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Objective: Evaluate the impact of real life use of remdesivir (RDV) as treatment for hypoxemic SarsCoV2 Pneumonia. Method(s): Of 1155 consecutive adult subjects hospitalised with SarsCov2 infection, we selected only those with cumulative evidence of: 1. positive PCR test;2. Radiologically confirmed pneumonia;3. Hypoxemia and need of supplementary O2 (>= 24%). We compared those treated with RDV versus those receiving Standard of Care (SoC), in terms of mortality, length of hospital stay and secondary effects of treatment. Result(s): 843 subjects were treated with RDV and 312 with SoC. In the RDV group, 97.1% patients were also receiving Dexamethasone (DEXA) and mean age was 69.7 (+/-14.4) years with 61.8% male prevalence, as opposed to the SoC group that registered 73.9 (+/-14.5) years and 49.7% male prevalence. Both groups had similar prevalence of Diabetes, Hypertension and Chronic Lung Disease;Overweight was more prevalent in the RDV group whereas Immunosuppressant conditions and Smoking were more frequent in the SoC subjects. Concerning the proposed outcomes: a) RDV patients had a mean Hospital Stay 4.25 days inferior than SOC subjects (p=0.002);b)The relative risk of death during hospital stay in the RDV group was 0.47 [0.38;0.60] when compared to those in the SoC group;c) 9 subjects in the SoC group (0.03%) and 12 patients in the RDV group (0.014%) had secondary effects attributable to treatment drugs, all resolved with treatment interruption. Conclusion(s): The use of RDV with DEXA in SARSCoV-2 Hypoxemic Pneumonia significantly reduced mortality and hospital stay, and registered no significant side effects in a real life cohort of consecutively enrolled patients.
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Introduction. Patients with chronic kidney disease (CKD) and COVID-19 are at high risk of adverse outcomes due to the presence of comorbidities. However, it is still unclear whether dialysis therapy is associated with a worse prognosis in patients infected with SARSCoV- 2. The objectives were to assess mortality and risk factors associated with a worse prognosis of these patients (e.g., age, sex, comorbidities, Intensive Care Admission [ICU] admission, and need for invasive mechanical ventilation [IMV]). Methods. An observational, descriptive, retrospective study was conducted in the private healthcare maintenance organization (Unimed-BH) of Belo Horizonte and 33 surrounding cities in Brazil. We used data collected from the organization's database. We included adult inpatients with CKD on previous dialysis therapy who tested positive for COVID-19, from February 2020 to June 2021. Results. During the period, 16182 patients were admitted to Unimed-BH with a diagnosis of COVID-19. Of these, 333 (2%) had dialysis CKD. Male patients were 180 (54%), age ranged from 22.85 to 95.75 years and the mean was 60.91 years. Of the 333 patients, 109 (32.7%) were admitted to the ICU, and 56 (16.8%) required IMV. Among the 14 comorbidities analysed, the mean number of comorbidities was 6, with 93 (27.9%) dyslipidaemia, 74 (22%) diabetic, 270 (81%) hypertensive, 25 (7.5%) asthmatic, 42 (12.6%) with chronic pulmonary disease (CPD) and 122 (36.6%) with congestive heart failure (CHF). There were 66 (19.8%) deaths, 29 (43.9%) were male, the mean age was 60.8 years, and 23 patients (34.8%) were elderly (>60 years). Among the patients who died, 55 (83.3%) were in the ICU and 46 (69.7%) on IMV. The mean number of comorbidities was 9.27 being 16 (24.2%) dyslipidaemia, 44 (66.6%) diabetic, 60 (90.9%) hypertensive, 5 (7%) asthmatic, 10 (15%) with CPD and 32 (48.5%) with CHF. Conclusions. Dialysis patients appear more susceptible to unfavourable outcomes than the general population. Our findings are similar to those reported in the world literature which is still scarce. It is important to conduct more studies on this population.
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Introduction. Life expectancy is increasing worldwide. However, during the COVID-19 pandemic, people 100 years or more (centenaries) were challenged by a potentially fatal disease. We evaluated the outcome of centenaries hospitalized due to COVID-19 in a private healthcare system of Belo Horizonte/Brazil (Unimed-BH). Methods. Administrative data were collected from the hospital database. Patients were included if they had a severe adult respiratory syndrome due to coronavirus type 2 (SARS-CoV-2) ribonucleic acid identified by quantitative real-time reverse transcriptase polymerase chain reaction (RT-qPCR) or by the International Code of Disease- 10th review (ICD-10) hospitalization codes U07.1, B34.2, or B97.2. Results. From March 1 2020 to October 31 2021, 316.4 & plusmn;12.9 centenaries/month were registered. Eighteen hospitalizations due to COVID-19 were identified. Median age was 101.8 years (interquartile range [IQR]:100.7,103.0). Most patients were female (83%). There was a median of 6.0 morbidities per patient (IQR:5.3,7.8), range 2-12 morbidities, among 71 possible morbidities. The most described morbidities were systemic arterial hypertension (94%), dementia (61%), and congestive heart failure (61%). Median length of hospitalization was 6.5 days (IQR:3.3,8.0). No patient was dialyzed. Seven (39%) patients died during hospitalization, of whom 3 (17%) were admitted to the Intensive Care Unit and 2 (11%) were oxygenated by invasive mechanical ventilation. No other patients were admitted to the Intensive Care Unit or invasively mechanically ventilated. Conclusions. Although the hospitalization rate was low, the mortality rate during hospitalization was high among centenaries. Further research is required to evaluate the actual risks of centenaries to be infected by SARS-CoV-2 and the subsequent outcomes.
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The world is changing, and Sars-Cov-2 has accelerated this process. Education was severely affected by countries emergency state where most students had remote classes. This change of the paradigm (for most of the students) affected students’ motivation and teacher failed to assess the real students’ knowledge. Pervasive Gaming has demonstrated to motivate the user while playing and learning. Indeed, with this work we intend to show how to assess the programming skills of the students in a remote learning scenario and, at the same time, give the student’s progress to the teacher. The number of tries, the type of errors and time spent to solve exercises are some metrics retrieved to the teacher in the form of a dashboard. This approach contrasts with current systems that do not provide any feedback to the teacher. As future work is intended to test the system in a real scenario and validate the extracted methods. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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BACKGROUND: Commercial availability of serological tests to evaluate immunoglobulins (Ig) targeting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has grown exponentially since the start of the coronavirus disease 2019 (COVID-19) outbreak. Thorough validation of these tests is important before use as epidemiological tools to infer seroprevalence in specific populations and as diagnostic tools to complement molecular approaches (e.g., quantitative reverse transcription-polymerase chain reaction). METHODS: Commercial serological tests from 11 suppliers were assayed side-by-side using 126 samples from SARS-CoV-2-infected inpatients and 36 from healthy and HIV-infected individuals. RESULTS: The majority of the tests assayed have >95% specificity. For the sensitivity calculation, samples were stratified by days since symptoms onset; sensitivity peaks at 16-21 days for IgM and IgA (maximum 91.2%, Euroimmun) and, dependant on the test, at 16-21 or >21 days for IgG (maximum 94.1%, Snibe). Data from semiquantitative tests show that patients with a severe clinical presentation have lower levels of Ig targeting SARS-CoV-2 at <10 days since symptoms onset and higher levels at >21 days, compared to patients with a non-severe presentation. CONCLUSIONS: This study highlights the heterogeneity of sensitivity and generally high specificity of the serological tests and establishes a basis for their usefulness to complement diagnostic techniques and population seroprevalence studies.