ABSTRACT
INTRODUCTION: Dynamic monitoring of D-dimer levels is a prognostic tool used for patients with COVID-19 and higher levels are associated with increased mortality. However, optimal D-dimer cutoff models for ARDS have not been previously evaluated. We aimed to determine the optimal D-dimer level for the prediction of ARDS in patients admitted with COVID-19. METHOD(S): We conducted a two-center retrospective study of 502 adult patients hospitalized between 2020 and 2021 with confirmed COVID-19 infection. The D-dimer on admission and peak value during hospitalization were obtained. Differences between groups were determined by one-way ANOVA, Wilcoxon rank-sum, or Fisher exact test. The cutoff D-dimer level and the C-index were obtained using the receiver operating curve (ROC). Univariate and multivariate regression models were used. Statistical analyses were performed using SPSS 28. RESULT(S): The mean age was 65+/-15 and 58.4% (294/502) were males. ARDS developed in 51.3% (258/502) of the patients, and 30.5% (153/502) died. Elevated D-Dimer (>0.5 ug/mL) was present on admission in 84% (423/502) of all patients. Patients who developed ARDS had higher peak (median 3.54 ug/mL, p< 0.001) and admission (median 1.5 ug/mL, p=0.005) D-dimer levels. D-dimer level of >3.05 ug/ ml predicted ARDS with a sensitivity of 71%, specificity of 67% and C-index 0.723 (p=0.001, CI 0.68-0.77). The C-index for D-dimer on admission was 0.59 (p=0.001, CI 0.54-64). Using the peak D-dimer level of 3.05 ug/mL, unadjusted logistic regression models showed a statistically significant effect on ARDS (p< 0.001, OR 4.62, CI 3.12-6.83). This effect persisted after adjusting for other variables (p< 0.001, OR 3.81, CI 2.51-5.79). CONCLUSION(S): Peak D-dimer level during hospitalization with a cutoff of 3.05 ug/mL is a useful tool to predict ARDS in patients admitted with COVID-19. Dynamic monitoring of D-dimer is an adequate and objective measurement during hospitalization for assessment of deterioration. Further studies with better-controlled monitoring on the timeframe of obtaining D-dimer are needed to further evaluate this threshold.
ABSTRACT
The coronavirus pandemic came to highlight all those deficiencies that society lived within Mexico City and the object of this article is to know the history of green urban space and its effects on the health of the citizens specifically with the COVID-19. In recent works, the role that nature has for urban populations well-being is revalued, and at this time a vital strategy to counteract physical distancing, a measure taken by governments to prevent the spread of COVID-19. In the 2030 agenda and the Sustainable Development Goals framework, the city rights, and the potential to create green spaces in Mexico City as a strategy to help maintain the population well-being in times of the New Normal. What we found in this study is that there is a correlation between the confirmed cases of COVID-19 and green area per habitant in each municipality of Mexico City with a probability of 0.975. © 2021 Elsevier Inc.
ABSTRACT
The pandemic has had implications at different levels. This article shows the im-pact on transborder women whose working lives have been affected, as has their struggle for their rights and their labor as care-workers. We underline the intrinsic articulation between economic and social relations of inhabitants on both sides of the international border, gender dimensions that affect trans-frontier women and the social differentiation that is generated between those that hold one type of document or another on view of the partial closure of the borderline. We base our analysis on ethnographic cases chosen a broader sampler (2019-2020) to account for a gamut of women who have made strides in their processes of autonomy and empowerment, but find themselves made vulnerable by the closure of the borderline. © 2021, Universidad Autonoma de Baja California. All rights reserved.