, Borno State, Nigeria. Methodology:Adescriptive cross-sectional study design was adopted for this study. Atotal of 384 questionnaires were administered in this study. However, only 367 questionnaires were retrieved for analysis. The sampling technique adopted for this study was multistate sampling techniques. Results: The findings of the study revealed that the majority (67.8%) of the respondents had poor knowledge of the COVID-19 vaccine. On the question of COVID-19 fear, 50.1% had moderate fear. Regarding the vaccination status of the respondents, 93.5% did not receive the COVID-19 vaccine jab and 6.5% did receive the vaccine as of the time of this study. Of the 367 respondents, 78.2% were unwilling to accept the COVID-19 vaccine, if made available to them. Conclusions: The study concluded that there is poor knowledge, and moderate fear and the majority of respondents were unwilling to receive or accept the COVID-19 vaccine in the study area. Therefore, this study recommends a comprehensive awareness campaign on the importance of the COVID-19 vaccine at the community level.

Seroprevalence of SARS-CoV-2 immunoglobulin G antibody during COVID-19 pandemic in Fayoum District, Egypt: a community-based pilot survey

Introduction: controlling the worldwide pandemic, coronavirus disease (COVID-19), could be impossible due to the hesitancy about the available vaccines and the difficulty to implement strict restrictions. Little information is available about herd immunity in the highly vulnerable region of North East Africa, Egypt. Objectives: to assess the seroprevalence of SARS-CoV-2 during the pandemic in one of the highly vulnerable populations in Egypt, Fayoum district of Fayoum Governorate. Additionally, to assess the predictive value of symptoms and other associated risk factors towards a positive COVID-19 test. Methods: in this cross-sectional community-based pilot study, immunoglobulin G (IgG) antibodies that are specific for the SARS-CoV-2 spike (S1-RBD) protein were tested during the period from February 2021 to July 2021. Results: out of 155 participants, 60.6% were SARS-CoV-2 seropositive. Out of symptomatic and asymptomatic individuals, 76.5% and 56.2% were seropositive, respectively. Surprisingly, only one individual had received the COVID-19 vaccine. Previous history of COVID-19; such as symptoms and gender are statistically significant predictors of high seroconversion independent of age, comorbidities, and level of education. Conclusion: this study which disclosed unexpectedly high SARS-CoV-2 seroconversion among the Egyptians, might provide a clear insight into COVID-19 transmission patterns and state of immunity. Further study with a larger sample size on a large scale is required to represent the whole local population.

Percepción de riesgo, automedicación, mitos y creencias relacionados con COVID-19 entre jefes de hogar peruanos / Risk perception, self-medication, myths, and beliefs related with COVID-19 among Peruvian head of households

Resumen Introducción: A más de un año del inicio de la pandemia COVID-19, el número de contagiados y muertes aún presenta frecuencias que escapan al control de manejo hospitalario. Aunado al temor, se acrecentó la aparición de mitos, creencias, automedicación e inadecuada percepción de riesgo en la población. Objetivo: Identificar la percepción de riesgo, automedicación, mitos y creencias de prevención respecto al COVID-19 en adultos jefes de hogar del distrito Gregorio Albarracín de Tacna en el 2020. Material y métodos: Se aplicó una encuesta a una muestra representativa de 250 jefes de hogar, residentes en el distrito Gregorio Albarracín. Resultados: El promedio total del grupo en percepción del riesgo expresado en porcentaje fue de 60,96 % (59,81-62,11) de un total de probable esperado ideal de 100 %. La percepción de "estar en riesgo en la pandemia" es baja. Solo el 15,20 % acató el aislamiento domiciliario estricto cuando fue indicado. El 14,8 % se automedicaba y en este grupo, los productos usados fueron Ivermectina (48,6 %) y dióxido de cloro (45,9 %). Los mitos y creencias más frecuentes fueron "rociarse con alcohol o cloro mata el virus" y "los remedios caseros pueden curar o prevenir el coronavirus". Hubo diferencia según edad (p<0,05), nivel de instrucción (p<0,001). Conclusiones: La automedicación estuvo fuertemente asociada con elevada percepción de riesgo (p<0,001) y presencia de mitos y creencias (p<0,001). El nivel de instrucción estuvo altamente asociado con la presencia de mitos y creencias (p<0,001)

Abstract Introduction: More than a year after the beginning of the COVID-19 pandemic, the number of infections and deaths is still beyond the control of hospital management. In addition to fear, myths, beliefs, self-medication and inadequate risk perception in the population have increased. Objective: To identify the perception of risk, self-medication, myths and prevention beliefs regarding COVID-19 in adult heads of household in the Gregorio Albarracin district of Tacna in 2020. Method: A survey was administered to a representative sample of 250 heads of household residing in the Gregorio Albarracin district. Results: The total average of the group in risk perception expressed as a percentage was 60.96% (59.81-62.11) out of a total expected ideal of 100%. The perception of "being at risk in the pandemic" is low. Only 15.20% adhered to strict home isolation when instructed to do so. The 14.8% self-medicated and in this group, the products used were ivermectin (48.6%) and chlorine dioxide (45.9%). The most frequent myths and beliefs were "spraying with alcohol or chlorine kills the virus" "home remedies can cure or prevent coronavirus"; there were differences according to age (p<0.05) and educational level (p<0.001). Conclusions: self-medication was strongly associated with high-risk perception (p<0.001) and presence of myths and beliefs (p<0.001). Educational level was highly associated with the presence of myths and beliefs (p<0.001).

Evolución de pacientes hospitalizados durante la pandemia de COVID-19 en Perú / Evolution of hospitalized patients during the COVID-19 pandemic in Peru

Resumen Introducción: La hospitalización de pacientes durante la pandemia de COVID-19 se incrementó de manera importante, y evidenció las carencias de los sistemas de salud, que no respondieron de forma adecuada y eficiente. Objetivo: Determinar la evolución de pacientes hospitalizados durante la pandemia de COVID-19 en Perú. Métodos: Investigación descriptiva, transversal, retrospectiva. Efectuada con una data de 115 306 pacientes, a quienes se valoró su última evolución, el ingreso a Unidad de Cuidados Intensivos, si recibieron oxígeno o ventilación, fallecidos por COVID-19 y vacunación contra esta enfermedad, según los datos de la plataforma nacional de datos abiertos del Ministerio de Salud del Perú. Para analizar los datos se usaron frecuencias absolutas y relativas y para la asociación comparativa de variables, el chi cuadrado de homogeneidad con una significancia estadística de p < 0,01. Resultados: De los pacientes que ingresaron a Unidad de Cuidados Intensivos, que recibieron oxígeno y ventilación, el 51,1 %, 59,1 % y 44,9 %, respectivamente, fueron dados de alta. Del 28,3 % de pacientes que fallecieron, el 90,2 % fue por COVID-19. La mayor proporción fueron adultos (51,1 %) y adultos mayores (31,2 %), de los cuales el 36,3 % y 62,4 % fallecieron por COVID-19. De los fallecidos por COVID-19, el 96,9 % no tenía ninguna dosis de vacuna contra la enfermedad. Conclusión: Más de la mitad de los pacientes que ingresaron a Unidad de Cuidados Intensivos y recibieron oxígeno fueron dados de alta, la mayoría de los fallecidos por COVID-19 fueron adultos, adultos mayores y no vacunados. Las diferencias entre todos los pares de variables comparadas fueron altamente significativas (p < 0,001).

Abstract Introduction: The hospitalization of patients during the COVID-19 pandemic increased significantly, and evidenced the shortcomings of the health systems, which did not respond adequately and efficiently. Objective: To determine the evolution of hospitalized patients during the COVID-19 pandemic in Peru. Methods: Descriptive, cross sectional, retrospective research. Done with a data of 115,306 patients, who were assessed their latest evolution, admission to the Intensive Care Unit, if they received oxygen or ventilation, died from COVID-19 and vaccination against this disease, according to data from the national data platform open from the Ministry of Health of Peru. To analyze the data, absolute and relative frequencies were used and for the comparative association of variables, the chi-square of homogeneity with a statistical significance of p <0.01. Results: Of the patients admitted to the Intensive Care Unit, who received oxygen and ventilation, 51.1%, 59.1% and 44.9%, respectively, were discharged. Of the 28.3% of patients who died, 90.2% were from COVID-19. The largest proportion were adults (51.1%) and older adults (31.2%), of which 36.3% and 62.4% died from COVID-19. Of those who died from COVID-19, 96.9% did not have any dose of vaccine against the disease. Conclusion: More than half of the patients who were admitted to the Intensive Care Unit and received oxygen were discharged, the majority of deaths from COVID-19 were adults, older adults and not vaccinated. The differences between all pairs of compared variables were highly significant (p <0.001).

Social stigmas towards people living with HIV in the Sars-CoV-2 vaccination process / Estigmas sociales hacia personas viviendo con VIH en el proceso de vacunación anti Sars-CoV-2

Introduction: Social stigmas in people living with Human Immunodeficiency Virus (HIV) have been part of their history and can still be identified in today's care environments. Objective: To analyze the social stigmas in relation to the care of people living with HIV by those who provide the anti Sars-CoV-2 vaccination service. Materials and methods: A descriptive quantitative research were developed that included a census sample of 126 people. The scale of social stigma in the care of people with HIV/AIDS (Acquired immunodeficiency syndrome) was applied. The information was analyzed through SPSS version 25. Results: Most of the participants reported not knowing people with HIV, but they have been treated as users (54%) and considered that they are discriminated (88.1%). Although a low level of stigma was evidenced (71.4%), these are present in 85.7%. Having had contact as a user with people with HIV was associated with the level of stigma (p=0.008). Conclusions: It is necessary to promote training in which the complexity of the phenomenon is addressed and aspects such as social stigmas are identified, incorporating the biopsychosocial paradigm together with a gender perspective in favor of the comprehensive provision of care.

Introducción: Los estigmas sociales en personas que viven con VIH han sido parte de su historia y aún se puede identificar en los entornos actuales de atención. Objetivo: Analizar los estigmas sociales en relación con la atención de las personas que viven con VIH por parte de quienes otorgan el servicio de vacunación anti Sars-CoV-2. Materiales y métodos: Se desarrolló una investigación cuantitativa descriptiva que incluyó una muestra censal de 126 personas. Se aplicó la Escala de estigma social en la atención de personas con VIH/SIDA. La información fue analizada a través del SPSS versión 25. Resultados: La mayoría de participantes refirió no conocer a personas con VIH, pero sí les han atendido como usuarios (54%), y consideró que son discriminadas (88,1%). Pese a que se evidenció un nivel bajo de estimas (71,4%), éstos están presentes en el 85,7%. El haber tenido contacto como usuario con personas con VIH se asoció con el nivel de estigma (p=0.008). Conclusiones: Se requiere fomentar capacitaciones en las que se aborde la complejidad del fenómeno y se identifiquen aspectos como los estigmas sociales, incorporando el paradigma biopsicosocial y con perspectiva de género en pro de la prestación integral de los cuidados.

Factors associated with the stigma-discrimination complex towards healthcare workers among university students during the coronavirus pandemic in Mexico / Factores asociados al complejo estigma-discriminación hacia trabajadores de la salud entre estudiantes universitarios durante la pandemia de coronavirus en México

Introduction: COVID-19-related stigma towards healthcare professionals negatively influences their job performance and well-being, however, this issue has not been sufficiently investigated. Objective: To determine the frequency and variables associated with COVID-19-related stigma toward health care workers in a university population in Mexico. Materials and methods: Cross-sectional study. An online questionnaire was sent to 1,054 students between 18 and 29 years of age. Demographic variables, religiosity, fear of COVID-19 and its association with COVID-19-related stigma-discrimination towards health workers (dependent variable) were analyzed. Bivariate analysis and a generalized linear model were performed to calculate adjusted prevalence ratios. Results: The proportion of high stigma-discrimination was 12.4% and was associated with high fear of COVID-19 RPa= 1.51 (95% CI 1.06 - 2.23). Conclusion: The findings highlight the importance of establishing programs to reduce COVID-19-related stigmatization towards healthcare professionals.

Introducción: El estigma relacionado con la COVID-19 hacia los profesionales de la salud influye negativamente en su desempeño laboral y bienestar, sin embargo, este tema no ha sido suficientemente investigado. Objetivo: Determinar la frecuencia y las variables asociadas al estigma relacionado con el COVID-19 hacia los trabajadores de la salud en una población universitaria de México. Materiales y métodos: Estudio transversal. Se envió un cuestionario en línea a 1.054 estudiantes de entre 18 y 29 años. Se analizaron variables demográficas, religión, miedo al COVID-19 y su asociación con el estigma-discriminación hacia el personal de salud relacionado con la COVID-19 (variable dependiente). Se realizó un análisis bivariado y un modelo lineal generalizado para calcular las razones de prevalencia ajustadas. Resultados: La proporción de estigma-discriminación alto fue de 12,4% y se asoció con miedo alto a la COVID-19 RPa=1,51 (IC=95% 1,06-2,23). Conclusión: Los hallazgos destacan la importancia de establecer programas para reducir la estigmatización relacionada con COVID-19 hacia los profesionales de la salud.

Covid-19: perfil epidemiológico dos usuários testados em uma unidade de Atenção Primária à Saúde / COVID-19: epidemiological profile of users tested at a Primary Health Care unit / COVID-19: perfil epidemiológico de los usuarios testeados en una unidad de Atención Primaria de Salud

O segundo semestre de 2019 foi marcado pelo debate mundial acerca de casos de contaminação por um agente etiológico, que, após pesquisas genéticas, foi classificado pela Organização Mundial da Saúde (OMS) como covid-19. No Brasil, o vírus chegou em fevereiro de 2020. A partir de então, a Atenção Primária à Saúde (APS) se tornou fundamental no cenário pandêmico com a oferta de serviços, como testes rápidos, para diagnóstico do vírus. O objetivo deste artigo é descrever o perfil epidemiológico da população usuária de uma unidade de Atenção Primária à Saúde que realizou teste rápido para covid-19. Este é um estudo descritivo, documental, com abordagem quantitativa do tipo perfil epidemiológico. A pesquisa foi feita em Natal, Rio Grande do Norte, entre 10 de junho e 5 de agosto de 2020. Dos usuários testados, observaram-se prevalência do sexo feminino (60%); cor/raça parda (53,8%); faixa etária entre 56 e 60 anos (14%); em relacionamento estável (61,5%); ensino médio completo (45,4%); não praticantes de atividade física (56,9%) e não tabagistas (96,2%). Os resultados permitiram traçar o perfil epidemiológico local e, somados aos demais dados obtidos no curso da pandemia, contribuem para novas medidas de promoção, prevenção e recuperação do processo saúde-doença.

The second semester of 2019 was plunged into a worldwide debate concerning cases of contamination by an etiological agent that, following genetical research, was classified by the World Health Organization (WHO) as COVID-19. In Brazil, the virus was first recorded in February 2020, from then on Primary Health Care (PHC) played a key role during the pandemic by offering services such as the rapid testing for virus detection. Hence, this epidemiological, descriptive, quantitative and documentary study sought to describe the epidemiological profile of PHC users tested for COVID-19 using the rapid test. The research took place in Natal, Rio Grande do Norte, Brazil, between June 10 and August 5, 2020. Most tested users were women (60%), mixed race/brown (53.8%), aged 56 to 60 years (14%), in stable relationships (61.5%), with complete high school (45.4%), sedentary (56.9%), and non-smokers (96.2%). The results allowed us to outline a local epidemiological profile which, when taken with other data obtained throughout the pandemic, has contributed to new measures for promotion, prevention and recovery in the health-disease process.

En el segundo semestre de 2019 estuvo en debate mundial los casos de contaminación por un agente etiológico, que después de investigaciones genéticas la Organización Mundial de la Salud lo clasificó como COVID-19. En Brasil, el virus llegó en febrero de 2020. A partir de ese momento la Atención Primaria de Salud (APS) se convirtió en el elemento fundamental en el escenario de la pandemia con la oferta de servicios, como la realización de exámenes rápidos para diagnóstico del virus. El objetivo de este estudio es describir el perfil epidemiológico de la población usuaria de una unidad de Atención Primaria de Salud que realizaron examen rápido para COVID-19. Este es un estudio descriptivo, documental, con enfoque cuantitativo, del tipo perfil epidemiológico. El estudio se realizó en Natal, Rio Grande do Norte (Brasil), entre 10 de junio a 5 de agosto de 2020. En los usuarios testados, se observó el predominio del sexo femenino (60%); color/raza parda (53,8%); franja etaria entre 56 a 60 años (14%); en una relación estable (61,5%); enseñanza secundaria completa (45,4%); no practicantes de actividad física (56,9%) y no fumadores (96,2%). Los resultados permitieron trazar el perfil epidemiológico local que, sumado con los demás datos obtenidos durante la pandemia, contribuyen con nuevas medidas de promoción, prevención y recuperación del proceso salud-enfermedad.

Ensino remoto na pandemia por coronavírus: perspectivas de estudantes de Enfermagem / Remote teaching in the coronavirus pandemic: perspectives of nursing students / Enseñanza remota en la pandemia del coronavirus: perspectivas de los estudiantes de enfermería

Objetivo: Identificar os reflexos da utilização de tecnologias para o ensino remoto na pandemia por coronavírus na perspectiva de estudantes de enfermagem. Métodos: Pesquisa de abordagem qualitativa, descritiva, com 14 estudantes de enfermagem de uma Universidade Pública do Sul do Brasil. Os dados foram produzidos mediante entrevistas semiestruturadas realizadas na Plataforma Google Meet no segundo semestre de 2020, e submetidos a análise temática de conteúdo. Resultados: Elaborou-se duas categorias temáticas: Impactos do distanciamento social na vida de estudantes de enfermagem; Uso de tecnologias digitais para o ensino remoto na perspectiva de estudantes de enfermagem. O uso de tecnologias digitais ampliam as possibilidades de manutenção das atividades de ensino no período pandêmico e auxiliam no desenvolvimento de estratégias para a continuidade do vínculo entre docentes e estudantes. Portanto, os estudantes ainda se encontram em um cenário de incertezas referente ao futuro de sua formação, que contribui para a manifestação de sentimentos de ansiedade, medo e preocupação. Conclusão: Diante do contexto da pandemia, as tecnologias digitais se constituíram em estratégias adotadas para a continuidade da prática pedagógica, contudo os efeitos do isolamento social e o contexto de incertezas geram preocupações nos estudantes, podendo produzir desgastes emocionais nestes. (AU)

Objective: To identify the reflexes of the use of technologies for remote education in the pandemic by coronavírus from the perspective of nursing students. Methods: Qualitative, descriptive research with 14 nursing students from a public university in southern Brazil. The data were produced through semi-structured interviews conducted on the Google Meet Platform in the second half of 2020, and subjected to thematic content analysis. Results: Two thematic categories were elaborated: Impacts of social distance in the life of nursing students; Use of digital technologies for remote teaching from the perspective of nursing students. The use of digital technologies expands the possibilities of maintaining teaching activities in the pandemic period and helps in the development of strategies for the continuity of the link between teachers and students. Therefore, students are still in a scenario of uncertainty regarding the future of their education, which contributes to the manifestation of feelings of anxiety, fear and concern. Conclusion: Given the context of the pandemic, digital technologies have become strategies adopted for the continuity of pedagogical practice, however, the effects of social isolation and the context of uncertainties generate concerns in students, which can produce emotional distress in them. (AU)

Objetivo: Identificar los reflejos del uso de tecnologías para la educación a distancia en la pandemia por coronavírus desde la perspectiva de los estudiantes de enfermería. Métodos: Investigación descriptiva cualitativa con 14 estudiantes de enfermería de una universidad pública del sur de Brasil. Los datos fueron producidos a través de entrevistas semiestructuradas realizadas en la plataforma Google Meet en la segunda mitad de 2020, y sometidas a análisis de contenido temático. Resultados: Se elaboraron dos categorías temáticas: Impactos de la distancia social en la vida de los estudiantes de enfermería; Uso de tecnologías digitales para la enseñanza a distancia desde la perspectiva de los estudiantes de enfermería. El uso de tecnologías digitales amplía las posibilidades de mantener las actividades docentes en el período pandémico y ayuda en el desarrollo de estrategias para la continuidad del vínculo entre docentes y estudiantes. Por lo tanto, los estudiantes aún se encuentran en un escenario de incertidumbre con respecto al futuro de su educación, lo que contribuye a la manifestación de sentimientos de ansiedad, miedo y preocupación. Conclusión: Ante el contexto de la pandemia, las tecnologías digitales se convirtieron en estrategias adoptadas para la continuidad de la práctica pedagógica, sin embargo los efectos del aislamiento social y el contexto de incertidumbres generan inquietudes en los estudiantes, que pueden producir estrés emocional en ellos. (AU)

Evidencia actual de la infección por SARS-COV-2 en la gestación: Revisión de alcance / Current evidence of SARS-CoV-2 infection in pregnancy: A scoping review

Introducción: El SARS-CoV-2 es un Betacoronavirus, así como el SARS-CoV y el MERS-CoV, ambos asociados a abortos espontáneos, parto prematuro, morbi-mortalidad materna y alto número de ingresos a UCI en las gestantes. Además, al ser un virus nuevo, se conoce poco sobre los efectos en la gestación. Esta revisión tiene como objetivo analizar la evidencia disponible sobre el SARS-CoV-2 en la gestación. Materiales y métodos: Se realizó una búsqueda de la literatura en PubMed, ProQuest, Scopus, BVS y SciElo. Se realizó la crítica de la evidencia y la extracción de la información con dos instrumentos propuestos por el Instituto Joanna Briggs. Lo anterior bajo las directrices de PRISMA-ScR. Resultados: Se incluyeron 85 artículos que evidenciaron que la mayoría de gestantes con SARS-CoV-2 desarrollaron enfermedad leve a moderada, pero presentaron mayor riesgo de muerte y complicaciones comparado con las pacientes no embarazadas. Se documentó bajo riesgo de transmisión vertical y los resultados perinatales se asociaron a la severidad del cuadro clínico materno. La efectividad del tratamiento no fue concluyente.Discusión: Se discute la presentación clínica de la infección en las gestantes, la transmisión vertical, el tratamiento, la gravedad de la enfermedad y los desenlaces neonatales.Conclusiones: La COVID-19 en la gestación es una complicación que genera mayor morbimortalidad, por lo que es de vital importancia el desarrollo de más investigaciones que amplíen la comprensión de su comportamiento, las implicaciones fisiológicas, emocionales y el posible tratamiento. Esta revisión hace un análisis riguroso de la calidad de los estudios y aporta información valiosa de la evidencia.

Introduction: SARS-CoV-2 is a betacoronavirus as well as SARS-CoV and MERS-CoV, both associated with spontaneous miscarriage, preterm birth, maternal morbidity and mortality and a higher number of ICU admissions for pregnant women. Being a new virus, its effects on pregnancy are little known. This review aims to analyze the available evidence on SARS-CoV-2 in pregnancy. Materials and Methods: A literature review was conducted in PubMed, ProQuest, Scopus, BVS and SciElo. Evidence criticism and information extraction were conducted using two instruments from the Joanna Briggs Institute, following the PRISMA-ScR guidelines. Results: 85 articles were included evidencing that most pregnant women with SARS-COV-2 suffered mild to moderate disease and were at a higher risk of death and complications compared to non-pregnant patients. Low risk of vertical transmission was documented and adverse perinatal outcomes were associated with severe maternal clinical manifestations. The effectiveness of treatment was inconclusive. Discussion: Clinical presentation of infection in pregnant women, vertical transmission, treatment, disease severity and neonatal outcomes were discussed. Conclusions: COVID-19 during pregnancy is a complication that generates greater morbidity and mortality, for which it is vital to develop further research on the understanding of the behavior, physiological and emotional implications and possible treatment. This review makes a rigorous analysis of the quality of studies and provides valuable information from evidence.

Introdução: O SARS-CoV-2 é um betacoronavírus, assim como o SARS-CoV e o MERS-CoV, ambos associados ao aborto espontâneo, parto prematuro, morbidade e mortalidade materna e alto número de internações na UTI em mulheres grávidas. Além disso, sendo um novo vírus, pouco se sabe sobre seus efeitos na gravidez. Esta revisão tem como objetivo analisar as evidências disponíveis sobre o SARS-CoV-2 na gravidez. Materiais e métodos: Foi realizada uma pesquisa bibliográfica na PubMed, ProQuest, Scopus, BVS e SciElo. A analise crítica das provas e a extração de dados foram realizadas utilizando dois instrumentos propostos pelo Instituto Joanna Briggs sob as diretrizes do PRISMA-ScR. Resultados: 85 artigos foram incluídos, mostrando que a maioria das mulheres grávidas com SRA-CoV-2 desenvolveu doença leve a moderada, mas tinha um risco maior de morte e complicações em comparação com pacientes não grávidas. Baixo risco de transmissão vertical foi documentado e os resultados perinatais foram associados à gravidade do quadro clínico materno. A eficácia do tratamento foi inconclusiva. Discussão: Apresentação clínica da infecção em mulheres grávidas, transmissão vertical, tratamento, gravidade da doença e resultados neonatais são discutidos. Conclusões: A COVID-19 na gravidez é uma complicação que gera maior morbidade e mortalidade, portanto, mais pesquisas para expandir a compreensão de seu comportamento, implicações fisiológicas e emocionais, e o tratamento potencial são de vital importância. Esta revisão fornece uma análise rigorosa da qualidade dos estudos e informações valiosas a partir das evidências.

Controversias en neuroinmunología: esclerosis múltiple, vacunación, SARS-CoV-2 y otros dilemas / Controversies in neuroimmunology: multiple sclerosis, vaccination, SARS-CoV-2 and other dilemas

La neuroinmunología es una disciplina que cada vez amplía más sus horizontes en la comprensión de las enfermedades neurológicas. Contemporáneamente, y a la luz de los nexos fisiopatológicos de las enfermedades neurológicas y la inmunología, se han planteado enfoques diagnósticos y terapéuticos específicos. A pesar de los importantes avances de esta disciplina, existen múltiples dilemas que le conciernen y se filtran en la práctica clínica. En esta revisión, se presentan y discuten 15 controversias, las cuales se construyen con la información clínica disponible más actualizada. Los temas incluidos son: disminución de esteroides en recaídas de esclerosis múltiple; recomendaciones terapéuticas en esclerosis múltiple a la luz de la pandemia por el SARS-CoV-2; evidencia de vacunación en esclerosis múltiple y en otras enfermedades desmielinizantes; panorama actual del síndrome clínico y radiológico aislado; y fallas terapéuticas en esclerosis múltiple; además, criterios para suspender las terapias modificadoras de la enfermedad; evidencia del manejo en recaídas leves; recomendaciones para la profilaxis contra Strongyloides stercolaris; utilidad de un segundo ciclo de inmunoglobulina en el síndrome de Guillain-Barré; criterios para diferenciar una polineuropatía crónica desmielinizante inflamatoria de inicio agudo de un síndrome de Guillain-Barré y, utilidad de la enzima convertidora de angiotensina en neurosarcoidosis. En cada una de las controversias, se presenta la problemática general y se ofrecen recomendaciones específicas que pueden adoptarse en la práctica clínica diaria.

Neuroimmunology is a discipline that increasingly broadens its horizons in the understanding of neurological diseases. At the same time, and in front of the pathophysiological links of neurological diseases and immunology, specific diagnostic and therapeutic approaches have been proposed. Despite the important advances in this discipline, there are multiple dilemmas that concern and filter into clinical practice. This article presents 15 controversies and a discussion about them, which are built with the most up-to-date evidence available. The topics included in this review are: steroid decline in relapses of multiple sclerosis; therapeutic recommendations in MS in light of the SARS-CoV-2 pandemic; evidence of vaccination in multiple sclerosis and other demyelinating diseases; overview current situation of isolated clinical and radiological syndrome; therapeutic failure in multiple sclerosis, as well as criteria for suspension of disease-modifying therapies; evidence of the management of mild relapses in multiple sclerosis; recommendations for prophylaxis against Strongyloides stercolaris; usefulness of a second course of immunoglobulin in the Guillain-Barré syndrome; criteria to differentiate an acute-onset inflammatory demyelinating chronic polyneuropathy versus Guillain-Barré syndrome; and, the utility of angiotensin-converting enzyme in neurosarcoidosis. In each of the controversies, the general problem is presented, and specific recommendations are offered that can be adopted in daily clinical practice.