Long-Term Evolution of Kidney Function of Covid-19 Survivors Who Were Hospitalized and Did or Did Not Develop Acute Kidney Injury

Introduction: Hospitalized COVID-19 patients are at increased risk for acute kidney injury (AKI, incidence 0.5-80%), which contributes to increased morbidity and mortality. However, the long-term effect of COVID-19 on kidney function is unclear, particularly in populations with a high prevalence of chronic kidney disease like ours. The aim was to assess the evolution, at least 6 months after hospital discharge, of kidney function in COVID-19 survivors who were hospitalized and did or did not develop AKI (KDIGO criteria). Additionally, patient survival was analyzed. Method(s): Prospective cohort of surviving patients with confirmed COVID-19 diagnosis, treated in our hospital from 08/Mar/2020 to 16/Oct/2021. From the inpatient registry, survivors were contacted by telephone;those who agreed to participate had a clinical interview and measurement of biochemical variables, including estimated glomerular filtration rate (eGFR) and albumin/creatinine ratio (ACR) in a single urine sample. Result(s): Of 585 patients hospitalized for COVID-19 and discharged alive, 121 (21%) developed AKI. So far, 166 without AKI and 34 with AKI have been included. Patient evaluations were performed at a mean (+/-SE) of 20.0+/-0.3 months, and main comparisons between groups are shown in Table 1 and Table 2.Overall mean time survival (+/-SE) was 26.1+/-0.5 months, and comparison of survival according to the development of AKI is shown in Figure. [Formula presented] [Formula presented] [Formula presented] Conclusion(s): A fifth part of surviving patients hospitalized for COVID-19 developed AKI, 73% of them recovered kidney function upon discharge. Patients who developed AKI had lower kidney function throughout the study and a higher ACR at the end of follow-up compared to those without AKI;however, this latter group displayed a slight decrease in eGFR at the end of the study compared to its baseline value. Survival of patients was significantly lower in those with AKI, and it was worse in those with higher stages. No conflict of interestCopyright © 2023

Sensitivity of the Panbio COVID-19 rapid antigen detection test in primary care

Introduction and objectives: primary care paediatricians need reliable rapid diagnostic techniques (RDTs) to prevent the spread of coronavirus disease 19 (COVID-19) through early and effective screening while awaiting a vaccine. The objective of this study was to evaluate the sensitivity (Sen) of the Abbott laboratory SARS-CoV-2 Panbio antigen test, newly introduced in primary care, in both adults and children (symptomatic and asymptomatic contacts) in comparison to the polymerase chain reaction (PCR) test. Sample and methods: the study included 591 patients (222 aged less than 14 years) from 7 primary care centres;of who 249 were symptomatic and 342 asymptomatic contacts. We calculated the Sen and specificity (Spe) with their 95% confidence intervals (CIs). We assessed the independence of the two results with the McNemar test. Results: the Sen of the test within 5 days from onset was 81% in adults (95% CI, 66.16-96.34) and 80% in children (95% CI: 34.94-100). In contacts, we assessed the Sen within 5 days, in adults (68%;95% CI: 51.13-86.37), in 5 to 9 days (85%) and in children (66%;95% CI: 30.31-100). The most frequent source of exposure were household contacts (52% of the cases). The Spe was 100% in every case. Conclusions: the Panbio SARS-CoV-2 rapid antigen test can be useful for diagnosis in adults and children within 5 days of onset, and from days 5 to 9 in contacts of confirmed COVID 19 cases. Further studies are required for adequate interpretation of the latter result. © 2022, Spanish Association of Primary Care Pediatrics. All rights reserved.

A novel approach to discover numerical association based on the coronavirus optimization algorithm

The disease caused by the SARS-CoV-2 (COVID-19) has affected millions of people around the world since its detection in 2019. This pandemic inspired the development of the Coronavirus Optimization Algorithm (CVOA), a bio-inspired metaheuristic that was originally used to adjust deep learning models for time series forecasting, by means of a binary codification. In this paper, a integer codification for the CVOA individual is introduced and used for optimizing a novel approach for numerical association rules mining. As an application case, the prediction of earthquakes of large magnitude has been addressed. This kind of events are rare and, therefore, they can be characterized by rules with very high interest or lift and low support. Thus, the algorithm has been applied to the extraction of rules meeting specific criteria in an earthquake data set, provided by the National Geographic Institute of Spain. The results show CVOA as a promising tool for numerical association rules mining, obtaining rules with useful and meaningful information for predicting the occurrence of large earthquakes. © 2022 Owner/Author.

Hybrid classrooms: The new normality for Higher Education since Covid-19

The purpose of the article was to carry out an analysis of the incorporation of the hybrid classroom method to the new changes produced in higher education from the new normal, as a result of the experience lived by the Covid-19 pandemic. The methodology adopted was the narrative review, for which various bibliographic sources on the subject were used, using search engines and databases such as Scopus, Web of Science, Scielo, and Redalyc. It was concluded that higher education institutions should orient their capacities and performance to new learning opportunities through hybrid classrooms, improving the teaching profile according to the demands of this model, fundamentally with respect to the management of information and communication technologies, which allows channeling a motivating and committed attitude to change.

Nationwide multicentre study on the organization of primary care paediatrics services in the first wave of the COVID-19

Introduction: the COVID-19 pandemic has driven changes in the organization of care delivery in primary care (PC) centres. The objective of our study was to describe the changes in PC paediatric care that took place in the first wave of the COVID-19 pandemic. Material and methods: we conducted a nationwide, multicentre, retrospective, observational and descriptive study through a survey of PC paediatricians with distribution of the questionnaire in June 2020. We collected data from March 16 to May 10, 2020, divided in four 2-week periods. We asked about care delivery in these centres during this period: use of triage systems, modalities of care delivery (in person or by telephone) and volume of visits. Results: we received 105 responses by PC paediatricians, of which 110 were considered valid. We ob-tained responses from paediatricians in 17 autonomous communities (72.4% in urban settings). Respondents served a cumulative population of 107 715 patients. A total of 90.5% provided remote care (38.1% did before the pandemic). Triage was conducted in all centres. The mean number of patients managed per paediatrician in each of the time intervals under study was 144, 114, 123 and 136 (com-pared to 277, 214, 207 and 233 in the same periods in 2019). In 88.6% of the caseloads, in-person ap-pointments were conducted as part of the child health programme (CHP). The total number of hospital admissions for any reason in the cumulative catchment population was of 79 patients, and the number of admissions to the intensive care unit was 7. The respondents did not report any deaths. Conclusions: in the first wave of the COVID-19 pandemic, there was a substantial increase in remote primary care paediatric visits parallel to a significant decrease in in-person visits. Triage systems were implemented. There was still substantial activity in the CHP. The number of hospital admissions and cases of serious disease was very low. © 2021, Spanish Association of Primary Care Pediatrics. All rights reserved.

Early COVID-19 re-infection

Although an immune response has been demonstrated in patients who have had Covid19, re-infec-tions are being reported with increasing frequency. To avoid confusion with cases of persistent infec-tion, the criteria for the diagnosis of reinfection require a minimum time interval between episodes and the performance of complementary tests that are not accessible to most clinicians. Two cases of reinfection in pediatric patients, attended in primary care and with a short time interval between the first episode and the reinfection are presented. © 2021, Spanish Association of Primary Care Pediatrics. All rights reserved.

Precarious Work and Health Care among Working-Class Men in Buenos Aires, Argentina

Introduction: We analyze the relation between work and health drawing on the labor experiences of adult men who reside in a working-class neighborhood located in the periphery of Buenos Aires City. More specifically, we analyze how precarious jobs impact on their psychophysical health through work conditions that expose them to diverse risks and deprivations for quality of life and health care. Methodology: Data come from qualitative, in-depth, interviews that we conducted with adult men as part of a larger study on health care with residents of the neighborhood. Results: Precarious jobs affect health in various ways. Some of the interviewees have been exposed to physical and psychosocial risks due to the work conditions and environment in the workplace. The negative consequences that precarious jobs have for quality of life are also salient, by limiting their capability to plan ahead, organize everyday life and develop self-care practices. Conclusions: We highlight the importance of considering precarious work as a social determinant of health, since it is a multidimensional trait that helps to analyze its negative consequences on working-class men. We also point to the adverse consequences for health of precarious jobs throughout the life-course, in part, due to age-based chronic conditions but also due to the cumulative disadvantages produced by precarious and vulnerable work trajectories.

Primary care health workers during the covid-19 pandemic in the outskirts of buenos aires

The COVID-19 pandemic has dislocated work routines within health facilities due to new public health priorities. In circumstances characterized by uncertainty and risk in the face of an unknown disease and the constantly changing care protocols, questions arise about how members of healthcare teams have experienced these changes. We analyze the experience of health workers in a primary care center in the periphery of Buenos Aires during 2020, and describe the coordination strategies they developed to achieve greater anticipation and safety in the workplace. © 2021 Grupo Editor Yocavil. All rights reserved.

Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units☆ Recomendaciones para el manejo de los pacientes críticos con COVID-19 en las Unidades de Cuidados Intensivos

The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients.

Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units.

The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients.

COVID-19 pandemic. What have we learned?

Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology. Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined. The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild. Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.

[Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units]. / Recomendaciones para el manejo de los pacientes críticos con COVID-19 en las Unidades de Cuidados Intensivos.

The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients.

Outcomes After Vascular Surgery Procedures in Patients with COVID-19 Infection: A National Multicenter Cohort Study (COVID-VAS).

OBJECTIVES: To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic. METHODS: This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across Spain and Andorra between March and May 2020. The primary end point was 30-day mortality. Clinical Trials registry number NCT04333693. RESULTS: The mean age was 70.9 (45-94) and 58 (77.0%) patients were male. Around 70.7% had postoperative complications, 36.0% of patients experienced respiratory failure, 22.7% acute renal failure, and 22.7% acute respiratory distress syndrome (ARDS). All-cause 30-days mortality rate was 37.3%. Multivariate analysis identified age >65 years (P = 0.009), American Society of Anesthesiologists (ASA) classification IV (P = 0.004), preoperative lymphocyte count <0.6 (×109/L) (P = 0.001) and lactate dehydrogenase (LDH) >500 (UI/L) (P = 0.004), need for invasive ventilation (P = 0.043), postoperative acute renal failure (P = 0.001), ARDS (P = 0.003) and major amputation (P = 0.009) as independent variables associated with mortality. Preoperative coma (P = 0.001), quick Sepsis Related Organ Failure Assessment (qSOFA) score ≥2 (P = 0.043), lymphocytes <0.6 (×109/L) (P = 0.019) leucocytes >11.5 (×109/L) (P = 0.007) and serum ferritin >1800 mg/dL (P = 0.004), bilateral lung infiltrates on thorax computed tomography (P = 0.025), and postoperative acute renal failure (P = 0.009) increased the risk of postoperative ARDS. qSOFA score ≥2 was the only risk factor associated with postoperative sepsis (P = 0.041). CONCLUSIONS: Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes <0.6 (x109/L) and LDH >500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality.

Pseudotumor Cerebri Caused by SARS-CoV-2 Infection in a Boy

We present the case of a 7-year-old boy who started with diplopia and paralysis of the sixth unilateral cranial nerve after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The cranial resonance was normal and the cerebrospinal pressure was 32 cm H 2O detected by lumbar puncture. The treatment with corticosteroids and acetazolamide was effective. This is the first case of idiopathic intracranial hypertension associated to SARS-CoV-2 probably due to immune-mediated process.