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Background. Infection with SARS-CoV-2 and the resulting host immune response has been primarily characterized in middle and older aged populations due to a higher incidence of symptoms in these age groups. Due to reduced severity of disease, children were poorly studied and assumed to be less frequently infected compared to older age groups. We measured the viral load and adaptive immune response across the age-spectrum to define the age-dependent viral and host responses. Methods. From March 2020-March 2022, we enrolled individuals across the age spectrum who presented to U.S. military medical treatment facilities with COVID-19-like symptoms. In this longitudinal cohort study, demographic and clinical data were collected in addition to nasopharyngeal swabs and peripheral blood. Magnitude of viral RNA was measured by quantitative PCR (qPCR) from nasopharyngeal samples and SARS-CoV-2-specific IgG antibodies were measured from blood with multiplex microsphere immunoassays. Results. 4,768 SARS-CoV-2 positive participants were enrolled, among whom 42, 64, 89, 380, 948 and 245 individuals were in age brackets 0-4y, 5-11y, 12-17y, 18-44, 45-64y, and >65y, respectively. Viral load as measured by qPCR was determined to be similar across age groups within the first week post symptom onset. The magnitude of the IgG antibody response against the spike protein was also compared across age groups at early and convalescent time points and was higher in those over the age of 65 years. Conclusion. Early viral load during acute infection did not correlate with age in individuals who experienced COVID-19. These findings diverge from other respiratory viruses, such as respiratory syncytial virus and influenza where children tend to have higher viral loads. In contrast, the magnitude of the antibody response against the spike protein correlated with older age at acute and convalescent time points. Together our data suggest that the host response against SAR-CoV-2 differs with age and is not associated with the acute viral load. Defining age-dependent immunity against SARS-CoV-2 has the potential to identify key immunologic responses that can be used to optimize treatment and vaccine strategies.
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The receptor-binding domain (RBD) of SARS-CoV-2 Spike protein constitutes the key access for the virus inside the host cell. A positive correlation between titers of anti-RBD immunoglobulin G and antibodies (Ab) capable of neutralizing the virus has been demonstrated. In this context, passive immunotherapies such as convalescent plasma and hyperimmune equine serum have gained relevance as therapies against COVID-19. Another promising alternative is the use of polyclonal Ab from llamas (Lama glama), because of their unique features. For this reason, we aimed to obtain recombinant RBD as an immunogen to generate anti-RBD Ab in llamas. To achieve this, HEK 293 cells were transfected and transduced with the RDB encoding sequence, resulting in higher yields with this last method. The RBD was purified by affinity chromatography. An immunization schedule was designed and evaluated on two male animals, which were initially inoculated with RBD, followed by periodical boosters. Exploratory bleedings were performed in order to evaluate the reached titers, and larger bleedings in order to obtain enriched plasma with anti-RBD Ac. Ac quantification was accomplished by an in-house ELISA. Results showed that the immunization scheme was successful, achieving a maximum titer of 168000 at 28 days post-immunization. The results lay the foundations for the production of polyclonal anti-RBD Ab.
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Despite worldwide efforts to develop different treatments for SARS-CoV-2 COVID-19, the situation remains critical, requiring rapid and effective strategies. In this regard, antibodies (Ab) have demonstrated clinical potential. Among them, camelid nanoAb (VHH) arise as a possible alternative, as they recognize epitopes which are inaccessible to conventional Ab. Further advantages of VHH are their small size, high solubility, high stability, and resistance to low pH. The aim of this work is to describe a purification scheme of different isotypes of anti-SARS-CoV-2 immunoglobulin G (IgG) produced after immunizing two llamas (Lama glama). To achieve this, plasma was injected into an affinity chromatographic column (Protein G), and the resulting fractions were analyzed by SDS-PAGE under non-reducing conditions. The anti-RBD titers were determined by an “in house” ELISA, reaching titers of 52000 and 13000 for IgG1 and IgG3 fractions, respectively. Subsequently, an affinity column (HiTrap NHS-activated) was prepared to separate monospecific anti-RBD polyclonal Ab. RBD produced in our laboratory was covalently coupled to this column, achieving a coupling efficiency of 97%. Different isotypes of monospecific anti-RBD Ab (IgG1: 140 kDa and IgG3: 95 kDa) were obtained. IgG3 represent the starting point for obtaining VHH and/or evaluating their potential use as a therapeutic or preventive alternative, which represents a notable regional contribution in the fight against COVID-19.
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The COVID-19 pandemic and the increase of working-from-home have drastically changed many aspects of work life, causing very negative effects on employees' physical and psycho-social well-being. Healthy organisations have healthy employees, who have at least five psycho-social strengths of engagement, self-efficacy, resilience, optimism and hope, which are reinforced by physical activity, relating to each other in a positive way and leading to numerous benefits for the company. These strengths are being weakened by the pandemic, and the aim of this empirical study is to analyse through a case study the effects of an updated corporate wellness programme in times of pandemic on these strengths of the healthy employee. The sample was of 251 employees, 91 women and 160 men. The instruments used were the International Physical Activity Questionnaire and the adaptation of the Healthy and Resilient Organization questionnaire. The results indicated that workers with high physical activity, higher seniority, well guided by supervisors, as well as a comprehensive (multi-component) well-being programme, not only physical but also psycho-social, and with the use of different digital tools (an App is not enough), can mitigate these negative effects. Whereas companies are grappling with reduced employee engagement among other harmful psychosocial and physical effects, this case study suggests that a good corporate well-being programme could help mitigate these detrimental consequences for their workforce and be helpful for the company to adapt to this rapidly changing workplace. This study considers the impact of immigration and ethnic diversity on government spending in 31 OECD countries over 25 years and compares the marginal effects for expenditures and revenues to approximate the fiscal burden. Results suggest that ethnic fractionalization, not immigration itself, has a negative impact on spending in the OECD. On the whole, immigrants tend to contribute more in taxes than they cause in expenditures, at least relative to the averages for the population as a whole, but this effect is reversed for immigrants from poorer countries. © 2022.
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INTRODUCTION: The impact of the SARS-CoV-2 pandemic on healthcare has already been described, since it has caused an increase in diagnostic delay and morbidity. Our objective was to assess its influence on the development of complications in children with acute appendicitis. MATERIALS AND METHODS: A retrospective cohort study was carried out. It included acute appendicitis patients under 15 years of age treated from January 1, 2019 to December 31, 2020. They were classified according to diagnosis date as before the pandemic (B) (January 2019-February 2020) and during the pandemic (D) (March 2020-December 2020). According to operative findings, they were classified as complicated appendicitis (perforated/abscess/plastron/peritonitis) and non-complicated appendicitis (catarrhal/phlegmonous/gangrenous). Demographic data, progression time, and postoperative complications were analyzed. RESULTS: A total of 309 patients were included, 193 (62.5%) in Group B, and 116 (37.5%) in Group D, with an age of 9.2 ± 0.4 and 9.4 ± 0.6 years, respectively (CI = 95%). Diagnostic time was 1.35 and 1.43 days (p>0.05) in Groups B and D, respectively, with ≥ 3 days representing 15.5% of cases in Group B, and 16.4% of cases in Group D (p = 0.84). The proportion of complicated appendicitis was 23.3% in Group B vs. 21.6% in Group D (p>0.05). Postoperative complications were observed in 11.4% of patients in Group B, and in 13.8% of patients in Group D (p>0.05), with intra-abdominal abscess being the most frequent complication in both groups (54.5% of the total complications in Group B vs. 65.5% in Group D; p>0.05). CONCLUSIONS: The management of acute appendicitis and its complications in pediatric patients has not been impacted by the SARS-CoV-2 pandemic or the safety measures enforced.
INTRODUCCION: Se ha descrito el impacto de la pandemia del SARS-CoV-2 en la atención sanitaria, al suponer un aumento del retraso diagnóstico y morbilidad. Nuestro objetivo es evaluar su influencia en el desarrollo de complicaciones en las apendicitis agudas en niños. METODOLOGIA: Estudio retrospectivo de cohortes, incluyendo los pacientes menores de 15 años tratados por apendicitis aguda desde 01/01/2019 hasta 31/12/2020. Se distribuyeron según su fecha de diagnóstico en: antes de la pandemia (A) (enero/2019-febrero/2020) y durante la pandemia (P) (marzo-diciembre/2020). Según los hallazgos quirúrgicos se clasificaron en: apendicitis complicadas (perforadas/abscesos/plastrones/peritonitis) y no complicadas (catarrales/flemonosas/gangrenosas). Se analizaron datos demográficos, tiempo de evolución y complicaciones postoperatorias. RESULTADOS: Se incluyeron un total de 309 pacientes, 193 pacientes (62,5%) en el grupo A y 116 (37,5%) en el P, con edades de 9,2 ± 0,4 y 9,4 ± 0,6 años respectivamente (IC = 95%). Los días al diagnóstico fueron 1,35 y 1,43 (p>0,05) en A y P respectivamente, siendo ≥ 3 días en 15,5% de A y 16,4% en P (p = 0,84). La proporción de apendicitis complicada fue un 23,3% en A vs. 21,6% en P; con p>0,05. Se observaron complicaciones postoperatorias en 11,4% de A y 13,8% de P (p>0,05), siendo la más frecuente el absceso intraabdominal en ambos grupos (54,5% del total de complicaciones vs 65,5%; en A y P respectivamente; p>0,05). CONCLUSIONES: La atención sanitaria de la apendicitis aguda y sus complicaciones en pacientes pediátricos no se ha visto modificada por la pandemia del SARS-CoV-2 o las medidas de seguridad adoptadas durante la misma.
Subject(s)
Appendicitis , COVID-19 , Laparoscopy , Acute Disease , Appendectomy , Appendicitis/complications , Appendicitis/epidemiology , Appendicitis/surgery , COVID-19/complications , Child , Delayed Diagnosis , Humans , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/surgery , Retrospective Studies , SARS-CoV-2ABSTRACT
The COVID-19 pandemic has changed our lives completely: social distancing, confinement, telework and above all, negative consequences on our mental and physical health caused mainly by increased physical inactivity and sedentarism. Up to 34% of employees were doing telework during lockdown in Spain, and 30% remained working remotely even afterwards. Companies have developed corporate wellness programs that have proven its positive results before the pandemic. The problem with the situation caused by this pandemic is that workers cannot exercise anymore in the workplace facilities, so if they want to take care of their health and well-being at home, they should go digital. The aim of this research is to show how a well-known Spanish fitness company, O2 Centro Wellness, has applied all its digital knowledge to help its partner company, Mahou-San Miguel, to adapt its wellness program into the new reality, developing a successful online corporate wellness program using a fitness app and other social media tools. This case study may help other companies around the world as telework is growing and corporate wellness programs should adapt to this new reality. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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INTRODUCTION: The SARS-CoV-2 pandemic brought about a reduction in surgical activity. The objective of this work was to analyze its impact on inguinal hernia morbidity. MATERIAL AND METHODS: A retrospective study of cases and controls was carried out. Patients under 18 months of age undergoing inguinal hernia surgery from January 1, 2019 to August 31, 2020 were included. They were divided into two groups: patients undergoing surgery before (group A) or after (group D) the state of alarm was declared in Spain. Primary variables: episodes of incarceration and postoperative complications. Secondary variable: urgent or scheduled surgery. Demographic variables: sex, gestational age (GA), previous pathologies, age at diagnosis (AD), and age at surgery (AS) (months). RESULTS: 64 patients were included - 43 in group A and 21 in group D. In group A, median GA was 37+3, 90.5% of patients were male, median AD was 2.33, and median AS was 3.27. In group D, median GA was 31+2, 72.1% of patients were male, median AD was 3, and median AS was 3.63. There were no statistically significant differences. However, differences in terms of previous pathologies were significant (16.3% for Group A vs. 38.1% for group D) (p = 0.05). Regarding the primary variable, 25.6% of patients in group A had incarcerations vs. 33.3% of patients in group D (p = 0.51), whereas 9.3% of patients in group A had postoperative morbidity vs. 14.3% of patients in group D (p = 0.41). Regarding the secondary variable, 88.4% of surgeries in group A were scheduled vs. 90.5% of surgeries in group D (p = 0.583). CONCLUSION: In spite of reduced surgical activity, inguinal hernia morbidity did not surge in our environment. An increase in patients with previous pathologies was noted, which means severe patients should be prioritized.
INTRODUCCION: La pandemia del SARS-CoV-2 supuso una reducción de las jornadas quirúrgicas. Analizamos el efecto en la morbilidad de la hernia inguinal. MATERIAL Y METODOS: Estudio retrospectivo de casos y controles. Incluimos menores de 18 meses intervenidos de hernia inguinal desde 01/01/2019 hasta 31/08/2020, divididos en 2 grupos: intervenidos antes (grupo A) o después (grupo D) de la declaración del estado de alarma. Variables principales: episodios de incarceraciones y complicaciones postoperatorias. Variable secundaria: intervención urgente o programada. Variables poblacionales: sexo, edad gestacional (EG), patología previa, edad al diagnóstico(ED) y a la intervención (EI) (meses). RESULTADOS: Incluimos 64 pacientes, 43 grupo A y 21 grupo D. En el grupo A la mediana de EG fue 37+3, el 90,5% fueron varones, la mediana ED fue 2,33 y EI 3,27. En el grupo B la mediana de EG fue 31+2, el 72,1% fueron varones, la mediana ED fue 3 y EI 3,63. No hubo diferencias estadísticamente significativas. Si fueron significativas las diferencias en patología previa 16,3% A y 38,1% D (p = 0,05). Sobre la variable principal: 25,6% del A sufrieron incarceraciones frente a 33,3% del D (p = 0,51) y un 9,3% tuvieron morbilidad postoperatoria en A frente a 14,3% en D (p = 0,41). Respecto a la variable secundaria un 88,4% se realizaron de forma programada en el grupo A y un 90,5% en el grupo D (p = 0,583). CONCLUSION: Pese a la reducción de jornadas quirúrgicas no ha aumentado la morbilidad de la hernia inguinal en nuestro medio. Hemos observado un aumento de pacientes con patología previa, implicando la priorización de los pacientes más graves.
Subject(s)
COVID-19 , Hernia, Inguinal , Hernia, Inguinal/epidemiology , Hernia, Inguinal/surgery , Herniorrhaphy , Humans , Infant , Male , Pandemics , Retrospective Studies , SARS-CoV-2ABSTRACT
OBJECTIVES: Conducting contact tracing (CT) programs in low- and middle-income countries is challenging, and there is no evidence of their effectiveness in Latin America. We evaluated the effectiveness of CT on reducing fatality from COVID-19 in Colombia. STUDY DESIGN: The study design is a retrospective cohort study with nation-wide data of suspected and confirmed cases of severe acute respiratory syndrome (SARS-CoV-2) infection and their registered contacts. METHODS: We analyzed confirmed and suspected COVID-19 cases and their chains of contact using a nation-wide registry from March 28, 2020 to January 13, 2021. To estimate the effect of CT on fatality, we adjusted a multilevel negative binomial model using the number of deaths and the number of people within a chain of contacts as the outcome variable and offset variable, respectively. Sensitivity analysis was conducted using different cutoff values of contacts traced and a logistic model for the effect of CT on death at an individual level. RESULTS: We analyzed 1.4 million cases, 542,936 chains of contact, and 46,087 deaths. Only, 5.8% of total cases and contacts were included in a chain of a case and five or more contacts. We found that tracing of at least five contacts per case reduces fatality by 48% (95% confidence interval: 45-51), and, at the current levels of tracing in Colombia, it prevents 1.8% of deaths. Results obtained from the sensitivity analysis were consistent with the reduction of fatality at an individual level and higher protective effect with the higher number of contacts traced. CONCLUSIONS: In Colombia, tracing of at least five contacts per case reduces fatality from COVID-19. The coverage and intensity of tracing needs to be increased as a strategy to mitigate fatality in Colombia.
Subject(s)
COVID-19 , Contact Tracing , Colombia/epidemiology , Humans , Retrospective Studies , SARS-CoV-2ABSTRACT
COVID-19 has been an opportunity to improve the teaching of Social Responsibility at the UFV. The pandemic has increased the urgency of trustworthy mass media and that is something to be taught at University. Training in values such as ethics and social justice for journalism students can also be done through online service-learning. We proceed to make a description of the subject, as well as its curricular adaptation using new resources due to confinement. We carry out a qualitative analysis, applying Atlas.ti on the material produced by the students, to show how they have become agents of social change. The main consequence is the significant increase in the degree of social responsibility of the university student during the pandemic through different forms of communication from the usual ones. The pandemic has provided an opportunity to rethink the subject and has enriched the experience of the university student in the search for collaborative solutions and help, reinforcing their social commitment to the common good through on line learning. © 2021 Universidad de Murcia. All rights reserved.
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The research presents the background and foundation of the “Structured Virtual Learning Management System” of the Metropolitan University of Ecuador as a consequence of the measures adopted for the continuation of studies in the context of the Covid-19 pandemic. The system is conceived as the support to guarantee the conditions of implementation of the hybrid and online learning modalities;its faculty, technical team, resources and technological support. © 2020, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.
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Introduction: recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. Objective: to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: a rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection;b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.