Artificial intelligence and sustainable tourism development. the value of collaboration agreements

Objective and interest of the work: This study focuses on the application of artificial intelligence in the tourism sector to improve the consumer experience in a significant way through the work developed by different organizations to increase social innovation. The objective of the study is, on the one hand, to present an analysis of the literature to determine good practices in the sector, and on the other hand, to analyze data about the tourism sector based on models of collaboration between Administration, Universities and the State to promote innovation in the commitment to sustainable models. Methodology design: S e conducted an analysis of experiences that demonstrate the existence of collaborative practices promoted by different public and private institutions to promote the use of technology in the tourism sector. A compilation of secondary sources was carried out to gather information on these initiatives. Results: The work shows that the topic is of interest to the scientific community and compiles the practices in Spain linked to the interest of organizations that are committed to new initiatives that help the competitiveness of tourism in Spain, with the use of artificial intelligence in the reality of the sector being incipient. Practical implications: New trends in technology are being applied in the growing and sustainable recovery of tourism over the long term in the wake of the numbers left by the COVID-19 pandemic. This is the fruit of a new school of thought that emphasizes cooperation for social progress.

Female Entrepreneurship in College Students: A Literature Review

There are still gender asymmetries in entrepreneurship, which generates that female entrepreneurship is lower than that of men, so there must be equity and gender jus-tice that may imply acting with coherence in an econo-mic, political and cultural environment providing women with the same opportunities as men. For this reason, in the present article it was intended to characterize female en-trepreneurship in university students as a response to the pandemic of COVID 19, being the same of bibliographic review in which the PRISMA schematization was consi-dered, through an exhaustive search of articles in the va-rious databases such as Scopus, Science Direct, Scielo and Ebsco of which it was possible to analyze 20 articles by complete reading, These were from 2018 to 2022, with which it was concluded that women tend to undertake mostly by necessity, either economic or to feel self-reali-zed and advance in their careers, or because they are not satisfied with their jobs, since their workplace does not allow them to move up to a position with higher hierarchy and prefer to spend more time with their children.

A Usability-focused Method to Design a Cybersecurity MOOC for Children

Teaching cybersecurity to children is not a trivial task due to the complexity of explaining online-threat-related topics such as sexting or cyberbullying. Moreover, most of the courses designed to raise awareness in these controversial subjects has been mainly produced in English. However, during the Covid-19 pandemic, getting access to Spanish-based training for protecting children online became a priority for parents in countries such as Ecuador, which was not prepared to have children studying at home whilst being exposed to such threats. In this paper, we show that it is feasible to design a virtual course (MOOC) to teach cybersecurity to Spanish-speaking children with acceptable usability levels and minor usability issues. Our proposed methodology combines ADDIE, DPIPE and UDL for developing the course, and uses both SUS and Nielsen as methods to assess the MOOC from an usability point of view. For enhancing user engagement, our course uses novel 3D anthropomorphic characters and storyboards to aid the learning process. Regarding usability results, our proposed MOOC has very high and acceptable scores, with around 86/100 using the SUS scale, and less than 3 in the Nielsen score. © 2022 IEEE.

The Effect of Country Economic Institutions and Cultural Values on Government Policy and Societal Compliance in the Covid-19 Pandemic

Using data from 88 countries, we test hypotheses linking a country's economic freedom and cultural values with the propensity and timing of decisions to impose stringent policies to combat the spread of Covid-19, as well as society's compliance with those restrictive measures. Our analysis supports hypotheses that a country's economic freedom and cultural dimensions of individualism and masculinity predict early implementation of stringent policies. After accounting for endogeneity, we find that individualism also helps explain residents' compliance with stringent measures. These findings illustrate how institutions and cultural values influence government policies and societal compliance. © The Author(s) 2023.

Aptamer-Capped Nanoporous Anodic Alumina for SARS-CoV-2 Spike Protein Detection

The COVID-19 pandemic, which began in 2019, has highlighted the importance of testing and tracking infected individuals as a means of mitigating the spread of the virus. In this context, the development of sensitive and rapid methods for the detection of SARS-CoV-2, the virus responsible for COVID-19, is crucial. Here, a biosensor based on oligonucleotide-gated nanomaterials for the specific detection of SARS-CoV-2 spike protein is presented. The sensing system consists of a nanoporous anodic alumina disk loaded with the fluorescent indicator rhodamine B and capped with a DNA aptamer that selectively binds the SARS-CoV-2 spike protein. The system is initially evaluated using pseudotype virus systems based on vesicular stomatitis virus carrying different SARS-CoV-2 S-proteins on their surface. When the pseudotype virus is present, the cap of the solid is selectively removed, triggering the release of the dye from the pore voids to the medium. The nanodevice demonstrated its ability to detect pseudotype virus concentrations as low as 7.5·103 PFU mL. In addition, the nanodevice is tested on nasopharyngeal samples from individuals suspected of having COVID-19. © 2023 The Authors. Advanced Materials Technologies published by Wiley-VCH GmbH.

Understanding nursing care from Heidegger's philosophical referential in times of Covid-19.

Objective: reflect on the philosophical work of Martin Heidegger, as an ontological reference to understand nursing care, from the care challenges arising from the Covid-19 pandemic. Result(s): this article unravels the background of the state of the art on the understanding of the nature of nursing care, from the concepts proposed by Heidegger in his work "Being and Time", contrasted with the background of the current reality in nursing. Conclusion(s): Finally, Heidegger's work is proposed as a philosophical referential for reflective practice in the care of people diagnosed with Covid-19.Copyright © 2022, Fundacion Index. All rights reserved.

Association between a Frailty Index from Common Laboratory Values and Vital Signs (FI-LAB) and Hospital and Post-Hospital Outcomes in Veterans with COVID-19 Infection.

OBJECTIVES: Determine the association of higher FI-LAB scores, derived from common laboratory values and vital signs, with hospital and post-hospital outcomes in Veterans hospitalized with COVID-19 infection. DESIGN, SETTING, AND PARTICIPANTS: A retrospective, multicenter, cohort study of 7 Veterans Health Administration (VHA) medical centers in Florida and Puerto Rico. Patients aged 18 years and older hospitalized with COVID-19 and followed for up to 1 year post discharge or until death. Clinical Frailty Measure: FI-LAB. MAIN OUTCOMES AND MEASURES: Hospital and post-hospital outcomes. RESULTS: Of the 671 eligible patients, 615 (91.5%) patients were included (mean [SD] age, 66.1 [14.8] years; 577 men [93.8%]; median stay, 8 days [IQR:3-15]. There were sixty-one in-hospital deaths. Veterans in the moderate and high FI-LAB groups had a higher proportion of inpatient mortality (13.3% and 20.6%, respectively) than the low group (4.1%), p <0.001. Moderate and high FI-LAB scores were associated with greater inpatient mortality when compared to the low group, OR:3.22 (95%CI:1.59-6.54), p=.001 and 6.05 (95%CI:2.48-14.74), p<0.001, respectively. Compared with low FI-LAB scores, moderate and high scores were also associated with prolonged length of stay, intensive care unit (ICU) admission, and transfer. CONCLUSIONS AND RELEVANCE: In this study of patients admitted to 7 VHA Hospitals during the first surge of the pandemic, higher FI-LAB scores were associated with higher in-hospital mortality and other in-hospital outcomes; FI-LAB can serve as a validated, rapid, feasible, and objective frailty tool in hospitalized adults with COVID-19 that can aid clinical care.

Association between a Frailty Index from Common Laboratory Values and Vital Signs (FI-LAB) and Hospital and Post-Hospital Outcomes in Veterans with COVID-19 Infection

Objectives Determine the association of higher FI-LAB scores, derived from common laboratory values and vital signs, with hospital and post-hospital outcomes in Veterans hospitalized with COVID-19 infection. Design, Setting, and Participants A retrospective, multicenter, cohort study of 7 Veterans Health Administration (VHA) medical centers in Florida and Puerto Rico. Patients aged 18 years and older hospitalized with COVID-19 and followed for up to 1 year post discharge or until death. Clinical Frailty Measure: FI-LAB. Main Outcomes and Measures Hospital and post-hospital outcomes. Results Of the 671 eligible patients, 615 (91.5%) patients were included (mean [SD] age, 66.1 [14.8] years;577 men [93.8%];median stay, 8 days [IQR:3-15]. There were sixty-one in-hospital deaths. Veterans in the moderate and high FI-LAB groups had a higher proportion of inpatient mortality (13.3% and 20.6%, respectively) than the low group (4.1%), p <0.001. Moderate and high FI-LAB scores were associated with greater inpatient mortality when compared to the low group, OR:3.22 (95%CI:1.59-6.54), p=.001 and 6.05 (95%CI:2.48-14.74), p<0.001, respectively. Compared with low FI-LAB scores, moderate and high scores were also associated with prolonged length of stay, intensive care unit (ICU) admission, and transfer. Conclusions and Relevance In this study of patients admitted to 7 VHA Hospitals during the first surge of the pandemic, higher FI-LAB scores were associated with higher in-hospital mortality and other in-hospital outcomes;FI-LAB can serve as a validated, rapid, feasible, and objective frailty tool in hospitalized adults with COVID-19 that can aid clinical care. Electronic Supplementary Material Supplementary material is available for this article at 10.1007/s12603-023-1886-0 and is accessible for authorized users.

[Survival and decannulation at 90 days after percutaneous dilation tracheostomy in the COVID-19 intensive care unit]

INTRODUCTION: Tracheostomy (TCT) is the most frequently performed surgical procedure among COVID-19 patients. In Argentina, survival and decannulation rates are unknown. The main objectives of this study were to evaluate mortality and decannulation rates after 90 days of the percutaneous TCT performance. Secondarily, airway injury rate, days on invasive mechanical ventilation (IMV) and days of hospitalization in the intensive care unit (ICU) were also evaluated.

COVID-19 and Health Sciences Libraries of public hospitals in Spain

The COVID-19 Pandemic has ostensibly affected the workability of libraries in all sectors, including health service libraries. The aim of this study is to analize the impact of this situation with a descriptive cross-sectional study carried out in specialized libraries of health sciences within public hospitals in Spain. Methodology: This study was carried out via an email questionnaire from june to november of 2020, comprising 35 items and it gathered data in reference to personnel, services and collections before and during phase 0 of the alarm state. Results: 137 libraries were identified and 100 were analyzed. During the phase 0 of the alarm state 72% remained closed and 76% of the staff combined working in person with working from home. The greatest demand was for research papers/documentation and bibliography searches, no change was experienced with regard to collections. More than half who have participated in collaborative work groups value it as very useful. According to the authors, while this situation has revealed that the librarians have had a great capacity to readapt, they conclude that it has also directly affected libraries with their temporary reconversion or in some cases their total closure. © 2022 CSIC. Este es un artículo de acceso abierto distribuido bajo los términos de la licencia de uso y distribución Creative Commons Reconocimiento 4.0 Internacional (CC BY 4.0).

PERCUTANEOUS TRACHEOTOMY IN ICU: OUR EXPERIENCE IN 2020-2021 (COVID-19 PANDEMIC)

INTRODUCTION Percutaneous tracheostomy (PT) is a surgical procedure for the placement of a tracheal tube through the anterior wall of the trachea. It is performed using a modified Seldinger technique between the second and third tracheal rings and guided under direct vision by the fiberoptic bronchoscope. It is a minimally invasive procedure with a low number of complications by experienced physicians. It is considered a safe alternative to surgical tracheostomies (ST), a more aggressive procedure. According to the internal protocols of the Anesthesia Intensive Care Unit (ICU) of the Valencia University General Hospital (CHGUV), PT are performed by anaesthesiologists, while ST are performed by otorhinolaryngologists. This study aims to confirm that PT is just as safe as ST, as well as that it presents the same or fewer immediate complications, understanding these as bleeding, loss of the airway due to the exit of the endotracheal tube, creation of a false pathway, injury to the posterior wall, injury to one or more tracheal rings, the appearance of subcutaneous emphysema and damage to the fiberoptic bronchoscope with the puncture needle. Due to the Covid-19 pandemic, patients with Covid-19 have been included. The modified protocol for this type of patient has been followed, following the consensus document of the Spanish Societies of Intensive Medicine (SEMICYUV), Otorhinolaryngology (SEORL-CCC), and Anesthesia (SEDAR). OBJECTIVE Review the total number of tracheotomies performed by anesthesiologists and otolaryngologists in the CHGUV ICU in 2020-2021, including patients with SARS-COV2 infection, as well as the total of immediate complications that occurred concerning the procedure. Confirm that PT is the technique of choice in critically ill patients due to its lower number and less severity of complications. MATERIAL AND METHODS Descriptive, observational, and retrospective study, in which each one of the tracheotomies performed in the CHGUV anesthesia ICU in 2020-2021, as well as their immediate complications, were collected. Patients with Covid-19 were included too. RESULTS A total of 294 tracheostomies were performed (20 were patients with SARS-COV2 infection). 294 were TP (12 with SARS-COV2) and 11 TQ (8 with SARS-COV2). Among the complications recorded, the most frequent was mild bleeding appearing in a total of 35 patients. Of these patients, only 30% belonged to the PD group. No cases required a surgical revision. In addition, within the ST, there was one case of accidental decannulation with loss of the airway. CONCLUSIONS Our study shows in general a low rate of early complications in tracheostomies, however, ST caused a higher incidence of immediate complications. Furthermore, PT has shown not only a lower incidence of complications but a lower severity of these too. The data from this study support the PT performed by experimented anesthesiologists as the technique of choice in critical patients compared to CT.

Changes in conditions, practices, and relationships between teachers and students in rural Mexican high schools during the covid-19 pandemic

This article analyzes some of the changes that occurred in Mexican Community Distance-Learning High Schools during the COVID-19 pandemic, particularly regarding the conditions of actors within school systems, the new activities associated with distance-learning, and teacher student relationships. From the perspective of interpretive sociology and through semi-structured interviews, the aim is to take the perspective of head teachers and teachers into account, in order to show their role in the transformation of the schools. It was found that, even though the preexisting problems of head teachers and teachers were exacerbated, these actors played a leading role and carried out this teaching work with creativity and commitment.

Enfermedad invasiva por neumococo en 2021. Impacto de la pandemia de COVID-19

Objetivos El objetivo del estudio es analizar los cambios provocados por la pandemia de COVID-19 en la demanda asistencial hospitalaria, solicitud de pruebas diagnósticas para neumococo y casos confirmados de enfermedad neumocócica invasiva (ENI) en la población pediátrica en 2021 respecto al periodo prepandémico (2018-2019). Métodos El estudio se realizó en 3 hospitales de nuestra comunidad autónoma que atienden el 32% de la población pediátrica hospitalizada en la misma. En 2021 y en 2018-2019 (promedio) se recogieron: visitas a urgencias, solicitudes de PCR diagnóstica de ENI, casos de ENI, y distribución por serotipos (incluidos en vacuna antineumocócica conjugada-13v [PCV13] y no incluidos [noPCV13]), y por grupos de edad (< 5 y ≥ 5 años). Se compararon las tasas de incidencia (TI) en 2021 respecto 2018-2019 mediante el cálculo de razón TI (RTI), con IC 95%. El cambio porcentual en RTI se expresó según fórmula: (1-RTI) × 100. Resultados El número de visitas a urgencias en 2018-19 fue de 227.148 y de 178.243 en 2021 (-21%;p < 0,0001). La variación en visitas a urgencias en < 5 años fue de + 4% y de -38% en ≥ 5 años. El número de PCR solicitadas en 2018-19 fue de 641 y de 754 en 2021 (+ 19%;p = 0,001) y el de casos por ENI en 2018-19 de 57 y de 19 en 2021 (-66%;p < 0,0001). El número de serotipos PCV13 en 2018-19 fue de 25 y de 8 en 2021 (-68%;p = 0,003), y el de serotipos no-PCV13 fue de 29 en 2018-19 y de 10 en 2021 (-65%;p = 0,002);siendo esta variación especialmente marcada en < 5 años. Conclusiones En 2021 se observó una disminución de carga asistencial en visitas a urgencias respecto al periodo prepandémico, pero un incremento en las pruebas diagnósticas solicitadas. La disminución de casos de ENI ha sido del 66% en 2021. Las medidas no farmacológicas de prevención podrían explicar estos resultados.

STUDY 'aR-CAT INICI': MANAGEMENT of EARLY RHEUMATOID ARTHRITIS in CATALONIA

Background: Given the progressive change in the management of infammatory diseases,an observational study was conducted on the management of Early Rheumatoid Arthritis (ERA) in Catalonia. Objectives: To know the management of ERA in Catalonia, to assess whether the recommendations of the EULAR/ACR guidelines are followed and to study the causes of management variability,to set improvement objectives. Methods: An observational,descriptive,and cross-sectional study was conduct-ed,with data collection from June 15 to 30, 2021.The rheumatologists' partners of the Catalan Society of Rheumatology were the object of study. An online survey was conducted with 304 members on the management of the ERA. Variables related to the characteristics of the respondents,the derivation and variables of the disease including clinical variables,type of treatment and outcomes used for follow-up including the impact of the SARS-CoV2 pandemic were included. The univariate study was performed using a study of proportions with Pearson's correlation. Results: A total of 105 members (34.5%) responded to the survey.11.6%>60 y, only 7.8% <30y. 99% were in public assistance.The number of rheuma-tologists per service is 7.2[1-17],but 34.2% had< 5 rheumatologists,with a reference population of 200,000-300,000p in 42% of respondents.The number of weekly visits made is 67.5[20-130].42.2% do not have a monographic RA or ERA dispensary and 30.4%not have specialized nursing.Characteristics of ERA:77.5% are derived from primary care(PC),52% have been between 6 weeks,42.1%>3 months.54.9% make a frst visit within 2-4 weeks of PC referral and 14.7%> 8 weeks.100%provide previous analysis,only 47% had had RX performed.98% were previously treated(50.4%NSAIDs + CG,36.1%NSAIDs,12.3% CG).4.3% had GC doses>10 mg/day,11.3%> to 20mg/day.The treatment:DMARDs of choice in 100% is MTX,44.1% start doses of 10mg/week and 3.9%7.5 mg/week.The route of choice is oral(55.9% vs 44.1%).92.2% associate GC and 31.7% have not withdrawn them after 6 m.57.8% consider the maximum of MTX 25mg/W.87.1% use doses<10 mg/day,with the most used dose being 5 mg/day(35.6%).Follow-up after the start of DMARDs is performed 72.5% between 4-6 weeks and 12.7% is performed by nursing.100% use DAS 28 and 53.5% also CDAI.31.4% perform PROs(HAQ 83.3%,RAPID 3 14.3%).The use of systematic ultrasound is collected in 33%, being himself who performs it in 59.9% and an expert rheu-matologist in 46.1%.Finally, when asked about incidence of pandemic in the follow-up,53.3% consider that it is doing the same as before. 46.1% consider that telephone visits are not suitable for the follow-up of the ERAvs14.7% who consider that Yes.When questioning the situations in which they consider them to be appropriate,75.9% that it was adequate in the control after the beginning of the DMARDs.Regarding the treatment of ERA, 66% delayed the onset of biological DMARDs, 72.1% due to difficulty of follow-up and only 8.8% due to an increased risk of infection. When performing the univariate analysis, it is evident that having a monographic dispensary is associated with earlier onset of MTX(p< 0.001)and at doses≥15 mg/W(p = 0.05),greater nursing intervention(p< 0.001),greater use of PROs(p = 0.008)and there is a tendency to a shorter waiting time for frst visits(p = 0.07).It is also associated with not considering telephone visits(p< 0.001), making them in less than 25%(p< 0.0001).Similarly,hospital level is directly proportional to initiation at higher doses of MTX(p< 0.0001),lower use of GC<10mg.Among the rest of the variables, no association has been found. Conclusion: The recommendations of EULAR/ACR in the treatment and follow-up of ERA are consistently followed,although the wide use of MTX orally is striking.It is evident that the variable that most influences the early onset of FAME and at higher doses,is a monographic dispensary,as well as greater presence of nursing and performance of PROs.

EFFICACY and SAFETY of SARS-COV-2 THIRD VACCINE in PATIENTS with RHEUMATOID ARTHRITIS WHO DID NOT RESPOND after PRIMARY TWO-DOSE REGIMEN

Background: Vaccination for COVID-19 is an essential tool to fght the pandemic. Evidence suggests that patients with immune mediated infammatory diseases (IMIDs) have less response. The application of a booster shot is a strategy that has been implemented in this population, however there is scarce information about its efficacy. Objectives: To assess the humoral and cellular immune response after a third dose of SARS-CoV-2 vaccine in patients with rheumatoid arthritis (RA) with undetectable antibodies titles after primary regimen of two doses. Methods: Observational study. Patients with RA (ACR/EULAR 2010 criteria) from two rheumatology centers, ≥18 years old, with no seroconversion after two doses of SARS-CoV-2 vaccine, who received a third dose of either mRNA or vector-based vaccines (BNT162b2 or ChAdOx1 nCoV-19) were included. Anti-SARS-CoV-2 IgG antibodies, neutralising activity and T cell responses were assessed between 21 and 40 days after the third dose. Sociodemographic data, comorbid-ities, treatment, vaccine applied and the presence of adverse events (AE) were recorded. Statistical analysis: descriptive analysis. Chi2 or Fischer test and T test. Results: A total of 21 non-responder patients were included, all of them females with a mean age of 63.7 years (SD 11,6) and mean disease duration of 15.8 years (SD 8). Most of them (81%) reported comorbidities, being the most frequent arterial hypertension, obesity and dyslipidemia. At vaccination time, 6 (28.6%) were receiving glucocorticoids, 3 of them ≥10 mg/day, 17 c-DMARDs (methotrexate 57.1%) and 18 (85.1%) b-DMARDs, 6 abatacept (ABT) and 4 rituximab (RTX). Regarding the primary vaccination regimen, 13 (61.9%) received two doses of BBIBP-CorV, 3 (14.3%) Gam-COVID-Vac, 3 (14.3%) ChAdOx1 nCoV-19 and 2 (9.5%) a mix regimen of Gam-COVID-Vac/mRNA-1273. The majority (95.2%) received BNT162b2 vaccine and only one of them ChAdOx1 nCoV-19, with a mean time between the second and third dose of 151,4 days (SD 46,4). After the third dose, 90.5% of the patients presented detectable anti-SARS-CoV-2 IgG and 76.2% presented neutralizing activity. The median of neutralizing antibodies titers was 1/12 (IQR 1/7-1/48). Both patients who did not present detectable antibodies were obese, recieved BBIBP-CorV during the primary regimen and BNT162b2 as the third dose, one of them was taking methotrexate and ABT and the other one RTX. Compared to other treatments, ABT and RTX was associated with no neutralizing activity in 4 (80%) patients and lower titers of neutralizing antibodies [median 1/3 (IQR 0-1/20) vs median 1/8 (IQR 1/4-1/128), p=0.197]. A T-cell response was present in 41.2% of all patients after the second dose, increasing to 75% after the third dose. The use of ABT was associated with a lower frequency of T-cell response (80% vs 20%, p=0.014). Sixteen (76.1%) patients reported at least one AE, 66.7% injection site reaction and 25% fu-like syndrome. Conclusion: In this RA cohort who failed to seroconvert after two doses of SARS-CoV-2 vaccine, 90.5% presented detectable anti-SARS-CoV-2 IgG and 75% T-cell responce after a third dose. The use of ABT was associated with a lower frequency of T-cell response. This data highlights the importance of a third vaccine in this group of patients.

ONE YEAR PROGRESSION of INTERSTITIAL LUNG DISEASE in CONNECTIVE TISSUE DISEASES. A DESCRIPTIVE STUDY in A SINGLE TERTIARY CENTER

Background: Interstitial lung disease (ILD) in connective tissue diseases (CTD) is an important cause of morbidity and mortalitiy. Objectives: To evaluate ILD in CTD (systemic sclerosis, myositis, Sjögren syndrome, rheumatoid arthritis, mixed connective tissue disease), sarcoidosis and interstitial pneumonia with autoimmune features and its progression in 12 months evaluated through high resolution computed tomography (HRCT) and pulmonary function test (PFT). Methods: A retrospective single tertiary center cohort study in CTD-ILD outpatients seen between 2012 and 2021. Clinical, serological data, PFT and HRCT results were collected. ILD patterns were classifed into: usual interstitial pneumonia (UIP), inconsistent UIP, nonspecifc interstitial pneumonia (NSIP), fbrosing NSIP, organizing pneumonia, interstitial lymphoid pneumonia and associated to sarcoidosis. Progression of ILD was defned as:->10% decline in FVC in PFT.->15% decline in DLCO in PFT.-Progression of fbrosis in HRCT. IBM SPSS v23 was used for statistical analysis. Results: 51 patients were collected. Baseline characteristics are shown in Table 1. Figure 1 shows ILD progression in 1 year. During follow up, 1 patient with sarcoidosis died of COVID19 bilateral pneumonia. Conclusion: In our series most patients were middle aged women. Anti-Ro antibodies and smoking status (former or current) were common among patients. Common clinical features were Raynaud (45%), skin affection (45%) and arthritis (40%). 47% of the patients expressed dyspnea at ILD diagnosis. 29,4% were treated with MP pulses, 23,5% with rituximab, 31,4% with mycofenolate mophetil. Fibrosing pattern in HRCT (UIP and fb-NSIP) was the most prevalent. 20% of the patients had progressive fbrosis under PFT criteria and 18% under HCRT. More studies of ILD-CTD are necessary to identify factors for progression and response to treatment and throw out more conclusions of prediction and prognosis of disease.

PREVALENCE of LONG COVID in RHEUMATIC DISEASE PATIENTS: ANALYSIS of SAR COVID REGISTRY

Background: Persistent symptoms after acute COVID have been described previously. Main symptoms reported are fatigue, arthralgias, myalgias and mental sickness. Defnition and methods vary widely.1 Objectives: To asses prevalence and related factors to long COVID in a retrospective cohort of patients with rheumatic diseases from Argentina. Methods: A total of 1915 patients were registered from August 18th, 2020 to July 29th, 2021. Patients > 18 years old, with rheumatic disease and confrmed infection by SARS-CoV-2 (antigen or RT-PCR) were included. Those dead, with unknown outcome, wrong date or missing data were excluded. Demographic data, comorbidities, rheumatic disease, and characteristics of SARS-CoV-2 infection were recorded. Long COVID was defned according to NICE guidelines (persistent symptoms for more than 4 weeks, without alternative diagnosis). Long COVID symptoms were defned by rheumatologist. Severity of infection was clas-sifed according to WHO ordinal scale. We used descriptive statistics, univariate model (Student's test, chi square test, ANOVA) and multivariate logistic regression analysis. Results: 230 (12%) had long COVID. Median age was 51 (IQR 40-61]) years, 82% were females, 51% were not caucasian. Median of education was 13.3 years (IQR 12-16), 79 % had private health insurance and 55 % were employed. Nearly half (n=762, 46%) had comorbidities, the most prevalent was hypertension (n=396, 24%). The most frequent rheumatic diseases were rheumatoid arthritis (n=719, 42%) and systemic lupus ery-thematosus (n=280, 16 %). Most were in low activity/remission (79%), used Conventional DMARD (n=773 patients, 45%) and steroids (n=588, 34%) at low dose (n=415, 71%). Main laboratory findings were abnormal D-di-mer (n=94, 28%) and leukopenia (n=93, 26%). Most patients had a WHO ordinal scale < 5 (n=1472, 86%). Median of hospitalization at intensive care unit (ICU) was 8 days [IQR 5, 13]. Treatment for SARS-CoV-2 infection (steroids, anticoagulation, azithromycin, convalescent plasma) was used in 461 (27%) patients. Most of long COVID (n= 152, 69%) reported 1 symptom, the most frequent was fatigue (n= 55, 22%). Figure 1. Univariate analysis is presented in Table 1. In multivariate logistic regression analysis non-caucasian ethnicity OR 1.44 (1.07-1.95), years of education OR 1.05 (1-1.09), treatment with cyclophosphamide OR 11.35 (1.56-112.97), symptoms of COVID-19 OR 13.26 (2.75-242.08), severity scale WHO ≥ 5 OR 2.46 (1.68-3.57), and ICU hospitalization days OR 1.09 (1.05-1.14) were factors associated to long COVID. Conclusion: Prevalence of long COVID was 12%. Non-caucasian ethnicity, higher education, treatment with cyclophosphamide, symptoms of COVID-19, severe disease and ICU hospitalization days were related to long COVID.

SARS-COV-2 INFECTION after VACCINATION in PATIENTS with RHEUMATIC DISEASES from ARGENTINA

Background: Patients with rheumatic diseases (RD) have been excluded from SARS-CoV-2 vaccine trials. Though data appear to show safety and efficacy, mostly evidence remains in mRNA vaccines. However in our country, adenovirus and inactivated vaccines, as well as heterologous schemes are frequently used. Objectives: To describe clinical characteristics and outcomes of SARS-CoV-2 infection after vaccination in patients with RD from de the SAR-CoVAC registry and to compare them with patients who got infected before vaccination. Additionally, factors associated with COVID-19 unfavorable outcome were assessed. Methods: Adult patients with RD who have been vaccinated for SARS-CoV-2 were consecutively included between June 1st and December 21st, 2021. Con-frmed SARS-CoV-2 infection (RT-PCR o serology) was reported by the treated physician. Infection after an incomplete scheme was defned when the event was diagnosed at least 14 days after frst dose;and after a complete scheme when it occurred > 14 days after second dose. Homologous scheme is defned by two same doses of vaccine and heterologous by two different doses. Patients with previous SARS-CoV-2 infection were excluded. To compare SARS-CoV-2 infection characteristics in not vaccinated patients, subjects from the SAR-COVID registry, which includes patients with RD and SARS-CoV-2 infection, were matched 2:1 by gender, age and RD. WHO-Ordinal Scale ≥5 was used to defne unfavorable infection outcome. Descriptive statics, Chi2 test, Fischer test, T test and ANOVA were used. Results: A total of 1350 patients from the SAR COVAC registry were included, 67 (5%) presented SARS-CoV-2 infection after vaccination. The later were mostly (72%) females with a mean age of 57 (SD 15) years old. The most frequent RD were rheumatoid arthritis (41%), psoriatic arthritis (12%) and systemic lupus erythematosus (10%). At vaccination, most of them (75%) had low disease activity or remission, 19% were taking steroids, 39% methotrex-ate, 27% bDMARDs and 6% JAK inhibitors. A total of 11 (16%) patients had SARS-CoV-2 infection <14 days after the frst vaccine dose, 39 (58%) after an incomplete scheme and 17 (25 %) following a complete one. In the incomplete scheme group, 59% received Gam-COVID-Vac, 31% ChAdOx1 nCov-19 and 10% BBIBP-CorV;and in patients with complete scheme 47%, 24% and 29%, respectively. No event was reported after a complete heterologous scheme. No signifcant differences regarding sociodemoghraphic characteristics, RD, disease treatment, type of vaccine and regimen was found between in those with infection and those without it. After vaccination only 8 (12%) of the patients who got infected had an unfavorable course, 88% of them following an incomplete scheme (5 received Gam-COVID-Vac, 1 ChAdOx1 nCov-19 and 1 BBIBP-CorV) and one subject after a complete homologous Gam-COVID-Vac scheme. Having an unfavorable outcome of SARS-CoV-2 infection was associated to: male gender [63% vs 24%, p=0.036], older age [mean 70 years (SD 7) vs 55 years (SD 15), p=0.005], being Caucasian [100% vs 54%, p=0.018], higher education [mean 17 years (SD 4) vs 12 years (SD 4), p=0.010], the presence of comorbid-ities [100% vs 39%, p=0.001, having pulmonary disease [37% vs 5%, p=0.019], dyslipidemia [63% vs 17%, p=0.011] and arterial hypertension [63% vs 24%, p=0.036], RD, treatments, disease activity and types of vaccines received were comparable between groups. When comparing patients with and without vaccination prior SARS-CoV-2 infection, those who received at least one dose of vaccine had less frequently severe COVID-19 (12% vs 24%, p=0.067) and presented lower mortality due to COVID-19 (3% vs 6%, p=0.498). However these differences did not reach statistical signifcance. Conclusion: In the SAR-CoVAC registry 5% of the patients had SARS-CoV-2 infection after vaccination, most of them mild and 25% after a complete scheme. Any vaccine was associated with severe COVID-19. When comparing with non-vaccinated patients, those with at least one dose, had less frequently severe disease and died due COVID-19.

SAFETY and EFFICACY of VACCINES for SARS-COV-2 in PATIENTS with RHEUMATIC and IMMUNEMEDIATED INFLAMMATORY DISEASES: DATA from the ARGENTINEAN REGISTRY SAR-COVAC

Background: Currently there is little information on the efficacy and safety of SARS-CoV-2 vaccination in patients with immune-mediated diseases and/or under immunosuppressive treatment in our country, where different types of vaccines and mix regimens are used. For this reason, the Argentine Society of Rheumatology (SAR) with the Argentine Society of Psoriasis (SOARPSO) set out to develop a national register of patients with rheumatic and immune-mediated infammatory diseases (IMIDs) who have received a SARS-CoV-2 vaccine in order to assess their efficacy and safety in this population. Objectives: To assess SARS-CoV-2 vaccine efficacy and safety in patients with rheumatic and IMIDs. Methods: SAR-CoVAC is a national, multicenter and observational registry. Adult patients with a diagnosis of rheumatic or IMIDs who have been vaccinated for SARS-CoV-2 were consecutively included between June 1st and September 17th, 2021. Sociodemographic data, comorbidities, underlying rheumatic or IMIDs, treatments received and their modifcation prior to vaccination and history of SARS-CoV-2 infection were recorded. In addition, the date and place of vaccination, type of vaccine applied, scheme and indication will be registered. Finally, adverse events (AE), as well as SARS-CoV-2 infection after the application of the vaccine were documented Results: A total of 1234 patients were included, 79% were female, with a mean age of 57.8 (SD 14.1) years. The most frequent diseases were rheumatoid arthritis (41.2%), osteoarthritis (14.5%), psoriasis (12.7%) and spondy-loarthritis (12.3%). Most of them were in remission (28.5%) and low disease activity (41.4%). At the time of vaccination, 21% were receiving glucocorti-coid treatment, 35.7% methotrexate, 29.7% biological (b) Disease Modifying Anti-Rheumatic Drugs (DMARDs) and 5.4% JAK inhibitors. Before vaccine application 16.9% had had a SARS-CoV-2 infection. Regarding the frst dose of the vaccine, the most of the patients (51.1%) received Gam-COV-ID-Vac, followed by ChAdOx1 nCoV-19 (32.8%) and BBIBP-CorV (14.5%). In a lesser proportion, BNT162b2 (0.6%), Ad26.COV2.S (0.2%) and Coro-naVac (0.2%) vaccines were used. Almost half of them (48.8%) completed the scheme, 12.5% were mix regimenes, the most frequent being Gam-COVID-Vac/mRNA-1273. The median time between doses was 51days (IQR 53). More than a quarter (25.9%) of the patients reported at least one AE after the frst dose and 15.9% after the second. The fu-like syndrome and local hypersensitivity were the most frequent manifestations. There was one case of mild anaphylaxis. No patient was hospitalized. Altogether, the incidence of AE was 246.5 events/1000 doses. BBIBP-CorV presented signifcantly lower incidence of AE in comparison with the other types of vaccines. (118.5 events/1000 doses, p<0.002 in all cases) Regarding efficacy, 63 events of SARS-CoV-2 infection were reported after vaccination, 19% occurred before 14 days post-vaccination, 57.1% after the frst dose (>14 days) and 23.8% after the second. In most cases (85.9%) the infection was asymptomatic or had an outpatient course and 2 died due to COVID-19. Conclusion: In this national cohort of patients with rheumatic and IMIDs vaccinated for SARS-CoV-2, the most widely used vaccines were Gam-COVID-Vac and ChAdOx1 nCoV-19, approximately half completed the schedule and in most cases homologously. A quarter of the patients presented some AE, while 5.1% presented SARS-CoV-2 infection after vaccination, in most cases mild.