Correlation between two methodologies for the measure- ment of antibodies against the spike protein of coronavi- rus of the Severe Acute Respiratory Syndrome 2

Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has sev-eral structural proteins including the spike (S) protein, which is the main target of current vaccines. There are various methodologies for the mea-surement of antibodies against it that provide information about the im-mune response to vaccination. The objective of this study was to determine the correlation between chemiluminescence (CLIA) and enzyme-linked im-munoassay (ELISA) for the measurement of IgG anti-S protein (IgG anti-S) antibodies. Serological results were collected from 169 individuals and antibody levels were determined by both methodologies. Out of the total samples, 106 were positive by both methodologies and 15 were discordant (CLIA+, ELISA-), with a Kappa index of 0.80. The correlation between both methodologies was good. This study could contribute to the management and follow-up of the vaccinated population, in order to obtain a cut-off value to evaluate the appli-cation of an additional dose.

Bimekizumab safety in patients with moderate-to-severe plaque psoriasis: Analysis of pooled data from up to three years of treatment in Phase 2 and 3 clinical trials

Background: Bimekizumab (BKZ) is a monoclonal IgG1 antibody used in the treatment of psoriasis which selectively inhibits interleukin (IL)-17F in addition to IL-17A.1,2 Data pooled over two years have indicated that BKZ is generally well-tolerated.3 We report three-year BKZ pooled safety data in patients with moderate-to-severe plaque psoriasis. Method(s): Safety data were evaluated for all patients who received one or more dose BKZ in four Phase 3 trials (BE SURE [NCT03412747], BE VIVID [NCT03370133], BE READY [NCT03410992], and their ongoing open-label extension BE BRIGHT open-label extension [NCT03598790;data cut-off : 10/23/2021]) and four Phase 2 trials (BE ABLE 1 [NCT02905006], BE ABLE 2 [NCT03010527], PS0016 [NCT03025542], PS0018 [NCT03230292]). Safety data were evaluated separately for patients receiving BKZ dosed 320mg every four weeks (Q4W) or every eight weeks (Q8W). Exposureadjusted incidence rates (EAIRs) for treatmentemergent adverse events (TEAEs) are the incidence of new cases per 100 patient-years (PY). Result(s): Total BKZ exposure was 4,245.3 PY (N=1,789) across Phase 2/3 trials, and 3,876.4 PY (N=1,495) in Phase 3 trials. TEAEs occurred at a rate of 186.1 across Phase 2/3 trials, serious TEAEs at 5.6, and TEAEs leading to discontinuation at 3.5. Eighteen deaths occurred (0.4/100 PY), all unrelated to study treatment except one (relationship unknown). TEAEs occurred less frequently in Q8W- than Q4W-treated patients in Phase 3 trials. Consistent with previous reports, most common TEAEs (EAIR) in Phase 2/3 trials were nasopharyngitis (15.3), oral candidiasis (10.2), and upper respiratory tract infection (7.1).3 EAIR of serious infections was 1.2. Most frequently reported were serious coronavirus infections (0.2). There were no cases of active tuberculosis. EAIR of oral candidiasis was 10.2, decreased vs two-year data (12.6),3 and was less common with BKZ Q8W vs Q4W. The vast majority of oral candidiasis events were mild or moderate (99.4%);none were serious. EAIRs of hepatic events (4.0) and elevated liver enzymes (3.4) were decreased vs. two-year data (4.3 and 3.6, respectively).3 EAIRs for inflammatory bowel disease (0.1), adjudicated major adverse cardiac events (0.6), and adjudicated suicidal ideation and behavior (0.1) were low. EAIRs for other safety topics of interest were also low and were similar to or lower than two-year EAIRs.3 Conclusion(s): BKZ was well-tolerated over three years. No safety signals were identified;EAIRs of TEAEs did not increase compared with data from two years.3.

Errors Detected in the Telepharmacy Procedure

Background and Importance After the rise of telemedicine with the COVID-19 pandemic, a telepharmacy consultation has been implemented in our hospital in the pharmacy outpatient area, sending medicines to community pharmacies within a population area of 600,000 inhabitants. Aim and Objectives The purpose of this study is to analyse the medication errors (ME) that have occurred during a specific period of time, throughout the process of medication delivery. The aim is finding causes and possible improvements. Material and Methods We carried out a retrospective descriptive study. The errors that occurred between January 2021 and August 2022 (20 months) in the telepharmacy process were analysed, taking into account everything from the preparation in the hospital pharmacy to the collection of the medication by the patient in the community pharmacy. The MEs were collected in a local database. We described date, personal data of the patient, codes assigned to the single shipping route and destination community pharmacy, type of error and step in which the ME was detected. Results In the period studied, a total of 69 MEs were recorded. We break them down into the following types: 20 cases with a quantitative lack of medication (28.99%), 19 cases in which a different medication was sent (27.54%), 15 with another patient's medication (21.74%), 10 with medicine with wrong dose (14.49%), 2 cases in which the medicine was not sent (2.90%) and another 2 in which the medicine was sent badly packaged (2.90%), 1 case in which the one in which the misidentified medicine was sent (1.45%) and 1 case in which a larger quantity was sent (1.45%). 48 MEs were detected by the patient (69.56%), 15 were detected in the community pharmacy (21.74%), 4 were detected in the hospital pharmacy (5.80%) and 2 cases were detected during the transportation of the medication (2.90%). None of the errors detected had consequences for the patient to our knowledge. Conclusion and Relevance Among the MEs detected, the most common were those related to a quantity defect or lack of a medication and those in which a different medication was sent. In general, they are errors that could be avoided by automating processes that are currently carried out manually.

Euglycaemic diabetic ketoacidosis in a pregnant woman with SARS-CoV-2 infection: Case report

Euglycaemic diabetic ketoacidosis (EDK) is a complication of diabetes mellitus (DM) that is associated with high morbidity and mortality if it is not treated early and vigorously. Pregnancy is a risk factor for developing EDK, with a higher incidence than the general population, and is associated with high maternal-foetal mortality and morbidity (till 35%). In the absence of marked hyperglycaemia, delays in the diagnosis and treatment of this entity may occur. SARS-CoV-2 infection has also been associated with the development of EDK, so in a pregnant COVID+ patient with a history of DM, EDK should be suspected if metabolic acidosis with a high anion gap develops. We present the case of a 36-year-old woman, 32 weeks pregnant, with a history of DM, who developed EDK in the context of SARS-CoV-2 infection. © 2022 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo

Clinical Profile and Outcomes of COVID19 confirmed cases with Acute Respiratory Distress Syndrome Undergoing Protocol directed assisted Prone Positioning at Lung Center of the Philippines (LCP)from May 1, 2020 to April 30, 2021

Background: Prone positioning is an emerging tool in the care provided to patients infected with COVID-19 with Acute Respiratory Distress Syndrome (ARDS) at Lung Center of the Philippines (LCP). Objective(s): This study aimed to characterize the clinical profile of COVID-19 confirmed cases undergoing protocol directed assisted prone positioning. Method(s): This retrospective single-arm cohort study involved 87 eligible patients seen from May 1, 2020 to April 30, 2021 by reviewing their medical records. Result(s): Patients were predominantly middle-aged (49.4%) males (69.0%) with normal BMI (56.3%). Hypertension (59.8%) was the most prevalent comorbidity. Patients were admitted because of acute hypoxemic respiratory failure that required respiratory support. Biochemical markers of inflammation and disease severity, such as LDH, D-dimers and ferritin were consistently high in our study population. On average, the duration of symptoms before intubation was 7.7 days (SD=3.7) while the number of days of illness prior to prone positioning was 10.1 (SD=4.9). In terms of clinical outcomes, 94.3% of the patients had no accidental extubation. However, the all-cause mortality accounted for 29.9%. The mean number of days intubated was 14.1 days (SD=9.3) while the average length of hospital stay was 18.1 days (SD=11.4). Conclusion(s): This study revealed a broad picture and proportion of COVID-19 with ARDS undergoing protocol directed assisted prone positioning. Prone position is safe and impacts the clinical outcome of patients.

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.

Association of the FVIII/DD and FvW/DD indices as an indicator of severity and mortality in patients with COVID-19

Background: There are different studies on severity and mortality indices, such as the neutrophil/lymphocyte ratio (NLI), which has been relevant as a biomarker for mortality. However, indices where hemostatic factors are present, such as the FVIII/DD and FvW/ DD ratio, have not been established for mortality in the Mexican population. Aim(s): To determine whether the factor VIII and D-dimer (FVIII/DD) and the von Willebrand factor (VWF/DD) indices can be useful as markers of poor prognosis and mortality and to identify patients with a poor prognosis in cases of COVID-19 hospitalized from the National Institute of Respiratory Diseases. Method(s): A prospective, longitudinal study was carried out in which patients were admitted in the first 24 hours of hospitalization with a diagnosis of SARS-CoV- 2 infection with a test confirmed by PCR;In a period from March to November 2020, laboratory data were recorded to generate the FVIII/DD and FvW/DD indices, including clinical, epidemiological data and discharge status. Result(s): Data from 249 hospitalized patients with severe COVID-19 were analyzed. The clinical and laboratory characteristics are described in Table 1. The FVIIIDD24H and FVWDD24H indices were constructed by dividing each FVIII data by its corresponding DD data. and in the same way it was done with the VWF. The medians of these indices were then compared between the presence or absence of cyanosis, ventilatory status, and mortality. A value >115 was established as the cut-off point for the DD/FVIII and DD/FvW index to predict mortality, which are shown in Figure 1. Conclusion(s): Low FVIIIDD24H and FVWDD24H levels on admission were associated with cianosis, severe COVID-19 and mortality. Likewise, it was shown that the cut-off point < or equal to 115 is a prognostic factor for mortality in this cohort of patients hospitalized for covid-19. (Table Presented).

Virtualization of presential classes at the university

The COVID-19 pandemic has brought substantial changes in ways of life;and education as a fundamental part of cultural transformation has not been left out of the maelstrom of adaptations to new ways of life. The present work proposes the readjustment of the academic management of the Faculty of Chemical Sciences of the National University of Asunción (FCQ-UNA), through the creation of the Virtual Classroom 2020 as an integrating platform that allowed the continuity of the academic processes of the seven careers offered only in presence-based modality. For its proper execution, trainings have been carried out for teachers and students, which have been addressed with the objective of achieving digital skills in virtual teaching-learning environments. A survey of the teachers’ perceptions about the implemented mode was carried out, the results of which are presented in the paper, to report the effectiveness of the system for the achievement of the objectives. The results indicate a high satisfaction of the teachers about the implemented strategies, which have served to give a new, more dynamic, and open approach to their classes, both in theory and in laboratory practices and problem solving. © 2022 Facultad de Quimica, UNAM. All rights reserved.

Prevalence and factors associated with SARS-CoV-2 infection in institutionalized older adults

The objective of this study was to determine the prevalence of infection and the factors associated with COVID-19 in a geriatric institution in Cali, Colombia. This is an observational, cross-sectional study in institutionalized older adults after a COVID-19 outbreak. In a population of 252 adults who were screened for SARS-CoV-2. The prevalence of COVID-19 infection and its relationship with sociodemographic characteristics, comorbidities, symptoms, and geriatric clinimetry were analyzed using bivariate and multivariate regression models with prevalence ratios. Of this population, 84 (33.3%) were infected. A higher prevalence was found in adults >= 80 years (PR = 1.69 95% CI 1.16-2.47), with malnutrition (MNA <17) (PR = 1.44 95% CI 1.01-2.04 ) and with a Barthel index <60 (PR = 1.57 95% CI 1.09-2.25). Those infected presented mostly with fever (PR = 2.08 95% CI 1.39-3.09) and cough (PR = 1.61 95% CI 1.10-2.34). In conclusion, the prevalence of COVID-19 infection in institutionalized older adults is related to advanced age, malnutrition, and functional dependence.

Impact of the SARS-CoV-2 pandemic on the use of antifungals in an intensive care unit in a third-level hospital

Background and importanceWith the arrival of SARS-CoV-2, it has been observed that the number of cases of fungal infection has increased in critically ill patients, especially invasive pulmonary aspergillosis (IPA).Aim and objectivesTo analyse the use of antifungals, expressed in defined daily dose per 100 annual hospital stays (DDD/100S), and the difference in economic impact between 2019 and 2020 in the intensive care unit (ICU) of a tertiary hospital.Material and methodsRetrospective descriptive study of the use of antifungals in the ICU unit during the period 2019–2020. The data were obtained from the STOCK-Athos-APD drug management electronic program and PRISMA electronic prescription program. For each antifungal agent, the following information was collected: annual global DDD, annual DDD/100S and economic cost of antifungal agents in both years. To calculate this expense the mean annual cost/stay was used.ResultsEight antifungals were studied (liposomal amphotericin B, anidulafungin, caspofungin, micafungin, fluconazole, voriconazole, posaconazole and isavuconazole). The registered stays for admission to the ICU were 5768 in 2019 and 5782 in 2020. The global DDD/100S of antifungals in 2019 was 37.73 while in 2020 it increased to 38.43.The antifungals with the highest increase were isavuconazole and posaconazole, with a difference of 4.2 and 5.1 DDD/100S, respectively, despite being antifungals of restricted use in our hospital. This increase is due to the rise in IPA cases and a period of shortage of voriconazole, the first-line antifungal in our hospital for IPA in patients without renal failure and without drugs with a possible interaction. However, there was a reduction in the DDD/100S of fluconazole. This is due to a greater number of patients with complicated candidaemia, long-term in the ICU who required a broad-spectrum antifungal such as caspofungin. DDD/100S of the rest of antifungals was not modified compared to the previous year. Therefore, the cost of antifungals in the ICU had an increase of €112 086.62 (43.8% more than in 2019).Conclusion and relevanceThe global DDD/100S of many antifungals in ICU has shown a slight increase between both years. The consumption of these has changed, and this has been manifested with an increment in economic spending as they are drugs with a greater economic impact.References and/or acknowledgementsConflict of interestNo conflict of interest

The impact of COVID-19 pandemic on breastfeeding and birth care. The importance of recovering good practices

The SARS-CoV-2 pandemic has had a major impact on birth care and lactation. The lack of knowledge regarding the transmission mechanisms and the potential risks for the mother and the newborn, even when the vertical transmission of the virus has not been demonstrated, has led to the abandonment of practices such as skin-to-skin and the early initiation of breastfeeding (BF), which offer great benefits for maternal and child health. Taking into account the available scientific evidence and the protective effect of BF, the World Health Organization (WHO), and other organisms recommend, in cases of suspected or confirmed SARS-CoV-2 infection of the mother, maintaining mother-child contact and BF, adopting preventive measure procedures to minimize the risk of contagion. These measures include hand hygiene, before and after contact with the newborn and the use of a mask. If a temporary separation of mother and child is required, it is recommended to feed the newborn with expressed breast milk. The presence of IgA antibodies against SARSCoV- 2 has been confirmed in the milk of infected women, so BF could reduce the clinical impact of the disease in the infant, if it becomes infected.

DENTAL EDUCATION AT UNIANDES, EDUCATIONAL CHALLENGES IN THE FACE OF THE COVID-19 PANDEMIC

The recent crisis as a consequence of the SARS-CoV2 (covid-19) pandemic has had an immediate effect on medical education, highlighting the strengths and weaknesses of a system in which technology comes to occupy a predominant position, we would almost say protagonist, in the educational process. We have immediately resorted to technology to maintain the teaching and learning processes. The present work has the objective of arguing the great educational challenges undertaken by the UNIANDES dentistry career in times of COVID-19 pandemic. In this study, use was made of the content documentary analysis method, making a review of the different alternatives, measures and guidelines taken by the institutions of higher education of medical sciences before the COVID-19 pandemic and its contribution to the training of professionals. In the odontology career, after an analysis of the epidemiological situation and the impossibility of returning to face-to-face activities, methodological strategies were immediately adopted for the reorganization of the teaching-educational process. An option was satisfactorily established to give continuity to the teaching-learning process and to favor the acquisition of skills in an independent and creative way in the professionals in training, which requires constant self-preparation of the teacher on how to apply this modality with the highest possible teaching performance.

COVID-19 PANDEMIC: HEALTH AND SOCIAL IMPACT AND CHALLENGES

Pandemics are serious health problems with great social repercussions. The COVID-19 pandemic represents a major catastrophe with severe health and social impacts on health systems and weak socio-community organizational structures. The global mortality rate is close to five million deaths, especially in the Region of the Americas, with slow vaccination processes, due to various causes, delaying the definitive flattening of the contagion and lethality curve. The most visible socioeconomic consequences are drastic declines in national and regional economies, severe limitations in national and international mobility and uncontrolled predominance of psychosocial disorders of the population. The aim of the work was to examine the most significant health and social impacts and challenges of COVID-19 when global presence exceeds 18 months. With descriptive explanatory scope and analysis-synthesis methods, system approach and documentary analysis, an unstructured search was performed in PubMed, Google Scholar and SciELO databases until October 2021 according to selected terms.

Spanish Oncology Nursing Society efforts during COVID-19 pandemic

Background: During the first wave of the SARS-CoV-2 Coronavirus pandemic in Spain, the care of cancer patients was altered in all aspects and in all phases of the cancer patients’ paths, especially in determined areas of population. Given the seriousness of the situation, specific actions were implemented from Spanish Society of Oncology Nursing on behalf of oncology nurses in Spain, with the aim of (a)minimizing the risk of contracting the coronavirus disease and (b) continuing to guarantee the best assistance as possible. Methods: Working and coordination meetings were established, and we planned different strategies and lines of action. This planning was carried out in an open and permanent way to be able to introduce changes and improvements with capacity to adapt in the face of uncertainty. We evolved all the team work into an uninterrupted chain of communication leading to the board, as well as the continuity of the work within the scientific society was ensured. Results: All the proposed actions were implemented successfully, through emails, with dissemination both through social networks and newsletters. a) Safe circuits were established for the care of cancer patients at the hospitals, limited number of companions, antigenic testing from early April. A telephone follow-up was implemented for both outpatient visits and information. b) Training actions: webinars on the correct use of a mask. Protective measures, hand washing. From the very beginning, early march 2020, we strongly recommended all cancer patients to wear a mask, c) Publications: Recommendations on infection and Positioning against health strategies in collaboration with other scientific and patient societies for adult and pediatric patients, and their families. Conclusions: It was possible to continue with adequate care and several actions to improve care have been promoted, although the greatest impact has been detected in new diagnoses (1 in 5 cancer patients have not been diagnosed or have been diagnosed late). The impact of the first wave has been controlled and mitigated, however, persistently, we will have a delay in the implementation of treatments. We estimate that a large part of the delays in the first diagnosis or in the implementation of treatments may be due to the pandemic situation. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Nutritional status in locally advanced or metastatic solid cancer patients in Spain: The NutriOncoSearch (NOS) study

Background: Malnutrition is a common issue in oncology patients, and negatively affects patients' evolution and their quality of life, increasing the incidence of infection, hospital stay, and mortality. New approaches to targeted therapy and immunotherapy represent the future in the field of oncology, making it essential to understand its effect on patients. Study endpoints were (a). To describe the percentage of nutritional counseling or nutritional support among those diagnosed as malnourished or at risk. And (b) to categorize the percentage and descriptive characteristics of cancer patients with mild, moderate, or severe malnutrition in Spain and descriptive characteristics of patients with malnutrition according to sociodemographic and clinical characteristics. Methods: From a total of 585 patients from 10 hospitals, two groups were established, group A, N: 408, patients undergoing immunotherapy, group B with patients with inmuno plus chemotherapy and/or radiotherapy (N: 204). The objective of this observational study was to determine the prevalence (or risk) of malnutrition in the Spanish population of outpatients receiving immunotherapy. To do this, it was proposed to explore the nutritional status of these patients using Nutritional risk (NutriScore), Nutritional Global Subjective Assessment, ECOG PS;type of cancer and nutritional treatment: chemo, type of chemo, and COVID-19 diagnosis. Results: In group A (Immuno only) 28.3% of the patients were at risk of malnutrition, compared to 58.5% in group B (combined Immuno plus Chem&RT) with a statistically significant difference (p<0.0001);27.4% were on nutritional therapy, 97 (42.9%) of patients who obtained a score ≥of 5 (at risk), and 63 (17.5%) %) of patients who obtained a score <5 (out of risk) in NutriScore (p<0.0001). Dietary advice was the most common type of nutritional therapy, present in 123 (76.9%) patients of 160 with nutritional therapy, followed by oral supplements (69 (43.1%)) and enteral nutrition (11 (6.9%)). Conclusions: Nutritional diagnosis is key in cancer patients. It allows determining the needs of the patient in each of the phases of the patient's evolution, improving the quality of life through different interventions, especially dietary education. Clinical trial identification: NCT04168814. Legal entity responsible for the study: Spanish Society of Oncology Nursing. Funding: Baxter Healthcare Corporation. Disclosure: All authors have declared no conflicts of interest.

The Input–Output Method for Calculating the Carbon Footprint of Tourism: An Application to the Spanish Tourism Industry

The tourism sector is one of the most affected by COVID-19 pandemic. The global shutting down of non-essential sectors and the maintained global mobility restrictions have led to the industry’s partial closure worldwide. Tourism could play a leading role as the driver for achieving the sustainable development goals (SDG) and as an engine of wealth generation and cultural preservation. However, the negative impacts on the environment have to be considered when shaping the forthcoming and refurbished post-pandemic tourism industry of the future. In this chapter, we propose an environmentally extended input–output model to estimate the tourism carbon footprint to assess the sustainability of the tourism industry and applied it to tourism in Spain. This modelling allows for identifying direct and indirect emissions hot spots along the complex and intricate global value chains. The main results show how while Spain’s tourism contribution to GDP accounts for 12.3%, its carbon footprint accounts for 15% of the Spanish total emissions, which is above the global average (8%). In global terms, 29% of the total carbon footprint is imported, so it is, directly or indirectly, embodied in the global production chains. It is concentrated in some close European Union countries, China, BRIIAT, and the United States. Sectorally, the Spanish tourism carbon footprint is concentrated in some sectors where emissions are mostly domestic (air transport, land transport, or retail trade). © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

[Knowledge of thromboprophylaxis-COVID-19 in healthcare professionals in Spain]. / Conocimiento de la tromboprofilaxis-COVID-19 en los profesionales sanitarios en España.

INTRODUCTION: Patients suffering from coronavirus infection have an increased risk of venous thromboembolic disease (VTE) associated with COVID-19, which confers a higher risk of mortality. For this reason, it is necessary to analyze the knowledge and the different actions in the management of thromboprophylaxis in work environments. MATERIAL AND METHODS: Observational, descriptive and cross-sectional study with data collection through a Google® form with 19 questions for professionals involved in the care of COVID-19. 414 surveys were received. The quantitative variables were represented with means and standard deviation and the qualitative variables with percentages and confidence intervals. RESULTS: 414 surveys analyzed. 58.2% were women. The most participatory age group was 56-65 years. 95.2% stated that COVID-19 patients had a higher risk of VTE and peripheral arterial microthrombosis. 93.6% considered that outpatient COVID-19 patients should receive thromboprophylaxis. 60.5% of the physicians did not know any protocol for the evaluation of thrombotic risk in these patients. Low molecular weight heparin was considered the main treatment for thromboprophylaxis. CONCLUSIONS: The majority of doctors consider that COVID-19 patients have a higher risk of suffering VTE and peripheral arterial microthrombosis than the general population, however more than a third do not assess the thrombotic risk and a significant percentage claim not to know protocols to evaluate said risk. The survey highlights the training needs of our professionals in thromboprophylaxis so that our patients receive healthcare with the highest possible quality.

Covid-19 infection and stroke

The actual Coronavirus Disease 2019 (COVID-19) infection is an ongoing pandemic, characterized by high morbidity and mortality produced by SARS-CoV-2 virus. Studies reported a stroke frequency around 5-20% in infected patients;however, SNC invasion and pathophysiological mechanisms related to stroke in COVID-19 patients are still unknown. Several studies have demonstrated that SARS-CoV-2 infection is linked to a prothrombotic state causing venous and arterial thromboembolism. Also, an overstated inflammatory response with recruitment of blood cells and disproportioned secretion of proinflammatory cytokines has been reported. Finally, cardioembolism and hypoxia have been proposed as surrogate mechanisms. It is essential to define the pathophysiological mechanisms of stroke during the infection in order to apply more specific treatments to avoid further stroke complications. © 2021, Editorial Ciencias Medicas. All rights reserved.