ASSESSMENT OF MENTAL HEALTH IN MEDICAL PROFESSIONALS WHO EXERCISED THEIR ACTIVITY DURING THE COVID-19 HEALTH CRISIS.

Objectives: To study the impact of the health crisis on the mental health status of medical professionals who worked during the COVID-19 pandemic. Material(s) and Method(s): Anonymous online survey with occupational and non-occupational variables, Goldberg anxiety and depression questionnaire and the SF-12 perceived quality of life, conducted in September 2022, assessing current situation and one year ago in medical professionals. Result(s): In 2021, 58.1% had anxiety and in 2022, 46.5%. Regarding depression, in 2021 it was 39.5% and in 2022 it was 37.2%. The decrease in the anxiety score was significant (p <0.001). And the perceived quality of life (SF-12) on its mental scale in 2021 was 42.4 +/- 13.0 vs 47.1 +/- 11.8 in 2022, improving significantly (p <0.033). Conclusion(s): We found a high prevalence of anxiety and depression that is currently maintained, so it is of interest to implement mental health intervention programs for healthcare workers.Copyright © 2023, Accion Medica S.A.. All rights reserved.

Seguridad De La Endoscopia Ambulatoria Sin Test De Cribado Para Sars-Cov-2. Desde La Reanudacion De La Actividad Endoscopica Hasta La Vacunacion

Introduccion: Durante la pandemia del COVID-19 las sociedades endoscopicas recomendaron el uso de equipos de proteccion personal (EPP) y la realizacion de cuestionarios de cribado (CC) dirigidos a la deteccion de sintomas;sin quedar clara la necesidad de realizar test diagnosticos de SARS-Cov-2 (SCV-2). La seguridad de esta actitud no ha sido valorada adecuadamente. Metodos y objetivos: Nuestro objetivo primario es evaluar si para prevenir la infeccion por SCV-2 en los trabajadores de nuestra unidad (t-UE) es seguro hacer un CC a los pacientes con endoscopias programadas, sin realizarse test diagnosticos. Nuestro objetivo secundario es comparar la incidencia de SCV-2 en la poblacion de referencia (PR), los pacientes programados (SPs) y en t-UE. Se analizaron retrospectivamente los pacientes con endoscopias programadas de forma ambulatoria previamente a la vacunacion (junio/2020- diciembre/2020). Se realizo un CC en las 72h previas a la prueba y en el dia de la misma. Todos los trabajadores disponian de EPP. Resultados: Se programaron 7.089 endoscopias. Un 9,5% fueron canceladas: un 0,35% por sospecha de SCV-2 y un 0,1% por SCV-2 confirmado antes del procedimiento. 638 pruebas se suspendieron por motivos no relacionados con SCV-2. Se realizaron 6,419 endoscopias. Se diagnostico SCV-2 en 15 pacientes en los 15 dias siguientes a la endoscopia. De los 106 profesionales trabajaron en nuestra unidad se diagnostico SCV-2 en tres casos durante este periodo. En ninguno de ellos se demostro relacion con la exposicion laboral. En la tabla se muestra la densidad de incidencia (DI, x 100,000 habitantes) y la razon de tasas (RR) de la infeccion por SCV-2 en la PR, SPs y t-UE. [Table presented] Conclusiones: En ninguno de los trabajadores con diagnostico de SCV-2 se pudo atribuir la infeccion al medio laboral. La implementacion de CC de SVC-2 resulto seguro para los t-UE, incluso en ausencia de vacunacion global de la poblacion. La incidencia de SCV-2 fue menor en SPs y en los t-UE que en la PR.Copyright © 2023 Elsevier Espana, S.L.U. Todos los derechos reservados.

Post-Traumatic Stress in Children and Adolescents during the COVID-19 Pandemic: A Meta-Analysis and Intervention Approaches to Ensure Mental Health and Well-Being

Background: Since the World Health Organization (WHO) declared the COVID-19 pandemic in March 2020, many measures have been taken to prevent the spread of the virus. Consequently, many minors have been confined to their homes and have had to subsequently adapt to countless protocol changes. These factors appear to have contributed to post-traumatic stress disorder (PTSD) in many children. Materials and Methods: The authors searched Medline through PubMed and other databases for studies published from 1 December 2019 to 31 December 2021 on the prevalence of PTSD in schoolchildren. The authors used a random-effects model to calculate the pooled prevalence of PTSD. Results: A total of six studies were included in this review. Our results show a pooled prevalence of PTSD of 14% in children and adolescents. Subgroup analyses identify a significantly higher prevalence of PTSD for studies conducted in China and a higher prevalence in boys. The prevalence of PTSD appeared independent of child age or the methodological rigor of the study. Conclusions: Our results suggest that a large number of children may be suffering from PTSD (post-traumatic stress disorder). Public health measures are thus needed to improve children's mental health during and after the pandemic, so that the suffering is mitigated to prevent long-lasting effects.

Impact of the Covid-19 Pandemic on the Adherence of Hiv Patients

Background and Importance In 2020 Spain was involved in the SARS-CoV-2 pandemic. This situation entailed in the dispensing of drugs from pharmacy services to patients' homes. This way of reaching the patient facilitated the access to antiretroviral treatment (ART) in this difficult situation. However, due to the social stigmas, certain patients did not consent to access this dispensing system. Aim and Objectives The objective is to study how adherence to antiretroviral treatment was affected in HIV-positive patients during the months of the first alarm state in Spain (March 14 to June 21 2020);because during those period ART was home dispensation. Material and Methods Observational retrospective study, included patients HIV-positive who received ART during the first alarm state in Spain during COVID-19 pandemic and in the same period of 2019. Collected data were: sex, age and variables related to pharmacological treatment (ART in the selected periods, number of dispensations made, galenic units dispensed). To measure adherence, an indirect method was used, comparing the dispensations made in the hospital pharmacy of the hospital of Leon during the studied period and the same dates of the previous year. % adherence = [dispensed galenic units/planned galenic units] x100 Results We analyse 444 patients with a median age of 54 years (45-59) being 77.93% (n=346) men. During the study period 83 patients (18.69%) changed their ART. 38.55% (n=32) carried out a simplification of ART in 2020 (from a treatment based on several pharmaceutical forms to a treatment based on a single one). The mean adherence in the periods studied in 2019 and 2020 was 91.89% (CI 90.44-92.90) and 90.25% (CI 87.61- 92.90), respectively. In 2019, 67.12% (n=298) of patients had adherence greater than 95%, compared to 86.71% (n=385) in 2020. For 38 patients there are no medication dispensations during the 2020 period. Of the majority (n=27) the reason for the absence is unknown;6 were not disposed of from the hospital of Leon for spending the confinement outside the city;4 have died and 1 did not accept home dispensation. Conclusion and Relevance The implementation of home dispensing could have positively influenced adherence in HIVpositive patients. It is necessary to evaluate in the future that the implementation of new telepharmacy programmes can have a positive influence on adherence.

Escalation therapy for ARF in elderly patient

The prevalence of hypoxic respiratory failure in patients with COVID-19 has been reported in 19%. Recent reports from China showed that 4-13% of COVID-19 patients in these studies received noninvasive positive pressure ventilation (NIPPV), and that 2.3-12% required invasive mechanical ventilation. Although the true incidence of hypoxic respiratory failure in patients with COVID-19 is not clear, it appears that about 14% will develop severe disease requiring oxygen therapy, and 5% will require ICU admission and mechanical ventilation [1]. Some studies have shown that avoiding invasive mechanical ventilation (IMV) significantly decreases the risk of death [2, 3]. This is why choosing an optimal oxygen therapy device is very important for reducing the rates of IMV and mortality while also ensuring patients' safety and comfort [4]. The CDC reported an overall case-fatality rate (CFR) of 2.3%, with a CFR of 14.8% in patients aged 80 years or older [1]. We must consider oxygen therapy if [4, 5]. © Springer Nature Switzerland AG 2020.

Smell improvement by anti-IgE and anti-IL 5 biologics in patients with CRSwNP and severe asthma. A real life study.

BACKGROUND AND OBJECTIVE: Chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by partial (hyposmia) or total (anosmia) loss of smell, is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), worsens disease severity and quality of life. Objectives. The objective of this study was to determine whether, in real-life conditions, biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare smell improvement in N-ERD and non-N-ERD subgroups. METHODS: A multicenter, non-interventional, retrospective, observational study was performed, including 206 patients with severe asthma undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab) with CRSwNP. RESULTS: Improved olfaction was found after treatment with all monoclonal antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab (35.7%), and benralizumab (39.1%), with no differences between groups. Patients with atopy, greater use of short course systemic corticosteroids, and larger polyp size were more likely to experience improvement in smell. The proportion of patients experiencing smell improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. CONCLUSION: This is the first study to compare real-life improvement in sense of smell among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in sense of smell (with non-significant differences between biologic drugs). No differences were found in smell improvement between the N-ERD and non-N-ERD group.

Influenza Virus Infection in Children Admitted to the Pediatric Intensive Care Unit

BACKGROUND AND AIM: Flu is generally benign, although it can sometimes cause serious complications. The goal of the study was to describe the frequency, clinical evolution and complications of influenza in a PICU during five epidemic seasons. METHOD(S): Retrospective observational study of patients with influenza diagnosis admitted to PICU between 2015 and 2022. Demographic variables, morbidity, virus serotype, treatments, mortality and length of the PICU stay, were collected. RESULT(S): Twenty-five patients were admitted into the PICU for influenza, with a median age of 2 (IQR 2 - 6.5) years;52% were male and 40% had associated morbidity. Influenza A accounted for 80%, influenza B 12% and co-infection influenza A+B 8%. Bacterial co-infection was present in 20%, with the most common organisms being streptococcus pneumoniae and streptococcus pyogenes. We observed complications in 80% (sepsis/septic shock, bacterial pneumonia, pleural effusion, myocarditis, supraventricular tachycardia and seizures);64% received antibiotic therapy and 40% Oseltamivir. Non-invasive respiratory support was required in 48%, mechanical ventilation in 28% and inotropicvasopressor drugs in 20%. During the COVID-19 pandemic, there were no admissions for Influenza in the 2020-2021 season, and the first admission occurred in March 2022. Twenty-four months free of influenza were observed. During the study period, median PICU stay was 2 days [IQR 2 - 6.5]. Three children died (12%). CONCLUSION(S): We observed a high rate of complications and mortality, especially during the last SARS-COV-2 prepandemic season, since then we have only had 1 mild case admitted. Preventive measures against SARS-CoV-2 have probably contributed to reducing Influenza transmission.

Planned Exercise Behavior in an Older Adult in Times of COVID-19

Introduction: The human body is created to be in constant activation. However, sedentary behaviors in older adults are increasingly common. This is worrisome, since this age group has the belief that when they reach this stage of their life they should not do physical exercise, even though this need does not diminish with the passing of the years. Objective: To describe the experiences of planned physical exercise behavior in an older adult during the COVID-19 pandemic. Methods: Single case study with phenomenological approach, the reference used was Maurice Merleau-Ponty's phenomenology of perception, under the perspective of the planned behavior theory. An in-depth interview was conducted. For the qualitative analysis of the information, the referent proposed by Taylor-Bogdan was used. Results: Three categories and eight subcategories were obtained, they were defined based on the selected study phenomenon, the theory of planned behavior: experience to exercise;perceived control;subjective norm. Conclusions: The experience of practicing physical exercise in old age is lived with a positive attitude;however, this became negative, because due to the pandemic by COVID 19 it was mandatory to interact through technology to be able to perform physical exercise. © 2022, Editorial Ciencias Medicas. All rights reserved.

Outpatient Endoscopy without Sars-Cov-2 Testing: From the Resumption of Endoscopic Activity to Vaccination Was It Safe to Do That?

Introduction: Recommendations made by scientific societies regarding the need of pre-procedural testing for SARS-CoV-2 infection have been inconsistent throughout the pandemic. Several society guidelines advocated the use of personal protective equipment (PPE) and screening questionnaires for active COVID-19 disease without testing patients before endoscopy. The safety of this approach before the start of widespread vaccinations has not been properly assessed. Aims & Methods: Primary: To evaluate the safety of a screening questionnaire for active COVID-19 disease in the scheduled patients (SPs) for endoscopic procedures, without testing SARS-CoV-2, to prevent the infection in health-care workers of our endoscopy unit (EU-HCWs). Secondary: To compare the incidence of COVID-19 disease between the reference population (RP), SPs and EU-HCWs. Outpatient endoscopies scheduled from June 2020 to December 2020 were retrospectively analysed. Patients were screened by a questionnaire within 72 hours of their planned procedure and on the day of attendance. Healthcare professionals received appropriate training in infection control practices and handling of PPE. Patients were not tested for SARS-CoV-2 infection before endoscopy. Result(s): Seven thousand and eighty-nine outpatient endoscopies were scheduled. In 670 cases (9.5%) the procedures were cancelled. In 25 patients (0.35%) active COVID-19 disease was suspected before endoscopy. Two of the suspected cases had positive confirmatory tests (PT). Besides, 7 patients had a PT prior to endoscopy. Thus, 9 endoscopies (0.12%) were deferred because of confirmed COVID- 19 disease. The remaining 638 procedures were cancelled because the patient did not attend to the endoscopy unit (346) or due to a cancellation request other than COVID-19 disease from the physician or patient (292). A total of 6.419 endoscopies were performed. In 48 patients (0.75%) compatible symptoms with infection were present during the following 15 days after the procedure. COVID-19 disease was confirmed in 11 of these symptomatic patients. Besides, 4 asymptomatic patients had PT: two of them had close contact with a family member. There is no information about the reason for testing SARS-CoV-2 in the other 2 asymptomatic positive patients. In total 15 patients (0.2%) were positive within 15 days after endoscopy. One hundred and six professionals were working in our endoscopy unit (EU) during this period. Three EU-HCWs were diagnosed of COVID-19 disease. They were all physicians. None of these cases could be linked to occupational exposure. Table 1 shows the incidence rate (IR,) and rate ratio (RR, 95% confidence interval) of SARS-CoV-2 in our SPs, the RP and in our EU-HCWs. Conclusion(s): During the pre-vaccination period, 3 EU-HCWs were diagnosed of COVID-19 disease. None of them could be attributed to occupational exposure.The implementation of a COVID-19 infection screening questionnaire before the procedures without performing SARS-CoV-2 testing was safe enough for the EU-HCWs even in the absence of global vaccination of the population.The incidence of confirmed infections was lower in the SPs and EU-HCWs when compared to our RP.

Communication media and criteria related to coping with COVID-19 in adults and young people from Güines Municipality

Introduction: In information search and processing, as well as in coping with COVID-19, communication media and the criteria about the disease are determinant. Objective: To identify the communication media used to obtain information about the pandemic and the criteria related to coping with it. Methods: A descriptive research was carried out in May 2020 with young people and adults belonging to a family medical office in Güines Municipality, Mayabeque Province, Cuba. The methods used to obtain information were participant observation, survey and focus groups. Results: The main communication media through which the youth group obtained information was the Internet, while the adults did so mainly through television. The young mostly considered COVID-19 to be moderately dangerous and that they are not very susceptible to infection with it. The adults considered it very dangerous and contagious. The measure they believed to be most effective was wearing a face mask. Only a minority of the young assessed the effectiveness of physical distancing. Most of the individuals were found not to respect the rules of physical distancing and, although wearing a face mask is mandatory, several young people did it incorrectly. The main responsibility for avoiding contagion was attributed to government authorities. Conclusions: Communication media play a crucial role in obtaining information about COVID-19;the use of television prevails and the young clearly consider the disease not very dangerous, unlike adults, who feel more threatened and assume individual responsibility. © 2022, Editorial Ciencias Medicas. All rights reserved.

IMMUNE RESPONSES to MRNA VACCINES AGAINST SARS-COV2 in PATIENTS with IMMUNE-MEDIATED INFLAMMATORY RHEUMATIC DISEASES

Background: Patients with immune-mediated rheumatic diseases (IMRD) are commonly treated with immunosuppressors and prone to infections. Recently introduced mRNA SARS-Cov2 vaccines have demonstrated extraordinary efficacy across all ages. Immunosuppressed patients were excluded from phase III trials with SARS-Cov2 mRNA vaccines. Objectives: To fully characterize B and T cell immune responses elicited by mRNA SARS-Cov2 vaccines in patients with rheumatic diseases under immunotherapies, and to identify which drugs reduce vaccinés immunogenicity. Methods: Humoral, CD4 and CD8 immune-responses were investigated in 100 SARS-Cov2-naïve patients with selected rheumatic diseases under immunosup-pression after a two-dose regimen of SARS-Cov2 mRNA vaccine. Responses were compared with age, gender, and disease-matched IMRD patients not receiving immunosuppressors and with healthy controls. Results: IMRD patients showed decreased seroconversion rates (80% vs 100%, p= 0.03) and cellular immune responses (75% vs 100%, p= 0.02). Patients on methotrexate achieved seroconversion in 62% of cases and cellular responses in 80% of cases. Abatacept decreased humoral and cellular responses. Rituximab (31% responders) and belimumab (50% responders) showed impaired humoral responses, but cellular responses were often preserved. Antibody titers were reduced with mycophenolate and azathioprine but preserved with lefunomide and anticytokines. Conclusion: IMRD patients exhibit impaired SARS-CoV-2 vaccine-immuno-genicity, variably reduced with immunosuppressors. Among commonly used therapies, abatacept and B-cell depleting therapies show deleterious effects, while anticytokines preserved immunogenicity. The effects of cumulative meth-otrexate and glucocorticoid doses on immunogenicity should be considered. Humoral and cellular responses are weakly correlated, but CD4 and CD8 tightly correlate. Seroconversion alone might not refect the vaccine's immunogenicity.

Perceptions and experiences of an older adult during and after the diagnosis of COVID-19

Introduction: The COVID-19 pandemic has brought unprecedented challenges and a disproportionate threat to older adults, having an impact on their biopsychosocial and spiritual sphere. Objective: To explore the perceptions and experiences of an older adult during and after diagnosis of COVID-19. Methods: Single case study, with Merleau-Ponty's phenomenological approach. An in-depth interview was applied, which began with a generative question and five open-ended questions to deepen the phenomenon of perceptions and experiences of suffering from COVID-19. Colaizzi's phenomenological analysis technique was used for data analysis and interpretation. Results: The informant was an older adult of 66 years of age, who has been living with type 2 diabetes for 22 years, which made him vulnerable to the contagion of COVID-19. From the life experience, 4 categories and 8 subcategories were identified, where the impact of COVID-19 on corporeality, subjective expressiveness of the body in the face of the disease, the body in the interaction with others, awareness of support from a superior being and humanized attention in the lived world were addressed. Conclusion: The disease caused psychological, physical, social and spiritual changes since the appearance of signs and symptoms. Among them the feeling of fear, sadness, loneliness, deterioration of social and family function due to social isolation. Among the coping mechanisms of the disease is the family and God. © 2022, Editorial Ciencias Medicas. All rights reserved.

Myeloid-Dependent Immunosuppressive Features Drive and Predict IPF Progression

Rationale: Despite the availability of pharmacologic therapies, idiopathic pulmonary fibrosis (IPF) is still a clinical challenge with several unmet needs. Robust evidence supports monocytes as cellular biomarkers of progression in IPF. Yet, their precise role and whether specific subtypes might predict progression and drive disease is unknown. We reported, for the first time, that myeloidderived suppressor cells (MDSC), immature precursors of monocytes, are increased in numbers, functionally active in IPF. Monocytic MDSC is the predominant subtype in IPF, and yet, functional characterization and immune modulation properties have not been explored. Methods and Results: characterization of circulating myeloid populations in IPF by multicolor FACS confirmed the abundance of MDSC (Lin-, HLA-DRlo, CD33+, CD14+, S100A+, CD28L1+ and ICOSL+) in IPF (n=78) and fILD (n=83), also abundant in whole blood scRNA seq of severe Covid-19 patients that progressed into fibrosis, and not in mild Covid-19. Then, we prospectively followed 83 fILD patients (45% IPF, 55% non-IPF -EAA, CTD-ILD, NSIP-) over 1 year and immunophenotyped them every 3 months. Cross-sectional analysis showed that patients with a higher number circulating MDSC, had a higher GAP index (7-8) (p<0,001). Longitudinal follow-up showed that patients with constant higher circulating MDSC had lower transplant-free survival (p=0.0058). Primary isolated MDSC when co-cultured with autologous T cells induced CD8+ T cell exhaustion (PD1hi, Lag3hi, Tim3hi, TNFalpha lo, INFglo), and downregulation of co-stimulatory T cell signaling (CD28, ICOS, ITK, and LCK), preliminary data support the induction of de-novo FoxP3 Treg formation, creating a suppressive and immunosenescent microenvironment in IPF. FACS analysis of explanted lungs demonstrated the increase of tissue-resident MDSC in fibrosis (HP, NSIP, IPF) compared with donor lungs, as well as in bleomycin-induced fibrosis compared to PBS. Conclusion: Taking together, a high number of circulating MDSC reflects worse lung function and higher GAP index in cross-sectional analysis, and associates with lower transplant-free survival longitudinally. The role that immature and mature monocytes play during promotion of a suppressive microenvironment in IPF is an unexplored area that may lead to a paradigm shift in our understanding of the sequelae of exhaustion and immunosenescence, contributing to the identification of novel targets useful for therapeutic myeloid selection in IPF.

Le déficit en interféron de type I n’altère pas la réponse lymphocytaire B mémoire contre le SARS-CoV-2 après vaccination par ARNm

Introduction Les vaccins à ARN messagers ont joué un rôle majeur dans la lutte contre la pandémie de SARS-CoV-2 grâce à une excellente efficacité et sécurité clinique. Ces vaccins ont été développés suite à des années de recherche fondamentale, dont l’une des étapes cruciales a été de remplacer l’uridine de l’ARNm par de la 1-méthyl-pseudo-uridine afin d’éviter la reconnaissance par les récepteurs de l’immunité innée, notamment le toll-like-receptor (TLR) 7. Une hypothèse, très fréquemment défendue mais jamais étayée expérimentalement, est que cet ARN modifié garde une activité immunostimulatrice à bas bruit permettant la production d’interféron de type I, agissant comme un adjuvant du vaccin. Les interférons de type I sont des cytokines antivirales essentielles et les patients ayant un déficit dans les voies de l’interféron de type I sont à haut risque de COVID-19 sévère. Dans ce travail, nous avons analysé la réponse lymphocytaire B au vaccin à ARNm de patients présentant l’absence de signalisation par les interférons de type I. Ceci nous a permis de savoir si les vaccins par ARNm permettaient d’établir une réponse lymphocytaire B robuste en l’absence d’interféron de type I. Patients et méthodes Nous avons constitué trois cohortes de patients (i) des patients avec des déficits génétiques sur les voies de l’interféron de type I : 2 patients avec une mutation homozygote d’IRF7 (facteur de transcription responsable de la production d’interférons de Type I, notamment en aval de TLR7) et un patient avec une déficit hémizygote de TLR7 (ii) des patients ayant des auto-anticorps neutralisant les interférons alpha et oméga, dans le cadre d’une polyendocrinopathie auto-immune de type I (APS-1, n = 14) (iii) des patients ayant des auto-anticorps neutralisant les interféron, associés à l’âge, une entité récemment décrite et particulièrement fréquente chez les sujets âgés (n = 8). Ces sujets ont été comparés à 29 contrôles sains. Tous étaient naïfs du COVID-19 et ont reçu 2 doses de vaccin à ARNm (BNT162n2 ou mRNA1273). Les patients ont été prélevés à différents point de temps, dans les 3 premiers mois et entre 3 et 7 mois après la seconde dose. La réponse sérologique a été évaluée par ELISA anti-IgG et IgA RBD (receptor binding domain de la Spike) et la neutralisation sérique a été testée in vitro contre le D614G-SARS-CoV-2. Les lymphocytes B (LB) mémoires CD19 + IgD-CD27± spécifiques du RBD ont été analysés en cytométrie en flux et triés en cellule unique pour séquençage des régions variables de la chaîne lourde de l’immunoglobuline. Résultats La réponse sérologique anti-RBD IgG et IgA était comparable aux temps précoces et tardifs de la réponse vaccinale, évoluant de façon similaire chez les patients déficients en interféron de type I et les sujets sains. La capacité de neutralisation des sérums contre le SARS-CoV-2 était également identique dans tous les groupes, et corrélait fortement avec le taux d’IgG anti-RBD, suggérant que le RBD était également la cible de la réponse neutralisante chez les patients déficients en interféron de type I. Des LB mémoires circulants spécifiques du RBD étaient retrouvés dans toutes les cohortes de patients déficients en interféron de type I au cours des 3 mois suivant la vaccination. Ceux-ci se maintenaient dans le temps et étaient encore présents entre 3 et 7 mois après la vaccination (0,18 % des LB IgD-CD27+ chez les sujets sains, 0,24 % chez les sujets avec déficit génétiques, 0,16 % chez les APS-1 et 0,26 % chez les AAB, pas de différence statistiquement significative). Le séquençage de la chaîne lourde des régions variables de l’immunoglobuline des LB mémoires spécifiques du RBD révélait l’accumulation progressive des mutations jusqu’à 7 mois chez les sujets sains, témoignant d’une réaction des centres germinatifs permettant la maturation d’affinité et la génération de lymphocytes B mémoires à longue durée de vie. Chez les patients IRF7 déficients, les LB mémoires spécifiques du RBD acquerraient progressivement des mutations de M1 à M6, et les LB mémoires spécifiques du RBD de patients TLR7 et APS-1 arboraient un nombre élevé de mutation dès M4, témoignant que même en l’absence de réponse à l’interféron de type I, le vaccin permettait la génération des LB mémoire issus des centres germinatifs, comme chez les sujets sains. Enfin, des clones partagés étaient retrouvés entre les sujets sains et les patients déficient en interféron de type I témoignant d’une réponse qualitativement normale. Conclusion Notre travail apporte des données rassurantes sur la vaccination de ces patients à haut risque de forme de grave de COVID-19 et suggère que l’ARNm contenu dans les vaccins n’a pas de rôle adjuvant intrinsèque.

Riding the wave: Predicting the use of the bike-sharing system in Barcelona before and during COVID-19.

To simultaneously promote health, economic, and environmental sustainability, a number of cities worldwide have established bike-sharing systems (BSS) that complement the conventional public transport systems. As the rapid spread of COVID-19 becoming a global pandemic disrupted urban mobility due to government-imposed lockdowns and the heightened fear of infection in crowded spaces, populations were increasingly less likely to use public transportation and instead shifted toward alternative transport systems, including BSS. In this study, we use probabilistic machine learning in a quasi-experimental research design to identify how the relevance of a comprehensive set of factors to predict the use of Bicing (the BSS in Barcelona) may have changed as COVID-19 unfolded. We unpack the key factors in predicting the use of Bicing, uncovering evidence of increasing bike-related built infrastructure (e.g., tactical urbanism), trip distance, and the income levels of neighborhoods as the most relevant predictors. Moreover, we find that the relevance of the factors in predicting Bicing usage has generally decreased during the global pandemic, suggesting altered societal behavior. Our study enhances the understanding of BSS and societal behavior, which can have important implications for developing resilient programs for cities to adopt sustainable practices through transport policy, infrastructure planning, and urban development.

Delayed recovery from severe acute respiratory syndrome coronavirus-2 related anosmia predicts incomplete olfactory restoration.

OBJECTIVE: This study aimed to assess the olfactory recovery rates and patterns in a cohort of coronavirus disease 2019 positive patients, and to investigate the clinical predictors of poor long-term olfactory restoration. METHODS: An observational retrospective study was conducted on 146 patients between September 2020 and January 2021 at a tertiary referral hospital. Coronavirus disease 2019 positive patients with olfactory dysfunction were sent a modified version of the COVID-19 Anosmia Reporting Tool for Clinicians via e-mail. RESULTS: The difference in median recovery time between complete recovery and incomplete or no recovery was statistically significant. On multivariate analysis, the only significant factor associated with incomplete or no recovery was anosmia duration. CONCLUSION: After a mean time of 5.6 months from severe acute respiratory syndrome coronavirus-2 infection, persistent olfactory disorders were self-reported in 36.7 per cent of patients. Complete recovery was more likely to occur within 15 days. Given the high prevalence of coronavirus disease 2019, a large number of patients are expected to suffer from long-term olfactory morbidity.

CLINICAL CHARACTERISTICS AND EVOLUTION OF HEMATOLOGICAL PATIENTS AND COVID-19 IN ARGENTINA: A REPORT FROM THE ARGENTINE SOCIETY OF HEMATOLOGY

Individuals with malignancies and COVID-19 have a lower survival compared with the general population. However, the information about the impact of COVID-19 on the whole hematological population is scarce. We aimed to describe the 30th day overall survival (OS) after COVID-19 infection in patients with a hematological disease in Argentina. A completely anonymous survey from the Argentine Society of Hematology was delivered to all the hematologists in Argentina;it started in April 2020. A cut-off to analyze the data was performed in December 2020 and, finally, 419 patients were reported and suitable for the analysis (average age: 58 years, 90% with malignant diseases). After the COVID-19 diagnosis, the 30-day OS for the whole population was 80.2%. From the entire group (419), 101 (24.1%) individuals required intensive care unit admission, where the 30-day OS was 46.6%. Among allogeneic stem cell transplant recipients, the 30-day OS was 70.3%. Factors associated with a low OS were two or more comorbidities, an active hematological disease and history of chemotherapy. In individuals with the three factors, the 30-day OS was 49.6% while the 30-day OS in those without those factors was 100%. Patients with hematological diseases have a higher mortality than the general population. This group represents a challenge and requires careful decision-making of the treatment in order not to compromise the chances of cure.