Not Every Day is Monday for Employees Confined due to COVID-19: Anticipatory Happiness Matters

This study focuses on anticipatory happiness during the week (current happiness but considering the rest of the week) in employees confined due to COVID-19. In Diary Study 1, 71 employees with home-based telework participated on five consecutive workdays (Monday-Friday). We found a quadratic change pattern with an acceleration of the increase in anticipatory happiness right before the weekend. Results also confirmed a positive association between daily variability in anticipatory happiness and daily fluctuations in job satisfaction and positive affect. In Diary Study 2, 83 employees who carried out an essential activity outside the home participated for two consecutive weeks. Our findings showed a cubic change pattern where anticipatory happiness reaches its highest average score on Friday, dropping sharply on Monday, and then the cycle (rhythm) begins again. Changes in anticipatory happiness were positively associated with changes in job satisfaction and positive affect, and negatively related to fluctuations in negative affect. © 2022 Colegio Oficial de Psicologos de Madrid. All rights reserved.

Teaching Innovation for the Challenges of the 21st Century: History of Art and Slow Movement

The confinement experienced during the Covid 19 pandemic forced us to face life at a slower rhythm. In this context, the Research Group of Interdisciplinary Studies of Literature and Art (LyA) (UCLM) proposed to develop a project to rethink our teaching methods under the perspective of the Slow Movement principles. The aim of this text is to show the experiences carried out in the Art History courses in the Degrees of Humanities and Social Studies (Faculty of Humanities of Albacete, UCLM) and History of Art (Faculty of Letters of Ciudad Real, UCLM). © GKA Ediciones, authors.

Leucemia Aguda De Fenotipo Misto - Apresentacao Inicial Atipica - Um Relato De Caso

Introducao: Com desafiador tratamento e de diagnostico criterioso, a leucemia aguda de fenotipo misto (LAFM) e uma entidade rara dentro do espectro das leucemias agudas. Requer a presenca imunofenotipica de marcadores de linhagem B (CD19, CD22, CD79a), T (CD3) em conjunto com a linhagem mieloide (mieloperoxidase e diferenciacao monocitica - CD11c, CD14, CD64 ou lisozima). Relato de caso: Paciente masculino, 30 anos, obeso e diabetico tipo 2, hipertrigliceridemia, inicia com febre (38C), dor abdominal em hipocondrio direito e fadiga. Com dois dias de sintomas procura atendimento sendo liberado com sintomaticos. No quarto dia de sintomas houve piora da febre (39degreeC) e da dor, surgindo maculas hiperemiadas pruriginosas pelo corpo, ictericia e coluria. Retornou ao hospital de sua cidade sendo prescrito azitromicina e liberado com suspeita de influenza. No sexto dia de sintomas notou piora da ictericia, procurando, novamente, atendimento. Encaminhado, entao ao servico de referencia da regiao. Interna inicialmente na equipe da gastroenterologia como suspeita de hepatite viral. Na chegada: Hb 14,9, leucocitos 6140 com 2793 neutrofilos, 442 monocitos e 2812 linfocitos, 53 mil plaquetas;AST 57, ALT 733, hiperbilirrubinemia as custas de bilirrubina direta. Com todos os marcadores virais negativos, prosseguiu a investigacao de hepatite. No dia em que realiza ressonancia magnetica, que indicava processo infiltrativo/inflamatorio em figado e rim esquerdo, alem de testar positivo para COVID-19, ha evolucao no hemograma: Hb 10,7, leucocitos 7450 com 1192 blastos, 60 neutrofilos, 2012 monocitos e 4187 linfocitos, 23 mil plaquetas. Com o aparecimento de blastos, piora dos niveis de bilirrubinas e das lesoes de pele, foi realizado imunofenotipagem de sangue periferico que indicava leucemia monocitica aguda. Transferido a equipe da hematologia, sendo realizada biopsia de medula e iniciado protocolo 7 + 3 com substituicao das antraciclinas em falta no mercado por doxorrubicina 45 mg/m2. No terceiro dia da inducao, foi liberado o resultado da imunofenotipagem que confirmava o diagnostico de leucemia aguda de fenotipo misto B/mieloide, marcando CD19, CD22 e CD79a, com diferenciacao monocitica (CD14 e CD64). Cariotipo nao houve crescimento e PCR BCR/ABL negativo. Optado por seguir tratamento com 7 + 3, apresentando medula no D14 aplasiada e medula no D28 com doenca residual minima (DRM) negativa. Realiza tres consolidacoes com altas doses de citarabina (3g/m2). Paciente sustenta DRM negativa, estando em remissao completa. Iniciado manutencao com vincristina, mercaptopurina, metotrexato e prednisona. Aguarda transplante de celulas tronco hematopoieticas (TCTH). Discussao: Com o diagnostico de LAFM, o tratamento requer o maior numero de quimioterapicos, sendo sugerido o uso de protocolos para leucemia linfoblastica aguda. Como ja havia sido instituido o tratamento com doxorrubicina e citarabina, foi optado por seguir protocolo e, na manutencao da remissao completa, terminar as consolidacoes e iniciar a manutencao prevista pelo protocolo HyperCVAD. Devido a ser uma leucemia de alto risco, a realizacao do TCTH e necessaria e, neste caso relatado, a manutencao sera mantida ate a realizacao do transplante. Conclusao: Contudo, por se tratar de doenca rara e com poucos estudos publicados, requer compartilhamento de conhecimentos e condutas para melhora da abordagem. Copyright © 2022

Leucemia Promielocitica Aguda Ou Nao: Relato De Caso

Introducao: A Leucemia Promielocitica Aguda (LPA) e uma variante distinta de Leucemia Mieloide Aguda (LMA), correspondendo a 5 a 20% dos casos de todas LMA. Relato de caso: Paciente masculino, 18 anos, sem comorbidades, procura atendimento por febre com evolucao de 7 dias, associada a odinofagia, dispneia e cansaco. Relato de ter procurado atendimento anteriormente pelo mesmo quadro, sendo prescrito amoxicilina pela suspeita de amigdalite bacteriana. Hemograma da chegada demonstra uma pancitopenia com hemoglobina de 7,9, 560 leucocitos totais com diferencial de 189 neutrofilos, 50 bastoes, 240 linfocitos, 70 monocitos e 10 basofilos, alem de 85 mil plaquetas. Apos repeticao do hemograma e confirmacao da pancitopenia, paciente foi internado e submetido a analise de medula ossea (MO). Medulograma evidenciou em torno de 40% de infiltracao por celulas blasticas e promielocitos atipicos. Iniciado abordagem para LPA com acido trans-retinoico (ATRA). No dia seguinte, resultado de imunofenotipagem (IFT) nao evidencia populacao de celulas com fenotipo anomalo. Analise citogenetica revela um conjunto cromossomico masculino normal, sem evidencia de anormalidade clonal. Anatomopatologico (AP) de MO mostra hipercelularidade para idade (90%) as custas da serie granulocitica com falha de maturacao e hipoplasia eritroide. Repetido a analise de medula ossea no terceiro dia de internacao com confirmacao dos mesmos resultados. Realizados sorologias para hepatite B, C, citomegalovirus (CMV), Epstein-Barr e Parvovirus com resultados negativos. Descartada infeccao por COVID-19 com coleta de rt-PCR. Tomografia de torax apresenta extensas opacidades consolidativas de aspecto inflamatorio no lobo inferior esquerdo e cultura de lavado broncoalveolar apresenta crescimento de Staphylococcus Aureus, sendo realizado o diagnostico de pneumonia necrotizante. Apos 48h do inicio de antibioterapia com Piperaciclina-Tazobactam, paciente apresenta recuperacao de contagens com resolucao da pancitopenia. Discussao e conclusao: A LPA representa uma emergencia medica com alta taxa de mortalidade precoce, muitas vezes por hemorragia devido a um disturbio de coagulacao caracteristico. E fundamental iniciar o tratamento com um agente de diferenciacao celular, como o ATRA, assim que houver suspeita do diagnostico com base em criterios clinicos e citologicos, nao sendo necessario aguardar a confirmacao citogenetica ou molecular. Entretanto, e necessario considerar no diagnostico diferencial outras causas de pancitopenia por infiltracao medular de celulas imaturas, sendo a infeccao um diagnostico diferencial importante. Copyright © 2022

E-COMMERCE AND CONSUMER HABITS DURING THE COVID-19 PANDEMIC IN MEXICO

In 2020, the entire world had to abruptly adapt to a new re-ality: the health emergency caused by covid-19. Organizations had to re-arrange their marketing strategies based on the changes brought by this situation to market and consumer behavior. covid-19 forced social dis-tancing, thus leading to shifts in online consumption habits. This paper aims to present an overview of the significant changes in online commerce during the covid-19 pandemic in Mexico through a documentary, explor-atory, qualitative and cross-sectional research. Secondary data were col-lected with information from the National Survey on the Availability and Use of Information Technologies in Homes (endutih, in Spanish), conducted by the Mexican Internet Association, the Mexican Association of Online Sales (amvo, in Spanish), and the Global Consumer Perspectives Survey 2021 (PwC, 2021), among other sources. Results show that consumers and companies had to rapidly learn, adapt, and respond to new market require-ments, and that the onset of covid-19, variations in consumption habits, business digitization, and digital inclusion in Mexico favored e-commerce. © 2022, Universidad Nacional de Colombia. All rights reserved.

CONSUMER BEHAVIOR IN RESPONSE TO HEALTH CONTINGENCY BY COVID-19 IN MICHOACAN 2021: GENERATION X

This research is aimed at the study of Generation X consumer behavior during the health contingency caused by COVID-19, the objective of which is to identify the new consumer behaviors and trends that this generation has during the pandemic. Likewise, the research is made up of a theoretical section that helps to substantiate the central themes of the same, as well as a research section of the object of study whose methodology was carried out under a mixed exploratory and descriptive approach. Research was conducted through an online survey whose final scope was 224 observations in an established range of 41 to 61 years old. It was identified that members of Generation X as a result of the health contingency began to use digital platforms as a support tool, but this was not the only relevant change in their behavior since Generation X still prefers to make purchases in a traditional way.

FUNCTIONAL OUTCOME OF STROKE IN ACUTE SARS-COV2 INFECTION: A MULTICENTER STUDY IN MEXICO

Background and aims: Coronavirus disease 2019 (COVID-19) has been associated with stroke. Our proposal was to estimate the functional outcome (FO) of stroke associated with acute SARS-CoV2 infection in Mexico. Methods: We performed an observational, retrospective, multicenter study that included patients with stroke from May 2020 to November 2021. The population was divided in patients with COVID-19 (defined by positive PCR or thórax tomography with CO-RADS 4-5) and without COVID-19. FO was assessed with the modified Rankin scale (mRs) at discharge as good (0-2) or poor (3-6). Results: 998 patients with stroke were included, 87(8.7%) had COVID- 19 diagnosis, 534(53.5%) were men, the mean age was lower in COVID- 19 patients [59±15 versus 65±15 years old (range 16-99);p=0.002]. There were 762(76.4%) patients with ischemic stroke (IS), 164(16.4%) spontaneous intracerebral hemorrhage (SIH), 50(5%) transient ischemic attack (TIA) and 22(2.2%) cerebral venous thrombosis (CVT). TIA was more frequent in non COVID-19 patients [48(5.2%) versus 2(2.2%)] while CVT was more frecuent in COVID-19 patients [8(9.1%) versus 14(1.5%)]. There was no significant difference between the frequencies of IS and SIH between groups. COVID-19 patients had poorer FO than non COVID-19 patients [66(75.8%) versus 580(63.6%);p=0.023]. Mortality was also higher in patients with COVID-19 [14(16 %) versus 54(5.9%);p=0.002]. Conclusions: In our study, functional outcome of stroke in patients with acute SARS-CoV2 infection was worst than in patients without it. Also mortality was higher in these patients. Prompt diagnosis and high-quality acute stroke treatment should be emphasized in patients with SARSCoV2 infection.

Protocolo de tratamiento de la COVID-19 en pacientes con y sin indicación de ingreso hospitalario Treatment protocol for COVID-19 in patients with and without an indication for hospital admission

La infeccion por SARS-CoV-2 causa un amplio espectro de sintomas con distintos grados de severidad;desde casos asintomaticos o en forma de sindrome pseudogripal autolimitado, hasta un sindrome de distres respiratorio rapidamente progresivo debido a una respuesta anomala del sistema inmunitario en forma de tormenta de citoquinas. Tambien son frecuentes las complicaciones tromboticas. Multiples tratamientos antivirales se han probado en la COVID-19 sin resultados favorables, tan solo remdesivir puede ser util, pero no en todos los casos, y su uso es controvertido. Por el contrario, son los tratamientos inmunomoduladores los que mas solida evidencia de beneficio han acumulado, particularmente los corticoides. Otros inmunosupresores mas especificos, como los inhibidores de la interleuquina 6, tambien han logrado resultados favorables, y muchos otros estan actualmente en estudio. La tromboprofilaxis es el otro pilar del tratamiento de la COVID-19, aunque la dosis anticoagulante a emplear todavia esta en discusion.

Hepatobiliopancreatic symptoms in patients admitted to an intensive care unit with a diagnosis of SARS-CoV-2 infection

Introduction: COVID-19 infection has been characterized by respiratory manifestations. After the experience of the current pandemic, it has been shown that the profile of manifestations of this infection is not limited exclusively to the respiratory system. Purpose: To analyze the hepatobiliopancreatic manifestations of COVID-19 infection in patients admitted to the ICU. Methods: We carried out a retrospective observational study in a polyvalent ICU of a second level hospital. We collected demographic variables, severity scales at admission, comorbidities, analytical data, treatment received and mortality. Statistical analysis was performed with IBM.SPSS Statistics 25. Results: 101 patients were admitted, 26 requiring transfer due to the absence of beds in our Unit, which have been excluded from the present study. Of the 75 patients in our sample, 67.6% were male with a mean age of 59.66 years. 80.3% were obese, 43.4% had a history of arterial hypertension, 22.4% were diabetic, 48.7% were dyslipidemic, and 29.9% were bronchopathic. The average score on the APACHE II was 16.83 and on the SOFA 6.8. All were admitted with the diagnosis of severe respiratory failure secondary to atypical pneumonia without any clear hepatobiliopancreatic manifestation. 67.6% had a cytolic pattern (elevation of GOT and / or GPT), 64.9% had a cholestatic pattern (elevation of alkaline phosphatase, GGT and / or bilirubin). 5.4% suffered from ischemic hepatitis. None of the patients admitted to the unit had cholecystitis or acute pancreatitis. The multivariate analysis shows a statistically significant relationship between obesity (BMI> 30) and elevation of enzymes with a cytolytic pattern (P 0.04). None of the treatments administered to patients with COVID-19 infection (Kaletra, Rezolsta, Tocilizumab, Interferon, Chloroquine) is statistically significantly associated with any hepatobiliopancreatic manifestations. Among all the variables analyzed, no significant relationship with liver ischemia was observed. Conclusion: Despite the fact that the reason for admission of our patients was pulmonary involvement due to SARS-CoV-2, throughout their admission they developed alterations in the hepatobiliary profile, probably related to viral infection. In our cohort, it is evidenced that obesity could be a risk factor for increased cytolysis in COVID-19 infection, regardless of the drugs used.

Analysis of factors related to the clinical course of covid-19 infection in patients with hypertension

Background and importance Identification of the angiotensin converting enzyme (ACE2) as a target of the SARS-CoV-2 virus raises questions about a possible change in the clinical course of this infection associated with inhibitors of the renin-angiotensin-aldosterone system (RAAS). Furthermore, high blood pressure is considered a risk factor for COVID-19. Aim and objectives To characterise the clinical course in hypertensive patients admitted for COVID-19 and to determine if treatment with RAAS inhibitors, age and additional comorbidities may be related to mortality and development of acute respiratory distress syndrome (ARDS). Material and methods A single centre, observational, retrospective study was conducted. Inclusion criteria were: diagnosis of hypertension, hospital admission for COVID-19 between 1 March and 24 March 2020. Demographic, clinical and analytical variables were recorded. Clinical course was evaluated by: development of bilateral pneumonia, ARDS, length of stay and mortality. End of follow-up was 10 October 2020. To evaluate the possible influence of factors on evolution, binary logistic regression was performed using the STATA-IC14 programme. Quantitative dependent variables were transformed into dichotomous variables. Statistical significance was defined as p<0.05. Results 571 patients were analysed, with a median age of 76 years (IQR 66-83) and 59.2% were men. Of these, 69.7% were receiving treatment with RAAS inhibitors, 7.2% smoked and 80.0% had additional comorbidities. At hospital admission, 27.3% presented with hypoxaemia (SatO2<90%), 64.3% lymphopenia (<1000/mm3), 18.8% C reactive protein >20 mg/dL and 11.7% D-dimer >1200 ng/mL. During the hospital stay, 91.9% of patients required oxygen therapy, 76.4% developed bilateral pneumonia, 91.9% required oxygen therapy, 47.5% developed ARDS and 33.6% died. Median hospital stay was 15 days (IQR 9-24). Use of RAAS inhibitors was not linked to changes in mortality or development of ARDS (p>0.05). Risk factors associated with mortality were: additional cardiovascular diseases (OR=2.10;p=0.000) and older age (OR=1.05;p=0.000). Regarding ARDS, we found an association with obesity (OR=1.77;p=0.013), diabetes mellitus (OR=1.84;p=0.001) and age (OR=1.02;p=0.010). Hospital stay >14 days was significantly longer in advanced age (OR=1.02;p=0.022) and if chronic kidney disease was present (OR=1.73, p=0.043). Conclusion and relevance Antihypertensive treatment with RAAS inhibitors did not seem to be linked to the risk of worse evolution of COVID-19. Advanced age and additional cardiovascular disease appeared to be associated with higher mortality in hypertensive patients.

Epidemiology and clinical course of patients with cancer diagnosed with SARS-CoV-2 infection

Background and importance Cancer patients are a vulnerable population for SAR-CoV-2 infection. Aim and objectives The aim of our study was to describe the epidemiology and clinical course of patients with cancer infected with SARS-Cov-2, attending hospital. Material and methods A retrospective observational study was conducted in cancer patients attending a tertiary hospital for SARS-CoV-2 infection during the period 3 January 2020 to 31 May 2020. Demographic and clinical variables were analysed: comorbidities, tumour diagnosis, tumour stage and whether they had received anticancer treatment in the last month (active treatment). The clinical course was evaluated by hospital admission, pneumonia, oxygen therapy requirements, the development of acute respiratory distress syndrome (ARDS), admission to ICU, mortality rate and mortality rate <30 days from admission. Quantitative variables were expressed as means (SD). The association between dichotomous variables or proportions was compared using Fisher's exact test and between quantitative variables using the Mann-Whitney U test. Results 112 patients were included, 59.8% (67) were men, mean age 67±13.4 years. 94.6% (106) were Caucasian (4.4% (5) Latino). 61.6% (69) were non-smokers, 25% (28) exsmokers and 13.4% (15) current smokers;11.6% (13) had obesity. The most frequent comorbidities were: 57.1% (64) arterial hypertension, 34.8% (38) cardiovascular disease, 32.1% (36) diabetes mellitus and 21.4% (24) COPD. The most frequent cancer diagnosis were: 18.8% (21) breast cancer, 17.9% (20) lung cancer, 16.1% (18) colorectal cancer and 12.5% (14) prostate cancer. Tumour stage: 55.4% (62) metastatic disease, 25% (28) localised disease and 19.6% (22) locally advanced disease. 60.7% (68) of patients received active cancer treatment (42.7% chemotherapy, 32.3% hormonal treatment, 16.2% targeted therapy, 7% immunotherapy and 2.9% radiotherapy). At admission, 85.7% (96) of patients had pneumonia (78.1% bilateral), 59.9% (67) had lymphopenia (lymphocytes <1000/mL) and 31.3% (35) had p02 <90%. The variables for monitoring the clinical course are shown in table 1. Conclusion and relevance Mortality rate and mortality rate <30 days from admission were high. The clinical course in patients with active anticancer treatment was similar to that of all cancer patients. Larger series of patients are needed to continue studying outcomes of SARS-CoV2 infection in cancer patients. (Table Presented).

4CPS-282 Epidemiology and clinical course of patients with cancer diagnosed with SARS-CoV-2 infection

4CPS-282 Table 1 Cancer patients (n=112) Cancer patients receiving anticancer therapy (n=68) Hospital admission rate 92.9% (104) 94.1% (64) Mean days of admission 16±17 16±19 Oxygen therapy requirements 29.8% (31) 20.6% (14) ARDS 28.9% (32) 17.7% (12) Admission to ICU 7.7% (8) 7.3% (5) Mortality rate 27.7% (31) 25% (17) Mortality rate <30 days since admission 77.4% (24) 70.6% (12) Second admission rate 7.7% (8) 5.9% (4) Second emergency visits rate 8.9% (10) 8.8% (6) Conclusion and relevanceMortality rate and mortality rate <30 days from admission were high. The clinical course in patients with active anticancer treatment was similar to that of all cancer patients. Larger series of patients are needed to continue studying outcomes of SARS-CoV2 infection in cancer patients.References and/or acknowledgementsConflict of interestNo conflict of interest

COVID-19 Transmission during a Tsunami Evacuation in a Lockdown City

SARS-CoV-2 is a new and highly contagious virus that has expanded worldwide reaching the most distant places. In March 23rd (2020), the first case of COVID-19 was reported in the city of Iquique, northern Chile. Later, in May 15th authorities declared a city lockdown that has lasted for more than 14 weeks and counting. Using Agent Based Modeling and Simulation, we study the effects on COVID-19 transmission during a tsunami-Threat evacuation in the lockdown of the city of Iquique. Five different scenarios were simulated, considering different amounts of infected agents with capacity to spread the disease, different distribution of agents across the city and two different rates of contagion among agents. Results showed that most contagions occur within the first 15 minutes of the evacuation, while agents are fleeing to the safe zone. The effect on transmission rates resulted highly dependent on the spatial distribution of infected population. © 2020 IEEE.