ABSTRACT
This document is the update of the Consensus published by SAP in 2014, so that no child nor adolescent is excluded from their right to health and physical activity. The periodic medical control and the school physical education are fundamental tools. As a result, of the SARS-CoV-2 pandemic, sports practice decreased dramatically. Recommendations are formulated that serve as a reference to pediatricians, members of health care teams, educational institutions, and sports at the local, regional, and national level in the preparation of the health certificate for a child or adolescent who will participate in physical or sports activities. The pediatrician will evaluate the child or adolescent knowing that to carry out a healthy life, must perform physical activities with moderate or vigorous intensity. The health certificate implies a shared responsibility between the child or adolescent and/or the responsible adult, the doctor, the physical education teachers and/or the coaches in charge.
Este documento es la actualización del consenso publicado por la Sociedad Argentina de Pediatría en 2014, para que ningún niño, niña y adolescente (NNA) del país quede excluido de su derecho a la salud y a la actividad física. El control médico periódico y la educación física en el ámbito escolar son herramientas fundamentales para ejercer estos derechos. A raíz de la pandemia del coronavirus de tipo 2 causante del síndrome respiratorio agudo grave (SARS-CoV-2, por su sigla en inglés) disminuyó de manera notable la práctica deportiva. Se formulan recomendaciones que sirvan de referencia a pediatras, integrantes de los equipos de salud, instituciones educativas y deportivas en los niveles local, regional y nacional para la elaboración de la constancia de salud de los NNA que participarán en actividades físicas y deportivas. El pediatra evaluará al NNA sabiendo que para llevar una vida saludable éste debe realizar actividades físicas de moderada a vigorosa intensidad. La Constancia de Salud implica una responsabilidad compartida entre el NNA y/o adulto responsable, el médico, los profesores de educación física y/o los entrenadores a cargo.
Subject(s)
COVID-19 , Sports , Adolescent , Adult , Child , Consensus , Exercise , Humans , SARS-CoV-2ABSTRACT
BACKGROUND: Therapies to interrupt the progression of early coronavirus disease 2019 (Covid-19) remain elusive. Among them, convalescent plasma administered to hospitalized patients has been unsuccessful, perhaps because antibodies should be administered earlier in the course of illness. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older adult patients within 72 hours after the onset of mild Covid-19 symptoms. The primary end point was severe respiratory disease, defined as a respiratory rate of 30 breaths per minute or more, an oxygen saturation of less than 93% while the patient was breathing ambient air, or both. The trial was stopped early at 76% of its projected sample size because cases of Covid-19 in the trial region decreased considerably and steady enrollment of trial patients became virtually impossible. RESULTS: A total of 160 patients underwent randomization. In the intention-to-treat population, severe respiratory disease developed in 13 of 80 patients (16%) who received convalescent plasma and 25 of 80 patients (31%) who received placebo (relative risk, 0.52; 95% confidence interval [CI], 0.29 to 0.94; P = 0.03), with a relative risk reduction of 48%. A modified intention-to-treat analysis that excluded 6 patients who had a primary end-point event before infusion of convalescent plasma or placebo showed a larger effect size (relative risk, 0.40; 95% CI, 0.20 to 0.81). No solicited adverse events were observed. CONCLUSIONS: Early administration of high-titer convalescent plasma against SARS-CoV-2 to mildly ill infected older adults reduced the progression of Covid-19. (Funded by the Bill and Melinda Gates Foundation and the Fundación INFANT Pandemic Fund; Dirección de Sangre y Medicina Transfusional del Ministerio de Salud number, PAEPCC19, Plataforma de Registro Informatizado de Investigaciones en Salud number, 1421, and ClinicalTrials.gov number, NCT04479163.).