Frequency of antibiotic prescribing in adults hospitalized for SARS-CoV-2 in a high complexity institution in Santiago de Cali, Colombia.

Objective: To determine the frequency of antibiotic use and to know which clinical and socio-demographic variables were related to the probability of suffering infections associated with COVID-19. Method(s): Adults hospitalized for COVID-19 who received one or more antibiotics during hospitalization were evaluated. We performed a descriptive analysis of variables in the general population' bivariate analysis in two groups (documented vs. suspected infection) and multivariate logistic regression of factors associated with mortality. Result(s): It was determined that 60.4% of adults hospitalized for COVID-19 received antibiotics. Coinfection was documented in 6.2% and superinfection in 23.3%. Gram-negative germs were reported in 75.8% of cultures, fungi in 17.8% and gram-positive in 14.2%. Variables such as age, comorbidities, ICU, anemia, steroids, mechanical ventilation, hemofiltration were statistically significantly related to documented infection. High-flow cannula was associated as a protective factor. Overall mortality was 43.9%, 57.8% in the first group and 38.1% in the second (p=0.002). Conclusion(s): There is a considerable frequency of antibiotic use in subjects hospitalized for COVID-19, particularly related to relevant findings of bacterial superinfection, in those with comorbidities, such as diabetes mellitus, immunosuppression, anemia and fragility, in whom the behavior of the disease is more severe and lethal.Copyright © 2023 Asociacion Colombiana de Infectologia. All rights reserved.

Optimal Synergic Deep Learning for COVID-19 Classification Using Chest X-Ray Images

A chest radiology scan can significantly aid the early diagnosis and management of COVID-19 since the virus attacks the lungs. Chest X-ray (CXR) gained much interest after the COVID-19 outbreak thanks to its rapid imaging time, widespread availability, low cost, and portability. In radiological investigations, computer-aided diagnostic tools are implemented to reduce intra-and inter-observer variability. Using lately industrialized Artificial Intelligence (AI) algorithms and radiological techniques to diagnose and classify disease is advantageous. The current study develops an automatic identification and classification model for CXR pictures using Gaussian Fil-tering based Optimized Synergic Deep Learning using Remora Optimization Algorithm (GF-OSDL-ROA). This method is inclusive of preprocessing and classification based on optimization. The data is preprocessed using Gaussian filtering (GF) to remove any extraneous noise from the image's edges. Then, the OSDL model is applied to classify the CXRs under different severity levels based on CXR data. The learning rate of OSDL is optimized with the help of ROA for COVID-19 diagnosis showing the novelty of the work. OSDL model, applied in this study, was validated using the COVID-19 dataset. The experiments were conducted upon the proposed OSDL model, which achieved a classification accuracy of 99.83%, while the current Convolutional Neural Network achieved less classification accuracy, i.e., 98.14%.

Inflammatory and Infectious Vasculopathies

Inflammatory and infectious disorders have been important, if uncommon, causes of stroke. Primary and secondary vasculitides may cause stroke affecting large and small blood vessels of the central nervous system. The pathology may include granulomatous, lymphocytic, and necrotizing lesions. The underlying antigens leading to vasculitis may include amyloid deposition from amyloid angiopathy, or even from infectious agents, although the mechanisms for these disorders remain poorly understood. Many of these conditions have a poor prognosis, although steroid and other immunosuppressive therapies may improve outcomes. Further research, including well-designed clinical trials, are needed. Although infections, such as syphilis, have been associated with stroke risk for more than a century, understanding the relationship between infection and stroke has taken on even greater urgency in the era of the coronavirus disease 19 pandemic. A multitude of pathogens, including bacteria, viruses, parasites, and fungi, have been associated with specific stroke syndromes, through a number of different mechanisms, including large vessel vasculopathy, aneurysmal dilatation, thrombophilia, and cardioembolism. Some infections may also contribute to the atherosclerotic process. This chapter will cover the clinical features, pathophysiology, and potential treatment (where available) for inflammatory and infectious causes and contributors to stroke risk. © 2022 Elsevier Inc.

Cointegration between high base metals prices and backwardation: Getting ready for the metals super-cycle

This paper is devoted to test agents' behavior in the markets of hard commodities by trying to distinguish between managing future price structures to hedge their positions and speculating in on prices. We do a triple analysis: cointegration on the time series, structural breaks over the full time series and panel data. The analysis of the full series and the identification of structural breaks allows us to discover the connection between high prices and the negative futures price structure (backwardation) in rising prices scenarios of tin, copper, aluminium, and zinc. Moreover, we obtain that the base metals full matrix (price and futures price structure) is cointegrated in our analysis that uses panel data methods. We believe that these results are important for agents in the markets, as commodity traders or brokers, to maximize profits in their hedging positions.

Social Sciences, the World and the Pandemic: for a Possible Future

The reflection presented in the document addresses the social sciences, from a complex and multidimensional perspective, whose purpose is to address the current and future challenges derived from the COVID-19 pandemic, as a reconfiguring instrument of a new world order. The analysis will show the panorama outlined by the social sciences in the current situation, and will propose some lines of reflection regarding the possible future of humanity and institutions in the face of the new social scenario. This is based on a bibliographic review, which makes evident the profuse reflection on the construction of the social sciences of the future.

[Poor prognostic factors in patients hospitalized for COVID-19].

BACKGROUND: The clinical spectrum of COVID-19 varies from no or mild symptoms to pneumonia with fatal complications. The aim of the study was to find predictors of mortality and admission in the intensive care unit (ICU) in patients hospitalized for COVID-19. METHODS: Retrospective study of a cohort of patients admitted for COVID-19 between March 2020 and February 2021. Demographic, clinical, radiological and laboratory variables were described at admission. Independent predictors of mortality and ICU admission were identified by means of backward stepwise logistic regression and described in terms of odds ratio (OR) and 95% confidence interval (95%CI). RESULTS: A total of 883 patients were included, 51.8% men with a mean age of 68; 1.8% readmissions. 17.6% of patients died (n=154). The independent predictors of mortality were age (OR=1.071; 95%CI: 1.046-1.095), percentage of oxygen saturation (SatO2) (OR=0.938; 95%CI: 0.903-0.974), diastolic blood pressure (DBP, OR= 0.972; 95%CI: 0.955-0.989), creatinine (OR=1.516; 95%CI: 1.088-2.113), INR (OR=1.199; 95%CI: 1.012-1.419) and sodium (OR=1.082; 95%CI: 1.037-1.128). Eight percent of patients were admitted to ICU; the independent predictors were: male sex (OR=2.079; 95%CI: 1.099-3.935), age (OR=0.960; 95%CI: 0.942-0.979), SatO2 (OR=0.925; 95%CI: 0.889-0.962), creatinine (OR=1.551; 95%CI: 1.118-2.152) and C-reactive protein (CRP, OR=1.003; 95%CI: 1.000-1.007). CONCLUSION: The identification of independent predictors of mortality (age, SatO2, DBP, creatinine, INR, sodium) and ICU admission (sex, age, SatO2, creatinine, and CRP) allowed for the stratification of patients to adapt clinical care protocols to these findings, thereby improving medical decisions.

Increase in maternal mortality and prematurity during the COVID-19 pandemic in Chile

Introduction: At the third year of the pandemic in Chile, the reported cases of COVID-19 reached 4,769,638 and 61,725 deaths (1.4%), with 93% of the population with a complete vaccination schedule (17,686,528). Aim: The purpose of this study is a brief communication on the impact of the SARS-CoV-2 pandemic on maternal, perinatal and prematurity mortality in Chile. Method: The national database of the Informatics Department of the Ministry of Health of Chile (DEIS), and the information reported from the official WHO website were used. All births, general and fetal deaths from January 1990 to September 2022 were included. A comparison is made between the basic maternal and perinatal indicators of the last 30 years and those of the years of the pandemic. Results: From March 2020 to September 2022, approximately 61,000 people died in Chile with a diagnosis associated with COVID-19, 17% of the general mortality for the period (approx. 364.000 deaths). An acceleration in the historical trend towards a decrease in the overall birth/death ratio was observed from 1.9 pre-pandemic to 1.4 during the third year of the pandemic. Maternal Mortality Ratio in 2020 (28.1 × 100,000) increased compared to 2019 pre-pandemic (19.1) or the simple historical trend line projected for 2020 (18.0) by 56%. Prematurity under 37 weeks of gestation increased from 8.5% (2019) to 9.5% for the years 2021 and 2022. Neonatal mortality in the first 28 days remained stable at 9 per thousand births during the 3 years of the pandemic and fetal mortality (>21 weeks) had a slight increase to 4.7 per thousand (year 2020) in relation to 3.4 in 2019. Conclusions: In Chile, an increase of approximately 56% in maternal mortality occurred in the first year of the SARS-CoV-2 pandemic. In the second year, a significant increase in late prematurity and a slight increase in fetal mortality were observed. These findings have been reported in the reviews and latest updates of the year 2022. © 2023

One year overview of follow-up in a post-covid consultation of critical patients with covid-19

Introduction: Long-term clinical management and evolution of a cohort of critical COVID-19 survivors has not been well described. Method(s): We report a prospective observational study of COVID-19 patients admitted to ICU between March to August 2020. The follow-up comprised symptoms, pulmonary function test, 6-minute walking test (6MWT, and chest computed tomography (CT). Additionally, questionnaires to evaluate the prevalence of post-covid19 syndrome was performed at 1-year. Result(s) and Conclusion(s): A total of 181 patients were admitted at the ICU during the study period. They were predominantly middle-aged (median [IQR] of 61 [52;67] years old) male (66.9%) with a median of ICU stay of 9 (5- 24.2) days. Twenty percent of them died in the hospital and 39 were not able to be included, a final cohort of 105 patients initiated the follow-up. At one year, 32.2% persist with respiratory alterations and needed to continue the follow-up. 10% still had severe lung diffusing (DLCO) involvement (<60%) and 53.7% had a fibrotic pattern on CT. Moreover, patients had a mean (SD) of symptoms of 5.77 (4.66) and 61.3% meet criteria for post-covid syndrome at one-year. During the follow-up 46 patients were discharge and 16 were transfer to others consultations. Other conditions such as emphysema (21.6%), COPD (8.2%), severe neurocognitive disorders (4.1%) and lung cancer (1%) have been identified. A high use of healthcare resources is observed in the first year of these critical survivors after hospital discharge.

Hematological and hepatic alterations as predictors of mortality in patients hospitalized by SARS-COV-2

Introduction: SARS-COV-2 infection has generated high mortality. Symptomatology manifests in the respiratory, gastrointestinal tract and others, such as the hematopoietic system. Altered cell counts have been observed, such as lymphopenia standing out within hematological disorders. The cytokine storm together with the use of hepatotoxic drugs prolongs the inflammatory process and increases liver damage. Objective(s): To assess hematological and hepatic alterations in patients hospitalized for SARS-COV-2 who survived. Method(s): Cross-sectional study was conducted, including patients > 18 years, with positive test for SARS-COV-2. Serial measurements of hematological and hepatic parameters were carried out during the period of hospitalization. Those who did not require hospitalization were excluded. Result(s): Patients who died were older (62.71+/-13.52 vs 54.34+/-12.43, p=<0.001), required invasive mechanical ventilation (94.6% vs 86 78.9%, p=0.009) with peak pressure (29.27+/-5.26 vs 26.17+/-5.13, p=0.002) and showing decrease in Kirby index (128.39+/-49.14 vs 153.07+/-49.01, p=0.004) unlike those who survived. There was higher mortality in patients with lymphopenia (0.7 [0.45-1.15] vs 1 [0.7-1.5], p=<0.001), anemia (11.38+/-2.54 vs 12.38+/-2.48, p 0.018) and borderline ranges for platelets (265 vs 329, p=0.003) respectively. Regarding the liver profile, those patients who died had lower total proteins (5.38+/-0.81 vs 5.86+/-0.69, p <0.001), albumin (2.41 +/- 0.50 vs 2.83+/-0.49, p <0.001) and direct bilirubin (0.16 [0.1-0.25] vs 0.14 [0.1 - 0.23], p 0.006). Conclusion(s): Hematological and liver alterations are markers of higher mortality in patients with COVID-19 as an expression of multiorgan disease.

Neonatal late-onset sepsis caused by SARSCoV2: a case report

INTRODUCTION: The disease caused by SARS-CoV-2, also known as COVID-19, is a recently identified disease with mainly respiratory involvement in adults. Reported Latin- American cases of COVID-19 in neonates are scarce. Clinical manifestations are unspecific in this age, with respiratory involvement around 40%. CLINICAL CASE: We report a hospitalized patient at the neonatal intensive care unit due to meconium aspiration and hypoxic-ischemic encephalopathy sequelae, in whom is diagnosed COVID-19 at 18 days of life. He presented fever and late onset neonatal sepsis and was considered as an acquired-hospital infection. CONCLUSION: The purpose of this report is to contribute to the clinical description of this entity and highlight the SARS-CoV-2 infection in the differential diagnosis in late onset neonatal sepsis, even in hospitalized patients, to detect and contain opportunely this disease. © 2023 Instituto Nacional de Pediatria. All rights reserved.

Digital Native Media in the Face of Journalistic Security

In the scenario marked by digitalization, digital media have found spaces that allow them to face labor problems and at the same time face the risks and vulnerability that threaten the security of journalists. Therefore, this research is established to know some issues related to security: economic limitations of access to public information, censorship, and self-censorship in the journalistic exercise in Ecuador. The observation was carried out within the framework of the pandemic unleashed by the presence of COVID-19 and its variants. For the execution of the research, the qualitative methodology was applied with semi-structured interviews to investigative journalists of consolidated digital native media. Among the conclusions are noted that the pandemic brought with it labor precariousness;however, digital media have managed to maintain themselves with external funds or own resources. For the journalistic exercise, public information becomes a severe concern because access has been restricted, and there is little transparency in its disclosure. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

TH-208. Development and Evaluation of a Transcutaneous Stimulator for the Treatment of Refractory Epilepsy

Introduction: The design and first results of a transcutaneous electrical stimulator of the vagus nerve for the treatment of Refractory Epilepsy are discussed. Method(s): The device developed is based on the STM32L073CZ microcontroller and can generate fully configurable monopolar or bipolar stimuli, so that the electrical therapy can be adjusted to each patient following the therapeutic strategy designed by their doctor. The start time and duration of each therapeutic session are stored in an internal memory of the device, as well as the instants in which the contact of the electrodes is poor, or the therapeutic session is aborted. In this way, the doctor in charge can review what happened once the information is downloaded to a personal computer. Using 3D printing techniques, a plastic support for the electrodes was developed that allows the automatic adjustment of these to the left ear of the subject undergoing treatment;this ensures placement of the electrodes on the correct ear and proper contact of the electrodes with the skin. The operation of the device is easy, each session starts by pressing a button and ends automatically when the programmed time expires, the intervention of the subject undergoing treatment is minimal and thus stress is avoided. Result(s): 20 prototypes were built and passed technical tests in accordance with IEC 60601-1 and IEC 60601-2-10 standards. The results were satisfactory and thus it is guaranteed that the proposed solution is safe for patients and the techniques used are in the state of the art within this medical technology. The Cuban regulatory body approved a trial with 18 humans to test the effectiveness of the device developed;each patient will be under treatment for nine months, but not all began simultaneously due to restrictions put in place by the COVID-19 pandemic. Electrical stimulation was set as follows: bipolar square pulses of 200 microseconds duration at 25 Hz;three 60-minute sessions per day. A patient is considered as treatment's responder monthly crisis frequency decrease more than 50% that he suffered before starting treatment. To date, six patients have completed the trial, five with significant improvement. The other twelve patients are in treatment and after the third month the Monthly Seizure Frequency has decreased in all of them. Conclusion(s): The proposed solution has been effective in the first six patients ending the trial. Without concluding the study, the proposed solution seems an outstanding therapeutic solution. Copyright © 2022

Digital Native Media in the Face of Journalistic Security

In the scenario marked by digitalization, digital media have found spaces that allow them to face labor problems and at the same time face the risks and vulnerability that threaten the security of journalists. Therefore, this research is established to know some issues related to security: economic limitations of access to public information, censorship, and self-censorship in the journalistic exercise in Ecuador. The observation was carried out within the framework of the pandemic unleashed by the presence of COVID-19 and its variants. For the execution of the research, the qualitative methodology was applied with semi-structured interviews to investigative journalists of consolidated digital native media. Among the conclusions are noted that the pandemic brought with it labor precariousness;however, digital media have managed to maintain themselves with external funds or own resources. For the journalistic exercise, public information becomes a severe concern because access has been restricted, and there is little transparency in its disclosure. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Micromobility services before and after a global pandemic: impact on spatio-temporal travel patterns

Sudden changes in urban mobility were caused due to the COVID-19 pandemic. The impacts are yet to be furtherly measured and analyzed. Our article uses GPS records provided by three different micromobility operators in Madrid to study how the pandemic affected their service usage and its relationships with land use. Thus, spatio-temporal travel patterns are compared between pre-COVID 19 (from January 2019 to February 2020) and COVID times (from March to December 2020). Additionally, multiple regression analyses are conducted to assess how the two scenarios differentiate in relation to micromobility trips, generated or attracted, to or from different land uses, and during morning or afternoon peak hours. Results show that the most pandemic-resilient shared mode is bike-sharing, and that COVID-19 has caused a downfall in micromobility trips of approximately 10%, which is relatively lower compared to the 80% ridership drop reported by the public transport system. Our models reveal that residential and commercial areas gained importance after the pandemic, while workplace locations (office and industrial), educational and transport facilities lost relevance with teleworking and online studying. These findings could help authorities to plan future policies and improve the infrastructure needed to promote micromobility services. © 2022 Taylor & Francis Group, LLC.

Active Monitoring of Adverse Events in a Closed Population: Contributions from Colombia to COVID-19 Vaccines Safety

Introduction: Information on the effectiveness and safety of vaccines for COVID-19 is limited as clinical trials did not provide enough evidence about long-term effects and all possible adverse events [1]. Moreover, marketing authorization for these vaccines was conditioned on providing more information about adverse events and effects on populations not included in clinical trials, like pregnant and pediatric population [2,3]. Objective(s): To evaluate the clinical performance and Adverse Events Following Immunization (AEFIs) of the vaccines against COVID-19 in a closed cohort from a Colombian university. Method(s): This is an observational study of a prospective cohort, with members of the Universidad Nacional de Colombia (UNAL, by its Spanish acronym) followed from June 2021 to April 2022. Data was collected via a telephonic survey and additional clinical information was provided by the health institution Unisalud. Description of the AEFIs in the population and the characteristics of the people with adverse events was analyzed. Result(s): A total of 3,764 persons were included, 35.73% reported AEFIs from which around 8.55% (115/1,345) experienced them 5 days after immunization. AEFIs tended to have low or medium intensity (70% on a 5 Likert scale, from very low to very high) and a duration between 1 and 3 days (65.1%). The vaccine with fewer AEFIs was Sinovac and was statistically different from Pfizer and AstraZeneca (using Tukey HSD and 95% confidence). Conclusion(s): The percentage of AEFIs is consistent with findings in active monitoring programs. Risk factors coincide with other studies. This study demonstrates high rates of AEFIs in the population differing by brand. Serious events were rare. This study contributes to the knowledge of AEFIs for vaccines only used in middle and lowincome countries. The active monitoring program of UNAL gives very relevant and reliable information. Models to study risk factors for AEFIs are needed and are currently in development by the authors.

Reactogenicidad de la vacuna de ARNm BNT162b2 (Pfizer-BioNTech) frente a COVID-19 en trabajadores de un hospital de tercer nivel

OBJECTIVE: To analyze the local and systemic reactions that appeared after the first and second dose of the BNT162b2 vaccine against COVID‑19 (Pfizer- BioNTech) in a sample of workers from a tertiary hospital, and to identify the  factors related to greater vaccine reactogenicity. METHOD: A self-administered questionnaire was used to interview 291 workers  from a tertiary hospital who received the BNT162b2 vaccine against COVID-19  between January and March 2021. The questionnaire included questions about  the sociodemographic variables of the participants, previous COVID-19  infection, and local and systemic reactions after the first and second dose of  the vaccine. RESULTS: The most common adverse reaction was soreness at the injection site, which was reported more frequently after the first dose of the  vaccine. The systemic reactions evaluated were reported more frequently after the second dose of the vaccine. Women, younger adults, and  subjects with a prior COVID-19 infection reported increased reactogenicity. Furthermore, high reactogenicity after the first dose was found  to be related to a higher number of adverse reactions after the second dose of  the vaccine. CONCLUSIONS: The distribution of reactogenicity in the present study is consistent with the data reported in previous studies on the BNT162b2 vaccine, especially in terms of its association with the participants'  characteristics. These findings could facilitate the identification of people at a  higher risk of developing high reactogenicity to the vaccine, thereby making it  possible to anticipate the appearance of adverse reactions and plan for their  treatment. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved. OBJETIVO: Analizar las reacciones locales y sistémicas aparecidas tras la  primera y segunda dosis de la vacuna BNT162b2 (Pfizer-BioNTech) frente a  COVID-19 en una muestra de trabajadores de un hospital de tercer nivel, e  identificar los factores relacionados con una mayor reactogenicidad a la  vacuna.Método: Se empleó un cuestionario autoadministrado para entrevistar a 291  trabajadores de un hospital de tercer nivel que recibieron la vacuna BNT162b2  frente a COVID-19 entre enero y marzo de 2021. El cuestionario incluyó  preguntas acerca de las variables sociodemográficas de los participantes,  infección previa de COVID-19 y las reacciones locales y sistémicas tras la  primera y segunda dosis de la vacuna. RESULTADOS: La reacción más comúnmente informada fue el dolor en el lugar  de la inyección, siendo más frecuente tras la primera dosis de la vacuna. Las  reacciones sistémicas evaluadas se informaron con mayor frecuencia tras la  segunda dosis de la vacuna. Las mujeres, los adultos más jóvenes y las  personas con una infección previa por COVID-19 notificaron una mayor  reactogenicidad. Además, una alta reactogenicidad tras la primera dosis estuvo relacionada con un mayor número de reacciones adversas tras la segunda  dosis de la vacuna. CONCLUSIONES: La distribución de la reactogenicidad en el presente estudio es  consistente con los datos reportados en los estudios realizados  con la vacuna  BNT162b2, especialmente en términos de asociación con las características de  los participantes. Estos hallazgos pueden facilitar la identificación de personas  con mayor probabilidad de presentar una alta reactogenicidad a la vacuna,  permitiéndonos anticipar su aparición y tratamiento.

Eventos adversos autoinformados en los siete días posteriores a la vacunación con Spikevax® (Moderna)

OBJECTIVE: Continuous monitoring of COVID-19 vaccines safety may provide  additional information to health care professionals and the general population.  The aim of the present study was to analyze the local and systemic adverse  events following the administration of the Spikevax® (Moderna) vaccine, and  to identify the factors related to greater reactogenicity. METHOD: Using a telephone survey, we interviewed 331 recipient of the  Spikevax® vaccine (50.2% men;Meanage = 46.4). Participants  haracteristics, prior COVID-19 infection and local and systemic adverse events  within seven days following the first and second vaccine doses were asked. Results: Injection site pain, fatigue and headache were the most common adverse events. The prevalence and intensity of local events was higher after the first dose, while systemic events were higher in the  second one. Most adverse events were mild/moderate;1.2% of participants  needed hospitalization or emergency room visit. Women and participants aged  18-55 years were more likely to experience greater reactogenicity, participants  with prior COVID-19 infection had more systemic  events after the first dose, and participants with chronic diseases other than  hypertension reported fewer systemic adverse events following the second  dose. CONCLUSIONS: Our results are consistent with previous studies, identifying women, people aged 18-55 years and those with previous COVID- 19 infection as those who experienced the greatest reactogenicity to the  vaccine. A relationship was also found between reactogenicity and suffering from a chronic disease other than hypertension. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved. OBJETIVO: La monitorización continua de la seguridad de las vacunas COVID- 19 puede aportar información adicional a los profesionales sanitarios y a la  población general. El objetivo del presente estudio fue analizar los eventos  adversos locales y sistémicos tras la administración de la vacuna Spikevax®  (Moderna), e identificar los factores relacionados con una mayor  reactogenicidad.Método: Mediante un cuestionario telefónico entrevistamos a 331 receptores de la vacuna Spikevax® (50,2% hombres;mediaedad = 46,4). Se  preguntó acerca de las características de los participantes, infección previa  por  COVID-19 y eventos adversos locales y sistémicos en los siete días posteriores a la primera y segunda dosis de la vacuna. Resultados: El dolor en el lugar de inyección, la fatiga, y la cefalea fueron los  eventos adversos más frecuentes. La prevalencia e intensidad de eventos  locales fue mayor en la primera dosis, mientras que los sistémicos lo fueron en  la segunda. La mayoría de los eventos adversos fueron leves/moderados;  el 1,2% de los participantes necesitaron acudir a urgencias u hospitalización.  Las mujeres y participantes de 18-55 años presentaron mayor probabilidad de  experimentar mayor reactogenicidad, los participantes con infección previa por  COVID-19 presentaron más eventos sistémicos tras la primera dosis y los  participantes con enfermedades crónicas distintas de la hipertensión notificaron  menos eventos adversos sistémicos tras la segunda dosis.Conclusiones Nuestros resultados son consistentes con estudios previos, identificando a las mujeres, personas de 18-55 años y con infección previa por COVID-19 como los que mayor reactogenicidad a la  acuna experimentaron. También se encontró una relación entre la  reactogenicidad y padecer alguna enfermedad cronica distinta de hipertensión.

Miller Fisher syndrome: Adverse effect of booster dose for COVID-19

Introduction: The SARS-CoV-2 coronavirus has been a challenge for public health, establishing the vaccine as the best tool for its prevention. Clinical case: We present the case of a patient in whom Miller Fisher syndrome was documented after receiving her booster dose with the Oxford-AstraZeneca vaccine. Conclusion(s): At the moment, a causal relationship between vaccination against COVID-19 and the development of Miller Fisher syndrome cannot be established, but knowledge of this potential adverse effect is relevant for early diagnosis and timely treatment. Copyright © 2022 Sociedad Neurologica Argentina