Remdesivir and corticosteroids in the treatment of hospitalized COVID-19 patients.

Coronavirus disease 2019 (COVID-19) is a pandemic infection caused by the newly discovered severe acute respiratory syndrome coronavirus 2. Remdesivir (RDV) and corticosteroids are used mainly in COVID-19 patients with acute respiratory failure. The main objective of the study was to assess the effectiveness of remdesivir with and without corticosteroids in the treatment of COVID-19 patients. We conducted a prospective observational study, including adult patients consecutively hospitalized with confirmed COVID-19 and acute respiratory failure. Patients were divided according to treatment strategy: RDV alone versus RDV with corticosteroids. The primary outcome was the time to recovery in both treatment groups. We included 374 COVID-19 adult patients, 184 were treated with RDV, and 190 were treated with RDV and corticosteroid. Patients in the RDV group had a shorter time to recovery in comparison with patients in the RDV plus corticosteroids group at 28 days after admission [11 vs. 16 days (95% confidence Interval 9.7-12.8; 14.9-17.1; p = .016)]. Patients treated with RDV alone had a shorter length of hospital stay. The use of corticosteroids as adjunctive therapy of RDV was not associated with improvement in mortality of COVID-19 patients.

Prevención de las enfermedades infecciosas. Actualización en vacunas PAPPS 2022 Infectious Disease Prevention Group: Update on vaccines, 2022

La actualización de las actividades preventivas de este año 2022 en el campo de las enfermedades infecciosas es de especial relevancia debido a la importancia que ha cobrado la prevención y, más concretamente, la vacunación como herramienta para controlar la pandemia producida por el virus SARS-CoV-2 declarada el 11 de marzo de 2020. La pandemia ha centrado gran parte de los esfuerzos de prevención en su contención, pero no se debe olvidar la importancia de mantener altas coberturas de vacunación del resto de las vacunas recomendadas para mantener un buen control de las enfermedades inmunoprevenibles y evitar complicaciones en pacientes especialmente vulnerables. En la revisión de este año presentamos un documento práctico con el objetivo de facilitar herramientas a los profesionales de atención primaria que trabajan con adultos, para hacer la indicación de cada vacuna tanto si está recomendada de forma sistemática como si lo está porque el paciente pertenece a algún grupo de riesgo por su condición o por patología de base. De esta manera, a lo largo del documento comentaremos los aspectos más novedosos en la vacunación sistemática (gripe, neumococo, vacunas antimeningocócicas y vacunas contra el virus del papiloma humano [VPH]), las nuevas vacunas (vacunas pandémicas contra la COVID-19, vacunas contra el herpes zóster de subunidades, vacunas contra la viruela del mono) y las vacunas recomendadas según condición de riesgo (embarazo y lactancia, sanitarios, viajeros, pacientes con inmunosupresión o patología de base).

Transitions in the Post-pandemic COVID-19 Context: Building Youth Policies in the Global South

This article seeks to contribute to the field of youth studies, particularly to the tradition of youth studies as transition, from Global South standpoint and integrating a gender perspective into youth policymaking. Our approach endorses the development of plural public interventions, focusing on the debates of youth as a transition with a commitment to the construction of a political economy of transitions, through a feminist lens, and amidst the challenges of current youth policies within the post-pandemic COVID-19 context. Thus, in this article, we aim to promote the pluralization of socially just policies that can enable building new bonds of solidarity between generations, genders, and social groups. Ultimately, we argue for the importance of continuing the design of participatory, plural, and well-situated youth policies, underlining the importance of new intergenerational agreements in the construction of fairer and more democratic societies from a Global South perspective.

SARS-CoV-2 Seroprevalence Study in Pediatric Patients and Health Care Workers Using Multiplex Antibody Immunoassays.

SARS-CoV-2 infection has become a global health problem specially exacerbated with the continuous appearance of new variants. Healthcare workers (HCW) have been one of the most affected sectors. Children have also been affected, and although infection generally presents as a mild disease, some have developed the Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). We recruited 190 adults (HCW and cohabitants, April to June 2020) and 57 children (April 2020 to September 2021), of whom 12 developed PIMS-TS, in a hospital-based study in Spain. Using an in-house Luminex assay previously validated, antibody levels were measured against different spike and nucleocapsid SARS-CoV-2 proteins, including the receptor-binding domain (RBD) of the Alpha, Beta, Gamma, and Delta variants of concern (VoC). Seropositivity rates obtained from children and adults, respectively, were: 49.1% and 11% for IgG, 45.6% and 5.8% for IgA, and 35.1% and 7.3% for IgM. Higher antibody levels were detected in children who developed PIMS-TS compared to those who did not. Using the COVID-19 IgM/IgA ELISA (Vircell, S.L.) kit, widely implemented in Spanish hospitals, a high number of false positives and lower seroprevalences compared with the Luminex estimates were found, indicating a significantly lower specificity and sensitivity. Comparison of antibody levels against RBD-Wuhan versus RBD-VoCs indicated that the strongest positive correlations for all three isotypes were with RBD-Alpha, while the lowest correlations were with RBD-Delta for IgG, RBD-Gamma for IgM, and RBD-Beta for IgA. This study highlights the differences in antibody levels between groups with different demographic and clinical characteristics, as well as reporting the IgG, IgM, and IgA response to RBD VoC circulating at the study period.

Vitamin D-related polymorphisms and vitamin D levels as risk biomarkers of COVID-19 disease severity.

Vitamin D is a fundamental regulator of host defences by activating genes related to innate and adaptive immunity. Previous research shows a correlation between the levels of vitamin D in patients infected with SARS-CoV-2 and the degree of disease severity. This work investigates the impact of the genetic background related to vitamin D pathways on COVID-19 severity. For the first time, the Portuguese population was characterized regarding the prevalence of high impact variants in genes associated with the vitamin D pathways. This study enrolled 517 patients admitted to two tertiary Portuguese hospitals. The serum concentration of 25 (OH)D, was measured in the hospital at the time of patient admission. Genetic variants, 18 variants, in the genes AMDHD1, CYP2R1, CYP24A1, DHCR7, GC, SEC23A, and VDR were analysed. The results show that polymorphisms in the vitamin D binding protein encoded by the GC gene are related to the infection severity (p = 0.005). There is an association between vitamin D polygenic risk score and the serum concentration of 25 (OH)D (p = 0.04). There is an association between 25 (OH)D levels and the survival and fatal outcomes (p = 1.5e-4). The Portuguese population has a higher prevalence of the DHCR7 RS12785878 variant when compared with its prevalence in the European population (19% versus 10%). This study shows a genetic susceptibility for vitamin D deficiency that might explain higher severity degrees in COVID-19 patients. These results reinforce the relevance of personalized strategies in the context of viral diseases.Trial registration: NCT04370808.

[Infectious Disease Prevention Group. Update on vaccines, 2020]. / Prevención de las enfermedades infecciosas. Actualización en vacunas, 2020.

Vaccine development is one of the fastest growing sectors in medicine now and in the future, as we are living with the emergency health care for the SARS-CoV-2 coronavirus. The semFYC PAPPS program biannually publishes the recommendations of the group and, in this edition, special emphasis is placed on the common vaccination proposed by the Ministry of Health, where, at last, it no longer discriminates between paediatrics and adults, and proposes a calendar throughout life. The main novelties in the field of vaccinology today are focused on the consolidation of the nonavalent vaccine against the human papilloma virus and in the change of the dose of monovalent meningitis vaccine C for the tetravalent one, ACWY, at age 12. The pandemic we are experiencing has led to the postponement of most preventive activities. On the return to «normality¼, the vaccination calendar must be examined, and completed if necessary.