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OBJECTIVE: COVID-19 has tried out global health causing high mortality. There are some risk factors that associate greater severity and mortality from COVID-19;but their individual impact is unknown yet. There are also no fixed criteria for hospital admission. For this reason, this study aimed to analyze the factors associated with the severity of COVID-19 and create predictive models for the risk of hospitalization and death due to COVID-19. METHODS: A descriptive retrospective cohort study was made in Talavera de la Reina (Toledo, Spain). Data were collected through computerized records of Primary Care, Emergencies and Hospitalization. The sample consisted of 275 patients over eighteen years old diagnosed with COVID-19 in a centralized laboratory from March 1st to May 31st, 2020. Analysis was carried on using SPSS, creating two predictive models for the risk of hospitalization and death using linear regression. RESULTS: The probability of hospitalization increased independently with polypharmacy (OR 1.086;CI95% 1.009-1.169), the Charlson index (OR 1.613;CI95% 1.158-2.247), the history of acute myocardial infarction (AMI) (OR 4.358;95% CI 1.114-17.051) and the presence of COVID symptoms (OR 7.001;95% CI 2.805-17.475). The probability of death was independently associated with age, increasing 8.1% (OD 1.081;95% CI 1.054- 1.110) for each year of the patient. CONCLUSIONS: Comorbidity, polypharmacy, history of AMI and the presence of COVID-19 symptoms predict the risk of hospitalization. The age of individuals predicts the risk of death. Detecting patients at high risk of hospitalization and death allows us to define the target population and define measures to implement.
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OBJECTIVE: To determine the probability of hospitalization for chronic degenerative disease in patients with COVID-19. MATERIALS AND METHODS: A retrospective cohort in patients with COVID-19, confirmed by RT-PCR. Two study groups were integrated, the exposed group made up of 3 subgroups, exclusively diabetes mellitus, exclusively arterial hypertension and exclusively obesity;the unexposed group was the one in which any chronic comorbidity was ruled out. Relative risk, multiple logistic regression and probability calculation of the event (hospitalization) were used. RESULT(S): The relative risk for hospitalization in diabetes was of 3.59 (95%CI;2.44-5.29), 3.20 (95%CI;2.10-4.87) in hypertension and 2.56 (95%CI;1.72-3.81) in obesity. The multiple regression equation was y = -1358 + 2388 (diabetes mellitus) + 2005 (systemic arterial hypertension) + 1458 (obesity). The probability of hospitalization when there was no chronic disease was of 20.6%, when there was a chronic disease the probability fluctuated between 52.5% and 73.5%, when there were two chronic diseases it varied from 89.1% to 95.4%, and when there were three diseases the probability of hospitalization was of 98.9%. CONCLUSION(S): In the context of the probability of hospitalization when there is a chronic degenerative disease or it is absent, the research shows the difference in these two scenarios, as revealed by the more than 70 percentage points identified in the extreme scenarios, a condition that, led to the clinical field, reaffirms the presence of chronic degenerative disease as a risk factor for hospitalization.Copyright © 2023 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.
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Background: The mechanisms driving SARS-CoV-2 susceptibility remain poorly understood, especially the factors determining why a subset of unvaccinated individuals remain uninfected despite high-risk exposures. Method(s): We studied an exceptional group of unvaccinated healthcare workers heavily exposed to SARS-CoV-2 ('nonsusceptible') from April to June 2020, who were compared against 'susceptible' individuals to SARS-CoV-2, including uninfected subjects who became infected during the follow-up, and hospitalized patients with different disease severity providing samples at early disease stages. We analyzed plasma samples using different mass spectrometry technique and obtained metabolites and lipids profiles. Result(s): We found that the metabolite profiles were predictive of the selected study groups and identified lipids profiles and metabolites linked to SARS-CoV-2 susceptibility and COVID-19 severity. More importantly, we showed that non-susceptible individuals exhibited unique metabolomics and lipidomic patterns characterized by upregulation of most lipids -especially ceramides and sphingomyelin-and amino acids related to tricarboxylic acid cycle and mitochondrial metabolism, which could be interpreted as markers of low susceptibility to SARS-CoV-2 infection. Lipids and metabolites pathways analysis revealed that metabolites related to energy production, mitochondrial and tissue dysfunction, and lipids involved in membrane structure and virus infectivity were key markers of SARS-CoV-2 susceptibility. Conclusion(s): Lipid and metabolic profiles differ in 'nonsusceptible' compared to individuals susceptible to SARS-CoV-2. Our study suggests that lipid profiles are relevant actors during SARS-CoV-2 pathogenesis and highlight certain lipids relevant to understand SARS-CoV-2 pathogenesis. (Figure Presented).
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From a public health perspective, tobacco use is addictive by nature and triggers several cancers, cardiovascular and respiratory diseases, reproductive disorders, and many other adverse health effects leading to many deaths. In this context, the need to eradicate tobacco-related health problems and the increasingly complex environments of tobacco research require sophisticated analytical methods to handle large amounts of data and perform highly specialized tasks. In this study, time series models are used: autoregressive integrated moving average (ARIMA) and seasonal autoregressive integrated moving average (SARIMA) to forecast the impact of COVID-19 on sales of cigarette in Spanish provinces. To find the optimal solution, initial combinations of model parameters automatically selected the ARIMA model, followed by finding the optimized model parameters based on the best fit between the predictions and the test data. The analytical tools Autocorrelation Function (ACF), Partial Autocorrelation Function (PACF), Akaike Information Criterion (AIC), and Bayesian Information Criterion (BIC) were used to assess the reliability of the models. The evaluation metrics that are used as criteria to select the best model are: mean absolute error (MAE), root mean square error (RMSE), mean absolute percentage error (MAPE), mean percentage error (MPE), mean error (ME) and mean absolute standardized error (MASE). The results show that the national average impact is slight. However, in border provinces with France or with a high influx of tourists, a strong impact of COVID-19 on tobacco sales has been observed. In addition, the least impact has been observed in border provinces with Gibraltar. Policymakers need to make the right decisions about the tobacco price differentials that are observed between neighboring European countries when there is constant and abundant cross-border human transit. To keep smoking under control, all countries must make harmonized decisions. © 2023, Universidad Internacional de la Rioja. All rights reserved.
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Introduction: In the SARS COV2 pneumonia acute-phase reactants, such as ferritin levels (FL), are elevated due to cytokine storm and hemophagocytic lymphohistocytosis. No direct relation between radiographic pulmonary involvement and blood levels of ferritin has been proved. In this study we try to identify this relation. Material(s) and Method(s): We carried on a descriptive retrospective matched cohort study of patients diagnosed with COVID-19 from 07/01/20 to 12/31/20 who were reviewed in PostCOVID consult. For quantifying the severity of pneumonia, a score was calculated by adapting and simplifying the Radiographic Evaluation of Pulmonary Edema (RALE) scale proposed by Warren et al (2018). We chose more severe X-rays at diagnosis and the FL at that time and at 6 weeks. Statistical studies were performed with SPSS (v25). Result(s): The analysed sample was 130 patients (70 men) with average age 62yrs. The 96% required hospitalization. FL at diagnosis were high, in men 1.080mug/l (IQR=1.036) and in women 629mug/l (IQR=816), p=0.003. No significant differences were found when analysing by age groups (<54, 55-75 and >75yrs). When we compared FL and severity of Xr affectation with SCORE RALE (SR) at diagnosis, we obtained p=0.007 for mild-severe comparison. No other comparisons with statistical significance were obtained. The median of FL at review normalized regardless of the initial SR (global decrease 66%), with no differences observed between groups. Conclusion(s): - The patients in our study had high FL at diagnosis, being higher in men, and were normalized at control. - Patients with severe radiographic affectation had higher median of ferritin at diagnosis compared to the ones with mild affectation.
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The difficult socioeconomic scenario that is predicted in the wake of the health crisis is already a reality for young people. In this context, the aim of the study is to analyse the dimensions that determine the youth employability in order to identify the pillars of action that, with a political, socio-labour and educational character, should contribute to improve their professional and personal development. For that purpose, qualitative methodology has been followed, focusing on the review of reports, strategies and scientific research on youth employment from the Great Recession to the COVID-19 crisis (2008-2022). Three axes of intervention have been differentiated: (1) protection and promotion of employment, (2) improvement of employability and (3) transversal measures. The results point the need to make progress from public policies in the second and areas, since they make possible the promotion of effective labour transitions. © 2023 Servicio de Publicaciones de la Universidad de Navarra. All rights reserved.
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The exceptional situation experienced as a result of the health crisis produced by the Covid-19 pandemic has raised the need to adapt university teaching to a non-face-to-face context. Given this circumstance, virtual resources acquire high importance in reorganizing subjects in which field trips and fieldwork constitute an essential part of the teaching-learning processes. In the current health context, the difficulty of con-ducting field trips in safe conditions leads to an exploration of the usefulness of virtual resources that can mitigate or compensate for the lack of direct contact with the environ-ment. Academic geography must incorporate tools that allow students to visualize and understand the configuration of the natural environment, as a fundamental component for the knowledge of a territory and the interpretation of landscapes, where the structure of the relief acquires special relevance. © 2022, Universitat Autonoma de Barcelona. All rights reserved.
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Background: Interest in organ preservation (OP) strategies for rectal cancer (RC) patients persists. The efficacy of long course chemoradiation (LCRT) vs. short course radiation therapy (SCRT) relative to OP is unknown. We compared OP rates between SCRT and LCRT total neoadjuvant therapy (TNT) strategies. Method(s): During the COVID-19 pandemic we established an institutional SCRT mandate with no exceptions. For comparison, we identified RC patients treated with LCRT immediately before and after the mandate period. After completion of TNT, patients were restaged by clinical exam, endoscopy, and MRI. A watch and wait (WW) approach was recommended for patients with a clinical complete response (cCR), defined by the MSK regression schema. Total mesorectal excision (TME) was recommended for non-cCR patients. OP was defined as alive, TME-free, and with no evidence of disease in the pelvis. We performed survival analysis for: local regrowth rate, OP, disease-free survival (DFS), and overall survival (OS). Result(s): We identified 563 consecutive patients with RC treated with TNT, of whom 231 were excluded due to either metastatic disease, synchronous/metachronous malignancies, or non-adenocarcinoma histology (Jan. 2018-Jan. 2021). Patient and tumor characteristics were similar in the LCRT (n = 256) and SCRT (n = 76) cohorts. No significant differences in high-risk features were noted. Most patients had clinical stage III disease (82% in LCRT vs. 83% in SCRT). Induction chemotherapy followed by consolidative radiation was the most common treatment order (78% (LCRT) vs. 70% (SCRT)). The median interval from end of TNT to clinical restaging was 8 weeks (LCRT) and 9 weeks (SCRT). The cCR rate was 46% in both cohorts. The cCR rate was numerically higher in patients treated with radiation first, as compared to chemotherapy first (53% vs. 44% (LCRT) and 52% vs. 43% (SCRT)). Among patients with a cCR, the likelihood of WW management was similar (98% (LCRT) vs. 94% (SCRT)). From start of TNT, the median follow-up was 32 and 28 months respectively for LCRT and SCRT. The 2-year OS (95% vs. 92%), DFS (78% vs 70%), and distant recurrence (20% vs. 21%) rates were similar. Among all patients, the 2-year OP rate was 40% (95% CI 35-47%) for LCRT and 29% (95% CI 20-42%) with SCRT. In those patients managed by WW, the 2-year local regrowth rate was 20% (95% CI 12-27%) with LCRT vs. 36% (95% CI 16-52%) with SCRT. Conclusion(s): In this nonrandomized comparison, while cCR rates were similar, we observed a numerically higher OP rate with LCRT-TNT than with SCRT-TNT. The ongoing ACO/ARO/AIO-18.1 trial, hypothesizing that LCRT-TNT will increase OP rates relative to SCRT-TNT, should definitively answer this question.
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Google Earth Engine (GEE) is a geospatial processing platform based on geo-information applications in the ‘cloud'. This platform provides free access to huge volumes of satellite data for computing, and offers support tools to monitor and analyse environmental features on a large scale. Such facilities have been widely used in numerous studies about land management and planning. Considering the current lack of relevant overviews, it may be useful to evaluate the utilization paths of GEE and its impact on the scientific community. For this purpose, a systematic review has been conducted using the PRISMA methodology based on 343 articles published from 2020 to 2022 in high-impact scientific journals, selected from the Scopus and Google Scholar databases. After an overview of the publishing context, an analysis of the frequency of satellite features, processing methods, applications are carried out, and a special attention is given to the COVID-19 studies. Finally, the geographical distribution of the reviewed articles is evaluated, and the citation impact metrics is analysed. On a bibliometric approach, 90 journals published articles on GEE in the reference period (January 2020 to April 2022), and this large number of journals reveals the multidisciplinary application of GEE platform as well as the interest of publishers towards this topic of relevance for the international scientific community. The results of the meta-analysis following the systematic review showed that: (i) the Landsat 8 was the most widely-used satellite (25%);(i) the non-parametric classification methods, mainly Random Forest, were the most recurrent algorithms (31%);and (iii) the water resources assessment and prediction were the most common methodological applications (22%). A low number of articles about COVID-19, in spite of the planetary importance of the pandemic effects. The reviewed articles were geographically distributed among 86 countries, China, United States, and India accounting for the large number. ‘Remote Sensing' and ‘Remote Sensing of Environment' were the leading journals in the citation impact metrics, while the Random Forest method and the agriculture-related applications being the mostly cited. It is expected that these results might change over the mid to long term, due to fast progress in environmental and spatial information technologies, although currently our findings may be worthwhile and useful for assessing the current global deployment of GEE platform. © 2022 The Authors
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We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-β (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5;95% CI: 1.4-4.6), age >60 years (OR: 3.7;95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0;95% CI: 1.9-4.9).
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Background: Various studies have established a relationship between coronavirus infection (COVID-19) and diabetes mellitus (DM) as a factor of poor prognosis. Purpose(s): To determine the influence of DM on the evolution of patients hospitalised by COVID-19. Method(s): Retrospective observational study. All hospitalised patients with COVID-19 infection treated with Lopinavir/Ritonavir and Hydroxychloroquine during March and April 2020 were included. Two cohorts were performed: patients with DM and patients without DM. Patients who were not discharged or exited until April 30th 2020, were excluded. The treatment guidelines used were: Lopinavir/Ritonavir 200/50 every 12 hours mg for 14 days and Hydroxychloroquine 400 mg every 12 hours on the first day, followed by 200 mg every 12 hours during four days. Data were obtained through the Athos-Prisma inpatient prescription programme and review of medical records at Diraya. The chi-square test of comparison between data series of the two patient subgroups was performed. Result(s): Fifty-six (56) patients, 40 men and 16 women were included. The cohort of patients with DM (n=15) presented a mean of 66.7 years (53.8-79.6) vs 65.8 years (52.4-75.7) in the cohort of patients without DM (n=41). Mortality in the group with DM was 46.6% vs. 29.2% in the group without DM. After performing the chi-square test, a p>0.05 was obtained, so the differences between the two subgroups were not statistically significant. Conclusion(s): Our results do not associate DM with a poor prognostic factor in COVID-19 infection, although they are conditioned to the small sample size available. New studies with a larger number of patients will be necessary.
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The health conditions generated by the COVID-19 pandemic severely restricted in-person therapy, and as a result online therapy was put into practice. The objective of this study was to describe and analyse, from the perspective of the therapist, how the pandemic has influenced their experience and clinical practice. Qualitative interviews were conducted with 24 Latin American therapists who had performed online therapy during the pandemic. The information was analysed following the coding procedures of the Grounded Theory. Three core categories were constructed from the analysis: (a) impact on the therapist: spiral of uncertainty, oppression and adaptive astonishment;(b) incorporation of technologies into clinical practice: 'I never thought they could help';and (c) transformation of the practice of psychotherapy: 'water always finds its way'. The model incorporates and relates therapists' perceptions of their professional work, patients' attitudes towards this new psychotherapy method, perception of the therapeutic relationship and process, and the facilitators and obstacles experienced in online therapy.
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This Evidence-Based Practice paper contains a study about the similarities and differences in team development among first-year engineering students during an introductory design course at a major university in the eastern United States. The study contained ten teams that operated in a totally online environment in Spring 2021, due to COVID-19 restrictions, and ten teams that operated in person in Spring 2022. All teams consisted of students in their second semester of college. © 2022 First-Year Engineering Experience, FYEE 2022. All rights reserved.
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Introduction: The COVID-19 pandemic has rocked our society to its core. Insomnia is the most common sleep disorder in later life and impacts approximately 20%-50% of older adults >65 years, therefore, especially vulnerable to mental health problems, including fear, anxiety and depression. Objective(s): To analyse the changes in older patients with chronic insomnia produced by the covid-19 pandemic. Method(s): Consecutives individuals aged >=65 years of the sleep unit were included, 50 patients before a COVID-19 pandemic (BeCOVID) and 50 patients posterior a COVID-19 pandemic (POSTCOVID). Clinical history specific for sleep disorders;scores on sleep-questionnaires: Epworth Sleepiness Scale (ESS) >=8 sleepiness mild, moderate or severe;Insomnia Severity Index (ISI)>=15 clinical insomnia moderate or severe;psychological tests Beck depression inventory (BDI-II), no-mild <=19, moderate-severe (20-63);the state-trait anxiety inventory (STAI) considered positive above 50th percentile. Result(s): A total of 8 patients BeCOVID and 25 POSTCOVID with chronic insomnia, the most prevalent sleep disorders in older adults produced by COVID-19 (p = < 0,001), age (72.5 +/- 0.8 and 71 +/- 0.9) years old. Intake of benzodiazepine hypnotic drugs in (63/40%), nonbenzodiazepine hypnotic drugs (13/12%) and antidepressants (25/32%) of the patients. Chronic diseases (hypertension 75/76%;mellitus diabetes 38/18%, dyslipidaemia 56/25%;glaucoma 38/8%), psychiatric disease previous 0/8%. Other sleep disorders, obstructive sleep apnoea 63/72%, rest leg syndrome 32/25%, periodic leg movement (PLM) disorders 63/16%, REM sleep behaviours disorders 0/4% and circadian rhythms disorders 2/2%. When comparing polysomnography no significant difference were observed in sleep architecture parameters such as sleep latency, REM sleep latency, efficiency, total sleep time, proportion of sleep stages (N1, N2, N3 y REM), wake after sleep onset, arousals index, PLM index or apnoea-hypopnea index (AHI) or changes of phases number were observed. Sleeps questionnaires show moderate or severe clinical insomnia in 50/76%, depression mild 20/32%, moderate 20/16% severe 0/8%, anxiety state 60/40% and trait 60/64%. Conclusion(s): Immediate interventions are essential in order to enhance psychological resilience.COVID-19 pandemic was associated an increase of chronic insomnia and generalized anxiety disorder in older patients.
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Background: Since the beginning of the SARS-CoV-2 pandemic, identifying the COVID-19 pathophysiology not only has been addressed to applying diagnostic tests or preventing through vaccines, but also to the timely detection, especially of patients in risk groups such as those in transplants areas (renal, hematology, etcetera). In the case of these patients, using RT-PCR tests avoids putting them at risk by subjecting them to states of immunosuppression that could aggravate their situation if they were faced with an onset of a COVID-19 infection.