La percepción de la covid-19 en el ámbito universitario

La llegada de la covid-19 ha impactado a toda la población mundial. En el contexto universitario se ha presentado una situación especial;para los estudiantes, la presencialidad universitaria constituía un referente formativo complementario al de su propia familia. La interacción social y el aprendizaje, asociado a este tipo de entorno, sufrió rápidamente un transtorno marcado por el confinamiento y el aislamiento físico. Las nuevas condiciones de socialización suponen una nueva percepción y, por lo tanto, una nueva manera de ver la realidad. Esta situación, que se ha extiendido por casi tres años, ha colisionado con los estilos de aprendizaje tradicional, apelando a la autogestión y autorrregulación del proceso educativo, pero también a la resiliencia ante las afectaciones a la salud y a una redefinición de la manera de relacionarse con las demás personas, especialmente en una época de socialización asociada a la juventud universitaria.

Editorial

Desde el mes de marzo de 2020 nos hemos encontrado ante nuevos escenarios socio-sanitarios que han impactado de múltiples formas a nivel mundial. En el caso de latinoamérica, si bien no ha sido de los primeros en recibir la llegada del COVID-19, ha sufrido drásticamente sus efectos, acudiendo a la resiliencia como el camino más expedito para una vuelta controlada a la nueva normalidad.

Safety and efficacy of convalescent plasma for severe COVID-19: a randomized, single blinded, parallel, controlled clinical study.

BACKGROUND: Convalescent plasma (CP) has been widely used to treat COVID-19 and is under study. However, the variability in the current clinical trials has averted its wide use in the current pandemic. We aimed to evaluate the safety and efficacy of CP in severe coronavirus disease 2019 (COVID-19) in the early stages of the disease. METHODS: A randomized controlled clinical study was conducted on 101 patients admitted to the hospital with confirmed severe COVID-19. Most participants had less than 14 days from symptoms onset and less than seven days from hospitalization. Fifty patients were assigned to receive CP plus standard therapy (ST), and 51 were assigned to receive ST alone. Participants in the CP arm received two doses of 250 mL each, transfused 24 h apart. All transfused plasma was obtained from "super donors" that fulfilled the following criteria: titers of anti-SARS-CoV-2 S1 IgG ≥ 1:3200 and IgA ≥ 1:800 antibodies. The effect of transfused anti-IFN antibodies and the SARS-CoV-2 variants at the entry of the study on the overall CP efficacy was evaluated. The primary outcomes were the reduction in viral load and the increase in IgG and IgA antibodies at 28 days of follow-up. The per-protocol analysis included 91 patients. RESULTS: An early but transient increase in IgG anti-S1-SARS-CoV-2 antibody levels at day 4 post-transfusion was observed (Estimated difference [ED], - 1.36; 95% CI, - 2.33 to - 0.39; P = 0.04). However, CP was not associated with viral load reduction in any of the points evaluated. Analysis of secondary outcomes revealed that those patients in the CP arm disclosed a shorter time to discharge (ED adjusted for mortality, 3.1 days; 95% CI, 0.20 to 5.94; P = 0.0361) or a reduction of 2 points on the WHO scale when compared with the ST group (HR adjusted for mortality, 1.6; 95% CI, 1.03 to 2.5; P = 0.0376). There were no benefits from CP on the rates of intensive care unit admission (HR, 0.82; 95% CI, 0.35 to 1.9; P = 0.6399), mechanical ventilation (HR, 0.66; 95% CI, 0.25 to 1.7; P = 0.4039), or mortality (HR, 3.2; 95% CI, 0.64 to 16; P = 0.1584). Anti-IFN antibodies and SARS-CoV-2 variants did not influence these results. CONCLUSION: CP was not associated with viral load reduction, despite the early increase in IgG anti-SARS-CoV-2 antibodies. However, CP is safe and could be a therapeutic option to reduce the hospital length of stay. Trial registration NCT04332835.

Delayed Immune Reconstitution Inflammatory Syndrome in an Immunosuppressed Patient With SARS-CoV-2.

Both immune reconstitution inflammatory syndrome (IRIS) and severe coronavirus disease 2019 (COVID-19) are marked by hyperinflammation as a consequence of dysfunction in myeloid cells and increased production of proinflammatory cytokines. Although these features are common to both diseases, their physiopathology remains unclear. Here we report the case of a 63-year-old woman admitted for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In her clinical course, she developed acute respiratory distress syndrome, probably triggered by the use of granulocyte colony-stimulating factor (G-CSF). We hypothesize that G-CSF unmasked IRIS.

Delayed Diagnosis of an Atypical Pneumonia Resembling a Solitary Pulmonary Nodule.

Atypical pneumonia shows clinical features that are different from those of typical pneumonia, and it can mimic other entities. We report the case of a 42-year-old male with a solitary pulmonary nodule found in an X-ray for a preoperative evaluation. Our patient was asymptomatic, and a pulmonary neoplasm was the first diagnostic suspicion. The round-shaped nodule seen in the X-ray turned out to be a linear ground glass opacity in a thoracic CT scan. Viral pneumonia due to SARS-CoV-2 was diagnosed. We emphasize here the educational value of this case report. We do not report a new radiological finding because lung nodules resembling neoplasms have already been reported in the medical literature. However, some clinical features of COVID-19 are relatively new and can mimic other entities, and the results of some investigations and clinicians' interpretations of them can be misleading. Atypical radiological findings make it necessary to widen the spectrum of alternative diagnoses.