ABSTRACT
The impaired hematological parameters have been identified as risk factors for critical illness and higher mortality rates in patients with COVID-19. The aim is to analyze the changes in hematological cells ratios and the relationship to death in COVID-19 patients. Method(s): A retrospective study in COVID-19 patients, classified according to the PaO2/FiO2 relation. The plateletto-lymphocyte ratio (PLR), neutrophil-to-lymphocyte (NLR), and monocyte-to-lymphocyte (MLR) were determined during hospitalization, and changes between four observations during hospitalization were analyzed. Of 780 patients included, 464 were discharged by improvement, and 316 died. From deaths, 26.4% were classified as mild or moderate and 14.1% as severe COVID-19 at admission. The PLR, NLR, and MLR values at admission were higher in patients who died than those who survived. The increase of PLR during later hospitalization stages was associated with death in patients with mild or moderate COVID-19 (OR= 2.22, p<0.001) and, in severe disease (OR= 2.01, p=0.004), a similar association showed the increase MLR (OR= 3.07, p<0.001, and OR= 2.2, p<0.001, respectively). Conversely, the increase in NLR from early stages was associated with death outcome;in early stages (OR= 1.54, p=0.024, and OR= 1.60, p=0.04, according to severity category). In late stages (OR= 3.72, p<0.001 and OR= 3.26, p<0.001, respectively). All models were adjusted by age and sex. The positive change on PLR, MLR, and NRL is associated with death regardless of severity at hospital admission;therefore, the monitoring during the hospitalization stay will be useful to patients' management.
ABSTRACT
Background: The Interferon (IFN)-gamma pathway, including its receptor subunits (IFNAR1 and IFNAR2), is related to hyperinflammation and lower viral clearance in COVID-19. IFNAR2 and the soluble form of the protein have been associated with COVID-19 severity. Aim(s): We aimed to evaluate the association of the IFNAR2 rs2236757, rs1051393, rs3153, rs2834158, and rs2229207 with the clinical outcome (survivors and non-survivors) of patients with severe COVID-19. Method(s): The study included 1,136 patients (67% males, median 56 years old) with severe COVID-19, hospitalized in the Instituto Nacional de Enfermedades Respiratorias, a tertiary care hospital in Mexico. Variants were assessed using Taqman assays. The association study was performed using PLINK v2. Result(s): Four hundred and fifteen patients died during the hospital stay (36.5%). We found higher minor allele frequencies of the rs2236757, rs3153, and rs2834158 among non-survivors compared with survivors. The analyses of genotypes also showed associations of the dominant model for the three variants (Table 1). The rs2834158 was also associated with a logistic regression model adjusted for age (p= 0.038). Conclusion(s): IFNAR2 variants contribute to the genetic risk for mortality in patients with severe COVID-19. (Table Presented).
ABSTRACT
The objective of the project was the development of a prototype of a mobile application that allows learning through Gamification for students of the Software Career of the University of Guayaquil, who are taking the subject of Discrete Structures. The methodology used was exploratory research, where documents such as scientific articles from indexed journals were reviewed;descriptive research was applied to describe the flow of learning processes, before and after with the proposal of the mobile application. An interview was conducted with the teacher who teaches the subject and a feasibility survey was conducted with the students to know their degree of acceptance of the development of the mobile prototype. For software development, the Cascade Methodology was followed to identify the requirements, analysis, design, implementation and testing of the application. As a result, a mobile prototype was achieved in a first phase with 8 modules: 1) Account creation, 2) Login, 3) Home, 4) Profile, 5) Content, 6) Rating, 7) Achievements and 8) Forum. As for Gamification, it consisted of the student answering a questionnaire for each level of content of the unit, giving him a score for each question, this allows him to be in a ranking position with the best scores among all the students of all the parallels of that teaching period. As a conclusion, it can be established that the App will serve as a support tool for the students' learning, besides that the App will allow a competition among them about the knowledge acquired, obtaining a scale of achievements reached and thus obtaining a rating position. Another virtue of the application is a forum space as a means of exchanging queries on a particular subject;in a next phase it is planned to conduct a more in-depth study on Gamification techniques to include them in the App. © 2022 Latin American and Caribbean Consortium of Engineering Institutions. All rights reserved.
ABSTRACT
Introduction: Health personnel who care for patients with COVID-19 are at great risk of contagion, unless they learn and properly implement the procedure for donning and doffing personal protective equipment (PPE). Objectives: To evaluate the use of PPE (donning and doffing) using the CUSUM method in health personnel who care for hospitalized patients with a presumptive or confirmed diagnosis of COVID-19. Use the CUSUM curves as an appropriate method for the meaningful learning and psychomotor skills of these professionals. Materials and Methods: Cross-sectional study carried out in 10 health professionals from the National University Hospital. Measurements were made for one hour per participant from July 13 to 29, 2020, and in each one checklists were used to evaluate compliance with the protocol. In the formative evaluation using the CUSUM, an acceptable failure rate of 20% (Po) was considered and an unacceptable one of 40% (P1), with an error parameter α and β of 10%. Results: 40% reached H0, the goal;20% approached the target and 40% and 20% were distanced from the target with regard to donning and doffing the PPE. Conclusions: Proper use of PPE is a strategy for the prevention of contagion of COVID-19 in health personnel;The study found that less than half demonstrated adequate use, so training these professionals in the placement and removal of PPE according to an institutional protocol based on constant feedback and strict monitoring is essential to achieve the acquisition of skills, which will considerably reduce your risk of infection in clinical practice. © 2022 Sociedad de Anestesiologia de Chile. All rights reserved.
ABSTRACT
Background: Vaccination strategies against SARS-CoV-2 have been implemented worldwide. Safety and effectiveness outcomes in special populations, such as MS patients receiving diseasemodifying therapy (DMT) may guide future recommendations. Objectives: To assess the safety and seroconversion (SC) rates of mRNA (Pfizer-BioNtech) and inactivated (Sinovac-CoronaVac) vaccines in patients with MS in Chile. Methods: Multicentric, prospective, observational study including patients from 4 tertiary centres. Humoral immune response was determined at least 4 weeks after the second dose of either vaccine, by assessing IgG against spike 1 (S1) and nucleocapsid (N) proteins (ECLIA Cobas, Roche) and events supposedly attributable to vaccination (AESAV) were collected. Subgroup comparisons according to DMT and type of vaccine were also performed. Results: A total of 115 patients were included (71% women, mean age 41+11 years, mean disease duration 8+6 years, 83% RRMS, median EDSS 2.0 (range 0-7.5)). Humoral immune response rates of the whole sample were 67% (100% for S1 and 16% for N). Thirty percent of the patients received mRNA vaccine, and SC was significantly higher in this group compared to the inactivated vaccine (81% vs. 61%, p=0.04). Interferon beta/ glatiramer acetate were used by 4% of the patients (100% SC), teriflunomide/dimethylfumarate 8% (100% SC), fingolimod 11% (92% SC), cladribine 7% (88% SC), natalizumab 6% (100% SC), ocrelizumab/rituximab 57% (45% SC, 58% with mRNA and 38% with inactivated vaccine), alemtuzumab 5% (100% SC), and 2% without DMT (100% SC). The most frequent AESAV were local pain (16%), myalgia (13%), headache (11%), and mild fever (3%). Two mild relapses with the inactivated vaccine were observed within the 8 weeks after the first dose. By the time of this report, 3 patients developed COVID- 19 after full vaccination (1 fingolimod, positive IgG-S1, mild COVID19;1 natalizumab, positive IgG-S1, mild COVID19;1 rituximab, negative IgG-S1, required hospitalization and 1 day of non-invasive mechanical ventilation). Conclusions: Vaccination with mRNA and inactivated vaccines appear to be safe in patients with MS, with less than 2% risk of relapse after vaccination. Higher seroconversion rates were observed using the mRNA vaccine. Humoral immune response rate is lower in patients using antiCD20. Determining cellular response and clinical effectiveness on preventing SARS-CoV-2 infection or severe COVID-19 is still needed to be determined.
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Objective: To determine lifestyle changes, such as physical activity, nutrition, and sleep in an Argentinean university population, caused by confinement during the COVID-19 pandemic. Methods: Cross-sectional study via web survey. 1021 the Argentinean university population (women, n = 645 and men, n = 376) aged between 18-70 years old was participate. Survey was utilized to measure participant physical activity behavior, nutrition, and sleep April to May 2020. Results: The main findings revealed that 4.3% of the sample showed obesity;the highest proportion of the sample stayed more than 6 hours in a sedentary status;21.74% reported bad sleep quality;a reduction in good feeding pattern;and an increase in subjects who do not perform physical activity. According to sociodemographic and anthropometric factors, being a student (OR 2.19, CI95% 1.18 - 4, p= .012), overweight (OR 1.71, CI95% 1.19 - 2.44, p= .003), obesity (OR 4.45, CI95% 2.27 - 8.7, p< .001), and have been confined more than 45 days was associated with bad feeding. Likewise, low physical activity levels were associated with obesity (OR 3.2 CI95% 1.66 - 6.18, p= .001), being female (OR 1.61, CI95% 1.14 -2.28, p= .006) and get married (OR 1.72, CI95% 1.14 - 2.61, p= .009). Moreover, being a student was associated with poor sleep quality (OR 43.6, CI95%5.4 - 350, p< .001). Conclusion: This study suggests that confinement decreased healthy living habits such as good nutrition and physical activity and affected the quality of sleep in young subjects. © 2021 Federacion Espanola de Docentes de Educacion Fisica. All rights reserved.