ABSTRACT
Background. In March 2020 our Institution was designated a COVID-19 unit, since the start of 2021 conventional medical attention has been reinstalled and it became a hybrid hospital. Our objective was to compare the outcome of patients with Invasive Aspergillosis (IA) without COVID-19 during the COVID-19 pandemic, compared with past controls from a historical cohort, and describe their clinical characteristics. As a secondary objective, we described the characteristics of other Invasive Fungal Infections (IFI) in a similar patient group. Methods. Retrospective and descriptive study. The information was obtained from the electronic file. For IFI diagnosis, the EORTC/MSG criteria for proven and probable infection were considered, including the AspiCU modified criteria. The main outcome was death at 6 weeks, time from symptom onset to diagnosis/treatment, and having received antifungal treatment as secondary outcomes. Outcomes were compared to historical IA controls (2:1) from a pre-COVID-19 cohort. The study was approved by the local research and ethics committee. Results. From March 2020 to December 2021, 50 IFIs were diagnosed in non-COVID-19 patients, of which 27 (54%) were Invasive Aspergillosis, 10 (20%) Cryptococcosis, 8(16%) histoplasmosis, 4 (8%) mucormycosis, and 1 (2%) Fusariosis. The median age was 44 years (IQR 33-58) and 67% were men. Forty three percent (22/51) had immunosuppression and 35% (18/51) had hematological malignancy, the median time from symptom onset to IFI diagnosis was 30 days (IQR 11-90) and 38% died within 6 weeks. During the pandemic, in Invasive Aspergillosis non COVID-19 patients, the median number of days from symptom onset to start antifungal was 21 (IQR 6-68) vs 5 (IQR 3-10) of IA historic controls (p=0.0005), 81.5% (22/ 27) vs 93% (50/54) received antifungal treatment (OR 0.88 , 95% CI 0.72-1.0, p=0.13), and IA cases had a mortality of 44% (12/27) vs 41% (22/54) in the historical cohort (p=0.75). We show the IA characteristics in Table 1. GM: Galactomannan antigen Conclusion. During the COVID-19 pandemic, patients with IA withouth COVID-19 were diagnosed significantly later. Also, a trend towards increased mortality and lower proportion of antifungal treatment was observed. It is likely a consequence of hospital reconversion during the start of the pandemic.
ABSTRACT
Background. Post-COVID-19 syndrome occurs usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis (WHO definition, 2021). Our objective was to describe the prevalence, type, and duration of symptoms and their impact on the quality of life of patients hospitalized for COVID-19. Methods. A cross-sectional descriptive study was done, digital informed consent was obtained. Patients with a history of hospitalization for COVID-19 between March 2020 and October 2021 were invited to answer electronically an adaptation of the questionnaire for the identification of post-COVID-19 syndrome and the instrument EuroQol-5D (quality of life). Both were performed at 3, 6, 9 and 12 months after the initial evaluation for COVID-19. Results. We included 246 patients, of whom 76% (187/246) met the definition of post-COVID-19 syndrome, 54% were men, with a median age of 50 years (IQR 41-63). Sixty-three percent (117/187) of post-COVID-19 syndrome patients described a worse health status (OR 9.2, 95% CI 4.1-22.6, p=< 0.0001). The median time to symptoms onset after hospital discharge was 1 day (IQR 1-20), and the median duration of symptoms was 150 days (IQR 90-225). The most frequent symptoms were dyspnea 75% (141), arthralgia 71% (132), fatigue 68% (127), hair loss 60% (112), myalgia 53% (99), sleep disturbances 52% (97), dizziness 47% (88), and palpitations 41% (76) (Figure 1). Regarding quality of life, the post-COVID-19 syndrome patients presented a lower visual analog scale of the EQ-5D versus the group without syndrome (80mm [IQR 70-90] vs. 89.5mm [IQR 75-90], p=0.05). All five dimensions of the quality of life were affected in the post-COVID-19 syndrome group;and dimensions of pain/ discomfort, usual activities, and anxiety/depression showed a statistical difference (Fig 2). Euroqol (EQ)-5D:Specific instrument to describe and value health-related quality of life. Conclusion. Post-COVID-19 syndrome occurred in 76% of hospitalized patients, with prolonged duration and quality of life impairment. Dyspnea was the most frequent symptom. Timely diagnostic and therapeutic intervention is required.
ABSTRACT
The objective of this research was to study the transformations in the way of working and in the journalistic routines in the main digital media in Chile and Colombia. It investigated how journalistic routines were forcibly modified due to the restrictions imposed by the Covid-19 pandemic and what job challenges inherent to the profession journalists from these media had to face. The six most read news portals in each country were chosen according to the Alexa.com ranking. Twelve semi-structured interviews were conducted with editors and directors of digital press media to make a comparative study. The main results show that journalistic routines were adapted to the contingency. Some changed notably, such as access to sources and the relationship with the interviewees, teleworking and the use of technologies to collect and produce news. Others were strengthened, such as the editorial meeting and the editor's relationship with his work team. It is concluded that the media played a fundamental role during the pandemic by informing citizens about health measures and counteracting the fake news disseminated by social networks. In a way, journalism has once again grown in credibility and trust and the classic routines of journalism have been strengthened.
ABSTRACT
This chapter was written six months after COVID-19 pandemic was declared. The irruption of the virus has halted the socially constructed sense of normalcy and sparked a chain of alterities that triggers a new sense-making process of the learning processes. Engaging in a trajectory of the experience, subjects have gone through a discursive process in the which novelty is semiotized and a new self emerges. Universities, as open systems, are also treading their trajectory of experience. In a collective endeavor, subjects have engaged in a joint semiotic process to understand the disruption in their normalcy, and the educational practices that are new for many. The pervading culture of the presence has been suspended and even the traditional delivery of online learning has been recreated. A new online lecturer/ student is emerging. In this chapter, we will see that the interim responses that the university system has given are just steps in a trajectory of experience. Like any other individuals, faculty members, and students have also needed to deal with the fears, the anxiety, stress, and pain that lockdown periods, movement restrictions have brought with them.When COVID-19 resolves, as all pandemics do, Universities will hopefully learn that the culture of presence is necessary and so is the culture of online learning. Both can coexist to provide students with better tools in a digitalized world. © 2020, Springer Nature Switzerland AG.
ABSTRACT
Objective: To analyze the development characteristics mid way through the SARS-Cov2 pandemic in the Mexican population, the effect attributed to risk factors, comorbidity and predictability for symptomatic disease, degree of severity or death. Method: Analytical prevalence study. Results: The cases were preferentially concentrated in men and in the adult population, the comorbidity factors predictors of disease, had an increase in the exposure orchronic non-communicable pathologies of metabolic or cardiovascular cause, being a manor in the population equal to or older than 60 years, an attribute that was more prominent as a predictor of death (OR 5.30 95% CI 5.06-5.54 p <0.01), as well as suffering from chronic kidney disease (OR 4.16 95% CI 3.78-4.59 p <0.01), COPD (OR 3.65 95% CI 3.28-4.07 p <0.01), diabetes mellitus or arterial hypertension;in addition to some severity factors that interact for this outcome, such as the development of pneumonia during the disease. Conclusions: Useful information is provided for decision-making during the development of the disease and a basis for the evolutionary understanding of future analogous events.