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This research aims to evaluate endeavors on the part of the population to generate sustainable awareness during the "2020 lockdown", caused by the international health emergency related to the SARS-CoV-2 virus. For this purpose, a semi-structured survey was applied to the general population using CAWI (Computer Assisted Web Interviewing) methodology, generating a total of 3,125 responses. In order to analyze this, 37 of its 47 variables were selected, and subdivided into four groups. For the evaluation, a Principal Component Analysis was carried out, using multivariate methods;highlighting thirteen factors that explain the 57.2% of total variation. Subsequently, a Cluster Analysis was applied, identifying a total of five population groups;which when integrated revealed heterogeneity in terms of responses, exposing the need to generate efficient communication channels that bring together the importance as a society of participating more in the environment as well as in human healthcare;understanding that these two are closely correlated. The conclusion reached is that the way for more humane sustainable development requires a collective environmental awareness that will undoubtedly bring benefits to individual health.
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Introduction: With the situation created by COVID-19 pandemic, hospitals assumed protocols that could lead to a delay in the oncological process, adding to this, the fear of patients to go to medical consultations due to certain discomforts. Methods: Retrospective, observational and analytical study carried out in patients diagnosed with breast cancer. Two cohorts were determined according to the pandemic period, one prior to the rise of COVID-19, between January 2019 and February 2020, and another exposed to the emergency situation, between March 2020 and December 2021. The main objective was to determine the tumor stage during the pandemic to verify that it was higher than before. Results: The study sample contained 193 cases, with a mean age of 65.5 years. In the unexposed cohort there were 71 cases (36.6%) and in the exposed cohort 122 cases (63.4%). Among them, 46.1% had an advanced stage of the disease. 53 cases were diadnosed from the population screening, of which 35 were early stage. No statistically significant relationship was found between the period exposed to the pandemic and advanced tumor stage. Conclusions: The measures implemented during COVID-19 have not led to a later diagnosis of the disease in our hospital. © 2023
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The objective of this research is to evaluate the actions carried out by the population to generate sustainable awareness during the "2020 Contingency", caused after the international health emergency by the SARS-CoV-2 virus. As an instrument, a semi-structured survey was applied using the CAWI (Computer Assisted Web Interviewing) methodology to the general population, with a total of 3,125 responses. For its analysis, 37 of its 47 variables were selected, subdivided into four blocks. In the evaluation, a Principal Component Analysis was used through multivariate methods, highlighting thirteen factors that explain 57.2% of the total variation. Subsequently, a Cluster Analysis was applied, identifying a total of five population groups;their integration showed heterogeneity in the responses, exposing the need to generate efficient communication channels that intertwine the importance of being more participatory as a society in the environment and with the care of human health, understanding that both have a close correlation. Concluding that the way for a more humane sustainable development requires a collective environmental awareness that will undoubtedly bring benefits to individual health.
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Background: SARS-CoV-2 vaccines efficacy and safety have been tested in phase 3 studies which did not include cancer patients. Information is scarce regarding COVID-19 vaccines safety in this population. Methods: The objective of this study is to evaluate the safety profile of the mRNA-1273 vaccine across cancer patients and its relationship to patients' demographics. This cross sectional study included patients 18-years or older with solid malignancies receiving active treatment in Hospital Clínico San Carlos (Madrid, Spain) who had received the three dose schedule of the mRNA9 1273 vaccine. Patient electronic medical records were reviewed retrospectively to collect data between April 19, 2021 and December 31, 2021. Patients with documented previous infection by SARS-Cov-2 were excluded. Results: 93 patients met inclusion criteria. 31 patients (33%) were male and 62 patients (66%) were female. Mean age was 61 [SD 8]. 33% of the study population had metastatic disease. The majority of patients (60%) had ECOG 0 whereas 32% and 8% of the population had ECOG 1 and 2 respectively. Most common tumors were breast (33%) and gastrointestinal (17%). Treatment modalities included chemotherapy (37%), targeted therapy (23%), immunotherapy (12%) and combined therapy (28%). Local adverse effects at the site of injection and systemic adverse reactions had different trends, local adverse reactions were reported more frequently after the first and second dose than after the third (42%, 50% and 36% respectively), while systemic adverse reactions were reported less frequently after the first and second dose than after the third (16%, 35% and 53% respectively). Most common systemic adverse effect was fever followed by malaise and myalgia. No grade 4 or 5 adverse events were reported. We found a statistically significant association between sex and systemic adverse reactions after the third dose with a moderate correlation assessed by Cramer's V. Cochran-Armitage test showed a statistically significant linear trend, p = 0.012, with higher ECOG score associated with a lower proportion of patients suffering from systemic side effects. A logistic regression showed that females had 5.79 times higher odds to exhibit systemic adverse events after the third dose (p = 0.01) compared to males. Increasing age was associated with a decreased likelihood of exhibiting adverse events (p = 0.016). ECOG scores didn't show a statistically significant association. Conclusions: mRNA-1273 vaccine shows a tolerable safety profile, which is similar to the non-oncologic population. The likelihood of adverse reactions appears to be associated with gender and age. Its association with ECOG scores is less evident. Further studies are needed to elucidate the safety profile of COVID-19 vaccines in cancer patients.
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Background: The Spanish registry of Covid-19 in Spanish pregnant women, made up of 100 centers, is created in response to the need to know the morbidity that Covid-19 generates in pregnant women and their newborns, to know the real incidence of the disease in this population group and to establish and monitor the package of measures to improve their care. The aim of this paper was the creation of a registry of pregnant women with Covid-19 infection in order to establish the interventions and measures necessary to improve the care of these patients during hospital admission.
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Introduction: Patients with Irritable bowel syndrome (IBS) have been reported to have higher anxiety and depression levels than general population, as well as dysfunctional coping skills. The total/ partial lockdown due to COVID19 pandemic has been related with an increased incidence of psychological disorders in general population;however, its effect on IBS patients and patients with other chronic GI-conditions like ulcerative colitis (UC) is not known. Aims & Methods: The main goal of this study was to compare the lockdown effect on mental health and digestive symptoms in patients with IBS, UC and healthy volunteers. During April 2020 (Spanish total lockdown), 30 IBS, 30 UC in remission and 30 healthy volunteers were invited to answer an online survey evaluating stress and anxiety levels by the STAI questionnaire and depression using the Beck questionnaire. IBS patients' symptoms were evaluated with IBS-SSS. After 6 months, in October 2020 (partial lockdown in Spain), the same subjects were contacted, and they were asked to answer again the same online questionnaires. Results: Responses were obtained from 24 IBS (67% women, aged 21-67 years), 23 UC (56% women, aged 35-55 years) and 18 healthy volunteers (68% women, aged 23-70 years). During total lockdown, IBS patients presented higher depression index (11.52±1.6) than UC patients (5.78±0.9 (p=0.008)) and healthy volunteers (4.78±4.3 (p=0.001)). IBS patients also had higher anxiety index (state 29.4±2.5 / trait 26.5±2.5) than healthy volunteers (state 15.6±2.3 (p=0.001) / trait 14.4±1.9 (p=0.002)). After 6 months (during partial lockdown) depression levels increased significatively in IBS patients (from 11.52±1.6 to 16.08±2.22 (p=0.012)), but remained unchanged in healthy subjects and UC patients (from 4.78±4.3 to 3.28±0.6 and from 5.78±0.9 to 5.91±1.17 respectively;p< 0.001 vs IBS). Anxiety scores (both state and trait) remained stable during the partial lockdown (6 months after the total lockdown) in the 3 study groups. The severity of digestive symptoms remained unchanged in IBS patients (scores 283±80 and 285±84, total and partial lockdown, respectively;p=0.837). Conclusion: During the lockdown due to COVID-19 pandemic, IBS patients presented higher depression and anxiety levels than healthy volunteers and patients with UC in remission. Additionally, the depression index worsened in IBS patients during the pandemic, while it remained stable in healthy volunteers and UC patients. During this first phase of the pandemic, the observed changes in psychological traits did not impact on abdominal symptoms, but carefully monitoring of IBS patients in the next months seems to be crucial to evaluate the potential repercussion of worsened mental health due to COVID-19 pandemic in IBS.
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Background: Acute kidney injury (AKI) in COVID-19 is associated with disease severity. The aim of this study was to identify risk factors associated with the development of AKI and its clinical impact, such as need for RRT and mortality. Methods: Retrospective cohort study of hospitalized adult patients COVID-19, with normal kidney function, from April to December 2020 in Western Mexico. Results: 882 patients (60.8% men) with a mean age of 58.9y were included. 342 (38.8%) had a prior diagnosis DM, 412 (46.7%) HTN, 161 (18.3%) obesity, 59 (6.7%) heart diseases, 25 (2.8%) neurological disease, 47 (5.3%) lung disease. 216 (24.5%) smoking history. 270 patients (30.6%) developed AKI, 95 (10.77%) KDIGO stage 1, 44 (4.98%) stage 2, and 84 (9.52%) stage 3. 59 patients required RRT (6.23%), and 111 patients (12.6%) mechanical ventilation. Overall mortality was 30.6% (270 patients). Risk factors for mortality were: DM, HTN, neurological disease, age > 65 y, need for MV, and MAP < 65 mmHg, hyperNa, increased D-dimer or decreased HCO3 at admission. Risk factors for AKI were: DM, HTN, heart disease, age > 65 y, need for MV, and MAP < 65 mmHg, hyperNa, increased D-dimer or decreased HCO3 at admission. Image shows risk factors, ORs with CI. Conclusions: A high incidence of AKI in the Mexican population compared to reports from other countries, with a significantly high risk for death.
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Background: COVID-19 is a new disease of pandemic proportions. Currently, there are no reports on clinical outcomes in patients with CKD with and without KRT in the Mexican population. Our aim was to describe the clinical outcomes in patients with CKD. Methods: Retrospective cohort study of hospitalized adult patients COVID-19 confirmed with RT-PCR, from April to December 2020 in a second-level hospital in Western Mexico. Information was obtained from medical records. Results: 1012 patients were included, of which 130 patients (12.8%) had CKD (65.3% men), with a mean age of 53.8 years, 43.8% with Diabetes Mellitus and 82.3% with Hypertension. 84 patients (64.6%) were on KRT, within which 47 patients were on hemodialysis, 31 on peritoneal dialysis and 6 with a kidney transplant. 46 patients had no KRT, in stages ranging from KDIGO 3b to 5. 78.4%. 14 patients (10.7%) required mechanical ventilation. In our study, mortality among patients with normal kidney function was 30.6%. Regarding patients with CKD, patients on hemodialysis had a mortality of 25.5% (OR 0.74, 95% CI 0.39-1.5), patients on peritoneal dialysis had a mortality of 54.8% (OR 2.75, 95% CI 1.33-5.66), patients with CKD and no KRT had a mortality of 43.5% (OR 1.74, 95% CI 1.15-3.17). Conclusions: In our population, an increased mortality was found in patients with CKD with and without KRT, highlighting the mortality of patients on PD.
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The purpose of this study was to determine the influence of the internalization of ICT, in the emotional states in university students, for the internalization variable two dimensions were considered: Educational Sense and the Sense of Utility as independent variables, the dependent variable was the Emotional State and as a moderating variable the condition of expert in the Use of the Web. The investigation was carried out in a state of health emergency due to the presence of Covid-19 in Peru. The proposed structural model was validated with a sample of 102 undergraduate university students. It is concluded that the model, according to the results of R2, is explained by 41.2%, the most influential factor being the sense of usefulness of ICT, and the use and level of expert on the Web. © 2021 AISTI.
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Clinical sequelae of a disease as widespread as COVID-19 can be of great importance for primary care due to their prevalence and the morbidity they entail. The definition of long COVID and the establishment of its temporality are various, but some authors consider possible that this syndrome is actually myalgic encephalomyelitis. Similarities are observed when comparing the International Consensus Criteria for the diagnosis of myalgic encephalomyelitis with the symptoms described for long COVID. Blood tests, pulse oximetry, chest radiography, and thoracic ultrasound are recommended in patients with persistent symptoms after acute infection. Management in both conditions consists of treating the main symptoms. The possibility that COVID-19 can lead to a chronic condition such as myalgic encephalomyelitis makes long-term follow-up of patients who have suffered from this infection essential.
Subject(s)
COVID-19 , Fatigue Syndrome, Chronic , COVID-19/complications , Consensus , Fatigue Syndrome, Chronic/diagnosis , Fatigue Syndrome, Chronic/epidemiology , Fatigue Syndrome, Chronic/etiology , Humans , SARS-CoV-2 , Post-Acute COVID-19 SyndromeABSTRACT
Background: Madrid has been the epicenter of the SARS-CoV2 pandemic in Spain. We analyzed the experience at our hospital with SARS-CoV2 infection and cancer patients (p). Method(s): We analyzed our experience from March 1 to April 30 at the Puerta de Hierro University Hospital in Madrid. Diagnosis of SARS-CoV2 infection was made by RT-PCR, suspected cases not confirmed were excluded. Result(s): Overall in-hospital mortality cancer p with COVID-19 was 15.2% (95%CI, 6.3;5.2), similar to 12.7% (95%CI,11.1;4.4) with p=0.615 of the global COVID-19 hospitalised population and greater than that of patients admitted without SARS-CoV-2 infection during the same period 4.3% (95%CI;3.6;5.2) p0.001. Among 653 patients receiving active cancer therapy during this period, 24 (3.7%) developed COVID-19 and required admission, 4.2% of were receiving chemotherapy, 9.5% immunotherapy and 2.1% targeted therapies. Lung and breast cancer were the most frequent (26.1%), followed by colorectal (19.6%) and breast cancer. No significant differences due to the cancer treatment received were observed. Mortality in lung cancer patients was the highest (25%). The univariate analysis (between p who developed serious event vs. those who did not), showed that higher Brescia, CURB-65 scale, lactate dehydrogenase (LDH) or C-reactive protein (CRP) levels at admission, the greater risk of developing severe complications (p0.05) [Formula presented]. Conclusion(s): Patients with cancer, especially lung cancer, and SARS-CoV2 infection have a worse overall prognosis than the general population. Objective parameters such as LDH, CRP at admission, Brescia index or CURB-65 should alert us to a more serious evolution and suggest early an early intensive care unit (ICU) admission. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest. Copyright © 2020
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Introduction: Social distancing and isolation during quarantine due to coronavirus (COVID-19) has definitely affected people´s eating behavior, situation which must be evaluated in public health. Objective: description of food and nutritional context among the Paraguayan population and changes caused during the COVID-19 quarantine. Methods: an observational, exploratory, cross-sectional study was conducted among adults from 18 years old, both sexes, through a self reported digital survey which contained multiple choice questions on sociodemographic aspects, anthropometric data, presence of diseases, usual eating behaviors and perception about changes in food intake and physical activity during mandatory quarantine. The data was collected from May 22 to June 12, 2020 (second phase of quarantine). The results are presented in frequencies and percentages. Results: 2,178 people participated;54,2% were overweight (21,5% obese);29,2% referred to have at least one chronic disease;hypertension and hypercholesterolemia were the most frequent;62% consumed less than 2 servings of fruits and vegetables per day, and during quarantine their consumption decreased by 21% and 12% respectively. Only 12% consumed at least 3 servings of dairy products per day;60% felt that the quality of their diet was affected by the anxiety generated during the pandemic and 43% faced reduction in income which affected food purchasing capacity. Foods most frequently consumed during quarantine were rice, noodles, pasta and bread (41%), fried foods (31%), sugary foods (44%), sugary drinks (26%) and alcoholic beverages (21 %);64% practiced physical activity less frequently. Conclusions: The COVID-19 pandemic has had a strong impact on society, affecting among other aspects, food quality. It is important to rethink strategies focused on improving food and nutritional status considering the new health and social context.
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BACKGROUND: During the COVID-19 pandemic, healthcare professionals use personal protective equipment (PPE) on a constant basis and for extended periods, leading to adverse dermatological reactions, a situation little known and studied despite its relevance. OBJECTIVE: To determine the risk factors associated with the development of adverse dermatological reactions in health workers using PPE during the COVID-19 pandemic. MATERIAL AND METHODS: An observational, cross-sectional, analytical study conducted through an online survey that evaluated the association between dermatological reactions and the use of PPE through a descriptive and inferential statistical analysis. RESULTS: There was a sample of 171 healthcare professionals. It was reported a high prevalence of adverse reactions (59%) and the most affected sites were the facial region and hands. The use of PPE > 6 hours, a history of dermatological disease, female gender, use of plastic overalls and the use of a respirator were documented as risk factors. CONCLUSIONS: Being an infectious disease, COVID-19 forces healthcare professionals to use accessories as a form of personal protection, implying potential health risks;for this, effective preventive strategies and treatment are required.
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The COVID-19 pandemic has weakened the mental health of the population, health personnel are possibly an affected group, an important fact considering that they are the main elements in the face of the greatest challenge that the modern world has faced so far, in relation to diseases infectious. The COVID-19 disease has produced anxiety, depression, nervousness, and wakefulness in health personnel, among others;a result of stress, long shifts, excessive workload, inadequate training, and insufficient personal protective equipment;making them prone to disorders like Burnout Syndrome or Post Traumatic Stress Syndrome. Mental health is fundamental for public health and that of health personnel is a determinant of the quality of care and health of the patient;therefore, the objective of this paper is to carry out a bibliographic review that analyzes the mental health of health workers in the face of the COVID-19 pandemic. © 2020 EDIZIONI MINERVA MEDICA.
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The work we present is based on the experience of the knowledge transfer activities of the Mapfre Foundation Chair for Technology and Education, consisting of three webinars where the speakers are education professionals and researchers in the field of Educational Technology. In the public we have had university, Undergraduate and Postgraduate students and education professionals of different educational levels. Among the attendees, a questionnaire has been disseminated to know their impression of the situation experienced during confinement by the COVID-19 pandemic and the prospects that they predict on education in relation to the use of technology. We have performed a quantitative analysis of dichotomous and qualitative variables using an exploratory coding system, at both times, during and after the pandemic. We have also investigated the possible relationships between codes, through a co-occurrence analysis. The main results describe that most people have had sufficient resources to face the abrupt change to online teaching, although it has involved a high emotional effort. Regarding the future post-COVID-19, the people surveyed consider that, after the pandemic is over, greater methodological and didactic flexibility will be advocated both in the offer of itineraries in the subjects and in the offer of academic degrees.