Clinical Associations and Trajectory of "long COVID"

Background. Persistent symptoms after acute COVID-19 are being increasingly reported. To date, little is known about the cause, clinical associations, and trajectory of "Long COVID". Methods. Participants of an outpatient clinical trial of Peginterferon-Lambda as treatment for uncomplicated SARS-CoV-2 infection were invited to long term follow-up visits 4, 7, and 10 months after initial COVID-19 diagnosis. Ongoing symptoms and functional impairment measures (work productivity and activity index (WPAI), NIH toolbox smell test, 6-minute walk test) were assessed and blood samples obtained. "Long COVID" was defined as presence of 2 or more typical symptoms (fatigue, hyposmia/hypogeusia, dyspnea, cough, palpitations, memory problems, joint pain) at follow up. Associations between baseline characteristics, initial COVID-19 clinical course, and presence of "Long COVID" during follow-up were assessed using generalized estimating equations accounting for repeated measurements within individuals. Results. Eighty-seven participants returned for at least one follow-up visit. At four months, 29 (34.1%) had "Long COVID";19 (24.7%) met criteria at 7 months and 18 (23.4%) at 10 months (Figure 1). Presence of "Long COVID" symptoms did not correlate significantly with functional impairment measures. Female gender (OR 3.01, 95% CI 1.37-6.61) and having gastrointestinal symptoms during acute COVID-19 illness (OR 5.37, 95% CI 1.02-28.18) were associated with "Long COVID" during follow-up (Figure 2). No significant associations with baseline immunologic signatures were observed. Conclusion. "Long COVID" was prevalent in this outpatient trial cohort and had low rates of resolution over 10 months of follow up. Female sex and gastrointestinal symptoms during acute illness were associated with "Long COVID". Identifying modifiable risk factors associated with the development of persistent symptoms following SARS-CoV-2 infection remains a critical need.

Valladolid 2020 urban master plan, on the sunny side of the street

This paper presents the main ideas of the recent Urban Master Plan of Valladolid city, approved in 2020. The text addresses its main strategic proposals about the city model, urban structure and infrastructures, putting them in relation to previous planning and future urban challenges. Special emphasis is placed on the need to build a friendly city for citizens, expressive of rights. From a more technical point of view, land classification is described and the main characteristics of the planning and normalization of urban determinations are presented. The paper also summarizes, in a self-critical way, the process of preparing the plan and the public participation. Finally, and in relation to the challenges revealed by the COVID-19 pandemic, there is reflection on its impact in the city and the promotion of urban resilience. © 2021, Ministerio de Fomento. All rights reserved.