Impact of the COVID-19 Pandemic on Cancer Diagnosis in Madrid (Spain) Based on the RTMAD Tumor Registry (2019-2021).

The coronavirus disease 2019 (COVID-19) pandemic has caused a significant disruption to cancer diagnosis, treatment and prevention worldwide that could have serious consequences in the near future. We intend to evaluate the weight of this backlog on a community-wide scale in Madrid during the period 2020-2021, and whether a stage shift towards the advanced stage has occurred. Cancer diagnoses in the Madrid tumor registry (RTMAD) from 2019-2021 were evaluated. Absolute and percentage differences in annual volume and observed-to-expected (O/E) volume ratios were calculated. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated using the O/E ratio. The SIR for 2020-2021 compared to 2019 was 94.5% (95% CI 93.8-95.3), with unequal gender-specific cancer diagnosis recovery (88.5% for males and 102.1% for females). Most cancer types were underdiagnosed in 2020. The tendency worsened in 2021 for colorectal and prostate cancers (87.8%), but lung cancer recovered (102.1%) and breast cancer was over-diagnosed (114.4%) compared with reference pre-COVID-19 data. These changes have modified the ranking of the most frequent malignancies diagnosed in Madrid. Breast cancer has overtaken colorectal and prostate cancers, displaced to second and third position, respectively. Not only was colorectal cancer diagnosis affected more as a consequence of the COVID-19 pandemic but diagnosis of this malignancy at the advance stage also increased by 3.6% in 2020 and 4.2% in 2021 compared to the reference period of 2019. In summary, there is a large volume of undetected cancer in Madrid caused by the reduced access to care secondary to the COVID-19 pandemic, especially regarding colorectal and prostate cancer. Strategies are needed to recover the backlog of diagnoses and effectively treat these cases in the future and solve the negative impact that will be caused by the diagnostic delay. Analyzing the impact of new diagnoses suffered by each different malignancy and their recovery will help to understand how the future allocation of resources should look.

Influence of the COVID-19 lockdown on Spanish professional soccer teams' external demands according to their on-field ranking.

The main objective of this study was to analyse the changes in external demand parameters (e.g., total distance, high-speed running distance, accelerations/decelerations) in Spanish professional soccer teams after the COVID-19 lockdown considering their on-field ranking (i.e., teams whose ranking worsened after the COVID-19 lockdown [WRS] vs. teams that improved their ranking after the COVID-19 lockdown [IMP]). A total of 23,527 individual match observations were collected on players competing during the 2019/20 season in the First Spanish Professional soccer League (LaLiga). Goalkeepers and players who participated for less than 10 minutes in each match were excluded. Relative total distance (TD/min), distance covered at 21-24 km · h-1 (HIRD/min) and > 24 km · h-1 per minute (VHIRD/min), high metabolic load distance (HMLD), and the number of accelerations (3 m/s2) and decelerations (< 3 m/s2) performed were analysed by the ChryonHego video-tracking system. These variables were analysed during two differentiated periods, before the COVID-19 lockdown (i.e., 27 matches) and after the COVID-19 lockdown (i.e., 11 matches), and teams were classified into two groups according to their ranking (i.e., WRS vs. IMP). R-Studio was employed for data analysis and a mixed linear model was conducted. A decrease in external demands in all teams after the COVID-19 lockdown was observed, and this decrease was greater in WRS. These results suggest that, after an inactive period (i.e., the COVID-19 lockdown), teams that return with better physical performance, mainly related to high-intensity actions, have more possibilities of improving their final qualifying position.

Brief Research Report: Quantitative Analysis of Potential Coronary Microvascular Disease in Suspected Long-COVID Syndrome.

Background: Case series have reported persistent cardiopulmonary symptoms, often termed long-COVID or post-COVID syndrome, in more than half of patients recovering from Coronavirus Disease 19 (COVID-19). Recently, alterations in microvascular perfusion have been proposed as a possible pathomechanism in long-COVID syndrome. We examined whether microvascular perfusion, measured by quantitative stress perfusion cardiac magnetic resonance (CMR), is impaired in patients with persistent cardiac symptoms post-COVID-19. Methods: Our population consisted of 33 patients post-COVID-19 examined in Berlin and London, 11 (33%) of which complained of persistent chest pain and 13 (39%) of dyspnea. The scan protocol included standard cardiac imaging and dual-sequence quantitative stress perfusion. Standard parameters were compared to 17 healthy controls from our institution. Quantitative perfusion was compared to published values of healthy controls. Results: The stress myocardial blood flow (MBF) was significantly lower [31.8 ± 5.1 vs. 37.8 ± 6.0 (µl/g/beat), P < 0.001] and the T2 relaxation time was significantly higher (46.2 ± 3.6 vs. 42.7 ± 2.8 ms, P = 0.002) post-COVID-19 compared to healthy controls. Stress MBF and T1 and T2 relaxation times were not correlated to the COVID-19 severity (Spearman r = -0.302, -0.070, and -0.297, respectively) or the presence of symptoms. The stress MBF showed a U-shaped relation to time from PCR to CMR, no correlation to T1 relaxation time, and a negative correlation to T2 relaxation time (Pearson r = -0.446, P = 0.029). Conclusion: While we found a significantly reduced microvascular perfusion post-COVID-19 compared to healthy controls, this reduction was not related to symptoms or COVID-19 severity.

Detection of SARS-CoV-2 and its S and N proteins using surface enhanced Raman spectroscopy† † Electronic supplementary information (ESI) available. See DOI: 10.1039/d1ra03481b

The COVID-19 pandemic demonstrated the critical need for accurate and rapid testing for virus detection. This need has generated a high number of new testing methods aimed at replacing RT-PCR, which is the golden standard for testing. Most of the testing techniques are based on biochemistry methods and require chemicals that are often expensive and the supply might become scarce in a large crisis. In the present paper we suggest the use of methods based on physics that leverage novel nanomaterials. We demonstrate that using Surface Enhanced Raman Spectroscopy (SERS) of virion particles a very distinct spectroscopic signature of the SARS-CoV-2 virus can be obtained. We demonstrate that the spectra are mainly composed by signals from the spike (S) and nucleocapsid (N) proteins. It is believed that a clinical test using SERS can be developed. The test will be fast, inexpensive, and reliable. It is also clear that SERS can be used for analysis of structural changes on the S and N proteins. This will be an example of application of nanotechnology and properties of nanoparticles for health and social related matters. The COVID-19 pandemic demonstrated the critical need for accurate and rapid testing for virus detection.

Detection of SARS-CoV-2 and its S and N proteins using surface enhanced Raman spectroscopy.

The COVID-19 pandemic demonstrated the critical need for accurate and rapid testing for virus detection. This need has generated a high number of new testing methods aimed at replacing RT-PCR, which is the golden standard for testing. Most of the testing techniques are based on biochemistry methods and require chemicals that are often expensive and the supply might become scarce in a large crisis. In the present paper we suggest the use of methods based on physics that leverage novel nanomaterials. We demonstrate that using Surface Enhanced Raman Spectroscopy (SERS) of virion particles a very distinct spectroscopic signature of the SARS-CoV-2 virus can be obtained. We demonstrate that the spectra are mainly composed by signals from the spike (S) and nucleocapsid (N) proteins. It is believed that a clinical test using SERS can be developed. The test will be fast, inexpensive, and reliable. It is also clear that SERS can be used for analysis of structural changes on the S and N proteins. This will be an example of application of nanotechnology and properties of nanoparticles for health and social related matters.

Índice de vulnerabilidad y trayectorias espaciales del COVID-19 en el Distrito Metropolitano de Quito

Este trabajo analiza la trayectoria espacial de los contagios del COVID-19 en el Distrito Metropolitano de Quito (DMQ) durante el periodo definido como aislamiento social (el período de confinamiento social denominado “semáforo rojo” tuvo lugar en Quito desde 9 de abril al 3 de junio de 2020). El objetivo principal es identificar las principales tendencias de expansión del contagio y correlacionarlas con las dimensiones de la vida urbana. La investigación analiza los contagios en el área urbana funcional de Quito;esto es, el núcleo urbano consolidado y las parroquias rurales conurbadas con las que hay continuidad en la disposición del amanzanamiento. La investigación desarrolla un índice de vulnerabilidad a partir de dimensiones demográficas, socioeconómicas y del hábitat, para correlacionar las parroquias más vulnerables con la evolución de contagios del COVID-19. Por tanto, se trata de un estudio exploratorio que, con evidencia empírica puesta a disposición por los organismos oficiales, muestra los patrones socioespaciales de la pandemia y su correlación con los grados de vulnerabilidad en un lugar concreto. Finalmente, en base a los resultados obtenidos se plantea una discusión para la formulación de políticas que mitiguen el impacto social del COVID-19.Alternate abstract: This work analyzes the spatial trajectory of COVID-19 infections in the Metropolitan District of Quito (DMQ) during the period defined as social isolation (the period of social confinement called “red traffic light” took place in Quito from April 9 as of June 3, 2020). The main objective is to identify the main trends in the spread of contagion and correlate them with the dimensions of urban life. The research analyses the contagions in the functional urban area of ​​Quito, that is, the consolidated urban nucleus and the conurbed rural parishes with which there is continuity in the provision of amanzanamiento. The research develops a vulnerability index based on demographic, socioeconomic and habitat dimensions, to correlate the most vulnerable parishes with the evolution of COVID-19 infections. Therefore, it is an exploratory study that, with empirical evidence made available by official organizations, shows the socio-spatial patterns of the pandemic and its correlation with the degrees of vulnerability in a specific place. Finally, based on the results obtained, a discussion is proposed for the formulation of policies that mitigate the social impact of COVID-19.Alternate abstract: Este trabalho analisa a trajetória espacial das infecções por COVID-19 no Distrito Metropolitano de Quito (DMQ) durante o período definido como isolamento social (o período de confinamento denominado “semáforo vermelho” ocorreu em Quito de 9 de abril a 3 de junho de 2020). O objetivo principal é identificar as principais tendências de propagação do contágio e correlacioná-las com as dimensões da vida urbana. A pesquisa analisa o contágio na área urbana funcional de Quito, ou seja, o núcleo urbano consolidado e as freguesias rurais conurbadas com as quais existe continuidade urbanística. A pesquisa desenvolve um índice de vulnerabilidade com base nas dimensões demográficas, socioeconômicas e do hábitat, buscando correlacionar as freguesias mais vulneráveis com a evolução das infecções por COVID-19. Portanto, é um estudo exploratório que, com evidências empíricas disponibilizadas por órgãos oficiais, mostra os padrões socioespaciais da pandemia e sua correlação com os graus de vulnerabilidade em um determinado local. Por fim, com base nos resultados obtidos, propõe-se uma discussão para a formulação de políticas que mitiguem o impacto social do COVID-19.

Optimal COVID-19 Adapted Table Disposition in Hostelry for Guaranteeing the Social Distance through Memetic Algorithms

The COVID-19 pandemic has challenged all physical interactions. Social distancing, face masks and other rules have reshaped our way of living during the last year. The impact of these measures for indoor establishments, such as education or hostelry businesses, resulted in a considerable organisation problem. Achieving a table distribution inside these indoor spaces that fulfilled the distancing requirements while trying to allocate the maximum number of tables for enduring the pandemic has proved to be a considerable task for multiple establishments. This problem, defined as the Table Location Problem (TLP), is categorised as NP-Hard, thus a metaheuristic resolution is recommended. In our previous works, a Genetic Algorithm (GA) optimisation was proposed for optimising the table distribution in real classrooms. However, the proposed algorithm performed poorly for high obstacle density scenarios, especially when allocating a considerable number of tables due to the existing dependency between adjacent tables in the distance distribution. Therefore, in this paper, we introduce for the first time, to the authors’ best knowledge, a Memetic Algorithm (MA) optimisation that improves the previously designed GA through the introduction of a Gradient Based Local Search. Multiple configurations have been analysed for a real hostelry-related scenario and a comparison between methodologies has been performed. Results show that the proposed MA optimisation obtained adequate solutions that the GA was unable to reach, demonstrating a superior convergence performance and an overall greater flexibility. The MA performance denoted its value not only from a COVID-19 distancing perspective but also as a flexible managing algorithm for daily table arrangement, thus fulfilling the main objectives of this paper.

Development and validation of a laboratory-based risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19.

BACKGROUND: Early identification of patients with COVID-19 who may develop critical illness is of great importance. METHODS: In this study a retrospective cohort of 264 COVID-19 cases admitted at Macarena University was used for development and internal validation of a risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. Backward stepwise logistic regression was used to derive the model, including clinical and laboratory variables predictive of critical illness. Internal validation of the final model used bootstrapped samples and the model scoring derived from the coefficients. External validation was performed in a cohort of 154 cases admitted at Valme and Virgen del Rocio University Hospital. RESULTS: A total of 62 (23.5%) patients developed a critical illness during their hospitalization stay, 21 (8.0%) patients needed invasive ventilation, 34 (12.9%) were admitted at the ICU and the overall mortality was of 14.8% (39 cases). 5 variables were included in the final model: age >59.5 years (OR: 3.11;95%CI 1.39-6.97), abnormal CRP results (OR: 5.76;95%CI 2.32-14.30), abnormal lymphocytes count (OR: 3.252;95%CI 1.56-6.77), abnormal CK results (OR: 3.38;95%CI 1.59-7.20) and abnormal creatinine (OR: 3.30;95%CI 1.42-7.68). The AUC of this model was 0.850 with sensitivity of 65% and specificity of 87% and the IDI and NRI were 0.1744 and 0.2785, respectively. The validation indicated a good discrimination for the external population. CONCLUSIONS: Biomarkers add prognostic information in COVID-19 patients. Our risk-score provides an easy to use tool to identify patients who are likely to develop critical illness during their hospital stay.

Early experience with COVID-19 in kidney transplantation recipients: update and review

ABSTRACT Introduction: little is known on the risk factors, clinical presentation, therapeutic protocols, and outcomes of kidney transplantation recipients (KTRs) who become infected by SARS-CoV-2. Purpose: to provide an updated view regarding the early experience obtained from the management of KTRs with COVID-19. Materials and Methods: A narrative review was conducted using PubMed database to identify relevant articles written in English/Spanish, and published through May 15, 2020. Search terms included: "coronavirus", "severe acute respiratory syndrome coronavirus 2", "SARS-CoV-2", "COVID-19", "COVID", "renal transplantation", and "kidney transplantation". Case series were considered eligible, and case reports excluded. Thirty-four articles were included in the review. Results: KTRs should be considered immunocompromised hosts: potential risk for infection, non-negligible comorbidity, and exposure to long-term immunosuppression. Only single center small retrospective experiences are still available regarding KTRs with COVID-19. SARS-CoV-2 symptoms in KTRs are similar to that observed for the general population, being fever and cough the most frequently observed. Mild-to-moderate symptomatic KTRs can be managed in an outpatient setting, while patients exhibiting severe symptoms must be addmited to hospital. More rapid clinical progression, and higher complication and death rates have been observed for hospitalized KTRs, requiring hemodyalisis or ventilatory support. Lymphopenia, elevated serum markers (C-reactive protein, procalcitonin, IL-6, D-dimer), and chest-X-ray findings consistent with pneumonia are linked to worse prognosis. A number of antiviral therapies have been used. However, it is difficult to draw meaningful conclusions regarding their efficacy at this point. Baseline immunosupression regimen should be adjusted in a case-by-case manner. However, it poses a significant challenge.

Early experience with COVID-19 in kidney transplantation recipients: update and review.

INTRODUCTION: little is known on the risk factors, clinical presentation, therapeutic protocols, and outcomes of kidney transplantation recipients (KTRs) who become infected by SARS-CoV-2. PURPOSE: to provide an updated view regarding the early experience obtained from the management of KTRs with COVID-19. MATERIALS AND METHODS: A narrative review was conducted using PubMed database to identify relevant articles written in English/Spanish, and published through May 15, 2020. Search terms included: "coronavirus", "severe acute respiratory syndrome coronavirus 2", "SARS-CoV-2", "COVID-19", "COVID", "renal transplantation", and "kidney transplantation". Case series were considered eligible, and case reports excluded. Thirty-four articles were included in the review. RESULTS: KTRs should be considered immunocompromised hosts: potential risk for infection, non-negligible comorbidity, and exposure to long-term immunosuppression. Only single center small retrospective experiences are still available regarding KTRs with COVID-19. SARS-CoV-2 symptoms in KTRs are similar to that observed for the general population, being fever and cough the most frequently observed. Mild-to-moderate symptomatic KTRs can be managed in an outpatient setting, while patients exhibiting severe symptoms must be addmited to hospital. More rapid clinical progression, and higher complication and death rates have been observed for hospitalized KTRs, requiring hemodyalisis or ventilatory support. Lymphopenia, elevated serum markers (C-reactive protein, procalcitonin, IL-6, D-dimer), and chest-X-ray findings consistent with pneumonia are linked to worse prognosis. A number of antiviral therapies have been used. However, it is difficult to draw meaningful conclusions regarding their efficacy at this point. Baseline immunosupression regimen should be adjusted in a case-by-case manner. However, it poses a significant challenge.

Table Organization Optimization in Schools for Preserving the Social Distance during the COVID-19 Pandemic

The COVID-19 pandemic has supposed a challenge for education. The school closures during the initial coronavirus outbreak for reducing the infections have promoted negative effects on children, such as the interruption of their normal social relationships or their necessary physical activity. Thus, most of the countries worldwide have considered as a priority the reopening of schools but imposing some rules for keeping safe places for the school lessons such as social distancing, wearing facemasks, hydroalcoholic gels or reducing the capacity in the indoor rooms. In Spain, the government has fixed a minimum distance of 1.5 m among the students’desks for preserving the social distancing and schools have followed orthogonal and triangular mesh patterns for achieving valid table dispositions that meet the requirements. However, these patterns may not attain the best results for maximizing the distances among the tables. Therefore, in this paper, we introduce for the first time in the authors’best knowledge a Genetic Algorithm (GA) for optimizing the disposition of the tables at schools during the coronavirus pandemic. We apply this GA in two real-application scenarios in which we find table dispositions that increase the distances among the tables by 19.33% and 10%, respectively, with regards to regular government patterns in these classrooms, thus fulfilling the main objectives of the paper.