ABSTRACT
Background: Patients with SARS-CoV- 2 infection have highly variable presentations, from asymptomatic disease to severe bilateral pneumonia. Hyperinflammatory host response leads to lung and endothelial severe injury. Matrix-metalloproteinases (MMPs) and their inhibitors (TIMPs), involved in tissue degradation and remodeling, are dysregulated in inflammatory processes and could play a role in the pathophysiology of COVID-19. Aim(s): To evaluate the association of MMPs/TIMPs with SARS-CoV- 2 infection evolution and its role as prognosis biomarkers. Method(s): Retrospective study of SARS-CoV- 2 patients that required hospitalization between March and December 2020. Upon admission, plasma sample were collected. We measured MMPs (1, 2, 7, 9 and 10) with MAP Human MMP panel 2 (Luminex) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) with ELISA kit for TIMP-1 (R&D Systems). The primary outcome was all-cause death (Table Presented) during hospitalization. Secondary endpoint included a composite of death, requirement of mechanical ventilation or intensive care unit (ICU) admission and venous/arterial thrombosis. Result(s): We included 151 patients (mean age 62 +/- 14 years). Overall, 9.9% patients died during hospitalization, 17.9% required transfer to the ICU and 7.9% developed a thrombotic event, despite the use of antithrombotic therapy in 99% of the patients. Statistically significant but weak positive correlations (R< 0.4 in all cases) between MMPs/TIMP-1 and inflammatory biomarkers such as neutrophil count, CRP, Ferritin or IL-6 were stablished. In the multivariate analysis, MMP-10 was associated with the risk of death (odds ratio 6.05;95% confidence interval, 1.80-20.36;p = 0.004). Both, MMP-10 and TIMP-1 levels were independently associated with worse combined outcome (OR (95%CI) were 3.32 (1.41-7.83) and 4.38 (1.22-15.76) respectively). These OR were higher than those obtained for D-Dimer (OR 2.41 (95%CI: 1.05-5.57)). Conclusion(s): Baseline MMP-10 and TIMP-1 levels are predictors of unfavorable outcome in hospitalized COVID-19 patients. Future studies should focus their use as potential therapeutic targets.
ABSTRACT
COVID-19 restrictions in schools worldwide constitute an important limitation for peer support among students. The masks, the distance between tables or the established sitting order are new challenges that both students and teachers must face in Spain. The conventional strategies that took place among students prior to the COVID-19 pandemic have been altered. In this study, the mathematics achievement of high-school students prior to the COVID-19 pandemic and during the COVID-19 pandemic is examined. Quantitative and qualitative methods were used. A total of 368 students from 9th grade (ages 14 to 15) participated in this research. Statistically significant differences were reported when comparing the mathematics achievement of pre-COVID-19 and post-COVID-19 students (t = 22.21, p < 0.01). An overall negative effect size of -2.32 was reported for those students with COVID-19 restrictions. Mathematics achievement scores were 9.90% lower for the group with restrictions. No statistically significant differences were reported when analyzing results by gender or repeating condition. The qualitative information supported the quantitative findings. Alterations in peer support was identified as one of the main factors that could explain this decrease. The main conclusion of this study is that current restrictions due to COVID-19 could be producing an important decrease in students' mathematics achievements.
ABSTRACT
In this research, the influence of the Coronavirus disease (COVID-19) pandemic on 9th grade students' mathematics achievement is analyzed through quantitative and qualitative methods. A posttest only with control group design was used to compare the mathematics marks of 9th grade students from the previous school year (before the pandemic, control group) and the current school year (during the pandemic, experimental group). Seventy-three students from a public high school in Spain attending class on alternate days participated in the study. Three focus group sessions were held with students, and five semi-structured interviews were conducted - two with teachers and three with students' families. Results show statistically significant differences in students' mathematics achievement, with students enrolled in 9th grade the previous (pre-pandemic) year outscoring their peers currently enrolled in 9th grade (during the pandemic) by 22.17%. An overall negative effect size of Hedge's g = -1.11 was reported. Although significant statistical differences between groups were reported for both male and female students, the effect was 42.31% larger for male students (Hedge's g = -1.11) than for females (Hedge's g = -0.78). The qualitative information supported the quantitative results. Changes in educational settings, students' lack of motivation, monotony, and students' level of responsibility were qualitatively reported as factors that may explain this phenomenon. The main conclusion of this study is that the COVID-19 pandemic may be significantly and negatively affecting 9th grade students' mathematics achievement. © 2022 The Author(s).
ABSTRACT
Background: Knowledge on the immunopathobiology of COVID-19 is rapidly increasing but most studies analyzed relatively small series of patients and immune features predictive of fatal outcome are unavailable for routine stratification. Furthermore, an increased risk of death in patients with hematological cancer infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified, but it remains unknown if this is related to possible immunosuppression caused by cancer itself and cytotoxic treatment. Aims: Characterize the immune response to SARS-CoV-2 in a large cohort of patients to identify high-risk immune biomarkers and evaluate the association between COVID-19 severity and immunosuppression in patients with hematological cancer. Methods: Multidimensional flow cytometry was used to conduct holistic and unbiased analyses of17 immune cell types on 780 peripheral blood samples obtained from 513 COVID-19 patients, 24 cases with non-SARS-CoV-2 infection and 36 age-matched healthy adults.167 COVID-19 patients had 207 longitudinal samples collected over time. RNA sequencing on FACSorted cells and high-resolution flow cytometry were used to perform a deeper characterization of various myeloid and lymphoid subsets in14 COVID-19 patients and4 healthy adults. Results: Immune profiles of COVID-19 patients were generally similar to those of age-matched patients with non-SARS-CoV-2 infection, but significantly different from those of age-matched healthy adults. When compared to the later, COVID-19 patients showed increased percentages of neutrophils, CD4+CD56+ T-cells, and plasmablasts, whereas levels of basophils, eosinophils, and non-classical monocytes, as well as double-negative, CD8loCD56-, CD8-/loCD56+ and CD8hiCD56- T-cells, and B-cells were decreased. Both transcriptional and immunophenotypic data in myeloid and lymphoid subsets suggested an association between COVID-19 severity and neutrophil activation, as well as significantly reduced levels of specific adaptive immune cell types. Unsupervised clustering analysis of 513 patients revealed three immunotypes in response to SARS-CoV-2 infection. One of them, present in14% of patients (n=74), was characterized by significantly lower percentages of all immune cell types except neutrophils and plasmablasts, and was significantly associated with more severe disease. Of note, 50% of COVID-19 patients with blood cancer displayed this immunotype. Accordingly, hematological patients showed a significantly higher frequency of admission into intensive care units (50% vs 5%, P<.001) and death (30% vs4%, P<.001) than patients without tumor did. On multivariate analysis incorporating age and comorbidities, the frequency of B-cells and non-classical monocytes were independent prognostic factors for overall survival. Indeed, <1% B-cells in peripheral blood was most strongly associated with risk of death. Among patients with immune monitoring during follow-up, significant changes in the relative distribution of eight immune cell types, including basophils, CD8loCD56- T-cells, and B-cells, were observed from the first to last peripheral blood sample between patients who survived or died. Summary/Conclusion: Our results accelerate our understanding of the immunopathobiology of COVID-19 and unveil an association between altered immune profiles in patients with hematological cancer and their poorer outcome. Reduced percentages of B-cells and non-classical monocytes are high-risk immune biomarkers that could be readily implemented in routine practice for risk-stratification of COVID-19.
ABSTRACT
The covid-19 pandemic has significantly altered the organization and scheduling of high schools in Spain. Due to pandemic restrictions, most students from grades 9 to 11 come to class only on alternate days. In this situation, e-learning and distance learning have gained prominence as necessary methods of instruction. In this study 68 students from grades 9 and 10, attending on alternate days, participated in an online teaching experience for the first time in their lives. This took place during the first trimester of the 2020-2021 academic school year. On days when they did not attend class in person, students were expected to watch the mathematics classes which were broadcasted live via YouTube. Students could either watch the classes live and ask the teacher questions via an online chat, or alternatively, they could watch the pre-recorded classes at a later time. The two options were analyzed using quantitative and qualitative methods. Results showed a continuous decrease in the number of students who preferred the first option, switching progressively from online live classes to pre-recorded classes as the weeks passed. The qualitative results explained this progressive decrease as students preferred to watch the teacher’s explanations several times. Although e-learning is absolutely necessary in the 21st century, and especially during the current pandemic, controlling students’ level of application to distance work and online learning is still a challenge. © 2021 by the authors;licensee Asian Online Journal Publishing Group