Changes in the epidemiological profile of pituitary stalk thickening among pediatric population in Chile during COVID-19 pandemic (preprint)

Purpose Pituitary stalk thickening (PST) is a rare disease affecting mainly adults. Pediatric cases are infrequent. The aim of this study is to evaluate the frequency of pediatric patients with PST during the pandemic outbreak of COVID-19 in Chile and compare it with previous data. Methods A retrospective chart review was conducted in patients with PST diagnosed during COVID-19 outbreak. Patients <18 years with pituitary stalk width of 3mm or more at pituitary insertion and/or 4mm or more at optic chiasm were included. In order to characterize and compare these cases with those already published, a review of the literature was performed. Results Nine patients were diagnosed with PST. Seven were girls. Mean age at the onset of symptoms was 10.36 years (2.4-17). Germinal cell tumors (GCT) were diagnosed in 8 patients and Langerhans cell histiocytosis in one. All patients had negative tumor markers, arginine-vasopressin deficiency (AVD) and at least one anterior pituitary hormonal deficit at diagnosis. Diagnoses were confirmed histologically in all patients, and four required a second biopsy. We found a frequency of 4 patients per year with PST due to GCT which is twice the one expected in the same population in Chile. Conclusion A surprisingly high frequency of PST presented during the COVID-19 pandemic among Chilean pediatric patients, being GCT the most frequent etiology. The reasons behind this increase in reported cases are still to be elucidated.

Duelo y atención domiciliaria para pacientes al final de la vida durante la pandemia por COVID-19 en Colombia.Análisis desde la perspectiva de familiares Grief and palliative home-care services for patients at the end of life during the COVID-19 pandemic in Colombia. Analysis from the relatives´ perspective

Introducción: El cuidado al final de la vida es una de las experiencias más cruciales tanto para el paciente como para sus seres queridos. Sin embargo, a raíz de los cambios generados por la pandemia de COVID 19, el proceso de final de vida ha sufrido cambios a nivel familiar, social y sanitario. A su vez, esto ha alterado la percepción y desarrollo del duelo de familiares de pacientes que fallecieron durante la pandemia, independiente de la causa de muerte. De forma que el presente estudio tiene el objetivo de analizar las percepciones y algunos aspectos del proceso de duelo de los familiares de pacientes fallecidos durante la pandemia. Métodos: Se aplicó la versión adaptada del cuestionario internacional Care Of the Dying Evaluation (iCODE), a los familiares de personas fallecidas durante la pandemia en dos momentos diferentes tras la muerte de su familiar. Resultados: Se encuestaron 239 familiares, de los cuales 112 realizaron el cuestionario de seguimiento. Los pacientes fallecieron mayoritariamente en su domicilio y su familia estuvo altamente involucrada en su cuidado. La atención médica fue evaluada como adecuada y el síntoma que se percibió con mayor frecuencia fue el dolor. El 87% de los encuestados participaron en ritos fúnebres, y el 42% los calificó como muy sobrios. En cuanto al duelo predomina la subescala de crecimiento personal, sin embargo, en los aspectos negativos predomina la sensación de presión en el pecho y llanto frecuente. Conclusiones: El fin de vida durante la pandemia de pacientes de atención domiciliaria fue percibido como adecuado, permitiendo el acompañamiento por parte de la familia y control de los síntomas. El proceso de duelo no evidencia complicaciones. Es importante la formación de los profesionales de la salud en estos aspectos fundamentales de la atención y el cuidado de los pacientes.

Students and Teachers Using Mentimeter: Technological Innovation to Face the Challenges of the COVID-19 Pandemic and Post-Pandemic in Higher Education

The COVID-19 pandemic has prompted higher university lecturers to develop their digital skills in order to adapt to online teaching. A group of university teachers decided to evaluate the educational uses of Mentimeter to promote student participation and active learning. A questionnaire was answered by 400 students and 12 participating academics. These 12 academic respondents also participated in a focus group after experiencing this software during an academic course. Qualitative and quantitative data was collected and analyzed to conclude that this software not only facilitated student participation during the pandemic (both face-to-face and online) in synchronous and asynchronous ways but also improved attention, engagement, collaborative learning and interaction. Immediate feedback made it possible for teachers to monitor the students’ learning processes and to adjust the content and pace accordingly. Students and educators highlighted the inclusive potential of this tool, as it allows participation from a diverse audience with different backgrounds and capacities, ensuring inclusive and equitable education for all. Some opportunities for improvement were also identified, namely more functions to make the software more attractive and adapt it to different educational objectives.

Temporal Air Quality (NO2, O3 and PM10) Changes in Urban and Rural Stations in Catalonia during COVID-19 Lockdown: An Association with Human Mobility and Satellite Data (preprint)

In this study, changes in air quality by NO 2 , O 3 and PM 10 in Barcelona metropolitan area and other parts of Catalonia during the COVID-19 lockdown with respect to pre-lockdown and to previous years (2018 and 2019) were evaluated. Selected air monitoring stations included 3 urban (Gràcia, Vall d’Hebron and Granollers), 1 control site (Fabra Observatory), 1 semi-urban (Manlleu), and 3 rural (Begur, Bellver de Cerdanya, and Juneda). NO 2 lockdown levels showed a diminution, which in relative terms was maximum in two rural stations (Bellver de Cerdanya, -63% and Begur, -61%), presumably due to lower emissions from the ceasing hotel and ski resort activities during eastern holidays. In absolute terms and from an epidemiologic perspective, decrease in NO 2 , also reinforced by the high amount of rainfall registered in April 2020, was more relevant in the urban stations around Barcelona. O 3 levels increased in the transited urban stations (Gràcia, +42%, and Granollers, +64%) due to the lower titration effect by NO x . PM 10 lockdown levels decreased, mostly in Gràcia, Vall d’Hebron and Granollers (-35, -39% and -39%, respectively) due to traffic depletion (-90% in Barcelona's transport). Correlation among mobility index in Barcelona (-100% in retail & recreation) and contamination was positive for NO 2 and PM 10 and negative for O 3 ( P <0.001). Satellite images evidenced two hotspots of NO 2 in Spain (Madrid and Barcelona) in April 2018 and 2019 that disappeared in 2020. Overall, the benefits of lockdown on air quality in Catalonia were evidenced with NO 2 , O 3 and PM 10 levels below WHOAQG values in most of stations opposed to the excess registered in previous years.

New susceptibility loci for severe COVID-19 by detailed GWAS analysis in European populations (preprint)

Due to the highly variable clinical phenotype of Coronavirus disease 2019 (COVID-19), deepening the host genetic contribution to severe COVID-19 may further improve our understanding about underlying disease mechanisms. Here, we describe an extended GWAS meta-analysis of 3,260 COVID-19 patients with respiratory failure and 12,483 population controls from Italy, Spain, Norway and Germany, as well as hypothesis-driven targeted analysis of the human leukocyte antigen (HLA) region and chromosome Y haplotypes. We include detailed stratified analyses based on age, sex and disease severity. In addition to already established risk loci, our data identify and replicate two genome-wide significant loci at 17q21.31 and 19q13.33 associated with severe COVID-19 with respiratory failure. These associations implicate a highly pleiotropic ~0.9-Mb 17q21.31 inversion polymorphism, which affects lung function and immune and blood cell counts, and the NAPSA gene, involved in lung surfactant protein production, in COVID-19 pathogenesis.

Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry.

BACKGROUND AND PURPOSE: Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology. METHODS: We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20). RESULTS: Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p