Sensationalism vs. information during COVID-19 in Ecuador: A framing theory-based view

The different frames used in the COVID-19 coverage in Ecuador by the national and international press were analyzed through their Twitter accounts. This allowed the examination of which aspects of the pandemic were given greater prominence by each newspaper. The study was based on five generic frames, between 17 March and 16 April 2020. The exploration of these frames was carried out by means of an intersubjective content analysis, using four previously trained encoders. The dominant frames for COVID-19 in Ecuador varied according to the media group studied. 1) The concept of heterogeneity was confirmed within framing theory, according to which a single reality, understood as a textual and visual construct, is addressed in multiple ways by the selection of certain aspects that are given greater emphasis or priority;2) international newspapers and, to a lesser extent, the national press showed their propensity to "internalize" the dynamic of sensationalism;and 3) there are discrepancies in the interests of the readerships with respect to the dominant frames in the media. © 2021, IGI Global.

Clinical Characteristics of Critically Ill Patients with COVID-19 and Invasive Pulmonary Aspergillosis: A Case Series from Mexico City

Background. COVID-19 has emerged as a global public health emergency and has been the main cause of intensive care admission during the pandemic. COVID-19-associated pulmonary aspergillosis (CAPA) has been reported in case series of critically ill patients. However, the criteria for CAPA diagnosis has been inconsistent among most of the reports. Mexico has been widely affected by SARS-CoV-2. We present a series of CAPA cases at a teaching hospital in Mexico City. Methods. We performed a retrospective analysis of COVID-19 patients admitted to the ABC Medical Center from May 1st, 2020, to May 1st, 2021. Including only those with critical COVID-19 who required invasive mechanical ventilation (IMV). Patients with a diagnosis of CAPA were analyzed. We followed the 2020 ECMM/ISHAM consensus criteria for CAPA diagnosis. Aspergillus antigen testing in tracheal aspirate and serum was done with Aspergillus-specific galactomannoprotein (GP) ELISA (Euroimmun Medizinische Labordiagnostika). Results. Among the 230 admitted patients who required IMV, we identified 49 (21.3%) cases of CAPA, 46 probable CAPA and 3 proven CAPA. Nineteen (38%) of those died in the hospital. The mean age was 64.5 ± 12.6 years and 11 were female. Proven CAPA was diagnosed with culture in three cases (one A. niger, one A. terreus and one A. fumigatus). Probable CAPA was diagnosed by a positive serum GP in 27 (55.1%) patients and by a positive bronchoalveolar lavage (BAL) GP in 29 (59.2%) cases. Seven patients had both serum and BAL positive GP. Forty-six (93.9%) patients received corticosteroids, and 22 (49.9%) were treated with tocilizumab before CAPA diagnosis. All but one received isavuconazole as CAPA treatment. We detected 35 (71.4%) patients who had a bacterial co-infection. Eighteen of those died (51.4%) compared to only one dead in the subgroup without coinfections (7.1%). The mean time from hospital admission to CAPA diagnosis was 6.2 days (SD 7.1) among those who survived compared to 13.2 (SD 6.3) days in those who died p< 0.01. Conclusion. CAPA had a lower prevalence than previously reported in other series. However, it appears to be linked to high mortality when it occurs with other bacterial coinfections and when it is diagnosed late from admission.

Biomarkers associated with coronavirus disease-19 disease progression in a Mexican hospital

Introduction: The Coronavirus disease (COVID-19) pandemic is a worldwide challenge. There are few useful tools to predict patient outcomes. Identification of biomarkers able to predict progression of the disease could improve the treatment of these patients. Objective: The objective of the study was to identify biomarkers of disease progression among patients with severe COVID-19 pneumonia. Materials and methods: A retrospective cohort study was conducted among severe COVID-19 pneumonia patients hospitalized in the American British Cowdray Medical Center in Mexico City. Disease progression was defined as use of vasoactive amines, need of non-invasive or invasive mechanical ventilation or death. Studied biomarkers included neutrophil/lymphocyte index, lymphocyte/platelet Ratio, C reactive protein, procalcitonin, D Dimer, lactic dehydrogenase (LDH), ferritin, 25–OH–Vitamin D, and interleukin 6. Results: We report 46 patients with severe COVID-19 pneumonia. Mean age was 51 years, the majority of whom 30 (65%) male. Median hospitalization was 9 days. 23 (50%) of patients presented disease progression. Ferritin and LDH were strongly associated with disease progression among our cohort. In addition, age was associated with worst prognosis with a relative risk 4.5 (1.2-16.9, p = 0.003). Conclusions: Age, ferritin, and LDH were associated with disease progression among patients with severe COVID-19 pneumonia.

Comparision of CD4+ T cells in patients with severe vs critical COVID -19

Background: Over the past few years, it has been shown that T cells play an essential role in antiviral immunity, in the course of the COVID-19 pandemic some studies reported an association between lymphocytopenia and exhaustion of the surviving remaining T cells which are apparently functional in patients with acute COVID-19, specially in those with severe forms of presentation. Some studies have reported an association where less than 800 CD4 + T cells are negatively related to the survival of seriously ill patients with COVID -19. Methods: We included 19 patients admitted to our hospital (ABC Medical Center) from May 7 to 15, 2020 with a confirmed diagnosis of COVID-19 and were randomized into 2 groups according to the severity of the presentation (severe or critical) A determination of CD4 + T cells was made at admission, we also reported the need for invasive mechanical ventilation at some point of the hospitalization for each group, all patients were followed until their hospital discharge. One patient was excluded because he was still admitted at the time of the analysis. Results: Of the 18 patients included, 9 (50%) fulfilled criteria of severe and 9 (50%) of critical. The mean of CD4 + T cell was 455 (256-697) for the severe and 285.44 (145-430) for the critical (CI 95% P 0.46), the determination of CD8+ T cell was 212 (88-392) for the severe and 201 (59-534) for the critical (CI 95% P 1.19), of the critical patients 8 (88.9%) required invasive mechanical ventilation and only one non-invasive mechanical ventilation, while the severe patients only required support with supplemental oxygen by nasal cannula (9 (100%)).The mean lenght of hospitalization was 12.73 days (3-34) and all the patients survived until they were discharged home. Conclusion: As it has been reported in some studies, the pathogenesis of SARSCoV- 2 infection in humans is associated with a reduction and functional exhaustion of T cells in patients with COVID-19.In this study we presume that lower levels of CD4+T cells can be associated with critical forms of COVID 19 as the majority of critical patients in our report had < 300 CD4 +T cell count, while we need further studies with a greater number of patients and follow-up to establish reliable determinations, we propose than the levels of CD4+T cell count could be use as a good predictor of severity in COVID-19.

Clinical characteristics of critically ill patients with COVID-19 and invasive pulmonary aspergillosis: A case series from Mexico City

Background: COVID-19, caused by SARS-CoV-2, has emerged as a global public health emergency and has been the main cause of intensive care admission during the pandemic. Invasive pulmonary aspergillosis (IPA) superinfection has been reported in case series of critically ill patients. Mexico has been widely affected by SARS-CoV-2. We present a case series of COVID-19-associated IPA at a teaching hospital in Mexico City. Methods: We performed a retrospective analysis of COVID-19 patients admitted to the ABC Medical Center from March 13 to June 1, 2020. Only those with severe or critical COVID-19 were hospitalized. Patients with a diagnosis of putative IPA were analyzed. SARS-CoV-2 was diagnosed by Real-Time PCR from nasopharyngeal swabs. Aspergillus antigen testing in tracheal aspirate and serum was done with Aspergillus-specific galactomannoprotein (GP) ELISA (Euroimmun Medizinische Labordiagnostika).The study was approved by the hospital ethics committee. Results: Among the 47 admitted patients who required invasive mechanical ventilation (IMV), we identified seven (14.9%) cases of IPA. The mean age was 59.7 ± 17.8 years and five were male. All our patients had comorbidities, but none were under previous immunosuppressive treatment. All had critical COVID-19 pneumonia requiring IMV. All but one patient received corticosteroids, and five patients were treated with tocilizumab before IPA diagnosis. Putative IPA was diagnosed in six cases (86%) by a positive GP in tracheal aspirate, additionally in one of these, the tracheal aspirate culture also grew Aspergillus niger. The remaining one (14%) had a positive serum GP. The median time from COVID-19 to IPA diagnosis was 10 days. There were five bacterial co-infections, three with Pseudomonas aeruginosa, one with Stenotrophomonas maltophilia, and one with Mycobacterium tuberculosis. Six patients were treated with isavuconazole and one voriconazole. As of June 17, 2020, three patients had died, two patients had been discharged, and two were still in the intensive care unit receiving IMV. Aspergillus niger isolated from a tracheal aspirate of a critically-ill COVID-19 patient Conclusion: COVID-19-associated IPA had a lower prevalence than previously reported in other series. However, it appears to be linked to high mortality and could be associated with other bacterial coinfections.

The covid-19 pandemic according to the international media: Ecuador’s case through framing theory on twitter

The research exposes through Framing Theory the different approaches of the national and international press regarding the terrible events that occurred in Ecuador during the so called “Emergency of Guayaquil” between the end of March and the beginning of April 2020, being the hardest moments suffered under the Covid-19 pandemic. Taking as a basis the proposal of generic frames (conflict, consequences, human interest, morality and responsibility) in the Semetko and Valkenburg scale applied to Twitter, the existence of two very different news constructs between the national and international press is evidenced. While in the national press the frame of consequence predominates through a context of high demand for information from audiences to monitor the development of events, the international press emphasized the frame of human interest in the face of need for morbid scenes and sensationalism. © 2021, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Transmedia Context and Twitter As Conditioning the Ecuadorian Government's Action. The Case of the "Guayaquil Emergency" During the COVID-19 Pandemic

Communication ecosystems have multiplexed and increased their capacity to act, distort, and fight. COVID-19 pandemic and the response of the Ecuadorian Government to it are clear examples of the power of media to erode, to influence, and also to produce fake news. In this context, Twitter has become more than just a social platform, as it helped spread catastrophic pictures of the country, especially of Guayaquil. This article analyzes the tweets posted by the main domestic and global media and by the Ecuadorian government accounts since the out-break of the pandemic in Ecuador, as well as the interrelations among them and their polarity score. The aim is to show how the government changed its action plan by focusing on exogenous elements that had been excluded from its (pre)established strategy, which consisted in neglecting and deliberately minimizing a situation that turned out to be more serious than officially deemed and that was exposed by unofficial global media.