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Background: Gender disparities are well documented in many facets of medical careers, especially career advancement and scholarly work. Although the majority of neonatologists in the US are female, they are underrepresented as authors in pediatricfocused journals. Early reports show the COVID-19 pandemic amplified these baseline gender disparities. Our objective was to examine gender distributions of authorship and how they may have changed since the beginning of the COVID-19 pandemic in the Journal of Perinatology, the journal for the Section of Neonatal-Perinatal Medicine. Methods: We collected data from the Journal of Perinatology website;variables included name of first and last author, date of publication, country and institution of first author, and if article was listed as supported by any funding. Gender (female, male, nonbinary, or undetermined) was determined using Genderize.io, institutional websites, ResearchGate, social media outlets including LinkedIn and Doximity, or a general Google search. Our primary outcome was the difference between the number of articles authored by women during the pandemic period (March 2020-May 2021, period 2), compared with the preceding 15 month period (December 2018-February 2020, period 1). We analyzed the data using chi-square test. Results: Author characteristics are presented in Table 1. The number of publications increased from period 1 to 2. Of the 1,230 first and last authors from the combined periods, we were unable to determine binary gender for 24 authors (1.9%). Less than half (42.6%) of articles were supported by funding, with the majority having a female in either the first or last author position. Table 2 demonstrates the change in authorship by gender and time period. There were slightly fewer female authors overall (47.7%) and as last author (38.7%) for the combined time periods, compared with nonfemale authors. There was no significant difference in the proportion of female authors to non-female authors from time period one to time period two in regard to overall, first, or last authorship. Conclusion: The distribution of author gender in the Journal of Perinatology did not change significantly during the COVID-19 pandemic. Female authors still remain underrepresented overall and specifically as last author, which raises concerns about under-attainment in career advancement. As the majority of the neonatology workforce is female, this trend warrants further investigation. (Table Presented).
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Background : High prevalence of Lupus anticoagulant (LA) has been reported in COVID-19 infection. Aims : To determine the presence and the evolution of LA in COVID-19 pneumonia en the first 10 days at Intensive Care Unit (UCI). Methods : Prospective observational cohort study: Consecutive adult COVID-19 patients admitted to ICU. Exclusion criteria: age > 80 years, anticoagulation, tocilizumab, convalescent plasma transfusion, thrombophilia, pregnancy and cancer.Blood samples on day 1, 5 and 10 from UCI admission. Studies: PT, APTT, silica clotting time [HemosILSCT, Instrumentation laboratory(IL)], diluted Russell viper venom time HemosILDRVVT(IL) and STADRVVT(STAGO Diagnostic). Screening. Mixing with normal pooled plasma (NP) and confirmatory tests should be above their cur off points to be consider LA+. Biomarkers: D Dimer(DD), Reactive Protein C high sentitivity(cRP-H), Ferritina, LDH and interleukin 6(IL 6). Results : Patients included: 23, age 57 y (IQR52-71), 70% male, 15 required mechanical ventilation(MV).Twelve(52.1%) had LA+ by HemosILDRVVT in at least one time point, 3 in 3, 1 in 2(T5,10) and 8 in one(7/8 T1, 1/8 T5);4/5 patients with hospital discharge before T10 presented LA+ only at T1. LA prevalence was lower with STADRVVT(Table 1). SCT was negative in all samples. CRP-H, IL6 and Ferritin were higher in LA+, particularly at T5 and T10(Table 2). We cannot exclude CRP interference in DRVVT many samples had CRP > 126 (maximum concentration tested in vitro on NP). Patients received prophylactic enoxaparin, samples were taken at through, antiXa = 0.08 (0.04-0.12)U/mL, ruling out interference. LA+ was not associated with death ( n = 4) or VM requirement. Only one LA-patient developed pulmonary thromboembolism after leaving ICU. Conclusions : LA presence was demonstrated in this cohort of COVID-19 Pneumonia patients. Its presence was transient during the short period evaluated, LA was diagnosed through DRVVT with differences between regents. LA presence was associated with inflammatory biomarkers but not with MV requirement or death. These results confirm that LA is probably an epiphenomena.
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Background : SARs-CoV-2 and DENGUE share clinical symptoms triggering inflammatory processes with high biomarkers levels that can hinder their differentiation in periods of double viral circulation. Aims : To compare levels of D-dimer(DD), High Sentivity C-reactive protein(CRP-H), Ferritin, Lactic-Dehydrogenase(LDH) and haematological parameters among patients with COVID-19 or DENGUE at first hospital consultation in emergency department(FCED). Methods : Retrospective cohort study: consecutive patients (Age > 18y.o.) at FCED on suspicion of symptomatic COVID-19 infection (March-June 2020), in which DD (VIDAS-Exclusion II, Biomerieux) was measured. Only dengue or COVID-19 positive patients were included and classified as Dengue, Mild upper airway infection (MUAI) by COVID-19 and COVID-19 pneumonia. DD(ng/ mL FEU), CRP-H, ferritin and LDH(Beckman-Coulter), PT and APTT(ACLTOP, Instrumentation Laboratory) and haematological parameters( DxH800, Beckman Coulter), were compared. Statistics: SPSS-23 Software Results : A total of 229 patients were included. Non severe Dengue patients presented significantly higher DD levels than MUAI, but not different to COVID-19-positive pneumonia at FCED (Table 1). The leukocytes, neutrophils, lymphocytes, and platelets count(both considering FCED and nadir) were lower in DENGUE, compared to COVID-19 patients (Table 2). CRP-H levels were higher in DENGUE than in Covid-19 MUAI, but lower than COVID-19 pneumonia. DENGUE LDH and ferritin levels were higher than those of MUAI but comparable to those of Covid-19 pneumonia (Table 1). Ferritin and LDH show a statistically correlation to DD in DENGUE and COVID-19-positive patients, but DD and CRP-H only correlated in COVID-19 patients( r :0.567). Platelets correlated negatively( r :-0.437) with DD only in dengue. Dengue patients with platelets nadir<100 × 109/L and elevated liver transaminases have higher DD levels than those with higher platelels count and not liver inflamation. Conclusions : Dengue and COVID-19 infections can trigger inflammatory processes with increased biomarkers, including DD. We showed that in non severe dengue the magnitude of response may be greater than in MUAI and similar to pneumonia COVID-19 positive. Studies are needed to define and compare the prognostic role of biomarkers in these entities.
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Background : Hypercoagulability and pulmonary microvascular thrombosis has been related to COVID-19 hypoxemia. Rotational thromboelastometry (RT) could identify the procoagulant state. Aims : -To evaluate maximum clot firmness(MCF) and other RT parameters among COVID-19 patients in intensive care unit(ICU) compared to healthy controls(HC) -To compare them according to mechanical ventilation (MV) requirement Methods : Prospective observational cohort study (August-November 2020). ICU cohort: All adult patients admitted due to COVID-19. HC cohort: healthy volunteers. Coagulation profile was evaluated by RT NaHEPTEM assay in ROTEM Delta at day 1 (T1), 5 (T5) and 10 (T10) from ICU admission. D-Dimer and Fibrinogen were also evaluated. Results : Twenty three COVID-19 patients (under prophylactic dose enoxaparin) and 19 HC were included. MCF was statistically higher in ICU patients vs HC at admission (T1) and further increasing at T5. (Table 1) Distribution of NaHEPTEM parameters, DD and Fibrinogen in samples from ICU patients under MV or not are shown in Figure 1. ICU patients under MV compared to non-MV presented higher levels of fibrinogen from T1 to T10, DD and MCF at T5,and shorter clotting formation time (CFT), higher maximum velocity (MaxV) and 5 min Amplitude (A5) at T1. Maximum Lysis (ML) was significantly lower at T5 and T10 compared to T1, P = 0.003 and P = 0.008, respectively, but not associated with MV. (TABLE1). COVID-19 patients discharged from hospital before T10 ( n = 5) presented at T5 significant lower values of DD, Fibrinogen and RT MaxV compared to patients with longer UCI stay. Conclusions : NaHEPTEM assay could detect hypercoagulability among COVID-19 critically ill patients. Velocity parameters(CFT, MaxV) and A5 seem to be further altered in patients that required MV at early stages after ICU admission, probably reflecting increased thrombin generation. MCF and DD were higher at T5 post ICU admission in patients under MV. ML decreased along to study period without association to MV and no difference to HC. Further studies are needed to evaluate its clinical usefulness.
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The Covid-19 pandemic has changed everyone's life. Social researchers are no exception: they have adjusted their work to respond to emerging needs and conditions. This article provides a brief overview of social research in Ibero-America and reflects upon a series of interviews with colleagues from Mexico and the rest of Latin America, about their work as researchers and the knowledge they construct. Among the lessons that the pandemic has taught are the importance of collaborative work, the social relevance of knowledge, and responsibility to, and engagement with, the communities that are studied. © 2021. All Rights Reserved.
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The outbreak of the new coronavirus disease 2019 (COVID-19) has become a threat to global health. We know that the risk of serious disease and death in COVID-19 cases increases with age and the presence of comorbid health conditions such as obesity, systemic arterial hypertension, diabetes mellitus, COPD, and immunosuppressed states such as cancer. Since the first case emerged in Wuhan, China in December 2019, huge research efforts have been made to understand the transmissibility mechanisms and potential therapeutic offerings that impact mortality rates. In this review, the potential challenges of the COVID-19 patient and lung cancer are raised.
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Introduction: Co-infection between other microorganisms and SARS-CoV-2, such as viruses, bacteria and fungi, is an important factor in the management of COVID-19, which could increase the difficulties in diagnosis, management, prognosis, and even increase the mortality. Objectives: The objective of this review is to describe the published scientific evidence regarding coinfection in patients with COVID-19. Methods: A bibliographic search of studies published in Spanish or English was carried out using the PubMed, The Cochrane Library and Google Scholar search engines. Studies published between January 2020 and January 24, 2021 were assessed. Results: 25 articles from various continents (America, Asia and Europe) were included. All the studies had patients with a confirmed diagnosis of COVID-19 added to some other test that identified some co-infection. We identified 18 studies that showed bacterial coinfection, 17 studies of viral coinfection and 5 studies of fungal coinfection. The prevalence of coinfection showed extremely dissimilar figures according to the population studied and diagnostic criteria. Conclusions: The presence of coinfection seems to be linked to a higher frequency of unfavorable outcomes. However, it is important to develop Latin American studies, given the heterogeneity in the studies seen in different countries. Standardized definitions should be developed in order to be able to assess the impact of coinfections in patients with a diagnosis of COVID-19.