Bradyarrhythmias in patients with SARS- CoV- 2 infection: Report of two cases

Several cardiovascular diseases and arrhythmogenic events have been associated with COVID-19 due to SARS-COV-2 infection, a topic of current global interest. Bradyarrhythmias are less frequent than other types of arrhythmia. We present a patient at 27 weeks of pregnancy, who on the fourth day of infection presented asymptomatic transient sinus pauses that did not require treatment ( sinus bradycardia of 41 beats per minute, pauses of two seconds and junctional escape rhythm). She was diagnosed as possible atrial myopathy with third degree sinoatrial block, sinus arrest or atrial quiescence, primary sinoatrial node dysfunction due to myocarditis ( edema and inflammation of the conduction system). She continued under follow-up, since after the infection was overcome arrhythmical events may recur. The second patient, 39 years old, presented bradyarrhythmia on the ninth day of infection, transient absence of P waves and junctional atrioventricular and idioventricular escape rhythms, as well as atrioventricular dissociation. No specific treatment was required.

COVID-19 and Food Insecurity in Latin America and the Caribbean

The objective was to determine the prevalence of household food insecurity (FI) in Latin America and the Caribbean (LAC) during the COVID-19 pandemic. Secondary analysis was performed using the waves 1 to 3 of the 2020 COVID-19 High Frequency Phone Surveys in 13 LAC countries. The countries with the highest FI in the first wave were Honduras (60.3%), Peru (58.1%) and Ecuador (57.9%). Likewise, the countries with the greatest differences in the prevalence of FI between the first and last waves in percentage points (PP) were Peru (-29), Guatemala (-27.7) and Bolivia (-21.8). LAC countries face a great burden of FI.Copyright © 2022 Taylor & Francis Group, LLC.

Effectiveness of a telerehabilitation intervention using ReCOVery APP of long COVID patients: a randomized, 3-month follow-up clinical trial.

The main objective of this study is to analyze the clinical efficacy of telerehabilitation in the recovery of Long COVID patients through ReCOVery APP for 3 months, administered in the Primary Health Care context. The second objective is to identify significant models associated with an improvement in the study variables. An open-label randomized clinical trial was conducted using two parallel groups of a total of 100 Long COVID patients. The first group follows the treatment as usual methods established by their general practitioner (control group) and the second follows the same methods and also uses ReCOVery APP (intervention group). After the intervention, no significant differences were found in favour of the group intervention. Regarding adherence, 25% of the participants made significant use of the APP. Linear regression model establishes that the time of use of ReCOVery APP predicts an improvement in physical function (b = 0.001; p = 0.005) and community social support (b = 0.004; p = 0.021). In addition, an increase in self-efficacy and health literacy also contribute to improving cognitive function (b = 0.346; p = 0.001) and reducing the number of symptoms (b = 0.226; p = 0.002), respectively. In conclusion, the significant use of ReCOVery APP can contribute to the recovery of Long COVID patients. Trial Registration No.: ISRCTN91104012.

Cytokine Profile in Different Post-Covid-19 Condition Phenotypes

Background: At least 10% of SARS-CoV-2 infected patients suffer from persistent symptoms for >12 weeks, known as post-COVID-19 condition (PCC) or Long Covid. Reported symptomatology is diverse with >200 physical and neurological debilitating symptoms. Here, we analyzed pro-inflammatory cytokine levels as a potential mechanism underlying persistent symptomatology. Method(s): Clinical data and samples used belong to the KING cohort extension, which includes clinically well characterized PCC (N=358, 59 persistent symptoms evaluated), COVID-19 recovered and uninfected subjects. We used Gower distances to calculate symptom's similarity between PCC and Ward's hierarchical clustering method to identify different symptom patterns among PCC patients. Cytokine levels of randomly selected PCC, recovered and uninfected subjects (N=193) were measured on plasma samples collected >6 months after acute infection using the 30-Plex Panel for Luminex. Mann- Whitney t-test was used to compare PCC vs recovered groups and Kruskal-Wallis t-test for >2 groups comparisons (PCC vs recovered vs Uninfected and within PCC clusters). FDR correction was applied for statistical significance (p-adj). Result(s): Hierarchical clustering identified 5 different PCC clusters according to their symptomatology, where PCC3 and PCC5 clusters showed higher prevalence of women ( >80%) and more persistent symptoms, while acute COVID-19 was mild in >80% of the patients. We selected 91 PCC (belonging to each cluster), 57 recovered and 45 uninfected subjects for cytokine profiling (Table 1). 13 soluble markers were significantly elevated (IL-1beta, Eotaxin, MIP-1beta, MCP-1, IL-15, IL-5, HGF, IFN-alpha, IL-1RA, IL-7, MIG, IL-4 and IL-8) in PCC and recovered groups compared to uninfected subjects (all p-adj< 0.04). In addition, PCC subjects tended towards higher levels of IL-1RA compared to recovered group (padj= 0.071). Within PCC clusters, FGF-basic and RANTES were elevated while IL-2 and MIG were decreased in PCC3 and PCC5 compared to the other PCC clusters (all p-adj< 0.04). TNF-alpha, IP-10, G-CSF and MIP-1alpha were decreased in PCC3 and PCC5 not reaching statistical significance (all p-adj=0.07). Conclusion(s): Some cytokines remained altered in all SARS-CoV-2 infected subjects independently of persistent symptoms after 6 months from acute infection. Differences between PCC and recovered individuals are limited after correction. Importantly, PCC cytokine profiles showed differences between clusters, which suggests different PCC subsyndromes with distinct etiology. Subjects Characteristics (Table Presented).

IDENTIFICATION OF CLINICAL FEATURES ASSOCIATED WITH SARS-CoV-2 REINFECTIONS

Background: Over 600 million of COVID-19 cases have been reported. A remarkable fragment of these cases are reinfections, which are mostly explained by the genomic variability of the SARS-CoV-2 variants. However, little is known about other factors fostering these reinfections. Method(s): We recorded clinical and demographic data from subjects (N=3303, March 2020 - March 2022) with at least 2 PCR+ events separated by >=90 days, analyzed by the Microbiology Department, Northern Metropolitan Clinical Laboratory from Germans Trias i Pujol Hospital (Spain). Data collected included: age, sex, comorbidities, adjusted morbidity group (GMA), hospitalization, symptomatology, NAAT (PCR, TMA) tests, antigen tests, serology, and vaccination. Temporal data was encoded using Python, and demographic characterization was performed under R. Result(s): We identified 2344 cases of confirmed reinfections, where the 2 PCR+ events were separated by >=90 days and a negative test was obtained between episodes. 72.2% of reinfected subjects were females with a median age of 45 IQR [28-63] years. Age density analysis showed three peaks at 24, 45, and 85 years, probably mostly composed of young people, who usually are less cautious, healthcare workers, and people living in nursing homes, respectively, being all of them groups prone to be tested. Regarding health status, 86.2% of participants had at least one chronic condition, with 40.5% of patients having chronic conditions in >=4 systems based on GMA assessment. Interestingly, 75.2% of reinfected subjects < 26 years had at least one chronic condition. 121 (4.2%) participants were hospitalized during a COVID-19 episode, highlighting 8.3% (N=10) of them hospitalized during the reinfection (half of them vaccinated before hospitalization), and 5% (N=6) of them during both infections. The severity of the second infection may be caused by a diminished acquired immunity after the first infection. Time between reinfections density analysis provided three peaks at ~200, ~400, and ~600 days, corresponding with time between waves. A decrease of reinfections was observed between 40 and 100 days after vaccination, which would be the period of highest protection against reinfection. Conclusion(s): SARS-CoV-2 reinfections are more prevalent among women. Importantly, people with an undermined health status, independently of age, are more sensitive to reinfections, but in most of the cases no hospitalization was required. Finally, vaccination seems to have a short protective effect on reinfection.

Severity Clusters and Likelihood of Recovery from Post-Covid-19 Condition

Background: The Post-COVID-19 Condition (PCC) is a novel, long-lasting, poorly understood and highly disabling post-viral syndrome, which poses enormous healthcare, economic and socio-political challenges. Lack of validated biomarkers forces clinical management to be based on clinical definitions, which are imprecise. In the clinic, symptoms tend to present in clusters, which have yet to be properly defined. Also, it is unclear how often PCC resolves, and which factors influence PCC resolution. Method(s): To delineate PCC presentation clusters and explore factors related with PCC resolution, we performed a 2-year prospective cohort study in individuals who recovered from acute COVID-19 regardless of its acute and post-acute severity. All subjects were systematically followed in the outpatient post-COVID-19 clinic of a tertiary care hospital in Spain. PCC was defined as per the WHO 2021 definition. Persistent symptoms were those present >3 months after acute COVID-19, and lasting for >2 consecutive months. PCC recovery was the absence of PCC symptoms during >3 consecutive months. Symptom clusters were identified using Gower's distance matrices, dendograms, PCA and Silhouette techniques. Factors associated with PCC recovery were identified using a directed acyclic graph approach. Result(s): 548 subjects were included;341 (62%) had PCC. The latter were mostly females (69.8%) with mean age of 47.9 (SD 12.2) years. Only 38.1% required hospitalization and 9% required high-flow oxygen during acute COVID-19. Their most frequent comorbidities were allergy (31.4%), obesity (24.8%), dyslipidemia (24.0%) and hypertension (19.6%). At least 3 symptom clusters with additive symptoms were identified: considering only symptoms present in >35% of subjects, Cluster A was enriched in fatigue and dyspnea;Cluster B had Cluster A symptoms plus headache, arthralgia and neurocognitive complains;Cluster C had Cluster B symptoms plus chest pain and tachycardia. PCC recovery was achieved by 26 (7.6%) individuals over 2 years. Male sex (RR 3.01;CI 1.4-6.3), ICU admission (RR 7.85;CI 2.6-23.2), metabolic comorbidity (RR 2.07;CI 1.1-4.1), and mild acute COVID-19 (RR 2.70;CI 1.1-4.6) increased the likelihood of PCC recovery. Conversely, subjects with muscle pain, impaired attention, dyspnea, and tachycardia were less likely to recover from PCC (RR 0.26;CI 0.13-0.52). Conclusion(s): At least 3 severity clusters can be identified in the PCC. Over the first 2 years, only a minority of subjects fully recover from PCC.

Anxiety and depression among medical students during COVID-19 pandemic

Background: Medical students are especially prone to anxiety and depression. Aim: To characterize the presence of anxiety and depression and their association with gender and academic year among medical students. Material and Methods: Standardized electronic surveys about anxiety and depression symptoms were sent to 498 medical students with a response rate of 78%. Results: We analyzed 359 surveys. A mean of 11.4 points out of 27 was observed in the depression symptoms scale. Also, 23 and 10% of respondents had moderately severe or symptoms of depression, respectively. A mean of 8.9 out of 21 points in the anxiety symptoms scale was observed. Moderate or severe anxiety symptoms were present in 26 and 15% of respondents, respectively. Women and preclinical students had higher depression and anxiety scores. Conclusions: A high presence of anxiety and depression symptoms was characterized among medical students during the pandemic. Preclinical students and women had higher scores in both scales.

Perfectionism, Goal Orientation, and Emerging Adults' Identity Processing Styles

The current study explored the direct and interactive contributions of multidimensional measures of perfectionism and goal orientation in predicting patterns of identity-related self-processing for pre-COVID-19 and during-COVID-19 samples of traditional age (18–22 year old) emerging adult college students (N = 722). Regression models controlled for age, binary gender, and race, then tested the unique conditional effects and interactions between perfectionism and goal orientation in explaining variability in each of three identity processing styles. After controlling for multiple covariates and hypothesis tests, only a few effects were repeated between the two samples. Those results indicated that a growth-seeking goal orientation was predictive of an informational identity style whereas validation-seeking goal orientation was a significant predictor of diffuse-avoidant and normative identity processing styles. The overall findings suggested that fruitful targets for future intervention studies promoting healthy identity development during the college years might include reducing validation-seeking while strengthening growth-seeking motives. © 2023 Society for the Study of Emerging Adulthood and SAGE Publishing.

Effects of a brief behavioural cognitive e-therapy for emotional alterations, and inflammation in COVID-19 survivors

Background: The cellular inflammation generated by SARS-COV-2 has been linked with different psychological impairments to long-term. The Mindfulness-based cognitive therapy can generate positive changes in these patients. Aim(s): To know the effects of a brief behavioural cognitive e-therapy on emotional symptoms, and cellular inflammation in COVID-19 survivors. Method(s): A quasi-experimental study was carried out. Participated two groups of survivors COVID-19 patients;experimental group (TG;4) and wait-list group (WLG;6). Both groups were evaluated using The General Anxiety Disorder Questionnaire, the Patient Health Questionnaire, and the brief Davidson Trauma Scale. Cellular inflammation was evaluated by an assessment of salivary IL-6 in a three-phase paradigm: baseline, stress, and recovery. The TG has received eight virtual mindfulness-based cognitive therapy sessions lasting two hours. The statistical analysis was performed using the software SPSS version 26. Result(s): The average age was about 58+/-11.57 years (TG), and 44.33+/- 17.18 years (WLG). The TG showed a only a clinical differences in the psychological symptoms (anxiety;Mepre = 15.50, Mepost = 8, depression;Mepre =13, Mepost =6 and PTSD;Mepre = 10, Mepost = 5.50), and in the il-6 levels (Base line Mepre = 7.11 pg/mL, Mepost = 16 pg/mL, stress phase Mepre = 10.07 pg/mL, Mepost = 8.77 pg/mL, and recovery phase Me = 14.08 pg/mL, Me = 16.29 pg/mL). Conclusion(s): This type of therapy can helps to reduce the levels of the emotional alterations and generate a modulation of the il-6 levels. The effects of this type of treatment need to continue in research as a therapeutic option for the population that survives COVID-19.

Posttraumatic-stress disorder, and others psychological impairment in COVID-19 surviving patients

Background: The post-COVID syndrome generates physical and respiratory complications that can be accompanied by psychological impairments, which can affect long-term mental and physical health. Objective(s): Know the prevalence and severity of PTSD, anxiety, and depression in surviving COVID-19 patients in a follow-up evaluation. Method(s): A cross-sectional descriptive study was conducted. 227 survivors COVID-19 patients participated, were assessed three months following discharge hospital. The following questionnaires were used: The Brief Davidson Trauma Scale, the General Anxiety Disorder Questionnaire, and the Patient Health Questionnaire. A descriptive and statically analysis was performed using the statistical software SPSS version 26. Result(s): The 64.5% of the patients were men, 60.9% required of invasive mechanical ventilation (IMV) during the hospitalization, the average age was about 48.23+/-14.33 years old. The 40% of the patients showed symptoms associated with PTSD, 38.4% anxiety symptoms, 36.6% depression symptoms. There were statistically significant differences between the type of treatment during hospitalization (IMV vs without IMV), in PTSD (t=2.482, df=223, p=.014, XIMV = 5.21, XWIMV = 6.08) and anxiety (t= -2.006, df=223, p=.046, XIMV = 4.05, XWIMV =5.44). Conclusion(s): Survivors of COVID-19 experience a high prevalence of PTSD, anxiety, and depression even three months after discharge from hospital. Patients who did not require IMV during hospitalization experienced a high prevalence and severity of PTSD and anxiety symptoms. Screening for PTSD and other emotional disturbances should be considered in follow-up evaluations in patients discharged from the hospital.

Sleep disturbances in post-Covid patients as a function of sex

Introduction: Within the post-Covid syndrome, sleep disturbances are one of the most persistent symptoms, in which women are more 50% vulnerable than men to insomnia. Objective(s): To compare the prevalence of sleep disorders in post-Covid patients according to sex. Method(s): A cross-sectional observational study was carried out. The participants were 264 post-Covid patients evaluated 3 months after hospital discharge, divided into men (n=156, G1) and women (n=108, G2). A general sleep habits survey and the Berlin SAOS questionnaire were used for sleep assessment. Statistical analyses were performed using SPSS v25. Result(s): Mean age was G1: 54.16 +/-11.751 and G2: 54.23 +/- 13.319. There were differences (p<0.05) between both sexes in the following disorders (G1 vs G2): snoring (73.1% vs 58.3%), primary snoring (45.6% vs 28.6%), unrefreshing sleep more than 3 times a week (28.2% vs 43.5%), tiredness or fatigue during the day at least 3 times a week (30.1% vs 51.9%), sudden movements in extremities: (37.2% vs 22.2%), onset insomnia: (34.0% vs 53.7%), intermediate insomnia (36.5% vs 58.3%), final insomnia: (39.7% vs 55.6%). No differences (p>0.05) were found in pauses in breathing, teeth grinding, feeling of paralysis and feeling of choking, with a prevalence greater than 20% in all cases. Conclusion(s): In our study, the affectation of most sleep disorders are more frequent in the female sex, with the predominance of different types of insomnia (onset, intermediate and final);which could be related to affective disorders. In men, the most prevalent disorders were snoring and sudden movements, mostly linked to respiratory disorders.

Cognitive alterations in COVID-19 survivors with and without invasive mechanical ventilation during hospital stay

Introduction: Cognitive impairment is observed in patients for Covid-19;derived from both multiple organic dysfunctions due to the disease and its management during hospital stay. Existing literature reports greater cognitive impairment (60-80%) in patients with invasive mechanical ventilation (IMV), compared to those who did not require it (50-70%). Objective(s): To compare cognitive impairment among COVID-19 survivors with and without IMV during hospital stay. Method(s): A cross-sectional observational study was conducted. A total of 211 COVID-19 survivors participated, 64.9% required IMV (G1) and 35.1% did not (G2). The Montreal Cognitive Assessment (MOCA) was used to assess cognitive functions at a 9 month follow-up after hospital discharge. Statistical analyses were performed in SPSS V25. Result(s): Patients presented the following characteristics: male sex (G1: 61.8%, G2: 54.1%), and average age G1: 54.05+/-11.89, G2: 57.21+/-11.90 years. In both groups (G1 vs. G2) no significant differences (p<0.05) were found in the prevalence of probable mild cognitive impairment (72.3% vs. 82.4%), neither in the mean of principal affections reports: attention (4. 70+/-1.23 vs. 4.80+/-1.03) and memory (2.69+/-1.53 vs. 2.86+/-1.59). Orientation (5.60+/-.71 vs. 5.82+/-.41), was the only value that reached statistically significant differences (p=.013), but without clinical significance. Conclusion(s): Both groups have high prevalence of patients with probable mild cognitive impairment yet nine months after discharge, contrasting with the prevalence reported to patients with IMV and to the recovery time (3-6 months). Cognitive sequelae have a greater impact than reported in all patients regardless of treatment.

A Sensitive and Practical Evaluation to Detect Lower-Limb Strength Changes in Geriatrics: The Isometric Knee Extension Test

This study aimed to examine the sensitivity of the isometric knee extension (IKE) test to detect changes in the lower-limb strength of institutionalized older adults after exercise and inactivity periods. Thirty-four and fifteen institutionalized older adults completed the training and inactive periods, respectively. At each time point, the participants completed two testing sessions. In the first session, they performed the IKE test. As a complement to this evaluation, the second testing session was used to assess their functional capacity and handgrip strength. The sensitivity of the IKE test was examined by comparing the changes generated in this test against the repeatability of the protocol. A 4-week multicomponent Vivifrail program was implemented. After that, a subsample of the participants was re-evaluated after a 14-week inactivity period. Significant changes (p < 0.01;ES ≥ 0.27) in the IKE strength for both the dominant (+0.27 N/kg) and non-dominant legs (+0.25 N/kg) were produced after the training intervention. Likewise, significant decrements (p < 0.01;ES ≥ 0.31) were detected after the inactive period for the dominant (−0.29 N/kg) and non-dominant legs (−0.32 N/kg). All mean changes were found to be superior to the variability threshold of the IKE test for both legs, with superior sensitivity for the non-dominant leg (≥73%). Thus, the IKE test is a sensitive and practical tool for detecting changes in the lower-limb strength of institutionalized older adults after exercise and inactivity periods. Because of its applicability, it seems pertinent to implement the IKE test in a geriatric context. © 2023 by the authors.

Heart rate variability in post-COVID-19 patients with different anxiety levels

Introduction: More than 12% of COVID-19 hospitalized patients develop Generalized Anxiety Disorder (GAD) after discharged. High frequency band percentage of heart rate variability (hfHRV) is a reliable indicator of efficient functional coupling between autonomic branches across high-demanding adaptive situations. Objective(s): To compare hfHRV among post-hospitalized COVID-19 survivors by level of GAD. Method(s): We conducted an observational study with 211 post-COVID-19 participants (63.7% males;47.6y +/-14.3), 3 months after discharged. We registered their hfHRV with a computerized biofeedback equipment throughout four conditions: open-eyes (C1);closed-eyes (C2);closed-eyes+natural-relaxation (C3);and closed-eyes+deep-breathing (C4) (2.5 minutes per condition). Participants were classified into 3 categories using General Anxiety Disorder Scale (GAD-7): low anxiety (n=174, 67.5%, 47.2 yo +/-13.4;G1);moderate anxiety (n=24, 66.5%, 47.3 yo +/-15.3;G2) and severe anxiety (n=13, 60.5%, 46.1 yo +/-9;G3). Statistical analysis were performed with SPSS v28. Result(s): hfHRV percentage is higher at C3 in G1 (G1: 29.5 +/-21.1, G2: 21.1 +/-17.1, G3: 20.0 +/-20.4;p = 0.01). G3 display a 30% decrease in hfHRV during this condition in contrast with G1 (p = 0.006). Percentage of hfHRV in G1 (C1: 31 +/-22.6, C2: 29.2 +/-23.6, C4: 24.3 +/-20.7), and G3 (C1: 29.7 +/-22.8;C2: 27.9 +/-17.6;C4: 20 +/-20) didn't show any significant differences. Conclusion(s): C3 involve an adaptive challenge that demands an effective sympathetic-parasympathetic regulation. An increase in hfHRV during C3 in G1, indicates that the group with low anxiety exhibit a more effective psychophysiological adaptive feature than G2 and G3: a potential protective factor from GAD.

Cognitive impairment as a sequel to SARS-CoV-2 infection

Introduction: COVID-19 survivor patients report a complaint subjectively related to memory and attentionconcentration problems when carry out their daily activities. Objective(s): To investigate the presence of cognitive sequelae associated with COVID-19. Method(s): An observational cross-sectional study was conducted. Participated 229 COVID-19 survivor patients, who were evaluated with Montreal Cognitive Assessment (MoCA) and classified into three groups: a) severe cognitive impairment (G1, <13points, n=11), b) mild cognitive impairment (G2, 13-21 points, n=34), and c) without cognitive alterations (G3, 22-30 points, n=184). Statistical analyses were performed in SPSS V25. Result(s): Average age and male sex: G1: 67.36+/-10.71, 63.6%;G2: 58.76+/-11.55, 61.8%;G3: 53.32+/-11.39, 58.7%. G1 presented statistically differences (p <0.001) in all cognitive functions with the other groups (G1, G2, G3): visuospatial/executive ability (0.09+/-0.30, 0.53+/-0.50, 0.83+/-0.38), identification (2.00+/-0.89, 2.82+/-0.38, 2.92+/-0.32), attention (2.45+/-0.82, 3.97+/-1.16, 5.02+/-0.97), repetition (0.18+/-0.40, 0.29+/-0.46, 1.02+/-0.79), fluency (0.18+/-0.40, 0.68+/-0.47, 0.93+/-0.24), abstraction (0.18+/-0.40, 0.68+/-0.72, 1.41+/-0.77), deferred remembering (0.73+/-1.10, 1.44+/-1.37, 3.13+/-1.36) and orientation (4.64+/-0.92, 5.35+/-0.73, 5.79+/-0.49);except in executive ability, identification, repetition, abstraction and deferred remembering with respect to G2 (p<0.05). Conclusion(s): Cognitive alterations were found in patients post- COVID, especially in attention and deferred remembering, which could be related to errors of execution in other areas. In the case of the severe cognitive impairment, age may be a related variable. Necessary integrate this variable in the rehabilitation plan for a better prognosis and quality of life of patients.

Psychological affectation in surviving patients of COVID19, consideration of the use of invasive mechanical ventilation

Introduction: The presence of anxious, depressive and post-traumatic stress (PTSD) symptoms are the most reported psychological sequelae in post-COVID patients. The use of invasive mechanical ventilation (IMV) may contribute to the appearance of these symptoms. Objective(s): To know the differences in anxious, depressive, PTSD and fear of COVID symptoms among surviving COVID-19 patients with or without IMV, 3 months after hospital discharge. Method(s): An observational cross-sectional study was conducted. 239 surviving COVID-19 patients participated: 146 with IMV at hospitalization (67.80% men and 32.20% women) (G1) and 93 without IMV (61.29% men 38.70% women) (G2), who were evaluated with: GAD-7 for anxious symptomatology, PHQ-9 for depressive symptomatology, EMACOVID scale to measure fear of COVID-19, and the brief Davidson scale as screening for EPT. Statistical analyzes were performed in the statistical package SPSS V25. Result(s): Average age: G1= 48.62+/-13.62, G2= 48.49+/-15.43. There was a statistically significant difference in the EPT scores (G1: Md=4 [4.00-6.00];G2: Md=5 [4.00-7.00]). No statistically significant differences were found (P<0.05, G1 vs G2) in depression (Md=3 [0.00-6.00] vs Md=3 [0.00-8.50], anxiety (Md=2 [0.00-6.00] vs Md=3 [1:00-7:50]), nor fear of COVID (Md= 9 [7:00-15:00] vs Md=11.80 [7:00-14:00]), although there were clinical differences. Conclusion(s): Patients without IMV have a conscious experience of their hospitalization, which may lead to a higher level of PTSD compared to sedated patients with IMV.

The emotional well-being of Long COVID patients in relation to their symptoms, social support and stigmatization in social and health services: a qualitative study.

BACKGROUND: Long COVID patients have experienced a decline in their quality of life due to, in part but not wholly, its negative emotional impact. Some of the most prevalent mental health symptoms presented by long COVID patients are anxiety, depression, and sleep disorders. As such, the need has arisen to analyze the personal experiences of these patients to understand how they are managing their daily lives while dealing with the condition. The objective of this study is to increase understanding about the emotional well-being of people diagnosed with long COVID. METHODS: A qualitative design was created and carried out using 35 patients, with 17 participants being interviewed individually and 18 of them taking part in two focus groups. The participating patients were recruited in November and December 2021 from Primary Health Care (PHC) centers in the city of Zaragoza (Northern Spain) and from the Association of Long COVID Patients in Aragon. The study topics were emotional well-being, social support networks, and experience of discrimination. All an inductive thematic content analyses were performed iteratively using NVivo software. RESULTS: The Long COVID patients identified low levels of self-perceived well-being due to their persistent symptoms, as well as limitations in their daily lives that had been persistent for many months. Suicidal thoughts were also mentioned by several patients. They referred to anguish and anxiety about the future as well as a fear of reinfection or relapse and returning to work. Many of the participants reported that they have sought the help of a mental health professional. Most participants identified discriminatory situations in health care. CONCLUSIONS: It is necessary to continue researching the impact that Long COVID has had on mental health, as well as to provide Primary Health Care professionals with evidence that can guide the emotional treatment of these patients.

The road to data-driven public health emergency response in the overseas territory of Puerto Rico

Lingering economic troubles, natural disasters, and governmental instability placed Puerto Rico in uncertainty upon the emergence of the COVID-19 pandemic. In the lack of data and urgency to establish public health strategies, young scientists in Puerto Rico developed an epidemiological and health informatics system to collect, analyze, and monitor data in real time. The work done by the interdisciplinary team resulted in real-time decisions for public health policy as insights were gleaned about the dynamics of COVID-19 propagation. In this chapter, the authors describe an eight-month project which includes a structural assessment, information flow optimization, systemic expansion and enforcement, and data-driven decision-making enhancements to health informatics systems built in Puerto Rico as a model for global health systems. © 2023, IGI Global.

From the right to food to Good Eating. Notes for an XXI century agrarian question

Agroextractivism and its effects on the enjoyment and access to food in developing countries populations, is, without a doubt, a post-pandemic issue that urgently needs to reconceptualize, in the light of the devastating effects of COVID 19 on the population with food and nutritional deficiencies derived from the imbalance in the agri-food production chain, in the current context of the globalisation of commodities: food from here, there and nowhere, which arrives at our table without food and cultural identity, and with questionable nutritional value. Through a descriptive analysis, bibliographic content related to agroextractivism, published from 2000 to 2020, was analyzed, seeking to recognize its impact on the food systems of indigenous peasant communities in Mexico, the Caribbean and the Southern Cone, considering the effects on the biodiversity of the ecosystems of the communities and agricultural knowledge, climate change, and the enjoyment of the right to food and the access to it.. As a result of this literature review, new conceptual elements were found, recognizing the right to food as a peasant human right;and Good Eating as the agri-food worldview of the peasant communities of the indigenous peoples of Latin America. In addition, the right to food and Good Eating are proposed as emerging epistemic paradigms for the study and analysis of the agrarian question of the XXI Century.