Spanish Primary School Teacher's digital competence in the midst of the COVID-19 pandemic

As a consequence of the COVID-19 pandemic, the digital competence of teachers has become the backbone of education. Despite this, the studies carried out on it in Primary Education Teachers are still a minority. In order to fill the observed gap, this research examines the perceptions, beliefs and uses of 281 Primary Education Teachers aged between 21 and 51 years of age, from public, private and subsidized schools in the national territory, about the use of ICT, participating through the completion of an ad hoc online questionnaire, the CDMEP. The results show that digital competence is inversely correlated with age, as well as its development being conditioned by years of professional experience, at the same time that statistically significant differences are evidenced based on gender. In the light of these findings, the limitations are discussed, and new lines of future research are proposed. © 2022 Grupo de Investigacion FORCE. All rights reserved.

EVALUATION OF THERAPEUTIC VS PROPHYLACTIC ANTICOAGULATION IN NONCRITICALLY ILL PATIENTS HOSPITALIZED WITH COVID-19 PNEUMONIA

SESSION TITLE: Late Breaking Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Initial reports of COVID-19 autopsies revealed significant evidence of micro and macrovascular thrombosis. Due to concern for increased thrombotic events, many institutions implemented anticoagulation (AC) protocols for hospitalized patients. The study’s objective is to evaluate disease progression in patients treated with therapeutic anticoagulation vs. prophylactic anticoagulation in noncritical COVID-19 hospitalized patients. METHODS: We performed a retrospective cohort study of adults hospitalized with COVID-19 pneumonia between March 1-May 1, 2020. Inclusion criteria was any adult patient directly admitted to non-intensive care setting for radiologically confirmed COVID-19 pneumonia. T-test was performed for the continuous variables with normal distribution. Wilcoxon-rank-sum test for non-parametric groups. Chi-squared test for categorical variables. P-value <0.05 was considered statistically significant. RESULTS: Overall, 81 (34%) received therapeutic AC, and 159 (66%) subjected received prophylactic AC. The clinical characteristics of the therapeutic group included: average age 57.8 (vs. 55.7), 77.78% male (vs. 72.92%), 40.74% obese (vs. 37.92%), 64.74% had hypertension (vs. 40.88%), 44.44% had Diabetes Mellitus (vs. 37.92%) and 11.11% had chronic kidney disease (vs. 13.84%). Initial inflammatory markers were higher in therapeutic group vs. prophylactic, including D-dimer (845 vs 361ng/dL), Ferritin (918.5 vs. 632ng/mL), and CRP (20 vs. 11.2mg/dL). The average length of stay (LOS) of the therapeutic group was 10 days (vs. 7 for prophylactic), and a higher number of patients required mechanical ventilation (36 vs. 23), and hemodialysis (18 vs. 6). A higher number of adverse events (bleeding) was noticed in the therapeutic group (13.58% vs. 2.52%) with a p-value of <0.001. Higher odds of In-Hospital mortality observed in therapeutic group subjects with Hypertension (OR=5.41), chronic kidney disease (OR= 4.08), and lung disease (OR= 2.87) with a p-value of <0.05. CONCLUSIONS: In noncritically ill patients with COVID-19, treatment with therapeutic AC was related to greater LOS, requiring mechanical ventilation, hemodialysis, and adverse effects compared to prophylactic AC. We also observed a significantly higher D-dimer, ferritin, and CRP in the therapeutic group. RCT performed by ACTIV-4a investigators demonstrated increased organ support-free days in the therapeutic group, contrary to our study, which showed increased dependence of respiratory support and hemodialysis. Our therapeutic group patients appear to have higher comorbidities and significantly elevated initial inflammatory markers compared to the prophylactic group, which may explain these differences. CLINICAL IMPLICATIONS: Finally, our study supports the use of therapeutic anticoagulation depending on the patient overall clinical scenario. DISCLOSURES: No relevant relationships by Adebola Adetiloye No relevant relationships by Jennifer Arzu No relevant relationships by Kuldeep Ghosh No relevant relationships by Gabriel Ibarra no disclosure on file for Armeen Poor;No relevant relationships by Ingrid Portillo No relevant relationships by Fernando Quesada Mata No relevant relationships by Natoushka Trenard No relevant relationships by Julio Valencia Manrique

Spanish Primary School Teacher's digital competence in the midst of the COVID-19 pandemic

As a consequence of the COVID-19 pandemic, the digital competence of teachers has become the backbone of education. Despite this, the studies carried out on it in Primary Education Teachers are still a minority. In order to fill the observed gap, this research examines the perceptions, beliefs and uses of 281 Primary Education Teachers aged between 21 and 51 years of age, from public, private and subsidized schools in the national territory, about the use of ICT, participating through the completion of an ad hoc online questionnaire, the CDMEP. The results show that digital competence is inversely correlated with age, as well as its development being conditioned by years of professional experience, at the same time that statistically significant differences are evidenced based on gender. In the light of these findings, the limitations are discussed, and new lines of future research are proposed.

Interdisciplinary analysis of the legal consequences economic in the health situation

In this instalment the author determines and develops the various causes and consequences of the economic legal effect of the global pandemic, from an approach not only from the legal grounds, but also from the balcony of multidisciplinarity. That is, the administration, philosophy.

COVID-19 impact on elderly hemodialysis population: Results from the Spanish COVID-19 CKD working group registry

BACKGROUND AND AIMS: Age and chronic kidney disease have been described as mortality risk factors for coronavirus disease 2019 (COVID-19). Currently, an important percentage of patients in hemodialysis are elderly. This study aimed to investigate the impact of COVID-19 in this population and to determine risk factors associated with mortality. METHOD: Data was obtained from the Spanish COVID-19 CKD Working Group Registry, that included patients in renal replacement therapy (dialysis and kidney transplantation) infected by COVID-19. From March 18, 2020, to August 27, 2020, 1165 patients on hemodialysis affected by COVID-19 were included in the Registry. A total of 328 patients were under 65 years-old and 837 were 65 years old or older (elderly group). RESULTS: Mortality was 18.6% higher (95% confidence interval (CI): 13.8%-23.4%) in the elderly hemodialysis patients compared to the non-elderly group (see figure). Death from COVID-19 infection was increased 5.5-fold in hemodialysis patients compared to mortality in the general population for a similar period, and there was an age-associated mortality increase in both populations (see figure 1). In multivariate Cox regression analysis, age (hazard ratio (HR) 1.58, 95% CI: 1.31-1.92), dyspnea at presentation (HR 1.61, 95% CI: 1.20-2.16), pneumonia (HR 1.76, 95% CI: 1.12-2.75) and admission to hospital (HR 4.13, 95% CI: 1.92-8.88) were identified as independent mortality risk factors in the elderly hemodialysis population. Treatment with glucocorticoids reduced the risk of death (HR 0.71, 95% CI: 0.51-0.98) in aged patients on hemodialysis. CONCLUSION: Mortality is dramatically increased in elderly hemodialysis patients affected by COVID-19. Age, dyspnea at presentation, pneumonia or hospitalization are factors associated with a worse prognosis, after adjusting dialysis population to other confounding factors. Treatment with glucocorticoids could be a therapeutic option for this specific population. (Table Presented).

A case of saddle pulmonary embolism in the recovery phase of COVID-19 infection

Introduction: COVID-19 is an infection caused by severe-acute-respiratory syndrome coronavirus-2 (SARS-CoV-2).1 Many recent reports have shown an increased risk of venous thromboembolism (VTE)4-5. Despite therapeutic anticoagulation with elevated D-dimer is widely described7, data on post-discharge prophylactic anticoagulation is limited.Case report: A 52-year-old female presented with 1-day mid-sternal chest pain and difficulty breathing. Her medical history included type-2-Diabetes Mellitus, obesity, and a hospital admission 4 weeks prior for COVID-19. She received Ceftriaxone, Azithromycin, Hydroxychloroquine, and prophylactic anticoagulation. She remained stable, with no fever or oxygen requirements and was discharged home to selfquarantine. She returned to the hospital, describing pain as sharp, constant, mild, radiating to left chest and back, aggravating on lying down and alleviating on leaning forward. Physical exam was normal, with no tachycardia, tachypnea, or hypoxemia. D-dimer was elevated (6834ng/dL), with normal troponin-T and pro Btype natriuretic peptide. In light of the findings, a contrasted Chest-CT was performed, showing a saddle pulmonary embolus (PE) in left pulmonary artery and non-obstructing thrombus in right main pulmonary artery. Electrocardiogram showed sinus rhythm and right-bundle-branch block, but no “S1Q3T3 pattern”.Patient was admitted to ICU and received enoxaparin. COVID-19 was negative. She remained hemodynamically stable. Lower extremities venous duplex scan was negative for DVT, echocardiogram reported normal ventricular function and dilation of inferior vena cava, consistent with elevated right atrial pressure. Patient was discharged on apixaban.Discussion: Several COVID-19 case-studies have highlighted the association with VTE4-5. During SARSCoV-1 epidemic the reported incidence of DVT and PE was 20% and 11% respectively10. The underlying pathophysiology is probably related to excessive inflammatory response “cytokine storm” and microvascular thrombosis. It is known that infections, either viral, bacterial or fungal can activate immune-thrombotic pathways as initial inflammatory response. However, in COVID-19, such response is disproportioned. McGonagle6 described that the tropism for angiotensin-converting enzyme 2 expressed on type-II pneumocytes and the proximity of these cells to vasculature, combined with the aforementioned inflammation may play the main role. Is COVID-19 a risk factor for PE at the recovery phase of the disease? When are the patients at the highest risk for VTE? Should COVID-19 PE be treated as provoked? Can D-dimer be relied upon as indicator for anticoagulation initiation in these settings? and if so, at what levels? Should COVID-19 patients be discharged on prophylactic anticoagulation? As more patients are being treated, COVID-19's role as risk factor for VTE in the recovery is still unclear.

Reactive injuries in the oral cavity associated to sars-cov-2

The virus called SARS-COV-2 is a beta RNA positive-chain coronavirus. Several types of coronaviruses are known to infect humans, including the Middle East Acute Respiratory Syndrome (MERS-COV) HCOV-OC43, HCOV-NL63, HCOV-229E, among others. During SARS-COV-2 infection, skin and mucosal lesions occur as secondary reactive manifestations due to deterioration of the systemic condition, the possibility of opportunistic infections, or adverse reaction to given treatments. Due to the presence of multiple recep-tors in the respiratory tract, the lungs have been identified as the primary sites of infection, which leads to severe acute respiratory syndrome in severe cases. The immune response is measured by a variety of host factors, as well as by the activation of interleukins, cytosine, and chymosin, which can lead to skin and oral lesions. This article identifies and describes reactive lesions in the oral cavity observed in patients with SARS-COV-2 in order to help health professionals and patients recognize manifestations of the disease more immediately.