Management of lung cancer in the COVID-19 pandemic: A review

Since its inception, the COVID-19 pandemic has affected health care as a whole. Cancer patients in general and those suffering from lung cancer in particular are a vulnerable group because of their many intrinsic characteristics and care needs. How SARS-CoV-2 (COVID-19) infection affects these patients regarding their risk of infection and outcome in this patient cohort is still to be determined. In this review, we tried to summarize our main concerns regarding COVID-19 in the context of cancer patients from a clinical and multidisciplinary approach. Different types of lung cancer treatments (chemotherapy, radiation therapy and immunotherapy) may also influence the risk of infection and condition the patient's risk of having a worse outcome. Lung cancer patients require frequent radiologic study follow-ups, which may be affected by COVID-19 pandemic. COVID-19 related incidental radiologic findings can appear in routinely scheduled radiology tests, which may be difficult to interpret. Also cancer treatment induced pneumonitis may have similar radiologic features similar to those in acute SARS-CoV-2 pneumonia and lead to a wrong diagnosis. The different health care needs, the requirement for continuous health care access and follow-ups, and the clinical traials in which this patient population might be enrrolled are all being affected by the current COVID-19 health crisis. The COVID-19 pandemic has put health care providers and institutions in difficult situations and obliged them to face challenging ethical scenarios. These issues, in turn, have also affected the psychological well-being of health care workers.Copyright © The Author(s) 2021.

Covid-19 and University Distance Learning in Spain. The Practical Case of Journalism and Communication Degrees

The coronavirus crisis modified work routines in all professional fields, including university education with the temporary closure of academic buildings. Spanish universities continued to function despite the restriction of movement (State of Alarm Decree of 14 March 2020) as the teaching staff modified their routines by adjusting their theoretical and practical teaching procedures to the requirements of non-classroom teaching. This article is an approach to the perceptions and experience of university lecturers during the pandemic and the post-pandemic stage. Methodologically, it compares the case study previously carried out in the Faculty of Social Sciences and Communication of Pontevedra (Gomez Lopez and Alende Castro, 2022) with the findings of the present publication provided by lecturers from the universities of Navarra, Pontificia de Salamanca, Complutense de Madrid, Salamanca, Pompeu Fabra, La Laguna, Santiago de Compostela and A Coruna. The study involves a mixed methodology, with data collected from a standard questionnaire and an interview. The results show that the efforts made by Spanish teachers and higher education centres made up for the limitations of the physical classroom during the pandemic but transferred to the virtual classroom the resources of the face-to-face methodology. However, no significant progress was made in new teaching methodologies that would allow progress to be made towards more flexible educational models.

Risk of a major depressive episode in Colombian adults: Frequency and some associated variables during the COVID-19 pandemic

Introduction: The risk of a major depressive episode is a public health problem;however, the frequency during the coronavirus pandemic is unknown. Objective: To determine the frequency of the risk of a major depressive episode and its association with sociodemographic variables and cognitive social capital in Colombian adults during COVID-19 confinement. Method: A cross-sectional analytical study was conducted using an online questionnaire that explored demographic variables, cognitive social capital, and risk of a major depressive episode (General Well-being Index, WHO-5). Results: Seven hundred adults answered the questionnaire. They were between 18 and 76 years old (M= 37.1, SD=12.7), 32.1% were between 18 and 28 years old, 68% were women, 24.0% scored for low social capital, and 61.1% were categorized as high risk of a major depressive episode. Female gender (aOR=1.58, 95%CI 1.12-2.22), young age (18-29 years, aOR=3.82;95%CI 2.56-5.72), and low social capital (aOR=2.05, 95%CI 1.37-3.07) were associated with risk of a major depressive episode. Conclusions: The frequency of risk of the major depressive episode was high and was associated with the female gender, young age (18 to 28 years), and low social capital. It is necessary to corroborate these findings in a probabilistic sample of Colombians and, more frequently, to quantify social capital in research.

Pneumomediastinum and pneumothorax as extrapulmonary complications of pneumonia due to SARS-CoV-2.

BACKGROUND: Barotrauma is a lesion generated for changes in the pressure and/or volume within a specific anatomic way;pneumo-mediastinum and pneumothorax are clear samples of this effect, frequently related to infectious symptoms. CLINICAL CASES: Two clinical cases are presented, 34 and 44 years old, that had pneumonia due to COVID-19, with subsequent exacerbation of the symptoms caused by barotrauma. Patients were evaluated at emergency unit of the Hospital Angeles Pedregal, Mexico City;their clinical presentation was similar and was unleashed by repeated cough in the context of pneumonia due to SARS-CoV-2. CONCLUSION(S): Now there is more experience on the complications associated during COVID-19, although more cases must be study to know their prognostic meaning and, in case it becomes a progression marker of the illness, to establish specific measures and therapeutic recommendations. The presentation of pneumonia stands out despite the vaccination, having to get the general population make consciousness of continuing with measures of respiratory isolation.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.

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).

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.

Perceived privacy of the dwelling and psychological restoration during the COVID-19 lockdown

Dwelling is a fundamental factor for mental health. Lockdowns, established to contain the spread of SARS-CoV-2, forced millions of people to take shelter in their homes, enhancing the need to understand the characteristics of the dwelling that promote psychological restoration. In this paper, we analyze the relationship between some perceived conditions of dwelling habitability (appreciation of the physical environment, visible nature, crowding, and privacy) and their effect on psychological restoration through the concept of the perceived restorativeness of dwelling. An online survey was carried out with the participation of 478 Mexican adults. Physical environment, visible nature, crowding, and privacy showed significant correlations with the perceived restorativeness of housing and psychological restoration itself. However, only privacy showed an effect on psychological restoration in structural modelling. We propose that privacy is fundamental to improving dwellings' restorativeness and restoring their inhabitants, and experts should consider it when designing housing spaces. However, more evidence is needed to generalize beyond the context of lockdowns. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

A virtual reality platform for training in the management of acute respiratory diseases

Introduction: During the COVID-19 pandemic, alternatives to face-to-face teaching were on the urge. What's more, in the context of the respiratory support of COVID patients, the training and capacitation of personnel capable of taking care of these patients was critical. Aims and objectives: Develop a Virtual Reality (VR) app for remote training of medical staff in the management of different acute respiratory diseases, including COVID-19. Method(s): Pulmonologists and software developers designed an app based on a virtual hospital using VR glasses. The teacher programs different clinical scenarios, where the student can converse with the patient and explore him, observing the respiratory mechanics and the skin coloration, auscultating different noises in various cardiac and pulmonary foci, edema in the lower extremities, etc. The student can request different tests (blood analysis, radiography, etc.) and prescribe treatment, including oxygen therapy and respiratory support. The clinical situation of the patient can change during the simulation. Result(s): Different acute respiratory diseases were successfully simulated, with a correct interaction between the student and the teacher. Conclusion(s): VR can be used as a tool for the remote training of medical staff, and provide high fidelity simulations for training in a wide variety of clinical situations.

Multidimensional Assessment of Dyspnea in Postcovid Patients Referred to Pulmonary Rehabilitation

MULTIDIMENSIONAL ASSESSMENT OF DYSPNEA IN POSTCOVID PATIENTS REFERRED TO PULMONARY REHABILITATION In patients who suffer sequels after severe acute respiratory syndrome caused by Coronavirus 2 (SARS-CoV2), dyspnea is the most prevalent respiratory symptom. We aimed to analyze a subgroup of patients under follow-up in the pulmonology rehabilitation units after hospitalization for moderate-severe SARS-CoV2 pneumonia. We prospectively studied 455 patients until November 2021. We analyzed: dyspnea by mMRC scale, grade of fatigue by FACIT-F (0 without fatigue-4 intense fatigue), spirometry and DLCO, 6-minute walk test (Osses'equations), isometric strength of dominant quadriceps (weakness threshold <70%), maximal sniff nasal inspiratory pressure test (weakness thresholds <70 cmH2O for men and <60 cmH2O for women), body composition and physical activity IPAQ-7. We grouped our sample according to the severity of the mMRC dyspnea (>= 2 vs < 2) and results were compared for the global sample and separately for men and women. Table 1 shows the baseline characteristics. 41.5% of women and 19.5% of men showed inspiratory muscle weakness. 52.7% of the patients reported dyspnea mMRC >= 2 and studied variables were significantly worse (Table 2). In the women group, only the 6-minute walk distance, the level of physical activity and the fatigue grade were significantly worse in patients with greater dyspnea (Table 2). Conclusion(s): In our sample, multifactorial moderate-intense dyspnea becomes a good marker of functional capacity, muscle function, grade of fatigue and physical activity in patients who have suffered from moderate-severe Covid-19 pneumonia.

Interstitial pneumonia as a manifestation of COVID-19: case report [Version 1, Peer Review-In Progress]

Idiopathic interstitial pneumonia is a group of progressive diseases affecting the lower respiratory tract of unknown origin, characterized by diffuse alveolitis and disorders in the alveolar structures. We present a case of a 52-year-old male patient with a history of pulmonary nodule with suspected tuberculosis and a positive PCR test, who came to the clinic for a 15-day evolution, which is characterized by high termination and general malaise. Physical examination revealed dyspneic facies with semi fowler attitude and preserved psychomotor activity as well as the presence of dry oral mucosa, the other parameters were within normal. After several studies, a diagnosis of COVID-19 viral pneumonia and acute respiratory distress syndrome was made, given the severity of the patient, he was transferred to the ICU and treatment was started with oxygen therapy by mask with reservoir for SAT > 90 %, ringer's lactate 1000 cubic centimeters + 2 grams of vitamin C + 5 cubic centimeters of B complex (40 milliliters per hour) and antibiotic therapy with Piperacillin Tazobactam 4,5 grams in slow dilution over 3 hours every 6 hours. © Este es un artículo en acceso abierto, distribuido bajo los términos de una licencia Creative Commons.

Analysis of Survival in Patients with End-End Chronic Kidney Disease Switching from Peritoneal Dialysis to Hemodialysis Due to Refractory Peritonitis

Introduction: Peritonitis associated with peritoneal dialysis (PD) has complications such as transfer from PD to HD and increased morbidity and mortality. In our environment, there is little information regarding survival in this population. Method(s): Retrospective cohort, 147 PD patients, 18 years, with PD catheter removal between 2018-2021. Clinical, biochemical and technique-related variables were measured. Patients who died of cancer and other unrelated causes were excluded. Descriptive statistics, Kaplan-Mayer analysis and Cox regression analysis were used Results: Age 42 +- 17 years, 65% men, 65% unknown cause of CKD. The time between peritonitis diagnosis and catheter removal was 37 (25-61) days. Nine patients (6%) returned to PD, the rest (94%) remained on HD due to unfit abdomen (55%), patient decision (9%), unknown (17%), others (19%). Mortality was 31% and the causes of death were: sepsis (33%), COVID-19 (29%), pneumonia (19%), pulmonary edema (5%), hyperkalemia (5%), CVD (5%), others (4%). Survival after the refractory peritonitis event was 25 (95% CI 22-28) months. Survival at 3, 12, 24, and 36 months was 87%, 71%, 61%, and 35%. In the bivariate analysis, age, DM, time on dialysis, and serum albumin were associated with a higher risk of death. However, in the multivariate analysis, only time on dialysis was significant (OR 1.014, 95% CI 1.002-1.027). [Formula presented] Conclusion(s): Mortality was 31% and the most frequent cause of death was sepsis. Patient survival was 25 (95% CI 22-28) months. Time on dialysis was associated with a higher probability of death. It is necessary to compare these results with a group of patients who do not present failure of the technique. No conflict of interestCopyright © 2023

Neonatal late-onset sepsis caused by SARSCoV2: a case report

INTRODUCTION: The disease caused by SARS-CoV-2, also known as COVID-19, is a recently identified disease with mainly respiratory involvement in adults. Reported Latin- American cases of COVID-19 in neonates are scarce. Clinical manifestations are unspecific in this age, with respiratory involvement around 40%. CLINICAL CASE: We report a hospitalized patient at the neonatal intensive care unit due to meconium aspiration and hypoxic-ischemic encephalopathy sequelae, in whom is diagnosed COVID-19 at 18 days of life. He presented fever and late onset neonatal sepsis and was considered as an acquired-hospital infection. CONCLUSION: The purpose of this report is to contribute to the clinical description of this entity and highlight the SARS-CoV-2 infection in the differential diagnosis in late onset neonatal sepsis, even in hospitalized patients, to detect and contain opportunely this disease. © 2023 Instituto Nacional de Pediatria. All rights reserved.

Effectiveness of the BNT162b2 mRNA Covid-19 Vaccine in Spanish Healthcare Workers.

INTRODUCTION: Frontline health care workers (HCW) have higher risk than the general population to become infected by SARS.CoV.2, so they were a priority group for Covid-19 vaccine administration. We compared the incidence and prevalence of HCW infected pre-and post- vaccination with the BNT162b2 mRNA COVID-19 vaccine. MATERIAL AND METHODS: Prospective observational study carried out between 01/12/20 and 07/03/21 in La Paz University Hospital, Madrid (Spain). SARS.CoV.2 positive cases in HCW after vaccination were collected and compared to those hospitalized COVID-19 patients at the same hospital. RESULTS: Two weeks after finishing the first round of vaccinations daily new cases of HCW infections (symptomatic and asymptomatic) decreased substantially and cumulative cases of infected HCW and hospitalized COVID-19 patients started to diverge. No new positive cases of HCW infection were registered seven days after the second dose of BNT162b2 mRNA COVID-19 vaccine. CONCLUSIONS: BNT162b2 mRNA COVID-19 vaccine is highly effective in Spanish HCW.

Challenges in higher education and mental health in university studentes in times of COVID-19

This article is part of the context of the ongoing research "Educational inequalities, representations and experiences of university education in times of COVID-19 and post COVID-19", of the Directorate of Research and Development (DIDE) UTA, Ecuador. This work analyzes various investigations carried out in countries such as: Mexico, Peru, Spain, Chile, the Caribbean, and Colombia. In contexts of Higher Education in the framework of the COVID-19 Pandemic. Teachers, students and society in general experienced significant changes in their daily lives. On the one hand, the teachers of the Higher Education Institutions had to change or adapt the components of the curriculum such as the teaching methodology in online mode. The digital divide versus, the way to teach classes and pre-professional practices in person in physical classrooms. On the other hand, students consider that teachers are not prepared for this type of study. In addition, they consider that not all students have access to virtual education. The economic and technological aspect, as well as the physical interaction with peers and teachers, plays a very important role in times of pandemic. To all these variables are added the mental health of the students. Who were affected to a greater extent than teachers. Being the pictures: depressive, anxious the most common in the student community. Therefore, stress levels were also elevated in populations of university students before the Covid-19 pandemic.

The impact of maternal stress on placental pathology at delivery in COVID-19 patients

Objectives: The COVID-19 pandemic has placed unprecedented stress on many populations, particularly pregnant women. Maternal adversity has been shown to impact fetal development by way of placental perturbations. The aim of this study is to characterize the impact of maternal stress from the COVID-19 pandemic on placental pathology at delivery and on perinatal outcomes. Method(s): We recruited women with singleton pregnancies in a prospective, observational study on the impact of the COVID-19 pandemic on maternal-fetal wellness. Pregnant women completed a series of validated mental health questionnaires, namely the Speilberger State-Trait Anxiety Inventory (SSAI-S, state anxiety, SSTAI-T, trait anxiety) and the Perceived Stress Scale (PSS). Standardized placental pathologic examinations were performed and assessed using the Amsterdam classification scheme. Maternal mental health assessments and placental weight were analyzed using linear regression and group differences were assessed using student's t-test. Result(s): Thirty-one pregnant women with singleton pregnancies were recruited at a mean gestational age (28.48 +/- 13.34 weeks);of these, 5 (16%) had documented COVID-19 infection in pregnancy. Mean GA at birth was 39.45 +/- 1.49 weeks;14 (45%) of infants were male. Maternal mental health questionnaires were available for 24 women. Maternal anxiety state was significantly associated with increased placental weight at delivery, while anxiety trait and stress did not reach statistical significance (placental weight vs. STAI-S: p = 0.04, vs. STAI-T: p = 0.07, vs. PSS: p = 0.398);Figure 1A-C. Pregnant women with COVID-19 had greater placental weight compared to pregnant women without COVID-19 exposures (p = 0.025);Figure 1D. Conclusion(s): In this cohort, maternal anxiety and positive COVID-19 status have been associated with increased placental weight. Previous studies of increased placental weight have been associated with altered nutritional and endocrinologic functions of the placenta and subsequent fetal programming. The impact of maternal mental distress and disrupted placental growth on short-and long-term infant outcomes are currently underway. Optimizing maternal and fetal care, as well as perinatal outcomes, during the COVID-19 pandemic will require establishing stronger associations between pandemic stress, SARS-CoV-2 infections, and placental pathology.

Impact of the COVID-19 Pandemic on Antibiotic Use among Hospitalized Adults in Argentina, Brazil, and Chile

Background. Reports showing high rates of antibiotic use (AU) in patients with coronavirus disease 2019 (COVID-19) despite low rates of secondary bacterial infection have emerged from various countries across the globe. We evaluated the impact of the COVID-19 pandemic on AU in healthcare facilities (HCFs) in Argentina, Brazil, and Chile. Methods. We conducted an ecologic evaluation of AU in inpatient adult acute care wards (excluding maternity wards) in 6 HCFs in Argentina, Brazil, and Chile;2 HCFs per country. AU data for intravenously administered antibiotics commonly used to treat respiratory infections were collected from pharmacy dispensing records and aggregated to monthly defined daily dose (DDD)/1000 patient days. Graphs were created to depict AU and COVID-19 discharges over time throughout the 36-month study period (03/2018-02/2021). Relative changes in AU for all antibiotics combined and specific classes were calculated by comparing median AU for the 24-month prepandemic period (3/2018-2/2020) with the 12-month pandemic period (3/2020-2/ 2021). Only statistically significant differences (P< 0.05) determined by the Wilcoxon signed-rank test are reported. Results. Compared to the pre-pandemic period, the use of all included antibiotics combined increased in 4/6 HCFs (6.7-35.1%). In the 4 HCFs that experienced increases in AU, Figure 1 shows that use was high during months when COVID-19 patient surges occurred. In 3/4 of these HCFs, AU remained high despite significant decreases in COVID-19 discharges. Ceftriaxone use increased in 2/6 HCFs (27.1- 51.6%). Use of beta-lactam antibiotics with activity against Pseudomonas aeruginosa increased in 3/6 HCFs (31.3-82.5%) and decreased in 1/6 HCFs (-18.9%). Vancomycin and linezolid use increased in 3/6 HCFs (36.9-77.1%). Conclusion. Increases in AU among hospitalized adults were observed in 4 of 6 South American HCFs included in this study. The high rates of broad-spectrum antibiotic use in the HCFs may impact further emergence of antibiotic resistance. Understanding how this increase in antibiotic use compares to rates of bacterial infections during this time period is critical. (Figure Presented).

Effectiveness of a flash glucose monitoring systems implementation program through a group and telematic educational intervention in adults with type 1 diabetes

Objectives: Verifying the clinical effectiveness and the impact on quality-of-life parameters, fear of hypoglycaemia and satisfaction with the treatment obtained with a flash glucose monitoring (MFG) devices implantation program that includes a telematic and group educational intervention in adults with type 1 diabetes. Patients and Methods: Prospective quasi-experimental study, carried out during the COVID-19 pandemic period with a 9-month follow-up at the Virgen Macarena University Hospital, Sevilla. Result(s): Eighty-eight participants were included (men: 46.6%;mean age (years) 38.08, SD: 9.38);years of DM1 evolution: 18.4 (SD: 10.49);treatment with multiple doses insulin (MDI) 70.5% vs 29.5% subcutaneous insulin infusion therapy (CSII)). Baseline HbA1c was 7.74% (1.08). After the intervention, the global decrease in HbA1c was -0.45% (95% CI [-0.6, -0.25], P<.01), increasing to -1.08% in the group that started with HbA1c>=8% (P<.01). A mean decrease in the Fear of Hypoglycemia 15 (FH15) test score of -6.5 points was observed (P<.01). In the global score of the spanish version of Diabetes Quality Of Life (DQOL-s) test, the decrease was -8.44 points (P<.01). In Diabetes Treatment Satisfaction Questionnaire test (DTQ-s), global score increased in + 4 points (P<.01). Conclusion(s): The incorporation of an educational program in group and telematic format within the development of MFG devices implantation strategies is an effective option, with associated benefits in quality of life and fear of hypoglycemia in adult patients with DM1. This option can be implemented in usual clinical practice. Copyright © 2021 SEEN y SED

Kidney Function After SARS-CoV-2 Infection in Patients With and Without AKI During Hospital Admission in Western Mexico

Background: Kidney damage in COVID-19 patients has been of special concern. Kidney function after COVID-19 has not been comprehensively studied, and there is scarce information comparing kidney function among patients with or without AKI during hospital admission. Method(s): Retrospective cohort study in a secondary level center in Guadalajara, Mexico. Patients who were admitted due to COVID-19 from April-December 2020 and who survived at discharge and who had at least one follow-up visit in the outpatient clinic 6 months after initial symptoms were included. Information was obtained from outpatient electronic medical files. Result(s): From a total of 1085 patients, 733 survived at discharge. 113 had AKI during admission and only 33 (29.2%) had any kind of outpatient follow-up. Their mean age was 60.6 years, 63.6% were men, 48.4% had DM and 66.6% had HTN. Mean baseline SCr was 0.82 mg/dL with a mean eGFR of 90.82 ml/min. On follow-up mean stable SCr increased to 1.49 mg/dL, with a mean eGFR of 65.71 ml/min, a mean decrease of 25.11 ml/min. 15 patients (45.45%) developed CKD and 1 patient (3.03%) started RRT. Mean follow-up time was 451 days. 34 patients with no AKI during admission had a follow-up visit;mean age was 58.1 years, 58.8% were men, 47.1% had DM and 70.6% had HTN. Mean baseline SCr was 0.78 mg/dL and mean eGFR was 92.33 ml/min. On follow-up mean stable SCr increased to 0.86 mg/dL, with a mean eGFR of 86.64 ml/min, a mean decrease of 5.69 ml/min. 1 patient (2.94%) developed CKD and none required to start RRT. Mean follow-up time was 468 days. Conclusion(s): AKI during COVID-19 was associated to a significant decrease in eGFR on follow-up. Those with COVID19 without AKI during admission also had a small decrease in eGFR on follow-u. Timely and more intense follow-up strategies after COVID19 and AKI are needed.