Real World Long-term Assessment of The Efficacy of Tocilizumab in Patients with COVID-19: Results From A Large De-identified Multicenter Electronic Health Record Dataset in the United States.

BACKGROUND: Studies have shown conflicting results on the efficacy of tocilizumab (TCZ) for patients with COVID-19, with many confounders of clinical status and limited duration of the observation. Here, we evaluate the real-world long-term efficacy of TCZ in COVID-19 patients. METHODS: We conducted a retrospective study of hospitalized adult patients with COVID-19 using a large US-based multicenter COVID-19 database (Cerner Real-World Data; updated in September, 2020). The TCZ group was defined as patients who received at least one dose of the drug. Matching weight (MW) and a propensity score weighting method were used to balance confounding factors. RESULTS: A total of 20,399 patients were identified. 1,510 and 18,899 were in the TCZ and control groups, respectively. After MW adjustment, no statistically significant differences in all-cause mortality were found for the TCZ vs. control group (Hazard Ratio [HR]:0.76, p=0.06). Survival curves suggested a better trend in short-term observation, driven from a subgroup of patients requiring oxygen masks, BIPAP or CPAP. CONCLUSION: We observed a temporal (early) benefit of TCZ, especially in patients on non-invasive high-flow supplemental oxygen. However, the benefit effects faded with longer observation. The long-term benefits and risks of TCZ should be carefully evaluated with follow-up studies.

Analysis of Digital Literacy in Health through Active University Teaching.

As we have seen as a consequence of the COVID-19 global pandemic, our scientific-technological society requires a transformation of knowledge in a global, digital and virtual manner. In light of this, and to improve the public health skills of professionals working to promote health education, one of the current priorities is to train pre-service teachers on how to search for health-related scientific knowledge relating to bio-health through digital literacy in health. The objectives of this study were to determine the level of eHealth literacy, scientific knowledge in health and confidence on the part of students, analyzing the degree of improvement following a teaching intervention with students of the Bachelor's Degree of Education of the University of Extremadura. A quasi-experimental longitudinal study was carried out with pre-test and post-test groups and a mixed data analysis. It involved the application of an active cooperative methodology with tutoring using the jigsaw technique, with the use of four quality digital browsers to enhance scientific rigor. The results show that the initial level of eHealth literacy and confidence was problematic. Following the intervention with the cooperative methodology, both these levels and the level of scientific knowledge in health reached an excellent level. In conclusion, this suggests that university training programs need to be implemented to improve digital and scientific skills in health education as they are currently insufficient. It has been demonstrated that a cooperative active methodology improved these levels and accordingly its use in active and digital higher education should be promoted.

Is Colombia an example of successful containment of the 2020 COVID-19 pandemic? A critical analysis of the epidemiological data, March to July 2020.

BACKGROUND: Colombia detected its first coronavirus disease 2019 (COVID-19) case on March 2, 2020. From March 22 to April 25, it implemented a national lockdown that, apparently, allowed the country to keep a low incidence and mortality rate up to mid-May. Forced by the economic losses, the government then opened many commercial activities, which was followed by an increase in cases and deaths. This paper presents a critical analysis of the Colombian surveillance data in order to identify strengths and pitfalls of the control measures. METHODS: A descriptive analysis of PCR-confirmed cases between March and July 25 was performed. Data were described according to the level of measurement. Incidence and mortality rates of COVID-19 were estimated by age, sex, and geographical area. Sampling rates for suspected cases were estimated by geographical area, and the potential for case underestimation was assessed using sampling differences. RESULTS: By July 25, Colombia (population 50 372 424) had reported 240 745 cases and 8269 deaths (case fatality rate of 3.4%). A total of 1 370 271 samples had been analyzed (27 405 samples per million people), with a positivity rate of 17%. Sampling rates per million varied by region from 2664 to 158 681 per million, and consequently the incidence and mortality rates also varied. Due to geographical variations in surveillance capacity, Colombia may have overlooked up to 82% of the actual cases. CONCLUSION: Colombia has a lower case and mortality incidence compared to other South American countries. This may be an effect of the lockdown, but may also be attributed, to some extent, to geographical differences in surveillance capacity. Indigenous populations with little health infrastructure have been hit the hardest.