ABSTRACT
Background: It is known that survivors of acute SARS-CoV-2 infection can experience a complex disease known as post-acute sequelae of COVID-19 (PASC). The clinical manifestations of acute COVID-19 have been well characterized however less is known about the risk of new onset diabetes mellitus (DM) in the post-acute phase of COVID-19. Method(s): An adult cohort with confirmed COVID-19 (by diagnosis or positive test) and without COVID-19 was sampled from a large national health research network between January 1st, 2020 and July 8th, 2022. We investigated the outcomes of a new diagnosis of DM (type I or II) occurring after COVID-19 through 12 months after infection. Risk estimates [incidence, relative risk (RR), attributable risk] were used to describe the probability of incident post-COVID diabetes. Hazard ratios and 95% confidence intervals were used to describe risk factors associated with new diabetes. Result(s): The 3-month probability of new diabetes was 2.48/1,000 among COVID+ and the relative risk (RR) of new diabetes was highest at 12 months [8.94 (8.54, 9.36)]. Vitamin D deficiency [HR: 1.52 (95% CI: 1.42, 1.63)] was associated with increased risk of T2DM and having vitamin D deficiency with either obesity (BMI > 30 kg/m2) or kidney dysfunction (GFR < 60) was associated with more than five times increased risk of T1DM. Conclusion(s): We observed a large proportion of excess diabetes starting at 3 months post COVID infection. Traditional risk factors for diabetes, omicron variant, and vitamin D deficiency are associated with increased risk of new diabetes outcome. PASC care should involve identification and management of diabetes. (Figure Presented).
ABSTRACT
Background: People with HIV (PWH) are at a higher risk of severe acute COVID-19;however, their risk of subsequently developing post-acute sequelae of SARS-CoV2 (PASC) remains unclear. Furthermore, although vaccination has been shown to be protective against PASC in the general population, few studies have evaluated its effectiveness in PWH. Method(s): We used the TriNetX health research database to source data from 69 healthcare organizations within the US. We included any adults aged >= 18 years with positive SARS-CoV-2 between January 1, 2020 and September 16, 2022 and categorized them based on their HIV status, baseline sociodemographic characteristics, comorbidities and COVID-19 vaccination status. The primary outcome was risk of PASC, compared by HIV and vaccination status after 1:1 propensity score matching. PASC was defined as either the persistence of COVID-attributable symptoms or the occurrence of new-onset health conditions at least 28 days following COVID-19 diagnosis. For all analysis, statistical significance was set at p < 0.05. Result(s): Of 3,048,792 people with confirmed SARS-CoV-2 infection, 1% (n=28,904) were PWH, with 9% of PWH (n=2592) vaccinated. At 28 days post-COVID-19 diagnosis, PWH had lower mortality compared with their non-HIV counterparts (OR 0.78, 95% CI 0.70-0.87), but higher risk of developing new-onset diabetes (DM) (OR 1.26, 95% CI 1.11-1.42), heart disease (OR 1.27, 95% 1.14-1.41), malignancy (OR 1.66, 95% CI 1.45-1.89), thrombosis (OR 1.25, 95% CI 1.12-1.39) and mental health disorders (OR 1.70 (95% CI 1.53-1.90). Furthermore, vaccinated PWH had significantly lower odds of death (OR 0.63, 95% CI 0.42- 0.93) and each new-onset PASC outcome, as follows: DM (OR 0.51, 95% CI 0.32- 0.82), heart disease (OR 0.44, 95% CI 0.29-0.67), malignancy (OR 0.43 (95% CI 0.25-0.74), thrombosis (OR 0.51, 95% CI 0.33-0.78) and mental health disorders (OR 0.49, 95% CI 0.30-0.79). The risk of PASC was higher during the pre-Delta variant period but did not vary based on CD4 count or HIV viremia. Conclusion(s): HIV infection confers a higher risk of PASC. Importantly, COVID-19 vaccination significantly lowered mortality and was protective against PASC among PWH. With the increase in the number of COVID-19 survivors, vaccination offers an effective preventive strategy to address a burgeoning public health problem. (Table Presented).
ABSTRACT
The COVID-19 pandemic has negatively impacted the health and living conditions of the world's population. In educational matters, social confinement forced the transition from a face-To-face modality to a virtual scheme supported by the use of information technologies and the Internet. This represented a challenge to access quality education at all levels, especially for the most vulnerable population groups, such as intercultural university education aimed at the indigenous population. Objective: To describe the perception that teachers of an intercultural university in southeastern Mexico have, regarding the impact that the adoption of a virtual and distance educational practice has had on the quality of education due to Covid-19. Methodology: Descriptive and cross-sectional quantitative research. The information was collected through the application of structured questionnaires consisting of 27 questions and 41 items, which were applied to a universe of 34 teachers from the seven degrees offered by the university. Results: It was found that the pandemic negatively affected the university intercultural educational process, accentuating the inequity in access to technological means for quality education. © 2022 Universidad de La Habana. All rights reserved.
ABSTRACT
INTRODUCTION: The nationwide lockdown implemented in Spain in March 2020 in response to the 2019 coronavirus disease pandemic (COVID-19) could have had an effect on the clinical situation, disease management and access to care in patients with idiopathic intracranial hypertension. PATIENTS AND METHODS: A cross-sectional observational study was conducted by means of an online survey. The frequency and impact of headache, visual symptoms, dizziness, cognitive symptoms, diplopia, anxiety and depression on patients' quality of life were recorded. Disease treatment and delays experienced in accessing care were recorded. Participants were grouped according to the time elapsed since diagnosis. RESULTS: A total of 112 patients participated in the study (103 women). The average time since disease onset was 6.25 years. Headache, anxiety and depression were responsible for considerable impact in the period prior to lockdown. The impact of headache was not aggravated during lockdown, but anxiety and depression did become significantly worse. Recently diagnosed participants reported higher rates of anxiety, depression, dizziness and diplopia; chronically diagnosed participants reported a higher frequency of cognitive symptoms. CONCLUSIONS: The clinical situation of the participants deteriorated during lockdown, although the differences were smaller than previously thought. This was probably because the baseline situation was more severe than expected. Further studies are needed to clarify the medium and long-term impact of the COVID-19 pandemic on patients with idiopathic intracranial hypertension.
TITLE: Impacto del confinamiento por COVID-19 en pacientes con hipertensión intracraneal idiopática en España.Introducción. El confinamiento nacional instaurado en España en marzo de 2020 como respuesta a la pandemia por la enfermedad por coronavirus 2019 (COVID-19) pudo tener un efecto en la situación clínica, el manejo de la enfermedad y el acceso a la atención médica en pacientes con hipertensión intracraneal idiopática. Pacientes y métodos. Se realizó un estudio observacional transversal por medio de una encuesta en línea. Se registraron la frecuencia y el impacto en la calidad de vida de la cefalea, los síntomas visuales, el mareo, los síntomas cognitivos, la diplopía, la ansiedad y la depresión. Se registró el tratamiento de la enfermedad y los retrasos experimentados en el acceso a la atención médica. Se agrupó a los participantes según el tiempo de evolución desde el diagnóstico. Resultados. Participaron 112 pacientes (103 mujeres). El tiempo medio de evolución de la enfermedad fue 6,25 años. La cefalea, la ansiedad y la depresión fueron responsables de un impacto considerable en el período previo al confinamiento. El impacto de la cefalea no empeoró durante el confinamiento, pero la ansiedad y la depresión empeoraron significativamente. Los participantes diagnosticados recientemente comunicaron mayores tasas de ansiedad, depresión, mareo y diplopía; los de evolución crónica, mayor frecuencia de síntomas cognitivos. Conclusiones. La situación clínica de los participantes se deterioró durante el confinamiento, aunque las diferencias fueron menores de lo que se pensaba. Esto se debió, probablemente, a que la situación basal era más grave de lo esperado. Son necesarios más estudios para aclarar el impacto a medio y largo plazo de la pandemia por COVID-19 en pacientes con hipertensión intracraneal idiopática.
Subject(s)
COVID-19 , Pseudotumor Cerebri , Humans , Female , COVID-19/epidemiology , COVID-19/psychology , Quality of Life , Spain/epidemiology , Pandemics , Cross-Sectional Studies , Dizziness , Diplopia , Pseudotumor Cerebri/epidemiology , Communicable Disease Control , Anxiety/epidemiology , Anxiety/etiology , Headache/epidemiology , Headache/etiology , Depression/epidemiology , Depression/psychologyABSTRACT
Aim: To analyze suspected adverse events (AEs) caused by SARS-CoV-2 vaccines administered to community pharmacists (CP) and auxiliary personnel. Methods. Design: Cross-sectional observational study, in February-April 2021. Subjects: Pharmacists, technicians and auxiliaries who work in contact with the public, of legal age, vaccinated against SARS-CoV-2. Variables: Number, type and frequency of AEs, demographic characteristics. Procedure: A formulary was enabled on the website of the Association of Pharmacists of Pontevedra. It was announced to all the associates CP of the province its existence and the convenience of completing it. Outcomes: 167 participants, of whom 153 manifested symptoms related with reactivity to the vaccine, 122 (93.1%) women and 31 (86.1%) men. 146 (95.4%) who received VaxzevriaR, 116 (79.4%) women and 30 (20.6%) men and 7 (4.6%) who received ComirnatyR, 6 (85.7%) women and 1 (14.3%) man. 823 AEs were reported, 811 (5,3 SD=2,8 AEs, 0-12 per patient) with VaxzevriaR and 12 (0,9 SD=1,0 AEs, 0-3 per patient) with ComirnatyR. Most frequent AEs: pain at the injection site, 128 (87.7%), chills, 107 (73.3%) and muscle pain, 106 (72.6%). In all three, we found a higher proportion of women than men (p<0.01). The maximum number of AEs manifested by a participant was 12. 132 (86.3%) vaccinated who reported AEs, 106 (86.9%) women and 26 (83.9%) men, needed medication to relieve symptoms. 77 (46.1%) could not carry out their daily activities and 47 (28.1%) could not work the next day. Conclusions: The number of AEs reported by vaccinated pharmacists and auxiliary personnel was high. Although they were not serious, they considerably affected their daily and work activity.
ABSTRACT
The work links cross-border mobility and medical tourism during the COVID-19 pandemic. The objective was to analyze the behavior of medical tourism in Ciudad Juarez during October 2020 to July 2021 of this pandemic. The contextual variable is regular mobility compared to the activity of the trade in health services in border cities. It is a qualitative and exploratory study of 34 semi-structured interviews of real cases. Cross-border patients who come to Ciudad Juarez in search of health care for COVID-19 disease in public and private hospitals and for the care and follow-up of the related sequelae were found. The conclusions expose the vulnerability of people who carry out medical tourism and the institutional deficiencies that contribute to the challenges of the welfare state during the COVID-19 pandemic. The notion of the functionality of borders is identified.
ABSTRACT
—Overcrowding and crowd density monitoring in various places and establishments are being implemented since the pandemic, which helps observe social distancing. This study is about the development of a crowd density solution by utilizing YOLOv4 and Closed-Circuit Television (CCTV) called CrowdSurge. The practice of CCTV has been around for so many years with proven benefits. This has been combined with the state-of-the-art YOLOv4 algorithm that provides high video analytics and object detection performance. With the combination of the said technology and algorithm, it will serve as a smart surveillance system. A system and mobile application have been developed, and the YOLOv4 deep learning detection model was used to detect various set of scenarios considered to assess if the model executes according to the actions assigned in the experimental set-up. The browser-based application was tested using CVSS or Common Vulnerability Scoring system, which shows that the severity level of most vulnerabilities is low and has a minor impact on the system. Based on the overall usability testing and statistical results, the respondents are satisfied with both surveillance system and mobile applications developed in terms of functionality, usefulness, and aesthetics. Therefore, using the developed system in real-time surveillance can aid in crowd density reduction in an area. © 2022.
ABSTRACT
OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vertical transmission has been investigated extensively. Recently, the World Health Organization (WHO) published strict criteria to classify the timing of mother-to-child transmission of SARS-CoV-2 into different categories. The aim of this study was to investigate the possibility of vertical transmission in asymptomatic SARS-CoV-2-positive women. METHODS: Pregnant women attending for delivery at a perinatology center in Mexico City, Mexico, who had a SARS-CoV-2-positive nasopharyngeal swab 24-48 h before delivery, were asymptomatic at the time of the test and had an obstetric indication for Cesarean section were eligible for inclusion in this study. Amniotic fluid was collected during Cesarean delivery, and neonatal oral and rectal swabs were collected at birth and at 24 h after birth. SARS-CoV-2 detection was carried out using real-time reverse-transcription polymerase chain reaction in all samples. Relevant medical information was retrieved from clinical records. The WHO criteria for classifying the timing of mother-to-child transmission of SARS-CoV-2 were applied to the study population. RESULTS: Forty-two SARS-CoV-2-positive asymptomatic pregnant women fulfilled the inclusion criteria. Twenty-five (59%) women developed mild disease after discharge. Neonatal death occurred in three (7%) cases, of which one had a positive SARS-CoV-2 test at birth and none had coronavirus disease 2019-related symptoms. There were five (12%) cases with strong evidence of intrauterine transmission of SARS-CoV-2, according to the WHO criteria, as amniotic fluid samples and neonatal samples at birth and at 24 h after birth were positive for SARS-CoV-2. Our results also showed that 40-60% of infected neonates would have been undetected if only one swab (oral or rectal) was tested. CONCLUSION: This study contributes evidence to reinforce the potential for vertical transmission of SARS-CoV-2 even in asymptomatic women and highlights the importance of testing more than one neonatal sample in order to increase the detection rate of SARS-CoV-2 in affected cases. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Subject(s)
COVID-19/transmission , Infectious Disease Transmission, Vertical , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Cesarean Section , Cohort Studies , Female , Humans , Infant, Newborn , Mexico/epidemiology , Middle Aged , Neonatal Screening , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicityABSTRACT
Addiction to video games is a disease recently recognized by the WHO that could increase due to the conditions of confinement caused by the pandemic resulting from COVID-19. This paper investigates the types of addictions, including the consequences of video game addiction in people. Research articles are analyzed, finding that the excessive use of video games is considered a behavioral addiction and is recognized by the DSM-5 as a mental disorder. The relationship between video games and the identified consequences is discussed, where it is proposed a set of consequences and treatments based on the literature review. However, there is still a lack of information about how to know if a gamer is addicted and how to treat the disease efficiently and safely. © 2021 IEEE.
ABSTRACT
Vaccines are biological products containing antigens that aim to generate protection against real exposure to an infectious pathogen. They constitute the most cost-effective interventions in public health, being surpassed only by drinking water. Generally speaking, we can divide the vaccines into live attenuated and inactive;However, the new coronavirus has produced innovative platforms that use intracellular and molecular mechanisms with the same objective of generating immunity. A systematic literature search was carried out using the PUBMED, SCOPUS, and Web of Science electronic databases. All types of study design were selected, those written in English or Spanish were prioritized. We reviewed the existing platforms to generate immunity against the SARS-CoV-2 coronavirus. Each one is developed according to its route and form of action, and can be classified as protein subunits, recombinant viral vector, nucleic acids, inactivated viruses, viral particles, and live attenuated viruses. The mechanisms by which these vaccines generate immunogenicity are different;however, the constant insertion of mutations by the virus remains an object of interest and concern for researchers. © 2021, Universidad del Norte. All rights reserved.
ABSTRACT
The exceptional situation caused by COVID-19 has accelerated the much-needed digitization of Spain. The strengths and shortcomings of this way of proceeding have suddenly been highlighted, especially in the administrative sphere where the multiple possibilities of ICT are not yet a reality. Under this panorama, the Agenda Espana Digital 2025 has been released. A strategic plan, in line with European, which aims to achieve the country's digital transition. It is an ambitious bet, although it is not the only one;For this reason, this article examines the main plans and programs aimed at making this revolution possible, paying attention to their references to the administrative sphere and considering the international, European and national sphere;as well as the closest antecedents to evaluate the implementation of the different planning instruments.
ABSTRACT
Background: HIV infection is considered a risk factor for severe SARS-CoV-2 (COVID-19) infection;however, there are limited studies assessing the impact of HIV on COVID-19 presentation and clinical outcomes. Methods: We used TriNetX (a large global health research network) to compare adult HIV and non-HIV patients with confirmed SARS-CoV-2 infection who sought care across 44 healthcare facilities in the US January to December 2020. We assessed demographic characteristics, comorbidities, presenting symptoms, laboratory parameters, rate of hospitalization, rate of intensive care service utilization requiring mechanical ventilation and mortality at 30 days after diagnosis. Continuous data were compared using independent t-tests and categorical data were compared using Chi-square or Fishers exact test, as appropriate. Potential confounders were addressed using 1:1 greedy nearest-neighbor propensity score matching based on demographics and key comorbidities. For outcomes of interest, we calculated odds ratios (OR) and 95% confidence intervals (CI), with p < 0.05 considered statistically significant in all analyses. Results: Of 297194 confirmed COVID-19 cases, 1638 (0.6%) were HIV-infected, with > 83% on antiretroviral therapy (ART) and 48% virally suppressed (HIV-1 RNA < 20 copies/μL). Compared with their non-HIV counterparts, HIV patients were more commonly younger (p < 0.001), male (p < 0.001), African American or Hispanic (p < 0.001), had more cardiovascular disease (p < 0.001) and other comorbidities, were more symptomatic at presentation and had higher utilization of all healthcare services (Table 1). On laboratory parameters, HIV patients were more anemic (p < 0.001), thrombocytopenic (p < 0.001) and had elevated serum creatinine (p < 0.001), procalcitonin (p=0.042) and interleukin-6 (p=0.010) levels. In propensity score-matched analysis by demographics and relevant comorbidities, HIV patients had significantly higher odds of hospitalization [OR 1.26, 95% CI (1.04-1.53);p=0.023] and severe illness requiring intensive care stay and mechanical ventilation [OR 1.32, 95% CI (1.10-1.58);p=0.003]. Mortality at 30 days was higher among HIV patients but did not attain statistical significance (2.9% vs 2.3%;p=0.123). Conclusion: In one the largest studies to date, HIV patients had more underlying risk factors, symptom severity and higher odds of hospitalizationand mechanical ventilation but were not significantly more at risk of death at 30 days after COVID-19 diagnosis compared to non-HIV controls. (Figure Presented).
ABSTRACT
Aim: Assess the perception of pharmacy users about the impact of COVID-19 on their health at the end of confinement and compare the results with those obtained at the beginning. Material and methods: Randomized cross-sectional observational study, in pharmacies in Pontevedra and Ourense, from 10 to 25 June 2020. Subjects: 18 years of age who come on demand for medicines and/or protective material. Procedure: the user completed an anonymous questionnaire, depositing it in a daily disinfected tray.