Basic monitoring mechanical ventilation in patients with COVID-19, rethinking what we know

During the COVID-19 pandemic, 15% of hospitalized patients have required mechanical ventilation and because the reorganization of health services at COVID-19 centers, a large percentage of health personnel have assumed new functions in the care of the critical patient;situation that makes evident the need to analyze the different techniques, maneuvers and calculations for an adequate assessment and decision-making. A bibliographic review of the topic was made searching for references in Elsevier, Pubmed, SciELO, Medline, Nature, New England Journal of Medicine using the words mechanical ventilation, COVID-19, acute respiratory distress syndrome, lung protection strategy, airway pressures, pulmonary mechanics, published from 2010 to 201 9 in English and Spanish. During the COVID-1 9 pandemic, mechanical ventilation has been a fundamental procedure in the management of severe acute respiratory distress syndrome, becoming indispensable that health personnel who work in COVID-1 9 areas know and understand the different techniques, maneuvers and calculations used to determine the state of the respiratory system in the ventilated patient and apply treatments accordingly.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.

Motivational Factors for Undergraduate Students During COVID-19 Remote Learning

Pedagogical practices use support of empirical research conducted on students learning in-person, but traditional methods of teaching might not work in times of rapid changes. Globally, courses have switched to online/remote learning and the transition has created challenges to student achievement. The unexpected public safety hazards shifted research focus on the impact of remote learning during COVID-19. Previous interventions including positive reinforcement, negative punishment, perceived control, optimism, and factors of self-determination as single constructs have been used to increase student motivation and engagement. The literature reviewed provides an overview of the impact of previous motivation interventions and the theories used to examine students' motivation. Future implications to design courses incorporating these key five focuses are ideal for student achievement in remote learning. © The Author(s) 2023.

Sars-cov-2 reinfection vs. False positive in a health worker

It is described a case of a 30-year-old health worker who presents a clinical state compatible with reinfection by SARS-CoV-2 or with a false positive diagnostic test for active infection. The temporal sequence of tests performed and symptoms presented are described. The first cases of SARS-CoV-2 disease were reported in December 2019 and to date, knowledge of the diagnostic tests is under continuous review.

[Case detection and follow-up of an outbreak of COVID-19 in repatriated workers: A case series study.]

OBJECTIVE: The mobility of workers to other countries in a globalized work world has posed an added risk in the current pandemy of COVID-19 and can carry with it an increased risk of spread and transmission of the disease. The collaboration of the Occupational Health Units of the companies and the Health Authorities has been fundamental in the investigation of COVID-19 outbreaks secondary to international travel of workers on mission. The objective of this study was to describe the process of detection and follow-up of cases in an outbreak of COVID-19 in repatriated workers after a six-month mission in a factory of aircraft components in Poland. METHODS: A case series study was conducted. Data on sociodemographic, epidemiological and clinical course variables of the cases were collected by telephone clinical interview. Descriptive statistics were used to summarize the data. RESULTS: The outbreak involved 20 workers who shared the workplace and made the repatriation trip together. The outbreak investigation was initiated after detecting that a worker presented symptoms compatible with COVID-19 during the 4 days prior to the return trip, which was later confirmed by PCR. During follow-up, 40% (n=8) of the workers were considered cases confirmed by PCR. Of these, only 62.5% (n=5) presented symptoms. Fifty percent (n=4) had fever, 25% (n=2) had cough, respiratory distress, general malaise, and diarrhea, and 12.5% (n=1) had anosmia, ageusia, and conjunctivitis. All of them underwent home isolation with outpatient telephone follow-up. At the end of the follow-up, all were asymptomatic and returned to work. The mean close contact was 1.85 per case within the group (SD=3.13), with a range of 0-11, occurring primarily during attendance at extra work social events that were limited to members of the workers' own group and/or during the return flight. The health authorities were informed through established channels so that they could proceed with the detection and tracking of close contacts with people outside the group of workers that occurred during the flight and after arrival to Spain. CONCLUSIONS: Early detection of potential cases of COVID-19 with transmission capacity by the Occupational Health and Safety Departments of the companies, in collaboration with the Health Authorities, is essential for more efficient case and contact management of imported cases of COVID-19.

Adverse reactions reported after the vaccine administration against covid-19 inworkers of aterciary hospital

Objectives: The COVID-19 disease is a public health emergency of international importance and vaccination is considered the best tool against it. The objective of this study was to evaluate the possible adverse reactions to the vaccine against COVID-19 reported by workers at a tertiary hospital in Madrid. Making a description of the frequency, the presence in the technical sheet, the association with the history of infection by SARS-COV-2 and age. Methods: A retrospective descriptive study of the possible adverse reactions reported to the Occupational Risk Prevention Service of the hospital after the administration of the two doses of the vaccine for COVID-19 (Comirnaty®) was carried out in a sample of 8446 workers that received the first dose 1 and 8255 that received the second. A comparative analysis was performed by applying Pearson’s Chi-square test for qualitative variables and the Mann-Whitney test for quantitative variables. Results: The subjects who reported adverse reactions were 207 after dose 1 (2.45% of total vaccinated) and 397 after dose 2 (4.80% of total vaccinated). 76.8% were older than 55 years (dose 1) and 15.9% with dose 2. 57% had symptoms that were already described in the technical data sheet (dose 1) and 70.5% with dose 2. 50.7% had been previously diagnosed with COVID-19 (dose 1) and 30.5% with dose 2. Conclusions: The adverse reactions reported in our study have been mild or moderate, coinciding with the studies consulted. Adverse reactions were more frequent after the second dose. Among the workers who reported adverse reactions, there were more with a history of COVID-19, especially after the first dose. The reactions produced after vaccination and their causal relationship with it should continue to be studied. © 2021, Accion Medica S.A.. All rights reserved.

[Dermatological reactions secondary to the use of personal protective equipment]

BACKGROUND: During the COVID-19 pandemic, healthcare professionals use personal protective equipment (PPE) on a constant basis and for extended periods, leading to adverse dermatological reactions, a situation little known and studied despite its relevance. OBJECTIVE: To determine the risk factors associated with the development of adverse dermatological reactions in health workers using PPE during the COVID-19 pandemic. MATERIAL AND METHODS: An observational, cross-sectional, analytical study conducted through an online survey that evaluated the association between dermatological reactions and the use of PPE through a descriptive and inferential statistical analysis. RESULTS: There was a sample of 171 healthcare professionals. It was reported a high prevalence of adverse reactions (59%) and the most affected sites were the facial region and hands. The use of PPE > 6 hours, a history of dermatological disease, female gender, use of plastic overalls and the use of a respirator were documented as risk factors. CONCLUSIONS: Being an infectious disease, COVID-19 forces healthcare professionals to use accessories as a form of personal protection, implying potential health risks;for this, effective preventive strategies and treatment are required.

Severe myocarditis caused by SARSCoV-2 virus successfully treated with impella®: A case report

INTRODUCTION: We present a case of a woman who tested positive for SARS-CoV2 admitted to ICU with cardiogenic shock related to severe myocarditis. A cathetermounted ventricular assist device (Impella® CP) was successfully implanted in the left heart. METHODS: A 40-year-old female (68 kg - 150 cm) with history of hypertension, presented at the ED complaining of shortness of breath and chest tightness. A SARS-CoV2 PCR test returned positive. The laboratory workup was drawn, CXR showed bibasilar opacities, and the EKG 0,6 mm ST elevations in I, II, V4-V6 leads and low voltages. CTA chest was unremarkable for PE. She received Dexamethasone as a treatment for COVID-19 and, convalescent plasma, Remdesivir and Tocilizumab were deferred due to transaminitis. Aspirin and Colchicine were concurrently started. Due to respiratory failure and hypotension she was emergently intubated, started on IV Norepinephrine, Dobutamine and Heparin infusions and admitted to ICU. Initial TTE showed severely reduced LV systolic function with wall motion abnormalities and moderate pericardial effusion without evidence of tamponade. Given elevated Troponin I and TTE results with sudden depressed LVEF 19,4% (previously 65%) concerning possible myocarditis, interventional cardiology was consulted for an Impella® CP placement under fluoroscopic guidance via transfemoral access in the right CFA. It achieved a blood flow of 3.1 L/ min supported CO with an immediate improvement in hemodynamic parameters. On day 3, a pericardial window was performed draining 300 ml. On day 8, Impella® CP was removed and she is successfully recovering in the ICU. RESULTS: Fulminant myocarditis represents a lifethreatening complication related to SARS-CoV2 infection. New-onset chest pain and Troponin elevation without past cardiovascular disease and severely reduced LVEF may raise the suspicion of myocarditis, rather than M infarction. Cardiogenic shock without improvement with conventional treatment represents the recent U.S. FDA approved indication for V-A ECMO or Impella® CP use in COVID-19 patients. Direct LV unloading provided by Impella® is considered an advantage over V-A ECMO. Its percutaneous placement results to be very useful in pandemic conditions. The Impella® CP used in our patient provided adequate support for LV function recovery.