The impact of the arts on social and entrepreneurial actions during covid19. Educational perception

The impact of COVID-19 on the way of consuming art has led to changes in behavior to-wards more responsible and sustainable models. Art continues to be a fundamental part of people's lives, and significantly influences the quality of life, both in the educational and work environment. During confinement, the people who have been able to consume art have done so according to different needs and contexts. However, art, beyond its social benefits, has a direct implication both in sustaina-bility and in the business world. This work aims to know the consumption of art during the pandemic and its relationship with social and business responsibility. The methodological approach is quantitative and was based on an ad hoc questionnaire in which a total of 308 people participated. From the results it is clear that through the consumption of art responsible behaviors can be generated in companies. In addition, the relationship established between art and business success is highlighted, as well as the involvement and responsibility in sustainability.

Modeling SARS-CoV-2 True Infections in Catalonia through a Digital Twin

A dynamic view of the evolution of the infections of SARS-CoV-2 in Catalonia using a Digital Twin approach that forecasts the true infection curve is presented. The forecast model incorporates the vaccination process, the confinement, and the detection rate, and virtually allows to consider any nonpharmaceutical intervention, enabling to understand their effects on the disease's containment while forecasting the trend of the pandemic. A continuous validation process of the model is performed using real data and an optimization model that automatically provides information regarding the effects of the containment actions on the population. To simplify this validation process, a formal graphical language that simplifies the interaction with the different specialists and an easy modification of the model parameters are used. The Digital Twin of the pandemic in Catalonia provides a forecast of the future trend of the SARS-CoV-2 spread and information regarding the true cases and effectiveness of the NPIs to control the SARS-CoV-2 spread over the population. This approach can be applied easily to other regions and can become an excellent tool for decision-making. © 2023 The Authors. Advanced Theory and Simulations published by Wiley-VCH GmbH.

Can we detect in vivo hemolysis during extracorporeal membrane oxygenation support using endogenous carbon monoxide production?

Introduction: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with ARDS due to COVID-19. In vivo hemolysis (ivH) is one of its complications, characterised by peaks of plasma free hemoglobin (fHb). However, an increase in carboxyhemoglobin (COHb) has also been observed due to Hb metabolism by heme-oxygenase that releases carbon monoxide. The aim of this study is to evaluate the incidence of ivH events and their relation to COHb in COVID-19 patients undergoing ECMO. Method(s): Single-centre observational retrospective study that included 33 COVID-19 patients with ARDS who received VV-ECMO treatment in the ICU from March 2020 to September 2021. Daily analytical monitoring was carried out including arterial blood gas test with cooximetry and biochemical parameters, incorporating the estimation of fHb using quantitative hemolysis index (HI). Significant ivH was considered with fHb > 50 mg/dL after discarding in vitro hemolysis. Daily maximum values of HI and COHb were recorded and paired in order to evaluate their correlation by generalised linear model. Result(s): The total prevalence of patients having ivH in our cohort was 27.3%. Mortality during ECMO treatment in our study was 57.6%, higher within the group of patients with ivH events (77.8% vs 50%). A total of 777 daily maximum values of fHb from all the patients were obtained. Values of COHb were significantly higher during ivH episodes. Furthermore, positive significant correlation was obtained between daily analytical values of fHb and COHb (B coefficient 42.156;p = 0.042), as shown in Fig. 1. The cut-off value of COHb to be discriminative for hemolysis (fHb > 50 mg/dL) was 3.85% COHb (90.5% sensitivity and 83.3% specificity). Conclusion(s): Point-of-care carboxyhemoglobin is a cheap and widely available parameter that could be useful when detecting in vivo hemolysis during ECMO treatment.

A descriptive evaluation of COVID-19 disease in adult asthma patients at La Paz University Hospital

Background: COVID-19 is an infectious entity caused by the SARS-CoV-2 virus. There have been reported risk factors like chronic airway entities such as chronic obstructive pulmonary disease. Since asthma is a respiratory disease, it could be found as a risk factor to develop severe COVID-19 disease. However, most of the evidence reveals that asthma isn't associated with higher severity or worse prognosis. Madrid has been one of the most affected regions in the world during the pandemic. La Paz University Hospital has developed one of the largest cohorts in Europe. We used this data and described several characteristics around COVID-19 disease in asthma patients. Method(s): We collected data by individual review of the patients' electronic clinical records (DXC-HCIS, Healthcare Information System). Then we describe the general characteristics of the patients, their asthma, and COVID-19 evolution. The analyzed data includes general demographics, asthma classification (T2 or no T2), basal treatment, and pre-COVID-19 asthma control (by ACT and exacerbations). We studied acute COVID-19 disease symptoms and treatment, the presence of pneumonia, thromboembolism, the need for hospitalization, admission to the intensive care unit (ICU), and mortality. Result(s): The total number of patients studied was 173, the majority were women (67%) with an average age of 55 and type 2 asthma (67%) which was controlled before COVID-19 disease (ACT median was 25, the median of exacerbations was 0). The majority used the combination of long-acting beta 2 agonists and inhaled corticosteroids (ICS+LABA) for asthma treatment (67%). Only 2 patients were treated with omalizumab, which was discontinued during COVID-19 disease. The most frequent symptoms were cough and dyspnea (80% and 75% respectively). 4% of patients presented thromboembolism. 60% had pneumonia. 60% required hospitalization, 11% of whom died due to COVID-19 complications. The most common treatment was hydroxychloroquine and azithromycin (75% and 45% respectively), followed by oral corticosteroids (15%), lopinavir/ritonavir (8%), tocilizumab (5%), and remdesivir (2%). Conclusion(s): This cohort represents asthmatic patients in La Paz University Hospital. We observed that the proportion of hospitalizations, ICU admissions, and mortality due to COVID-19 was similar as described in previous studies and therefore no different from non-asthmatic patients. The characteristics presented in this study help us better understand the complications of asthmatic patients thanks to one of the largest COVID-19 cohorts in Europe.

Analysis of the influence of the SARS-CoV-2 virus pandemic on the bacteriemia rate in tunneled venous catheters in a hemodialysis unit

Background: Central venous catheter (CVC) related infection is associated with high morbidity and mortality. It has also been linked to CVC-associated bacteremia, catheter dysfunctions, as well as handling and hygienic measures taken during that time. Objective: The aim of the present study is to compare the bacteremia rate between 2019 and 2020, the last one during which the SARS-CoV-2 virus pandemic started. The study was accomplished in a hemodialysis unit at the Comunidad Autonoma de Madrid hospital. Material and Method: An observational retrospective cross-sectional study has been carried out in which data related to the management and functioning of the catheter were compared to the bacteremia rate linked to the catheter between 2019 and 2020 through the unit's database. Results: In 2019, thirty-five patients were included, who had a bacteraemia rate of 1.42/1,000 catheter days, and twenty-nine patients in 2020, with a bacteraemia rate of 1.82/1,000 catheter days, finding no significant differences (p=0.54), as well as not finding an increased or decreased bacteremia risk during the first year of the pandemic caused by the SARS-CoV-2 virus. Conclusions: As the main conclusion of this case of study, we are able to confirm that there is no evidence of the coronavirus pandemic and the measures adopted against the SARS-CoV-2 virus (both organizational and preventives), being a risk or protection factor in regard to the bacteraemia rate, most likely due to the low number of events found. © 2023, Sociedad Espanola de Enfermeria Nefrologica. All rights reserved.

Clinical outcomes in asthmatic patients following COVID 19 infection

Background: COVID-19 disease caused by SARS-CoV-2, has changed life as we know it, causing millions of deaths worldwide. Reported risk factors for mortality include advanced age, obesity, hypertension, diabetes mellitus, and chronic obstructive pulmonary disease. Although asthma is a chronic obstructive disease, most evidence reveals a protective effect between asthma, eosinophilia and COVID-19. La Paz University Hospital, in Madrid, has developed one of the largest cohorts in Europe, with more than 3500 patients with COVID-19. Our aim was to evaluate post-COVID-19 evolution at 6 and 12 months in asthmatic patients. Method(s): We selected the asthmatic patients in this cohort. We obtained information from their clinical history, including sex, age and comorbidities. We classified patients by T2 or non-T2 asthma and collected pre-COVID19 information: treatment, control (measured by asthma control test (ACT) and number of exacerbations), pulmonary lung function, eosinophils in blood and immunoglobulin E levels. Post-COVID-19 data after 6 and 12 months were recorded: symptoms (chest pain, cough, expectoration and dyspnea), ACT, number of exacerbations, the need to intensify the asthma treatment, and the pulmonary lung function. Result(s): Significant association was found between COVID-19 pneumonia in asthmatic patients and the risk of having chest pain after 6 months (p = 0.009). Fewer eosinophilic count was associated with dyspnea 6 months post-covid (p = 0.043). Asthmatic smokers had an increased risk of thromboembolism 12 months after COVID-19 (p = 0.025). Although significant association standards were not met nor demonstrated, thoracic pain was more frequent 6 months post-COVID-19 in non-T2 asthmatic patients (44.4%) than T2 patients (20.3%) (p = 0.064). Eosinophilic asthma (eosinophil counts higher than 250/ mcl), presented lower prevalence of chest pain 12 months post-COVID-19 (p = 0.081). Conclusion(s): This is the first study that demonstrates the association between risk of chest pain and dyspnea after 6 months in asthmatic patients with COVID-19 pneumonia. It was also found that if these patients smoked, there was an increased risk of thromboembolism at 12 months. Further studies, with a higher number of patients are needed to explore deeply the impact of COVID-19 in asthma outcomes.

Impact of SARS-CoV2 infection in asthmatic patients at the Hospital La Paz in Madrid

Background: COVID-19 is an infectious disease caused by the SARS-CoV- 2 virus. It presents a wide clinical spectrum from asymptomatic cases to severe pneumonia and even death. Since the report of its first cases in 2019, risk factors for mortality or clinical failure have been described. Asthma, as a respiratory disease, could be a risk factor for developing severe COVID-19 disease. Thus, the aim of this study was to evaluate the impact of COVID-19 disease in asthmatic patients Method: 173 electronic medical records (DXC-HCIS- Healthcare Information System) of asthmatic patients were individually reviewed and demographic and clinical data were extracted: sex, age, smoking habit, comorbidities (obesity, rhinosinusitis, nasal polyps, COPD and T2 or non T2-asthma), previous asthma treatment (inhaled therapy, oral corticosteroids (OCS), biological therapy, azithromycin and anti-leukotriene use), number of previous exacerbations, blood eosinophils and serum Total-IgE levels. Severity of infection was registered according to the presence of pneumonia, need for hospitalization, intensive care unit (ICU) admission and mortality. Result(s): Higher risk of pneumonia was found in males (p = 0.004), smokers (p = 0.025) and previous treatment with inhaled corticosteroids (ICS) + long-acting s-agonist (LABA) (p = 0.001). We did not find higher risk of pneumonia for obesity, COPD, T2 asthma, OCS treatment, or previously elevated number of exacerbations or eosinophils (> 250/mcl). Higher risk of hospitalization was found among males (p = 0.048), smokers (p < 0.001) or patients with previous ICS+LABA treatment (p = 0.003) and lower risk of hospitalization in T2 asthmatic patients (p = 0.002) and those previously treated with ICS (p = 0.005). Although there were non-significant associations, there was a relation between obese patients and hospitalization risk (p = 0.064). There was no increased risk of death or ICU admission in asthmatic patients adjusted for gender, smoking, obesity, T2 asthma, type of previous treatment and number of exacerbations Conclusion(s): Asthmatic patients present a higher risk of pneumonia and hospitalization if they are male, smokers or undergoing ICS+ LABA treatment. Asthmatics with T2 asthma and previous treatment with ICS alone have a lower risk of hospitalization. Further studies with a higher number of patients are needed to explore deeply the impact of COVID-19 on asthma outcomes.

Multisystem inflammatory syndrome in children during the first two years of the COVID-19 pandemic in Luxembourg.

Objective: Estimate the incidence of multisystem inflammatory syndrome (MIS-C) in children (0-15 years), the role of SARS-CoV-2 variants during the first two years of COVID-19 pandemic in Luxembourg; and describe the demographic, biological and clinical characteristics of the patients. Method: Observational retrospective cohort study. Cases between March 2020 and February 2022 were ascertained from the national registry of MIS-C cases by a retrospective review of medical records. Reported SARS-CoV-2 infections were obtained from the national COVID-19 surveillance system. We calculated monthly MIS-C incidence, the ratio between MIS-C and SARS-CoV-2 infections and associated rate ratios by the periods corresponding to the circulation of different variants. Results: 18 children were diagnosed with MIS-C among 35,200 reported infections. The incidence rate of MIS-C was 7.2 [95% confidence interval (CI) 4.5-11.4] per 1,000,000 person-months. A higher incidence of MIS-C was observed between September and December 2021, corresponding to the circulation of the Delta variant than during the first year of the pandemic (RR 3.6, 95% CI, 1.1-12.3). The lowest rate of MIS-C per infection was observed during the Omicron (RR 0.17, 95% CI, 0.03-0.82). Median age at diagnosis was 6.5 years. Previously healthy children made up 88% of MIS-C cases, none were vaccinated against SARS-CoV-2. 33% required intensive care. All patients recovered fully. Conclusions: MIS-C incidence and MIS-C risk per infection changed significantly over time during the first two years of COVID-19 pandemic. Monitoring of MIS-C incidence in future SARS-CoV-2 waves will be essential to guide public health interventions and vaccination policies for children.

Evaluation of Incidence and Complications during COVID-19 Desease in Patients with Asthma

Background: COVID-19 is presented by a wide clinical spectrum from asymptomatic cases to severe pneumonia and even death. Since the report of its first cases in 2019, risk factors for mortality or clinical failure have been described. Asthma, as a respiratory disease, could be a risk factor for developing severe COVID-19 disease. Thus, the aim of this study was to evaluate the impact of COVID-19 disease in asthmatic patients. Method(s): 173 electronic medical records (DXC-HCIS- Healthcare Information System) of asthmatic patients were reviewed and demographic and clinical data were extracted: sex, age, smoking habit, comorbidities (obesity, rhinosinusitis, nasal polyps, COPD and T2 or non T2-asthma), previous asthma treatment (inhaled therapy, oral corticosteroids, biological therapy, azithromycin and anti-leukotriene use), previous exacerbations, blood eosinophils and serum Total-IgE levels. Severity of infection was registered according to the presence of pneumonia, need for hospitalization, intensive care unit (ICU) admission and mortality. Result(s): Higher risk of pneumonia was found in males (p=0.004), smokers (p=0.025) and previous treatment with inhaled corticosteroids (ICS) + long-acting s-agonist (LABA) (p=0.001). Higher risk of hospitalization was found among males (p=0.048), smokers (p<0.001) or patients with previous ICS+LABA treatment (p=0.003) and lower risk of hospitalization in T2 asthmatic patients (p=0.002) and those previously treated with ICS (p=0.005). Conclusion(s): Asthmatic patients present a higher risk of pneumonia and hospitalization if they are male, smokers or undergoing ICS+LABA treatment. Asthma T2 and previous treatment with ICS are related with a lower risk of hospitalization.

Collaborative Working Spheres for Global Software Development Education during the COVID-19 pandemic: An International Experience

This paper presents our experience implementing Collaborative Working Spheres (CWS) in the context of an international undergraduate course on Global Software Development (GSD) during the COVID-19 pandemic. Many universities around the world increased their efforts in creating educational alternatives for adequately addressing the educational challenges that this pandemic has introduced. A particular case is the training of software skilled graduates to work in globally distributed environments because learning this topic requires a lot of practical work when student motivation could have been negatively affected by the COVID-19 pandemic. However, providing highly practical GSD courses during a pandemic is a challenging task for many of these universities. It is against this backdrop that we have developed an educational tool to provide CWS, enabling undergraduate students to acquire practical experience in GSD and improve their communication and teamworking skills, even during the COVID-19 pandemic. An international empirical evaluation was conducted involving students and teachers from seven universities in different countries around the world. The obtained results showed that our approach can make a significant contribution to the development of practical projects on undergraduate GSD courses with students developing their knowledge and social skills associated with this topic. The data collected on the teachers’perceptions suggested that our approach could also be useful in introducing the GSD approach at undergraduate level when social distancing is in place. Author

Evolution of asthmatic patients at 6 and 12 months after acute COVID-19 recovery

Nowadays, beyond the acute phase of COVID-19, there is a growing interest in the clinical manifestations that appear after the recovery of this phase, giving the potential repercussions that this could have in the recovered population. Asthma is a prevalent disease, and it is possible that its pathogenic basis could affect the postCOVID-19 course. Objective(s): evaluate the evolution of asthmatic patients at 6 and 12 months after the recovery of COVID-19. Method(s): Data was collected through manual revision of electronic clinical histories. There were included as demographic features the age and sex, and comorbidities such as smoking habit, COPD, obesity (BMI > 30 Kg/m2), obstructive sleep apnea, gastroesophagic reflux, rinosinusitis, nasal poliposis, anxiety and depression. Patients were classified according to whether they had T2 asthma or not. There were considered previous pneumonia, need of conventional hospitalization or ICU. Symptoms (chest pain, cough, sputum production and dyspnoea) and the development of further complications were also recorded. Result(s): After analyzing the variables at 6 months after recovery, we found statistical significance in the presence of chest pain in patients with previous COVID-19 pneumonia (p=0.009). In the same period, lower eosinophil blood levels were found in patients that had dyspnoea (p=0.043). Additionally, there was a significant association between smoking habit and pulmonary embolism at 12 months after recovery (p=0.025). Conclusion(s): Developing COVID-19 associated pneumonia in asthmatic patients is related to the presence of chest pain at 6 months after recovery. Also, the smoking habit seems to be associated with thromboembolic disease in postCOVD-19 period.

Impact of coronavirus infection on anxiety and quality of life in individuals with a kidney transplant

Background: The consequences of SARS-CoV-2 infection on the mental health of kidney transplant recipients have not yet been investigated. Objective(s): This study compares anxiety and quality of life in individuals with a kidney transplant who did or did not test positive for coronavirus. Design(s): Retrospective study of two prospective cohorts. Participant(s): Kidney transplant recipients under follow-up in a Spanish tertiary teaching hospital who tested positive for coronavirus (cases);and consecutive kidney recipients who had not suffered the infection (not-cases). Method(s): Mortality and case fatality data were compared between the two cohorts for the two pandemic waves. For the second wave (July 1 to December 5, 2020), the data compared between cases (n=22) and not-cases (n=36) were state and trait anxiety (STAI), kidney transplant-related quality of life (KTQ), and mortality as the main outcome variables. Result(s): 601 transplanted persons of mean age 61.7 years (SD 12.8), 61.9% men. 12.1% (n=73) tested SARS-CoV-2-positive over the first two pandemic waves with a mortality of 2.9% and case fatality of 24.7%. Over the second wave, the mean quality of life score was 4.1 (SD 0.9) and the overall anxiety score was 49 (SD 24.3) for the two cohorts, which did not vary in terms of the impacts of these measures on the descriptive variables examined. Conclusion(s): Quality of life is invariably affected, and levels of anxiety are high regardless of whether or not they have had a SARS-CoV-2 infection. Over the period examined, mortality was low while coronavirus case fatality was high. Copyright © 2022, Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires. All rights reserved.

Coinfection Characteristics among Children with COVID-19

Background. Coinfection in patients with SARS-CoV-2 has been associated with greater complications. We describe the clinical characteristics and outcomes of 126 pediatric patients with COVID-19 and viral, bacterial, or fungal coinfection. Methods. We retrospectively reviewed and analyzed electronic data of all pediatric patients who tested positive for SARS-CoV-2 from April 16, 2020, to April 15, 2022, in our center. Confirmation of COVID-19 was based on positive RT-PCR. Viral coinfections (VC) were identified using a multiplex RT-PCR respiratory viral panel, bacterial coinfection (BC) was determined by positive bacterial culture (blood, bronchoalveolar lavage, sputum, urine) or clinical/radiological manifestations and antimicrobial assessment by a pediatric Infectious Diseases expert and fungal coinfection (FC) diagnosis based on Consensus definitions of invasive fungal disease. Results. During the study period, among 400 pediatric patients with COVID-19, 126 children had coinfection. Children >10 years were the most affected age group. Underlying disease was present in 69%, hematological malignancies were the most common (17.5%). BC was detected in 76.9% (n=97), bacterial pneumonia (54.6%) was the main diagnosis, followed by oncologic patients with initial febrile neutropenia and posterior SARS-CoV-2 detection (14,4%). Unusual BC as congenital syphilis w detected;acute appendicitis was the initial presentation of COVID-19 in 8 patients. VC was identified in 15.87% (n=20), prevailing rhinovirus (9.5%) and adenovirus (3.96%), One FC presented as proven pulmonary aspergillosis (0.8%). B-V and B-F coinfection were detected in 2 patients. Fever and cough were the most common symptoms, higher fever >40degreeC was mostly observed in the BC group (3%). Twenty-seven patients with BC (27.8%) were admitted to intensive care, with the OR 0.7 IR 95% (0.611-1.008), 4.1% died. One ICU admission was observed in the VC group (5%) and all VC cases resolved without complications. Conclusion. Pediatric patients with COVID-19 coinfection, especially BC were common in our center representing nearly one-third of the infected children, including unusual coinfections. BC was identified as a risk factor for ICU admission OR 0.7 IR 95% (0.611-1.008). Favorable outcomes were observed in most cases.

Preliminary Study of Self-Esteem and Subjective Well-Being in Sports and Physical Exercise Students before and during the Covid-19 Pandemic

Social isolation has been an important strategy to fight the COVID-19 pandemic, which has affected the practice of sports and physical exercise and has also had an impact on perception of variables such as self-esteem and subjective well-being (Positive and Negative Affect Schedule [PANAS], and life satisfaction). Even though these variables have a significant relation, they may also give rise to affect mediation, which is not conclusive in this pandemic era. For this reason, this research's objective is to compare those variables before and during confinement, in addition to analyzing the mediation effect within a structural model in SmartPLS. By conducting a quantitative, correlational, and comparative research, a sample of 200 sports and physical exercise students from a university located to the northeast of Mexico was obtained. Significant differences were found in variables such as self-esteem (pre-pandemic [M= 3.65;DE= .272] and during [M= 3.23;DE= .543];p< .001) and positive (pre-pandemic [M= 3.64;DE= .601] and during [M= 3.41;DE= .797];p< .05) and negative (pre-pandemic [M= 2.37;DE= .733] and during [M= 2.11;DE= .765];p< .01) affects before and during the pandemic, as well as a mediation effect of positive affect in the relation between self-esteem and life satisfaction (t= 3.772;p< .001). This is intended to contribute to the understanding of the pandemic effects on the relation between sports practice and positive psychology variables, perspective which has gained great relevance in the last years.

Lessons learned after the disruption caused by COVID-19 in the management of urolithiasis: An example of adaptation in a high-volume center.

BACKGROUND: The aim was to determine the impact of COVID-19 pandemic on urolithiasis presentation and management. METHODS: In this retrospective study, we comparatively evaluated urgent and elective procedures due to urolithiasis during the early eight months of the COVID-19 pandemic (March 1, 2020, to October 31, 2020) compared to the same period a year before, and between waves. The student's t-test, chi-square test, Mann-Whitney U test and Fisher's exact test were used to compare the patients' characteristics and outcomes between the two periods and waves. RESULTS: Five hundred and thirty procedures were included. The overall numbers of surgical procedures due to urolithiasis were similar between pre-pandemic and pandemic periods. Regarding elective surgery, our data draw attention to the increased complication rate in the pandemic times, but no statistically significant differences in terms of types of procedures and need for complementary treatments were observed. We noted that patterns of presentation of complicated renal colic were different during COVID-19 pandemic, with a higher number of days after the onset of symptoms and a higher proportion of patients presenting acute kidney injury. Furthermore, a significant increase of creatinine levels at presentation in first wave was detected, and a growth in the number of urgent procedures after the first wave was noted, owing to the delay in urolithiasis treatment and diagnosis. CONCLUSION: The COVID-19 pandemic has negatively affected both urgent and elective management of urolithiasis. Lessons about the management of urolithiasis in this context should be learned to avoid fatal complications and improve standards of care.

Liver enzymes in high-risk patients diagnosed with COVID-19

Introduction: It is important to know the alterations in liver enzymes in patients with COVID-19, as markers of liver damage. Objective: To identify alterations in liver enzymes in high-risk patients with COVID-19. Methods: A prospective descriptive study was carried out on alterations in liver enzymes in 56 patients admitted with COVID-19. The variables studied were age, sex, evolution towards gravity, and liver enzymes. Serum samples were taken on the first day of admission and on the fifth day to determine liver enzymes. The Ritis index was also found. Results: The average age was 66.64 ± 13.12 years, 51.8% were older men and 37.5% progressed towards severity. In all enzymes there was an increase in the mean on the fifth day of the study. Lactate dehydrogenase (LDH) and γ-glutamyl transpeptidase (GGT) were found to be high in most of the patients from the first day. On the fifth day, aspartate aminotransferase (AST) was high in 71.4% of non-severe patients and alanine aminotransferase (ALT) in severe cases. At the beginning, a Ritis index < 1 was more frequent, but on the fifth day the Ritis index > 1 increased by 42.9% in seriously ill. 56.6% of seriously ill patients modified this index on the fifth day. Conclusions: The elevation of the mean liver enzymes on the fifth day was demonstrated. LDH and GGT remained high from the beginning of the disease. The majority of severe patients reversed the Ritis index on the fifth day. © 2022, Editorial Ciencias Medicas. All rights reserved.

ELTROMBOPAG (EPAG) INDUCES HEMATOLOGIC RESPONSES FOR PATIENTS WITH POST-ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANT POOR GRAFT FUNCTION (POST-ALLO HSCT PGF): RESULTS OF THE ELTION STUDY IN SPAIN

Background: Persistent cytopenia due to poor graft function (PGF) is a life-threatening complication in patients undergoing allogeneic HSCT (allo-HSCT). Several therapeutic approaches have been tested in this subset of patients with poor clinical results. Aims: The objective of this multicenter open-label interventional prospective phase II Novartis study (ELTION, ClinicalTrials.gov id: NCT03718533), was to analyze efficacy and safety of EPAG in patients with post-allo-HSCT poor graft function. Methods: Adult patients diagnosed with PGF (defined as severe cytopenia after day +30 post-transplant, with two or more of the following: platelets <20000/μL-mandatory-, ANC <1000/μL, hemoglobin< 10 g/dL), and full donor chimerism, were eligible to enter the trial. Study treatment consisted of EPAG. at 150 mg/day administered up to 36 weeks;dose adjustments were contemplated as per protocol on an individual basis. The primary efficacy endpoint was the overall hematologic response (partial and complete), as determined by platelet, hemoglobin and neutrophil counts by 16 weeks after the initiation of EPAG. Results: Although the aim of the study was to include 33 patients, recruitment stopped prematurely due to the difficulties for hospital visits posed during COVID-19 pandemic, and eventually only 10 patients were included. The decision for this premature termination is not related to any safety concern related to the drug. Patient characteristics are shown in the table 1 attached below. At EPAG. initiation, all 10 patients showed thrombocytopenia (<20000/μcL), 5 presented with anemia (Hgb <10 g/dL), and 4 had neutropenia (ANC <1000/μcL). Four patients discontinued EPAG before week 12 due to: disease progression/relapse (2 patients), protocol deviation (1 patient), and CMV infection (1 patient). In none of the cases, the event was related to study drug. At week 16, 4 patients (4/10, 40%) and at week 24, 5 patients, showed improvement in at least one of the 3 hematologic cell lines (partial response), respectively. Counts pre-and post-EPAG and global response in patients who stayed on treatment > 12 weeks are displayed below: Image: Summary/Conclusion: In our experience, EPAG worked well in subjects with PGF, an otherwise life-threatening condition for patients, and its use at 150 mg/day is safe and well tolerated in this setting. Our data suggest that eltrombopag might improve hematologic cell counts in patients with PGF, especially in those patients who remained on treatment at week 24, however further research is warranted to extend its applicability for larger cohorts.

Formal Modeling and Simulation for SARS-CoV-2 Containment Scenarios in Catalonia

We define interrelated models to simulate the spread of SARS-CoV-2 in Catalonia, which can be used to effectively build simulation applications and analyze the effects of nonpharmaceutical interventions. Due to the constant evolution of this pandemic, and the need to take a multidisciplinary approach, we use a formal specification to represent the model and to validate the model assumptions. We discuss the definition of the model using formal languages, and the Specification and Description Language to improve communication between stakeholders. We show formalization details, discuss implications in the validation process, and present how results obtained from the model of the pandemic in Catalonia can be used for decision-making.

POST-TRAUMATIC STRESS DISORDER and SYMPTOMS in PATIENTS with RHEUMATIC and MUSCULOSKELETAL DISEASES during the COVID-19 PANDEMIC: PRELIMINARY RESULTS from the PERMAS STUDY

Background: The COVID-19 pandemic, with its uncertainties, fears of contagion, mass lockdowns and containment measures, has dramatically impacted on people's everyday lives leading to an increased risk of mental disorders, particularly Post-Traumatic Stress Disorder (PTSD). Despite evidence in general population and healthcare workers1,2, scant data emerged on vulnerable populations, such as of patients with chronic illness, particularly rheumatic and musculoskeletal diseases (RMDs)3,4, who also underwent difficulties in the management and treatment of their disorders. Objectives: To assess PTSD and post-traumatic stress symptoms in a sample of patients with RMDs, during the COVID-19 pandemic in Italy. Methods: PERMAS is a monocentric prospective observational study led by the Rheumatology Unit, the Psychiatric Clinic and the Institute of Management of the School of Advanced Studies. Patients with a RMD diagnosis, were consecutively enrolled from May 2021 to January 2022. During the visit, sociodemographic characteristics and psychopathological data were collected through online survey, whereas clinical data were collected by physician. The survey included the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Impact of Event Scale-Revised (IES-R), aimed to assess symptomato-logical PTSD and post-traumatic stress symptoms related to the impact of the COVID-19 pandemic. Results: A total of 194 eligible patients, with a mean age of 50.3±12.17 years, was included: 142 (73.19%) were females;112 (57.74%) patients reported connective tissue diseases (CTD), 63 (32.47%) arthritis and 19 (9.8%) vasculitis. A total of 33 (17%) subjects reported a symptomatological PTSD by means of the TALS-SR. The prevalence of Partial PTSD (defned by at least 2 out of the 4 criteria for DSM-5 diagnosis of the disorder) was 56.7%, with signifcant higher rates among females (90, 81.8%) with respect to males (20, 18.2%) (p=.013). Accordingly, a IES-R mean total score of 21.90 ±15.98 was found in the total sample and a gender difference emerged, with higher mean scores among females rather than males (23.42 ±16.26 vs 21.90 ±15.98, p=.031). Conclusion: The present fndings point out high prevalence rates of symptoma-tological PTSD among patients suffering from RMDs, highlighting the potentially traumatic burden of the COVID-19 pandemic in this particular population, especially among females, suggesting the need of further investigations to address tailored prevention and intervention strategies.