COVID-19: prevention, diagnosis and treatment. Recommendations of a multidisciplinary group.

BACKGROUND: SARS-CoV-2 infection, which causes COVID-19, has impacted the entire world due to its extensive and rapid spread. In the last two years, more than 412 million cases have been confirmed, with more than 5.8 million deaths, as of February 14, 2022. OBJECTIVE(S): Integrate a series of recommendations based on the best level of evidence in prevention, diagnosis and treatment of SARS-CoV-2 infection, including its new variants. METHODOLOGY: Review of different international guidelines and recent articles published in peer-reviewed journals. Issue recommendations based on the level of evidence and degree of confirmation established by the guidelines of the National Institute for Health and Care Excellence (NICE). The authors analyzed the selected articles and, based on their experience, summarized the most relevant to meet the objectives of these recommendations. RESULT(S): 200 articles were found, of which only 124 were selected that met the requirements to identify the level of evidence and degree of recommendation. CONCLUSION(S): Prevention through vaccination continues to be the best tool to establish protection mechanisms against the virus and substantially reduce hospitalizations and associated mortality. Although homologous vaccination is still the accepted reference pattern, the efficacy of heterologous schemes to avoid hospitalization and mortality must be considered. Monoclonal experiments, such as sotrovimab, have activity against the Omicron variant and the AZD7442 molecule that have shown high efficacy in preventing symptomatic COVID-19 in pre- and post-exposure conditions.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.

Inhaled aprotinin reduces viral load in mild-to-moderate inpatients with SARS-CoV-2 infection

The objective of this work is to expand the information provided in the ATAC study, showing the viral load measurements by means of RT-qPCR in tracheobronchial samples from a group of patients with moderate COVID-19, before and after 5 days of standard treatment with aprotinin compared with standard treatment with placebo. The samples of the current study were rescued from participants of a multicentre, double-blind, parallel-arm, randomized phase III trial, performed in four Spanish hospitals with the same inclusion criteria at baseline. Viral load was compared between placebo group and aprotinin-treated group at two time points. At the pre-time (i.e. day 0 before treatment), no significant differences were observed between groups. However, at post-time (i.e. treatment day 5), viral load levels were significantly lower in the aprotinin-treated group. Additionally, a comparative analysis was performed between the placebo group and the aprotinin group. A significantly shorter treatment time was observed in the aprotinin-treated group (p = 0.032), as well as a greater decrease in viral load (p = 0.016). The remaining variables showed no differences between both groups.

Undergraduate perceptions of remote teaching in Computer-Aided Design courses

This research analyzes the undergraduate student's perceptions and challenges of the mandatory transition of six computer-aided design courses, from a blended modality to a completely remote one, in the context of the coronavirus pandemic. We analyzed a School of Architecture in Peru, which has implemented the blended learning in these six courses since 2015, to acquire technical skills in drawing, design, BIM, visualization, information graphic, video editing, computational design, and digital fabrication. We used an anonymous and self-administered survey between November and December 2021 to 1,045 students and received 435 responses for analysis. The results reveal the different ways in which the student interacts with the CAD software for each course. We concluded that the experience of going through the stages of face-to-face, blended, and online, prepares us to migrate into learning environments in the format of MOOCs. The study allowed us to identify challenges and strengths, such as usage preferences to consider for future transition, taking into account the characteristics of these types of courses as a basis for the creation of MOOCs for the inevitable demand for the technologies of the Fourth Industrial Revolution. © 2022 IEEE.

SARS-CoV-2 Infection in a Referral Cancer Center in Mexico City during the First Year of the COVID-19 Pandemic

Background. Literature on SARS-CoV-2 infection in cancer patients is scarce in Latin America. This population seems to have a higher risk for adverse outcomes. This study aims to correlate clinical characteristics with outcomes in patients with cancer in a referral center in Mexico. Methods. We included patients with cancer and confirmed SARS-CoV-2 infection, from April, 19 to December 30, 2020, at the Instituto Nacional de Cancerologia, Mexico. Clinical information was obtained from medical and epidemiological records. We conducted a descriptive analysis. For the association between variables with hospitalization, invasive mechanical ventilation (IMV), and mortality;univariate and multivariate logistic regression was performed;odds ratios and 95% confidence intervals were calculated. Results. Four hundred thirty-three patients were included;268 (62%) were female, the median age was 55 years. One hundred thirty-five (31%), 130 (30%), and 93 (21%) patients had obesity, hypertension, and diabetes mellitus (DM), respectively. Three hundred forty-one (79%) had solid cancer;82 (19%) hematological malignancy (HM), and 10 (2%) were under evaluation for cancer diagnosis. One hundred seventy (39%) had advanced or metastatic cancer. One hundred ninety-eight (46%) patients were hospitalized. Risk factors were: age (p= 0.001);woman (p=0.019);HM (p=0.050) and advanced or metastatic cancer (p= 0.041). Fourty-five (10%) patients required IMV. Age (p=0.018);DM (p=0.041);C-Reactive Protein (p= 0.002), and LDH (p= 0.033) were associated with invasive mechanical ventilation. Mortality within 30-days after diagnosis was 19% (82 cases). Associated characteristics were: age (p=0.041);lymphocytes (p=0.049);creatinine (p=0.005) and albumin (p=0.001). Conclusion. In this study, patients with cancer showed higher mortality, need of hospitalization, and invasive mechanical ventilation compared with groups of patients without cancer. We did not find an increased risk in mortality for hematological malignancies. Although our cohort was younger than others previously reported, age was a strong predictor of adverse outcomes. Variables associated with IMV and death were similar to those previously described in cancer patients with COVID-19.

Mobility strategies based on percolation theory to avoid disease spread: COVID-19

Human mobility is an important factor in the spatial propagation of infectious diseases. On the other hand, the control strategies based on mobility restrictions are generally unpopular and costly. These high social and economic costs make it very important to design global protocols where the cost is minimized and effects maximized. In this work, we calculate the percolation threshold of the spread in a network of a disease. In particular, we found the number of roads to close and regions to isolate in the Puebla State, Mexico, to avoid the global spread of COVID-19. Computational simulations taking into account the proposed strategy show a potential reduction of 94% of infections. This methodology can be used in broader and different areas to help in the design of health policies.

Management of bone metastasis and cancer treatment-induced bone loss during the COVID-19 pandemic: An international perspective and recommendations.

Optimum management of patients with cancer during the COVID-19 pandemic has proved extremely challenging. Patients, clinicians and hospital authorities have had to balance the risks to patients of attending hospital, many of whom are especially vulnerable, with the risks of delaying or modifying cancer treatment. Those whose care has been significantly impacted include patients suffering from the effects of cancer on bone, where delivering the usual standard of care for bone support has often not been possible and clinicians have been forced to seek alternative options for adequate management. At a virtual meeting of the Cancer and Bone Society in July 2020, an expert group shared experiences and solutions to this challenge, following which a questionnaire was sent internationally to the symposium's participants, to explore the issues faced and solutions offered. 70 respondents, from 9 countries (majority USA, 39%, followed by UK, 19%) included 50 clinicians, spread across a diverse range of specialties (but with a high proportion, 64%, of medical oncologists) and 20 who classified themselves as non-clinical (solely lab-based). Spread of clinician specialty across tumour types was breast (65%), prostate (27%), followed by renal, myeloma and melanoma. Analysis showed that management of metastatic bone disease in all solid tumour types and myeloma, adjuvant bisphosphonate breast cancer therapy and cancer treatment induced bone loss, was substantially impacted. Respondents reported delays to routine CT scans (58%), standard bone scans (48%) and MRI scans (46%), though emergency scans were less affected. Delays in palliative radiotherapy for bone pain were reported by 31% of respondents with treatments often involving only a single dose without fractionation. Delays to, or cancellation of, prophylactic surgery for bone pain were reported by 35% of respondents. Access to treatments with intravenous bisphosphonates and subcutaneous denosumab was a major problem, mitigated by provision of drug administration at home or in a local clinic, reduced frequency of administration or switching to oral bisphosphonates taken at home. The questionnaire also revealed damaging delays or complete stopping of both clinical and laboratory research. In addition to an analysis of the questionnaire, this paper presents a rationale and recommendations for adaptation of the normal guidelines for protection of bone health during the pandemic.