Cognitive impairment in young adults with post COVID-19 syndrome.

In this study, we aimed to examine different cognitive domains in a large sample of patients with post COVID-19 syndrome. Two hundred and fourteen patients, 85.04% women, ranged 26 to 64 years (mean = 47.48 years) took part in this investigation. Patients' processing speed, attention, executive functions and various language modalities were examined online using a comprehensive task protocol designed for this research. Alteration in some of the tasks was observed in 85% of the participants, being the attention and executive functions tests the ones that show the highest percentage of patients with severe impairment. Positive correlations were observed between the age of the participants in almost all the tasks assessed, implying better performance and milder impairment with increasing age. In the comparisons of patients according to age, the oldest patients were found to maintain their cognitive functions relatively preserved, with only a mild impairment in attention and speed processing, while the youngest showed the most marked and heterogeneous cognitive impairment. These results confirm the subjective complaints in patients with post COVID-19 syndrome and, thanks to the large sample size, allow us to observe the effect of patient age on performance, an effect never reported before in patients with these characteristics.

Driving under the influence of drugs (DUID) profiling in Spain: Data from oral fluid results between 2016 and 2022, including the effect of COVID-19 lockdown

Aim To provide information about driving under the influence of drugs (DUID) cases in Spain during the last 6 years and to evaluate the impact of the Spanish lockdown (March 14th to May 6th 2020) on drivers’ consumption profile. Method In total, 16,461 oral fluid samples were collected from drivers in Spain that tested positive on the roadside between January 1st 2016 and April 15th 2022. Samples were collected at different locations throughout the country and analyzed by LC-MS/MS at the Toxicology Service of the Institute of Forensic Sciences of the University of Santiago de Compostela. For data analysis, drugs and their metabolites were classified in 8 different groups (cannabis, cocaine, amphetamines, opioids, benzodiazepines, ketamine, methadone and zolpidem). Demographic characteristics and drug profile were evaluated during time. The impact of COVID-19 pandemic lockdown was also considered, applying Chi2 test. Results Drivers were mainly young adults (33.3±9.9 years old) and men (94.2% male). In 97.6% of cases, LC-MS/MS results confirmed at least one of the positive results detected on the roadside. Cannabis (72.6%) and cocaine (64.4%) were the most detected drugs, followed by amphetamines (13.8%), opioids (12.9%), benzodiazepines (7.7%), and methadone (7.4%). Polydrug use was observed in 55.1% of drivers, being the combination of substances from two different groups the most prevalent. Cannabis and cocaine were the most common combination (either only the two of them or mixed with more substances). Changes in drivers’ consumption profile was noticed when comparing data from the specimens collected during the Spanish lockdown period (n=151) vs. specimens obtained during 2020 before (“pre-lockdown”, n=557) and after (“post-lockdown”, n=1974) that period. During the lockdown period drivers were 3years older in average, and polyconsumers of 4 and 5 different groups of substances doubled (in average, 4.5% vs. 9.9% for 4 groups;0.7% vs. 1.3% for 5 groups). Nevertheless, results were only statistically different for consumers of 4 groups of substances during lockdown, either compared with pre- and post-lockdown results. Also, for polyconsumers, the combination of cannabis and cocaine with amphetamines, with high prevalence before lockdown, was substituted by the combination of cannabis and cocaine with methadone. Furthermore, opiates use was two times higher (in average, 14.0% vs. 24.5%), being this difference statistically significant when comparing the 3 periods. On the other hand, amphetamines and ketamine were less consumed by drivers during lockdown (in average, 11.2% vs. 9.9% for amphetamines;3.2% vs. 0.7% for ketamine). Nevertheless, these differences were only statistically significant when considering ketamine consumption post-lockdown (either compared with pre-lockdown or lockdown results). Discussion The use of oral fluid samples was able to confirm the vast majority of the screening results found in roadside screening tests. In Spain, cannabis and cocaine remain the most detected drugs on the roadside, as previously reported from our group in the period 2013–2015 (Lema-Atán JA. Drug Alcohol Depend 2019;195:106–113). During the lockdown period in Spain, due to stay-at-home orders, mobility was only allowed for “essential workers”. Samples collected in those months showed an increase in polydrug use, especially for opiates and methadone, as well as a decrease in the use of “party drugs” (amphetamines and ketamine). Conclusion

Involving Older Adults During COVID-19 Restrictions in Developing an Ecosystem Supporting Active Aging: Overview of Alternative Elicitation Methods and Common Requirements From Five European Countries

Background Information and communication technology solutions have the potential to support active and healthy aging and improve monitoring and treatment outcomes. To make such solutions acceptable, all stakeholders must be involved in the requirements elicitation process. Due to the COVID-19 situation, alternative approaches to commonly used face-to-face methods must often be used. One aim of the current article is to share a unique experience from the Pharaon project where due to the COVID-19 outbreak alternative elicitation methods were used. In addition, an overview of common functional, quality, and emotional goals identified by six pilot sites is presented to complement the knowledge about the needs of older adults. Methods Originally planned face-to-face co-creation seminars were impossible to carry out, and all pilot sites chose alternative requirements elicitation methods that were most suitable in their situation. The elicited requirements were presented in the form of goal models. In one summary goal model, we provide an overview of common functional, quality, and emotional goals. Results Different elicitation methods were combined based on the digital literacy of the target group and their access to digital tools. Methods applied without digital technologies were phone interviews, reviews of literature and previous projects, while by means of digital technologies online interviews, online questionnaires, and (semi-)virtual co-creation seminars were conducted. The combination of the methods allowed to involve all planned stakeholders. Virtual and semi-virtual co-creation seminars created collaborative environment comparable to face-to-face situations, while online participation helped to save the time of the participants. The most prevalent functional goals elicited were “Monitor health,” “Receive advice,” “Receive information.” “Easy to use/comfortable,” “personalized/tailored,” “automatic/smart” were identified as most prevalent quality goals. Most frequently occurring emotional goals were “involved,” “empowered,” and “informed.” Conclusion There are alternative methods to face-to-face co-creation seminars, which effectively involve older adults and other stakeholders in the requirements elicitation process. Despite the used elicitation method, the requirements can be easily transformed into goal models to present the results in a uniform way. The common requirements across different pilots provided a strong foundation for representing detailed requirements and input for further software development processes.

Convolutional Neural Network–Component Transformation (CNN–CT) for Confirmed COVID-19 Cases

The COVID-19 disease constitutes a global health contingency. This disease has left millions people infected, and its spread has dramatically increased. This study proposes a new method based on a Convolutional Neural Network (CNN) and temporal Component Transformation (CT) called CNN–CT. This method is applied to confirmed cases of COVID-19 in the United States, Mexico, Brazil, and Colombia. The CT changes daily predictions and observations to weekly components and vice versa. In addition, CNN–CT adjusts the predictions made by CNN using AutoRegressive Integrated Moving Average (ARIMA) and Exponential Smoothing (ES) methods. This combination of strategies provides better predictions than most of the individual methods by themselves. In this paper, we present the mathematical formulation for this strategy. Our experiments encompass the fine-tuning of the parameters of the algorithms. We compared the best hybrid methods obtained with CNN–CT versus the individual CNN, Long Short-Term Memory (LSTM), ARIMA, and ES methods. Our results show that our hybrid method surpasses the performance of LSTM, and that it consistently achieves competitive results in terms of the MAPE metric, as opposed to the individual CNN and ARIMA methods, whose performance varies largely for different scenarios.

Multicentre cohort study of acute cholecystitis management during the COVID-19 pandemic.

PURPOSE: To analyse acute cholecystitis (AC) management during the first pandemic outbreak after the recommendations given by the surgical societies estimating: morbidity, length of hospital stay, mortality and hospital-acquired SARS-CoV-2 infection rate. METHODS: Multicentre-combined (retrospective-prospective) cohort study with AC patients in the Community of Madrid between 1st March and 30th May 2020. 257 AC patients were involved in 16 public hospital. Multivariant binomial logistic regression (MBLR) was applied to mortality. RESULTS: Of COVID-19 patients, 30 were diagnosed at admission and 12 patients were diagnosed during de admission or 30 days after discharge. In non-COVID-19 patients, antibiotic therapy was received in 61.3% of grade I AC and 40.6% of grade II AC. 52.4% of grade III AC were treated with percutaneous drainage (PD). Median hospital stay was 5 [3-8] days, which was higher in the non-surgical treatment group with 7.51 days (p < 0.001) and a 3.25% of mortality rate (p < 0.21). 93.3% of patients with SARS-CoV-2 infection at admission were treated with non-surgical treatment (p = 0.03), median hospital stay was 11.0 [7.5-27.5] days (p < 0.001) with a 7.5% of mortality rate (p > 0.05). In patients with hospital-acquired SARS-CoV-2 infection, 91.7% of grade I-II AC were treated with non-surgical treatment (p = 0.037), with a median hospital stay of 16 [4-21] days and a 18.2% mortality rate (p > 0.05). Hospital-acquired infection risk when hospital stay is > 7 days is OR 4.7, CI 95% (1.3-16.6), p = 0.009. COVID-19 mortality rate was 11.9%, AC severity adjusted OR 5.64 (CI 95% 1.417-22.64). In MBLR analysis, age (OR 1.15, CI 95% 1.02-1.31), SARS-CoV-2 infection (OR 14.49, CI 95% 1.33-157.81), conservative treatment failure (OR 8.2, CI 95% 1.34-50.49) and AC severity were associated with an increased odd of mortality. CONCLUSION: In our population, during COVID-19 pandemic, there was an increase of non-surgical treatment which was accompanied by an increase of conservative treatment failure, morbidity and hospital stay length which may have led to an increased risk hospital-acquired SARS-CoV-2 infection. Age, SARS-CoV-2 infection, AC severity and conservative treatment failure were mortality risk factors.

Acral lesions in a pediatric population during the COVID-19 pandemic: a case series of 36 patients from a single hospital in Spain.

BACKGROUND: To describe the cutaneous acral findings in a pediatric population noticed during this pandemic. METHODS: A retrospective descriptive study was performed collecting data on 36 patients under 14 years old, presenting suspicious acral skin manifestations for coronavirus disease 2019 (COVID-19). RESULTS: Patients were mostly male (63.8%). The mean age was 11.11 years. 66.67% of patients showed erythematous papules, and 44.44% purpuric macules. Feet were affected in 97.22% of patients and hands in 5.55%. Lesions were asymptomatic in 50% of patients. 30.55% of patients showed extracutaneous findings, preceding skin lesions in 12.62 days. Seven patients underwent specific severe acute coronavirus 2 (SARS-CoV-2) testing; all of these patients tested negative. CONCLUSIONS: The association between these symptoms and SARS-CoV-2 remains unclear. We recommend using these manifestations as a sign of SARS-CoV-2 infection in children. This could lead to the examination of asymptomatic and mildly symptomatic children so that contagions may be avoided.

Maculopapular eruptions associated to COVID-19: A subanalysis of the COVID-Piel study.

A previous study has defined the maculopapular subtype of manifestations of COVID-19. The objective of our study was to describe and classify maculopapular eruptions associated with COVI-19. We carried out a subanalysis of the maculopapular cases found in the previous cross-sectional study. Using a consensus, we defined seven clinical patterns. We described patient demographics, the therapy received by the patient and the characteristics of each pattern. Consensus lead to the description of seven major maculopapular patterns: morbilliform (45.5%), other maculopapular (20.0%), purpuric (14.2%), erythema multiforme-like (9.7%), pytiriasis rosea-like (5.7%), erythema elevatum diutinum-like (2.3%), and perifollicular (2.3%). In most cases, maculopapular eruptions were coincident (61.9%) or subsequent (34.1%) to the onset of other COVID-19 manifestations. The most frequent were cough (76%), dyspnea (72%), fever (88%), and astenia (62%). Hospital admission due to pneumonia was frequent (61%). Drug intake was frequent (78%). Laboratory alterations associated with maculo-papular eruptions were high C-reactive protein, high D-Dimer, lymphopenia, high ferritin, high LDH, and high IL-6. The main limitation of our study was the impossibility to define the cause-effect relationship of each pattern. In conclusion, we provide a description of the cutaneous maculopapular manifestations associated with COVID-19. The cutaneous manifestations of COVID-19 are wide-ranging and can mimic other dermatoses.