Depression, Anxiety, and Stress Scale: Factor validation during the first COVID-19 lockdown in Mexico

Introduction: Globally, mental health problems have affected nearly 1 billion people and approximately 1 in 10 Mexicans. The detection and surveillance of depression, anxiety, and stress in Mexico requires more reliable and valid instruments. Objective: To determine the factor validity and internal consistency of the Depression, Anxiety, and Stress Scale-21 items (DASS-21) in a non-probabilistic national sample of Mexican adults. Method: Cross-sectional study by means of an online survey of 1 613 Mexican adults aged 18 years and older. The Spanish version of the DASS-21 was used, which evaluates the presence of depressive symptoms, anxiety, and stress. Factor validity was determined by comparing different confirmatory factor analysis models: one-dimensional, three factors (correlated and non-correlated), second or-der, and bifactor. Results: The application of the bifactor model to the DASS 21, supports its validity for identifying the presence of symptoms of depression, anxiety, and stress, as well as an altered general emotional state in a sample of Mexican adults. Conclusions: The DASS-21 is a theoretically robust instrument useful for research and clinical practice. © 2023 Fundación Universitaria Konrad Lorenz.

Long-Term Evolution of Kidney Function of Covid-19 Survivors Who Were Hospitalized and Did or Did Not Develop Acute Kidney Injury

Introduction: Hospitalized COVID-19 patients are at increased risk for acute kidney injury (AKI, incidence 0.5-80%), which contributes to increased morbidity and mortality. However, the long-term effect of COVID-19 on kidney function is unclear, particularly in populations with a high prevalence of chronic kidney disease like ours. The aim was to assess the evolution, at least 6 months after hospital discharge, of kidney function in COVID-19 survivors who were hospitalized and did or did not develop AKI (KDIGO criteria). Additionally, patient survival was analyzed. Method(s): Prospective cohort of surviving patients with confirmed COVID-19 diagnosis, treated in our hospital from 08/Mar/2020 to 16/Oct/2021. From the inpatient registry, survivors were contacted by telephone;those who agreed to participate had a clinical interview and measurement of biochemical variables, including estimated glomerular filtration rate (eGFR) and albumin/creatinine ratio (ACR) in a single urine sample. Result(s): Of 585 patients hospitalized for COVID-19 and discharged alive, 121 (21%) developed AKI. So far, 166 without AKI and 34 with AKI have been included. Patient evaluations were performed at a mean (+/-SE) of 20.0+/-0.3 months, and main comparisons between groups are shown in Table 1 and Table 2.Overall mean time survival (+/-SE) was 26.1+/-0.5 months, and comparison of survival according to the development of AKI is shown in Figure. [Formula presented] [Formula presented] [Formula presented] Conclusion(s): A fifth part of surviving patients hospitalized for COVID-19 developed AKI, 73% of them recovered kidney function upon discharge. Patients who developed AKI had lower kidney function throughout the study and a higher ACR at the end of follow-up compared to those without AKI;however, this latter group displayed a slight decrease in eGFR at the end of the study compared to its baseline value. Survival of patients was significantly lower in those with AKI, and it was worse in those with higher stages. No conflict of interestCopyright © 2023

Non-pharmaceutical interventions during COVID-19 in the UK and Spain: A rapid realist review

The paper is located at the crossroads of two modern intellectual movements. The first, evidence-based policy, seeks to locate vital information that will inform and improve key policy decisions on such matters as population health, social welfare, and human wellbeing. The second, complexity theory, describes the nature of the social world and perceives human action as persistently adaptive and social institutions as incessantly self-transformative. The first assumes that policies and programmes can achieve sufficient control to meet specific and measurable objectives. The second assumes that social actions are sufficiently capricious so that the society never conforms to anyone's plans - even those of the most powerful. The unparalleled resources committed to control the unprecedented attack of the COVID-19 pandemic are the epitome of complexity. The long struggle to contain the virus thus constitutes an ideal test bed to investigate this paradigmatic split. The paper undertakes this mission - focusing specifically on the effectiveness non-pharmaceutical interventions and examining evidence from the UK and Spain. © 2022 Serrano-Gallardo P et al.

[Pathogenic mechanisms of SARS-CoV-2 infection and kidney disease: a clinical and molecular perspective].

The SARS-CoV-2 infection has become as a worldwide public health emergency. It exhibits a variety of clinical presentations, ranging from benign to acute respiratory distress syndrome, systemic involvement, and multiorganic failure. The severity of the clinical picture depends on host and virus biological features and the presence of comorbidities such as chronic kidney disease. In addition, the interaction between the virus, angiotensin-converting enzyme 2, and the exacerbated immune response could lead to the development of acute kidney injury. However, the implications of SARS-CoV-2 infection on renal cells, the prognosis of patients with chronic kidney disease, and the long-term behavior of renal function are not entirely understood. This review aims to explore the role of SARS-CoV-2 in acute and chronic kidney disease and the possible pathogenic mechanisms of renal involvement.

Covid-19 pfizer-biontech vaccine-induced painless thyroiditis: A case report

Thyroiditis is an inflammatory process that can be triggered by infection, autoimmune diseases, medications, post-partum, and in very rare instances, vaccine adjuvants. In this case report, we focus on the latter cause of thyroiditis as we discuss a 35-year-old male who developed palpitations, heat intolerance, and night sweats after receiving the first dose of the COVID-19 Pfizer-BioNTech vaccine. Our patient presented with clinical symptoms of hyperthyroidism ten days after receiving the vaccine and he did not have a painful thyroid. Initial laboratory studies showed a suppressed TSH, elevated free triiodothyronine (FT3) and free thyroxine (FT4), elevated erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) and negative thyroid autoantibodies. Ultrasound showed a heterogenous thyroid with decreased vascularity and Radioactive Iodine Uptake and Scan had less than 5% uptake. Within two months, laboratory tests progressed into the thyroiditis pattern of transient hyperthyroidism followed by hypothyroidism. Based on imaging and laboratory results in conjunction with the clinical progression of our patient, we hypothesize that he developed vaccine-induced thyroiditis. Given the novelty of the COVID-19 vaccine, this hypothesis has yet to be validated by more reports of similar reactions in other patients. Before arriving to this diagnosis, we carefully evaluated for and excluded more common causes of painless thyroiditis including Hashimoto's, Graves' disease, and medication-induced thyroiditis. Interestingly, in recent months there have been reports of two females who developed Graves' disease three days after receiving the Pfizer vaccine (3) and one female who developed Subacute Thyroiditis five days after the same vaccine (16). A possible explanation for this autoimmune reaction is molecular mimicry due to the vaccine's spike glycoprotein having genetic similarities with a human heptapeptide (15). Additionally, this innovative vaccine contains a nanoparticle with polyethylene glycol lipid conjugates that has been reported to cause anaphylaxis and to induce autoimmune responses in susceptible patients (10-14). Although the numbers of CoVID-19 infections, and thus morbidity and mortality from this pandemic, have significantly decreased with vaccination, like with any other vaccine, adverse reactions will occur (17). We believe that as more patients get vaccinated, the data regarding vaccine-induced thyroid disease will increase.

Relationship of SARS-CoV-2 and chronic diseases of nutritional origin

The worldwide spread of the virus has claimed multiple lives, especially in vulnerable groups. Therefore, an investigation was carried out to present a viable solution for health personnel using the “JES” algorithm. The present study used the research to determine the possible complications presented by the sick individual, providing a viable and accessible healthcare personnel solution through the proposed “JES” algorithm. A non-experimental, descriptive, correlational, and explanatory research is presented. According to pathologies of interest, the articles were taken virtually from scientific journals present in Google Scholar and PubMed. The excluded publications were: articles that do not detail the established protocol for detecting SARSCoV-2, studies that do not present a significant number of people with Covid-19 disease, articles that the person has the covid-19 disease but no underlying diseases of nutritional origin. It focused on the vulnerable or higher risk population group, including scientific information from children (over five years old), adults (over 18 years old), and older adults (over 65 years old) found in countries of the Asian and American continents. The R program analyzed the scientific articles using the ggplot2 package with a pie and bar diagram. A higher prevalence in men than women (56% vs. 44%) stood out. Likewise, arterial hypertension was presented in the first place with 40.82%, followed by diabetes with 30.61%, obesity with 12.24%, overweight and dyslipidemia with 6.12%, malnutrition with 4.08%. There was a higher prevalence of stable individuals (29%) within the health facility than those admitted to the ICU (20%). Adults with 69.39%, followed by older adults with 16.33%, and mixed ages with 14.29%. Comorbidities stand out as risk factors in people infected with SARS-CoV-2, regardless of age. A more significant contagion was observed in the male versus female population;since men do not develop a rapid immune response and have a high content of cytokines that at the time of infection are released more quickly and can cause more significant damage. © 2021 Custode et al. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Potential bioactive compounds of medicinal plants against new Coronavirus (SARS-CoV-2): A review

Nowadays, COVID-19 cases are growing worldwide, and there is no evidence of an effective drug to combat the new SARS-CoV-2 virus. In this sense, medicinal plants as an alternative treatment are being used without control to handle the pandemic situation. Therefore, bioactive compounds against Coronavirus of medicinal plant species that grow in Ecuador are discussed. The plant species described in this review are Azadirachta indica, Cinchona pubescens, Coriandrum sativum, Cúrcuma longa, Eucalyptus spp, Morus alba, and Salvia rosmarinus[A3];and compunds are curcumin, coriandrin, deoxynojirimycin, kuwanon G, mulberroside A, oleanolic acid, rosmarinic acid, ursolic acid, quinine, eucalyptol, and jensenone. © the authors;licensee ecancermedicalscience. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Hypercoagulable state, CD4+ T-lymphocytopenia, dysregulated cytotoxicity and monocyte upregulation in COVID-19 positive cancer patients presenting with severe pneumonia

Background: There is growing evidence that cancer patients may be more susceptible to contracting coronavirus disease 2019 (COVID-19) infection, show a more aggressive course and associate a poorer prognosis than the general population. An unbalanced inflammatory response and systemic coagulopathy seem to define the pathological hallmark underlying severe presentations. However, the complex immune cell interplay and the role of the tumor-associated pro-coagulative state in COVID-19 remain a challenge. Methods: We prospectively evaluated cancer patients presenting to the emergency department of the Hospital Clínico San Carlos (Madrid, Spain) with severe pneumonia, and compared a comprehensive coagulation and immunological profile from blood samples on admission between those with SARS-CoV-2 positive and negative RT-PCR tests. Results: 14 patients with suspected COVID-19 and receiving in-hospital care were prospectively followed. SARS-CoV-2 RT-PCR was positive on admission in 6 patients, and negative on admission and on re-test in 8 patients. Peripheral blood samples were drawn on admission. In spite of the modest sample size, patients with SARS-CoV-2 positive showed higher levels of D-dimer (median 6,355 vs. 1,964 ng/ml, p=0.025), a decreased CD4+/CD8+ ratio (1.2 vs. 2.2, p=0.17) at the expense of CD4+ T lymphocytopenia (305 vs. 467, p=0.18), and NK cell expansion (17 vs. 9%, p=0.13). Several monocyte activation markers were found to be elevated in RT-PCR positive patients, including CD86 (2.8-fold increase in classic monocytes, p=0.06) and CCR2 (2.9-fold in intermediate monocytes, p=0.17;11-fold in non-classic monocytes, p=0.03). Conclusions: In cancer patients presenting with severe SARS-CoV-2 positive pneumonia, the infection may cause a hypercoagulable state, as suggested by higher levels of D-dimer, and unleash a pro-inflammatory response. Marked CD4+ T lymphocytopenia and NK expansion may reflect lymphocyte exhaustion and dysregulated cytotoxicity. Monocyte activation and recruitment also seem to be strongly upregulated. Legal entity responsible for the study: Hospital Clínico San Carlos. Funding: Cris Cancer Foundation. Disclosure: All authors have declared no conflicts of interest.

Clinical features and prognostic factors on admission of a prospective cohort of COVID-19 positive cancer patients in a third-level hospital in Madrid, Spain

Background: Coronavirus disease 2019 (COVID-19) pandemic is affecting a high percentage of the population at an unprecedented rate. Cancer patients comprise a subgroup especially vulnerable to this infection. However, to date, there is a critical need of medical data to optimize the management of these patients. Methods: We present a prospective analysis of epidemiological, clinical, radiological and laboratory data of consecutive adult cancer patients seen in the Medical Oncology Department of the Hospital Universitario Clínico San Carlos (Madrid, Spain), and admitted to hospital and tested for COVID-19 between February 21 and April 9, 2020 due to clinical suspicion of infection. Results: 193 patients with suspected COVID-19 were prospectively followed. Data from 58 patients with confirmed COVID-19 and active cancer or diagnosed within the last 5 years were analyzed. The most frequent malignancy was lung cancer (22%). 45 patients (78%) were on active cancer treatment, of which 36 (84%) had their last dose administered within 14 days before admission. Most common findings on presentation included fever (59%), cough (53%), and dyspnea (48%), and 25 (43%) patients showed oxygen saturation levels below 95%. Radiologically, 41 (71%) patients presented an abnormal pattern, the most frequent being infiltrates (62%). 17 (29.3%) patients died in hospital and 41 (61.7%) were discharged with clinical resolution of the event. Multivariable logistic regression showed higher odds of in-hospital death associated with a history of cardiovascular disease (odds ratio 5.14, 1.28-22.55;p=0.023), lower oxygen saturation levels (1.12, 1.01-1.30;p=0.049), and neutropenia (9.01, 1.08-100;p=0.047) on admission. Conclusions: The data presented here captures the course of COVID-19 in cancer patients during the initial phase of the outbreak and may help identify patients with a higher risk of death from COVID-19 at the time of diagnosis so that earlier and more intensive measures can be articulated. Legal entity responsible for the study: Hospital Clínico San Carlos. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.