Inflation and covid-19: An exercise for Colombia

The covid-19 pandemic distorted the pattern of household consumption. Consequently, the official fixed basket cpi could be measuring inaccurately the evolution of inflation. The exercise presented in this document, was to update the weighting structure of the basket with alternative information on consumption and household expenditures to explore how the inflation calculations could be affected during the pandemic period. The results indicate that cpi would be increasing faster than the fixed basket cpi measures reveals. © Revista de Economía del Rosario. Universidad del Rosario.

One Year after the COVID-19 Pandemic in the city of Guayaquil: Evidence of Municipal Response and the Socio-economic Impact

The objective of this article is to monitor the socio-economic impact of COVID-19 on the most vulnerable areas of Guayaquil one year after the start of the pandemic and to point out areas that remain vulnerable for future social linkage projects. The survey was used for the "EPICO-ECOTEC" Project, validated by expert judgment and the average score using Cronbach's alpha. Additionally, a description of the questions and contingency tables were made for better proactive decisions. In this way, this article recommends developing a System of Public Policies from the local level to face the consequences of inequity and the problems of sustainable human development due to COVID-19.

MODELING IMPACT of the COVID-19 PANDEMIC on HEPATITIS C VIRUS ELIMINATION in the US

Background: Due to the COVID-19 pandemic, hepatitis C virus (HCV) treatment in the U.S. reduced by 30% in March 2020 and remained low throughout the end of 2020, but the impact on HCV elimination is unknown. We use modeling to estimate the impact of the COVID-19 pandemic on the likelihood of reaching the World Health Organization (WHO) and U.S. National Academies of Sciences and Engineering (NASEM) HCV elimination targets by 2030 (80% reduction in HCV incidence, 65% reduction in HCV mortality from a 2015 baseline). Methods: We developed a general population model that simulates HCV transmission and progression in the U.S. The model is stratified by age and risk (young adult (20-30 years) non PWID, young adult (20-30 years) PWID, adults (31-51 years), and older adults (≥ 52 years)), HCV disease stage, diagnosis, and treatment status. The model was calibrated to data from the literature on number of chronic infections in 2011 and 2018, number aware of their infection and number cured in 2018. The model was validated against U.S. Centers for Diseases Control estimates of new HCV infections in 2019. We used the calibrated model to simulate the impact on HCV incidence and HCV-related mortality from 2015-2030 with: (1) no disruption to treatment uptake from 2020 onwards;(2) 1-year reduction in treatment (by 30%) from 2020 (as observed in national data), and (3) 2-year reduction in treatment (by 30%) followed by return to status quo. Results: We estimated there were 67,267 (95%CI 23,433-114,471) new HCV infections in 2015. Under all scenarios the 80% incidence reduction target is missed (29.7% reduction by 2030 even with no disruption to treatment, even less impact with COVID disruptions). There are overall 990 (95% 417-1,330) additional new infections from 2015-2030 for the 1 year disruption, and 1,933 (95% 800-2,599) additional new infections for the 2 year disruption. Similarly, all projections fail to meet the mortality target by 2030, with an anticipated relative reduction in mortality of 30.6% (95% 21.7-38.4%) with a 1 year disruption. Conclusion: The U.S. was not on track to achieve the WHO and U.S. NASEM elimination targets pre-pandemic and has fallen further behind during the COVID-19 pandemic. Urgent scale-up of HCV diagnosis, treatment, and prevention is required.

New strategies in the primary prevention of cardiovascular disease

Cardiovascular disease (CVD) is without a doubt an important cause of morbidity and mortality worldwide, occupying the first place over other disorders such as obesity and dia-betes. Therefore, primary prevention is essential, especially during the current COVID-19 pandemic. Thus, it is important to revise and update the strategies for prevention, including changes in lifestyle such as in nutrition and physical activ-ity, for which there are numerous possibilities and alternatives arising every day and that must be studied to determine their efficacy and safety. Likewise, additional factors and comorbidities that may elevate cardiovascular risk must also be assessed in order to apply opportune pharmacological treatments as prevention, some of them being accepted and widely used, and others being controversial. In con-sequence, further research is necessary to determine the best strategies for CVD prevention and continue innovation. Thus, the objective of this article is to review each of the modifiable cardiovascular risk factors with their respective alternatives, updates, and innovative therapeutic methods.

COVID-19 outcome in hemodialysis patients

Introduction and objective: The SARS-CoV -2 epidemic represents a special risk for patients on hemodialysis (HD) due to their comorbidities and the fact that they often have a more severe case of inflammation with fewer symptoms and a worse evolution and outcome. The aim of this study was to detect the clinical and biochemical characteristics of patients on hemodialysis (HD) who presented a suspicious involvement of COVID-19 (Corona Virus Disease – 2019), their risk factors and specific outcomes. Material and methods: This is a retrospective, observational case report study in HD patients suspected of having COVID-19. Records pointed to comorbidities, clinical and laboratory tests, quantitative reverse transcription polymerase chain reaction (RT-qPCR) tests for SARS-COV -2 and outcomes. Descriptive statistics and linear and logistic regression analyses were performed. Results: Of the total number of HD patients (1514), 248 HD patients were suspected to have COVID-19 (106 were positive, 83 were negative and 59 suspected using PCR testing);the median age was 51 years (IR 36-63 years), 54.8% were males, had hypertension (87.5%), with a hemoglobin count of 8.9 g (IR 7.5-10.6 g) and symptoms such as cough, fever and dyspnea (65.7, 64.5 and 53.2%, respectively). The fatality rate in the group of patients with positive RT-qPCR was 29.24%. Conclusions: The mortality and fatality rate is often high in this population. The age group, sex, and cardio-metabolic comorbidities behave similarly to the rest of the non-renal population. Pre-existing biochemical status does not make a difference in the outcome. The predominant symptomatology was pulmonary in nature.

Use of CIGB-258 peptide in a pediatric patient with severe pneumonia due to SARS-CoV-2

Introduction: The clinical presentation of the disease caused by SARS-CoV-2 is heterogeneous. Patients may be asymptomatic or have mild upper respiratory tract disease, or develop severe pneumonia that can progress to acute respiratory distress syndrome and lead to death. The pathophysiology of severe forms of the disease is characterized by a marked hyperinflammation. Therapies that modulate the immune response can be crucial in treating and preventing this state. The CIGB-258 peptide, brand name Jusvinza, is a therapeutic option for this purpose, due to its immunomodulatory properties. Objective: Describe the clinical evolution of a pediatric patient with severe pneumonia due to SARS-CoV-2, and treated with the CIGB-258 peptide. Case Presentation: A 12-year-old adolescent with refractory epilepsy, infantile cerebral palsy, and an epidemiological history of contact with a patient positive to PCR confirmatory test for SARS-CoV-2 who, eight days after contact, shows clinical, radiographic, and laboratory evidence of severe pneumonia due to COVID-19. Within the therapeutic protocol, he received treatment with CIGB-258 immunomodulatory peptide, with a favorable evolution and hospital discharge. Conclusions: The use of CIGB-258 peptide in the treatment of severe pneumonia due to COVID-19 in pediatrics could contribute to prevent progression to the critical stages of the disease. © 2021, Editorial Ciencias Medicas. All rights reserved.

Sinus bradycardia as the initial manifestation of multisystem inflammatory syndrome in children

Background: While cardiovascular complications, including arrhythmias are now a recognized manifestation of Multisystem inflammatory syndrome in children (MIS-C), there are no reports of primary bradycardia preceding the clinical presentation. We sought to describe a case series of sinus bradycardia as an initial manifestation of MIS-C. Methods: We included a series of 10 consecutive patients with confirmed COVID-19 who met WHO and CDC criteria for MIS-C, who developed sinus bradycardia with a heart rate measured in the awake state that was below the normal range for age for children, as an initial manifestation of the disease, in a prospective observational multicenter study. Patients underwent clinical, laboratory evaluation, ECG, Holter, telemetry, echocardiogram, chest X Ray, and a chest CT scan. Results: Of the 10 patients included, 6 were male, with a mean age of 6.52±5.35 years, range 4 months to 14 years. All cases were Hispanic. Bradycardia was transient and did not merit treatment. Coronary abnormalities were noted in 6 cases;4 patients had mild coronary ectasia;9 patients had pericardial effusion with no evidence of tamponade. All patients had a mild clinical course;none had shock, heart failure, the need for mechanical ventilation, or died. All blood markers (Troponin, BNP, Platelet count, C-reactive protein, D-dimer, Ferritin) returned to normal levels by discharge/follow-up with a favorable outcome including resolution of coronary dilatation in all but 2 in which aneurysm persisted. Treatment: All patients received steroids and low-weight-molecular heparin 10 patients, 8 aspirin and 8 intravenous immunoglobulins. Conclusion: Sinus bradycardia may be the initial manifestation of MIS-C, usually transient and mild. Physicians should be aware of this presentation. (Figure Presented).

Management and impact of atrial fibrillation in the COVID 19 era;Concomitancy of two procoagulant phenomena

Background: Atrial fibrillation (AF) is a widespread cause of prothrombotic state leading to long-term anticoagulant therapy. Literature describes coagulopathy as a key pathogenic mechanism of COVID-19 disease. Thus, antithrombotic therapy management is still a therapeutic challenge. During hospitalization, changing oral anticoagulant (OAC) therapies into subcutaneous heparin is common in daily clinical practice. Purpose: The primary endpoint of this study is to analyze the impact of AF in mortality within 30 day since admission of COVID-19 patients. The secondary endpoint is to analyze the impact of the anticoagulant therapy strategy (therapeutic dose of subcutaneous heparin vs. OAC) in 30-day mortality of hospitalized COVID-19 patients with AF. Methods: A total of 1001 consecutive patients hospitalized in our centre between 22nd August and 9th January 2021 with a confirmed microbiological diagnosis of COVID-19 by PCR were prospectively included. Of them, 134 had a previous diagnose of AF (13.5%). Cox regression analysis was performed to assess the impact of AF and the choice of anticoagulant therapy in 30-day mortality after adjusting for comorbidity (Charlson Comorbidity Index). Results: After adjusting for comorbidities, AF was not independently associated with a higher 30-day mortality in patients hospitalized due to COVID-19 infection (HR 1.04, CI 0.77-1.43, p=0.760). In the group of patients with AF, changing OAC to heparin therapy was not associated with an improved prognosis (HR 0.85, CI 95% 0.46-1.56, p=0.604). Conclusions: AF is not an independent prognostic factor in COVID-19 hospitalized patients. In hospitalized COVID-19 patients with AF, changing OAC to heparin therapy is not related to an improved prognosis.

Impact of previous cardiac conditions in prognosis and clinical management of patient with COVID-19 infection

Background: Recent studies suggest a higher mortality rate because of COVID-19 in patients with previous cardiac conditions compared to those without. Given the limited resources of intensive care units (ICU) during the pandemic outbreak, this fact has important implications. Purpose: The main purpose of this study was to compare the 30-day mortality of the COVID-19 infection in patients with and without previous cardiac conditions. The secondary end point was to assess the differences in clinical severity of the infection (as development of Acute Respiratory Distress Syndrome - ARDS) and ICU admission amongst these patients. Methods: A total of 1708 consecutive patients were prospectively included. The inclusion criteria were: a confirmed positive diagnosis of COVID-19 infection by PCR and being admitted to our centre between 18th and 23rd March 2020 and 22nd August and 9th January 2021. Patients were classified in two groups according to the presence of previous cardiac conditions (defined as previous history of myocardial infarction, heart failure and atrial fibrillation). Other comorbidities were extensively explored and Charlson Comorbidity Index was calculated. A propensity-score matching was performed and 145 patients with previous cardiac conditions were matched with 145 patients without. Results: The group of patients with a previous cardiac condition included 421 patients (24.6%). The crude analysis showed a higher 30-day mortality rate among patients with previous cardiac affections (35.6% vs. 14.6%, p<0.001). They were also less likely to be admitted to the ICU (9.8% vs. 6.2%, p=0.022) and had a higher prevalence ARDS (48.9% vs. 33.9%, p<0.001). In the matched cohort, there were no significant differences between both groups regarding mortality (24.8% in the group of patients with previous cardiac conditions vs. 31.0%, p=0.272) nor ARDS prevalence (50.3% vs. 53.1%, p=0.655). There was a trend toward patients with previous cardiac conditions to be less likely to be admitted to the ICU (4.8% vs. 9.7%, p=0.090). Conclusions: Patients with a personal history of previous cardiac conditions were less likely to be admitted to the ICU. However, our results show that when comparing cohorts with similar comorbidity burden, a previous cardiopathy per se does not significantly increase the risk of death in patients with a concomitant COVID infection.

Can we still consider treatment with colchicine effective in SARS-COV-2 infection? Systematic review, meta-analysis, and trial sequential analysis.

OBJECTIVE: To assess the effectiveness of colchicine, compared with standard of care, for reducing mortality, admission to intensive care, and use of mechanical ventilation. MATERIALS AND METHODS: We performed a systematic review, meta-analysis, and sequential trial analysis. The terms (SARS-CoV-2 OR COVID-19 OR coronavirus) AND (colchicine) were searched in MEDLINE, Scopus, Embase, Cochrane Central Register of Controlled Trials, and preprint repositories (February 2020 to April 2021, extended to June 2021). Risk of bias for randomised controlled trials and observational studies were assessed using the tools RoB 2.0 and ROBINS-I, respectively. We performed subgroup analyses based on study design and sensitivity analyses based on time of colchicine administration. RESULTS: We included six observational studies (1329 patients) and five clinical trials (16,048 patients). All studies but one were conducted in the hospital setting. Colchicine treatment was not associated with a significant decrease in mortality (RR 0.93, 95% CI 0.87 to 1; p=0.06, I2=72%) with a significant subgroup effect (p<0.001) depending on the design of the studies. The drug was effective in observational studies (RR 0.57, 95% CI 0.46 to 0.70, p<0.001, I2=50%) but not in clinical trials (RR 0.99, 95% CI 0.92 to 1.07, p=0.89, I2=21%). The effect of colchicine on intensive care admissions and the need for mechanical ventilation could not be confirmed. Trial sequential boundaries for cumulative meta-analyses of randomised controlled trials suggested no significant effect on mortality (p=0.182) beyond the optimal information size (13,107 patients). CONCLUSIONS: Our results suggest that colchicine treatment has no effect on mortality in hospitalised patients with SARS-CoV-2 infection, and that no further confirmatory clinical trials are needed owing to futility.

Changes in eating habits during lockdown period due to the COVID-19 pandemic in Spain

Background: The lockout of borders, lockdown of the population and social isolation are key measures adopted in many countries to contain the COVID-19 pandemic. This study describes changes in eating habits and other lifestyles during confinement in a population group in Spain. Methods: A cross-sectional, observational study was conducted on a convenience sample of people aged 18 yr. and over, recruited online between April 21 and May 8, 2020 (weeks 6-8 of lockdown) in Spain (n = 1036). The protocol considered sociodemographic data, characteristics of confinement, usual food consumption and physical activity, and changes during confinement. Results: Most frequently reported changes in dietary habits are increased consumption of fruit (27%), eggs (25.4%), legumes (22.5%), vegetables (21%) and fish (20%) and reduced consumption of processed meats (35.5%), lamb or rabbit (32%), pizza (32.6%), distilled alcoholic beverages (44.2%), sugary drinks (32.8%) or chocolate (25.8%). Some differences were observed depending on age and adequacy of the usual diet. Some 14.1% who do not usually cook do so during this period;15% do not do physical exercise, 24.6% sit more than 9 hours a day and 30.7% of smokers (14.7%) report increased tobacco use. 37% reported not sleeping well. Conclusions: Participants in this study report dietary changes during lockdown in Spain with a trend towards greater consumption of healthier foods, less consumption of foods of poor nutritional interest and an increase in the practice of cooking at home. © 2020 Sociedad Espanola de Nutricion Comunitaria. All rights reserved.

Covid Radar and Trackers: Collaboration Obligations and Guarantees

The epidemiological surveillance and the tracking are essential to control the COVID-19 crisis. The people who have to run these tasks, the duty to collaborate with them, the guarantees that must be respected and the use of mobile phones apps are legal questions to solve, taking into account the international organizations recommendations and best comparative practices.

Rastreadores y radar covid: Obligaciones de colaborar y garantías

The epidemiological surveillance and the tracking are essential to control the COVID-19 crisis. The people who have to run these tasks, the duty to collaborate with them, the guarantees that must be respected and the use of mobile phones apps are legal questions to solve, taking into account the international organizations recommendations and best comparative practices. © 2020, Iustel. All rights reserved.