Impact of the COVID-19 Pandemic First Wave on Clostridioides difficile Infection

Background. Clostridioides difficile infection (CDI) is the leading cause of nosocomial diarrhea and a costly burden on the healthcare system. The COVID-19 pandemic brought enhanced infection control measures that could hypothetically decrease CDI transmission. Nonetheless, diarrhea secondary to COVID-19 and increased usage of broad-spectrum antibiotics could potentially increase testing for or frequency of CDI. We aimed to assess variations in CDI testing and frequency during the first surge of the COVID-19 pandemic in a tertiary community medical center in the Southern United States. Methods. Records from adult patients were retrospectively reviewed at Princeton Baptist Medical Center, Birmingham, AL. Three groups spanning equal time periods were created based on the CDC COVID-19 rate curves for Alabama: PPG (pre-pandemic, 03/01/2020 to 05/31/2020), PG (pandemic, 06/01/2020 to 08/ 31/2020), and SCG (seasonal control, 06/01/2019 to 08/31/2019). We included patients >= 18 years old and excluded readmissions and follow-up visits. We determined the frequency, testing rates, and positivity rates for CDI in each group to assess their differences. Also, we measured the rate of coinfection between C. difficile and SARS-CoV-2. CDI cases were defined as positive toxin enzyme-linked immunosorbent assay (EIA) and glutamate dehydrogenase (GDH), or positivity of either in addition to positive nucleic acid amplification test (NAAT). Differences in frequencies and rates across groups were compared with Fisher exact test. Results. Overall, 7,252 hospitalized patients and 29,671 outpatients were included (Figure 1). No outpatient CDI cases were detected. Outpatient testing rates were: PPG 3 (0.05%), PG 4 (0.05%), and SCG 9 (0.06%). Among inpatients, 3,912 (53.9%) were female with a mean +/- SD age of 61.2 +/- 17.5 years. Overall, CDI frequency, testing rates, and positivity rates did not vary significantly among all groups (Table 1). Among those tested, the only case of C.difficile/SARS-CoV-2 coinfection corresponded to PPG. Conclusion. There were no statistically significant differences in CDI frequency, or positivity rate between the pre-pandemic, pandemic, and seasonal control groups for inpatients. No CDI cases were detected in outpatients. This is likely due to a low testing rate in our population.

Clinical validation of the isothermal rt-lamp test for the rapid diagnosis of SARS-CoV-2

Introduction: Since the first report in Wuhan (China) in 2019, the SARS-CoV 2 virus has spread throughout the world, with a significant impact in public health. To contain the spread of SARS-CoV-2, the WHO has encouraged the development of rapid, simple, sensitive and specific tests that complement the gold standard RT-qPCR. Loop-mediated isothermal amplification (LAMP) has shown a good yield to detect SARS-CoV2 in different fluids. Objective: To validate the colorimetric RT-LAMP technique using two sets of oligonucleotides aimed at identifying the N gene of SARS-CoV-2 in 117 nasopharyngeal swab samples, previously confirmed by RT-qPCR using the Charite/Berlin protocol. Material and methods: 153 nasopharyngeal swab samples from individuals with suspected Covid-19 were subjected to qRT-PCR and RT-LAMP using a commercial colorimetric kit (NEB, Germany). RT-LAMP was run using both extracted RNA samples and raw samples without prior RNA extraction, and the result was assessed by a simple color change in the reaction. Results: RT-LAMP sensibility and specificity for gen N SARS-CoV-2 detection using one primers set previosly reported got values 0.97 (0.85, 1.00) and 0.81 (0.65, 0.92) respectively, for CI 95%. The other set primer used in this paper also reported previosly had 0.96 (0.78,1.00) sensibility and 0.77 (0.55,0.92) specificity to RT-LAMP. Without RNA extraction we found sensibility value of 0.95 (0.74, 1.00) and specificity 0.88 (0.64, 0.99). Conclusion: Taking together, the obtained results show RT-LAMP technique could be considered a rapid diagnostic test, easy to perform, free of sophisticated equipment, sensitive and specific to diagnose SARS-CoV-2 in nasopharyngeal swabs with and without prior RNA extraction, which that allows scaling its portability to places with scarce sources of resources.

PROBABILITY OF CORPORATE BANKRUPTCY: APPLICATION TO PORTUGUESE MANUFACTURING INDUSTRY SMES

This paper aims to develop a model for predicting corporate bankruptcy for SMEs in the Portuguese manufacturing industry where this question remains rather unaddressed. Using profitability, activity, liquidity, leverage, and solvency ratios, it was added the size and age variables, for a group of 208 firms, including 49 bankrupt firms and 159 active firms, during the years 2011 to 2015. The logit model allowed us to estimate a model with 82.3% of predictive capacity. The most important variables identified were profitability, solvency, and size. Estimations only with the data closest to the bankruptcy date improved predictive capacity. It is evidenced that financial and non-financial variables can predict bankruptcy probability. A possible future approach would be to analyze a larger sample. Also, a larger period could be considered, allowing to test either the effects of the 2007/8 crisis or the effects of the recent economic turmoil related to Covid-19. Important for both corporate managers and investors. Conclusions may be disclosed regarding the influence that economic turmoil certainly has on corporate defaults and bankruptcies allowing its extension to other countries. The contribution of this paper is to find the best specification for a bankruptcy prediction model applied to the Portuguese manufacturing industry SMEs. This paper also contributes to the existing literature by using non-financial variables and analyzing a sector still unexplored in Portugal, albeit its conclusions can be extended to other countries. © 2022, Universiti Malaysia Sarawak. All rights reserved.

Psychological impact and coping strategies in peruvian adults during the Covid-19 pandemic

Objective: To analyze the psychological impact and coping strategies in Peruvian adults during the Covid-19 pandemic. Methods: A qualitative study was developed with 6 males and 4 women, compiled through a semi-structured interview guide. Results: The most stressful situations for peruvian adults were their health vulnerability, the limitation of their freedoms, labor and economic changes, and family conflicts. The psychological impact on them was expressed through emotional distress, physiological, somatic and cognitive changes. And, they used selfcare, compliance with health measures, relaxation, relaxation and entertainment as coping strategies, as well as the reassessment of the situation. Conclusions: The pandemic and compulsory social confinement caused a psychological impact on peruvian adults and they have used active and avoidant coping strategies functional to the context.

Allelic variation in class I HLA determines CD8(+) T cell repertoire shape and cross-reactive memory responses to SARS-CoV-2

[Figure: see text].

Impact of the pandemic in Mexican High School education. An analysis of its pedagogical, psychological, and technological effects

This article describes how Mexican students and teachers in High School are adapting to COVID-19 emergency situation. For this aim were collected in a sample of n=11,850 teachers and n=39,852 students that represent different geographical regions and public and private institutions. An online questionnaire was designed to study three dimensions of this social phenomenon: The pedagogical, psychological and, the technological. Among the main findings are the following: Pedagogically, teachers and students have been flexible, looking for ways to adapt teaching and learning, combining digital and traditional resources. Technologically, only half of teachers report adequate Internet connectivity, which limits their use of digital resources. Psychologically, discouragement is identified, as well as vulnerable social-emotional individuals. Through regression tree analysis, the importance of learning assessment and contact with students is revealed, both for learning and for social-emotional well-being. The research is relevant because it allows us to see strengths and areas of opportunity for the Mexican Educational System.

Early Acute Respiratory Support for Pregnant Patients With Coronavirus Disease 2019 (COVID-19) Infection

The present coronavirus disease 2019 (COVID-19) pandemic is affecting pregnant patients worldwide. Although it appears that the severity of disease is reduced in pregnant patients, some are likely to develop severe disease. Our objective is to summarize the basic initial respiratory support interventions recommended for pregnant patients with infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).