Electrocardiographic alterations in hospitalized patients with COVID-19 / Alteraciones electrocardiográficas en pacientes hospitalizados con COVID-19

Resumen: Introducción: Como consecuencia del daño directo provocado por el virus SARS-CoV-2 sobre el corazón se producen alteraciones electrocardiográficas. Objetivo: Determinar si existe relación entre las alteraciones electrocardiográficas intrahospitalarias, con los antecedentes cardiovasculares y su evolución hospitalaria. Materiales y método: Estudio de cohortes, prospectivo, analítico, en 373 pacientes con el diagnóstico positivo de enfermedad por el nuevo coronavirus 2019 que ingresaron en la Unidad de Cuidados Intensivos del Hospital Docente "Comandante Manuel Fajardo" (La Habana, Cuba) entre marzo del 2020 y octubre del mismo año. Resultados: La mediana de edad fue de 69 (RIC 57-77); el 14.2% de los pacientes presentó fibrilación auricular, el 8,3% bloqueo de rama derecha y el 4.8% alteraciones del segmento ST. La edad, los antecedentes de cardiopatía isquémica y la diabetes mellitus se identificaron como variables predictoras independientes de alteraciones electrocardiográficas (RR 1.02; IC 95%: 1.01-1.04; p = 0.007; 2.21; IC 95%: 1.19-4.10, p = 0.012 y RR 1.71; IC 95%: 1.04-2.85, p = 0.036, respectivamente). Conclusiones: La prevalencia de alteraciones electrocardiográficas en pacientes hospitalizados con el nuevo coronavirus fue mayor comparada con otras series. Los antecedentes de cardiopatía isquémica y diabetes mellitus, además de la edad, se identificaron como variables predictoras independientes de alteraciones electrocardiográficas en pacientes con afección grave por la enfermedad del nuevo coronavirus 2019.

Abstract: Introduction: As a consequence of the direct damage caused by the virus on the heart, electrocardiographic alterations occur. Objective: To determine if there is a relationship between in-hospital electrocardiographic alterations with cardiovascular history and hospital evolution. Materials and method: Analytical prospective cohort study in 373 patients with a positive diagnosis of disease due to the new coronavirus 2019 who were admitted to the Intensive Care Unit of the "Comandante Manuel Fajardo" Universitary Hospital (Havana, Cuba) between March 2020 and October of the same year. Results: The median age was 69 (IQR; 57-77), 14.2% of patients had atrial fibrillation, 8.3% right bundle branch block, and 4.8% ST-segment abnormalities. Age, history of ischemic heart disease, and diabetes mellitus were identified as independent predictor variables of electrocardiographic abnormalities (RR 1.02; 95% CI: 1.01-1.04, p = 0.007; RR 2.21; 95% CI: 1.19-4.10, p = 0.012 and RR 1.71 95% CI: 1.04-2.85, p = 0.036, respectively). Conclusions: The prevalence of electrocardiographic abnormalities in hospitalized patients with the new coronavirus was higher compared to other series. History of ischemic heart disease and diabetes mellitus, in addition to age, were identified as independent predictors of electrocardiographic abnormalities in patients severely affected by the new coronavirus disease 2019.

Convalescent plasma donors show enhanced cross-reactive neutralizing antibody response to antigenic variants of SARS-CoV-2 following immunization.

BACKGROUND: The therapeutic benefit of convalescent plasma (CP) therapy to treat COVID-19 may derive from neutralizing antibodies (nAbs) to SARS-CoV-2. To investigate the effects of antigenic variation on neutralization potency of CP, we compared nAb titers against prototype and recently emerging strains of SARS-CoV-2, including Delta and Omicron, in CP donors previously infected with SARS-CoV-2 before and after immunization. METHODS AND MATERIALS: Samples were assayed from previously SARS-CoV-2 infected donors before (n = 17) and after one (n = 43) or two (n = 71) doses of Astra-Zeneca or Pfizer vaccinations. Ab titers against Wuhan/wild type (WT), Alpha, Beta, and Delta SARS-CoV-2 strains were determined by live virus microneutralization assay while titers to Omicron used a focus reduction neutralization test. Anti-spike antibody was assayed by Elecsys anti-SARS-CoV-2 quantitative spike assay (Roche). RESULTS: Unvaccinated donors showed a geometric mean titer (GMT) of 148 against WT, 80 against Alpha but mostly failed to neutralize Beta, Delta, and Omicron strains. Contrastingly, high GMTs were observed in vaccinated donors against all SARS-CoV-2 strains after one vaccine dose (WT:703; Alpha:692; Beta:187; Delta:215; Omicron:434). By ROC analysis, reactivity in the Roche quantitative Elecsys spike assay of 20,000 U/mL was highly predictive of donations with nAb titers of ≥1:640 against Delta (90% sensitivity; 97% specificity) and ≥1:320 against Omicron (89% sensitivity; 81% specificity). DISCUSSION: Vaccination of previously infected CP donors induced high levels of broadly neutralizing antibodies against circulating antigenic variants of SARS-CoV-2. High titer donations could be reliably identified by automated quantitative anti-spike antibody assay, enabling large-scale preselection of high-titer convalescent plasma.

Dysfunctional patterns of food intake by anxiety during isolation by COVID-19 in Chile, Colombia and Mexico

The aim of this research was to compare food intake dysfunctional patterns score with the subjective perception of anxiety and sociodemographic characteristics of the participants in isolation by COVID-19 from Chile, Colombia, and Mexico. A cross-sectional research was carried out, with a virtual questionnaire of subjective perception of anxiety and the questionnaire of three 18-item feeding factors. 958 people of both sexes participated (F = 83%,M = 17%), mainly in the 18 to 35 age range. Dysfunctional eating patterns presented high scores in people who perceived anxiety, as well as in participants from Chile. Additionally, it was found that women present greater cognitive restriction and emotional intake, and college students showed greater disinhibition. In conclusion, the scores of the three dysfunctional eating patterns were higher in people with subjective perception of anxiety during social isolation due to COVID-19, and there were also differences according to country, sex, and educational level. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) El objetivo de esta investigacion fue comparar el puntaje de los patrones disfuncionales de la ingesta con la percepcion subjetiva de la ansiedad y caracteristicas sociodemograficas de los participantes en aislamiento por COVID-19 de Chile, Colombia y Mexico. Se realizo una investigacion de tipo transversal, con un cuestionario virtual de percepcion subjetiva de la ansiedad y el cuestionario de tres factores de alimentacion 18-items. Participaron 958 personas de ambos sexos (F = 83%,M = 17%), principalmente en el rango de edad de 18-35 anos. Los patrones disfuncionales de la ingesta presentaron puntajes altos en personas que percibieron ansiedad y en participantes de Chile. Adicionalmente, se encontro que las mujeres presentan mayor restriccion cognitiva e ingesta emocional y los estudiantes universitarios mostraron mayor desinhibicion. En conclusion, los puntajes de los tres patrones disfuncionales de la ingesta fueron mas altos en las personas con percepcion subjetiva de ansiedad durante el aislamiento social por COVID-19 y asi mismo se presentaron diferencias de acuerdo al pais, sexo y nivel educativo. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Impact of COVID-19 Pandemic on California Farmworkers' Mental Health and Food Security.

OBJECTIVES: To examine the mental health and economic impact of the COVID-19 pandemic on Latino farmworkers in California. METHODS: We conducted a cross-sectional study of adult farmworkers (n = 1,115) between July 16 and November 30, 2020. We collected information via phone interviews. We used the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2 scales to assess depression and anxiety symptoms. We adapted the U.S. Department of Agriculture six-question scale to assess household food insecurity. RESULTS: Nearly 20% of study participants reported symptoms of depression and 15% reported symptoms of anxiety. Six percent reported increasing an increase in their substance use and 37% experienced food insecurity during the pandemic. Depression and anxiety symptoms were more frequent among women or those who had experienced ≥1 recent COVID-19 related symptom, but less frequent among those who were married and/or worked in the fields. Increased substance use was more common among farmworkers who had ≥1 COVID-19 related symptom, but less common among women and those who spoke a language other than English at home, were born outside the U.S., or lived in crowded housing. Food insecurity was common among those who were born outside the U.S. or lived with children <18 years, but less common among those with more education, a higher income, or who had lived longer in the U.S. CONCLUSIONS: The pandemic has exacerbated challenges affecting mental health and and food security among farmworkers. Interventions and prevention efforts, led by respected and trusted members of the community, should include on-the-spot supplemental income, increased mental health services, and food support services.

Risk Factors Associated With SARS-CoV-2 Infection Among Farmworkers in Monterey County, California.

Importance: Essential workers in agriculture and food production have been severely affected by the ongoing COVID-19 pandemic. Objective: To identify risk factors associated with SARS-CoV-2 infection among farmworkers in California. Design, Setting, and Participants: This cross-sectional study invited farmworkers in California's Salinas Valley (Monterey County) receiving transcription-mediated amplification (TMA) tests for SARS-CoV-2 infection at federally qualified community clinics and community sites to participate. Individuals were eligible if they were not pregnant, were 18 years or older, had conducted farmwork since the pandemic started, and were proficient in English or Spanish. Survey data were collected and SARS-CoV-2 tests were conducted among participants from July 16 to November 30, 2020. Exposures: Sociodemographic, household, community, and workplace characteristics. Main Outcomes and Measures: TMA- and immunoglobulin G (IgG)-positive SARS-CoV-2 infection. Results: A total of 1107 farmworkers (581 [52.5%] women; mean [SD] age, 39.7 [12.6] years) were included in these analyses. Most participants were born in Mexico (922 [83.3%]), were married or living with a partner (697 [63.0%]), and worked in the fields (825 [74.5%]). Overall, 118 of 911 (13.0%) had a positive result on their TMA test for SARS-CoV-2 infection, whereas 201 of 1058 (19.0%) had antibody evidence of infection. In multivariable analyses accounting for recruitment venue and enrollment period, the incidence of TMA-positive SARS-CoV-2 infection was higher among those with lower than primary school-level education (adjusted relative risk [aRR], 1.32; 95% CI, 0.99-1.76; non-statistically significant finding), who spoke an Indigenous language at home (aRR, 1.30; 95% CI, 0.97-1.73; non-statistically significant finding), who worked in the fields (aRR, 1.60; 95% CI, 1.03-2.50), and who were exposed to a known or suspected COVID-19 case at home (aRR, 2.98; 95% CI, 2.06-4.32) or in the workplace (aRR, 1.59; 95% CI, 1.18-2.14). Positive results on IgG tests for SARS-CoV-2 infection were more common among those who lived in crowded housing (aRR, 1.23; 95% CI, 0.98-1.53; non-statistically significant finding), with children aged 5 years or younger (aRR, 1.40; 95% CI, 1.11-1.76), with unrelated roommates (aRR, 1.40; 95% CI, 1.19-1.64), and with an individual with known or suspected COVID-19 (aRR, 1.59; 95% CI, 1.13-2.24). The risk of IgG positivity was also higher among those with body mass index of 30 or greater (aRR, 1.65; 95% CI, 1.01-2.70) or diabetes (aRR, 1.31; 95% CI, 0.98-1.75; non-statistically significant finding). Conclusions and Relevance: In this cross-sectional study of farmworkers in California, both residential and workplace exposures were associated with SARS-CoV-2 infection. Urgent distribution of COVID-19 vaccines and intervention on modifiable risk factors are warranted given this population's increased risk of infection and the essential nature of their work.

Dysfunctional Patterns of Food Intake by Anxiety during Isolation by COVID-19 in Chile, Colombia and Mexico.

The aim of this research was to compare food intake dysfunctional patterns score with the subjective perception of anxiety and sociodemographic characteristics of the participants in isolation by COVID-19 from Chile, Colombia, and Mexico. A cross-sectional research was carried out, with a virtual questionnaire of subjective perception of anxiety and the questionnaire of three 18-item feeding factors. 958 people of both sexes participated (F = 83%, M = 17%), mainly in the 18 to 35 age range. Dysfunctional eating patterns presented high scores in people who perceived anxiety, as well as in participants from Chile. Additionally, it was found that women present greater cognitive restriction and emotional intake, and college students showed greater disinhibition. In conclusion, the scores of the three dysfunctional eating patterns were higher in people with subjective perception of anxiety during social isolation due to COVID-19, and there were also differences according to country, sex, and educational level.

El objetivo de esta investigación fue comparar el puntaje de los patrones disfuncionales de la ingesta con la percepción subjetiva de la ansiedad y características sociodemográficas de los participantes en aislamiento por COVID-19 de Chile, Colombia y México. Se realizó una investigación de tipo transversal, con un cuestionario virtual de percepción subjetiva de la ansiedad y el cuestionario de tres factores de alimentación 18-items. Participaron 958 personas de ambos sexos (F = 83%, M = 17%), principalmente en el rango de edad de 18 35 años. Los patrones disfuncionales de la ingesta presentaron puntajes altos en personas que percibieron ansiedad y en participantes de Chile. Adicionalmente, se encontró que las mujeres presentan mayor restricción cognitiva e ingesta emocional y los estudiantes universitarios mostraron mayor desinhibición. En conclusión, los puntajes de los tres patrones disfuncionales de la ingesta fueron más altos en las personas con percepción subjetiva de ansiedad durante el aislamiento social por COVID-19 y así mismo se presentaron diferencias de acuerdo al país, sexo y nivel educativo.

Prevalence and Clinical Profile of Severe Acute Respiratory Syndrome Coronavirus 2 Infection among Farmworkers, California, USA, June-November 2020.

During the ongoing coronavirus disease (COVID-19) pandemic, farmworkers in the United States are considered essential personnel and continue in-person work. We conducted prospective surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and antibody prevalence among farmworkers in Salinas Valley, California, during June 15-November 30, 2020. We observed 22.1% (1,514/6,864) positivity for SARS-CoV-2 infection among farmworkers compared with 17.2% (1,255/7,305) among other adults from the same communities (risk ratio 1.29, 95% CI 1.20-1.37). In a nested study enrolling 1,115 farmworkers, prevalence of current infection was 27.7% among farmworkers reporting >1 COVID-19 symptom and 7.2% among farmworkers without symptoms (adjusted odds ratio 4.16, 95% CI 2.85-6.06). Prevalence of SARS-CoV-2 antibodies increased from 10.5% (95% CI 6.0%-18.4%) during July 16-August 31 to 21.2% (95% CI 16.6%-27.4%) during November 1-30. High SARS-CoV-2 infection prevalence among farmworkers underscores the need for vaccination and other preventive interventions.

Environmental Health Threats to Latino Migrant Farmworkers.

Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population.