Analysis of paxlovid® for the treatment of COVID-19 in Aragón, Spain

Background and ImportancePaxlovid® is indicated for the treatment of COVID-19 in adults who do not require supplemental oxygen and who are at increased risk for progressing to severe COVID-19. The Spanish Drug Agency published prioritisation criteria for it access. Paxlovid® has significant drug interactions, mainly due to ritonavir. Hospital pharmacists must validate the prescription, carrying out a thorough review of the patient‘s medical history to check its suitability, as well as the concomitant medication to avoid interactions.Aim and ObjectivesAnalyse the use of Paxlovid® in Huesca and Sector-1 of Zaragoza (Aragon, Spain) in early months post-authorisation.Material and MethodsAll Paxlovid's prescriptions from April to September 2022 were reviewed. The following variables were collected: gender, age, vaccination schedule, prioritised high-risk criteria and renal function. All concomitant medication was reviewed for drug interactions using a protocol created by Coordination Unit for the Rational Drug Use of Aragon. The observations made to the prescribing physician by the hospital pharmacist were recorded.Results40 requests were received. 5 were prescription errors. 29 (82.9%) were accepted and 6 (17.1%) rejected. Median age (years, interquartile-range q1-q3) was 52.2 (45.6–65.3), 57.1% were male. Vaccination status was complete primary vaccination with booster-dose (62.8%) followed by complete vaccination (25.7%) and incomplete vaccination (11.5%). As high-risk criteria prioritised, 91.4% belonged to group composed by immunocompromised persons. 91.4% had renal function >60ml/min. Only in 3 cases (8.6%) the prescribing physician indicated the patient had potential drug interactions.All patients had concomitant medication, median of 8 drugs (4–10). 60% had any potential interaction, with serious drug interactions in 42.9% of them. Drugs with potential serious interactions were statins (5/11);benzodiazepines (2/11) and antithrombotic agents (2/11).44.8% prescriptions were accepted with recommendations to modify or temporary stop some of the patient‘s usual treatment. 80% of the rejected cases were due to serious drug interactions.Conclusion and RelevanceIn the use of Paxlovid®, the role of hospital pharmacists was crucial, as drug interactions were detected in 60% of patients and were serious in 42.9% of them, leading to recommendations for adjustments in patients‘ drug therapy in almost half of the cases, with potentially serious drug interactions being the main reason to not dispense Paxlovid®.References and/or AcknowledgementsConflict of InterestNo conflict of interest

Reticencias vacunales COVID-19

Introducción y objetivos Las reticencias vacunales frente a COVID-19 en España han ido evolucionando de un 32 a un 10%, causando que España sea uno de los países con mayores tasas de vacunación sin ser obligatoria. De febrero a mayo del 2022 se observó un levantamiento de restricciones y uso de medidas no farmacológicas, dejándose de exigir también el certificado digital, no obstante, una parte de la población continuó iniciando la vacunación frente al COVID-19. El objetivo es evaluar las causas que conducen a la vacunación en las personas vacunadas de forma tardía. Métodos El presente es un estudio cualitativo, descriptivo y prospectivo, con entrevistas telefónicas individuales a personas vacunadas frente a COVID-19 de forma tardía, entre febrero y mayo del 2022. El cuestionario se realizó telefónicamente, se efectuaron 2 llamadas por identificador y se utilizaron preguntas cerradas, obteniendo información de datos sociodemográficos, así como relacionados con la COVID-19 y su vacunación. Resultados La población vacunada de primera dosis durante el período de estudio fue de 1.768, contactando con 801, accediendo a contestar la encuesta 338 personas. Las variables sociodemográficas de la población encuestada se encuentran recogidos en la tabla, los resultados de los motivos de no vacunación en la tabla 2 y los motivos que conducen a la vacunación en la tabla 3.Unlabelled ImageUnlabelled ImageUnlabelled Image Conclusiones Una prioridad de la Estrategia Nacional de Vacunación frente a COVID-19 es iniciar la vacunación en las personas no vacunadas. Para las campañas hacia este colectivo es necesario diseñar estudios específicos para conocer a las personas reticentes frente a esta vacunación. Uno de los motivos que han fomentado la vacunación es considerar «ya» segura la vacuna, siendo fundamental reforzar los mensajes de seguridad. Además, viajar es un motivo reiterado para la vacunación, siendo importante no olvidar la posibilidad de exigir la vacunación para alguna actividad.

Could lockdown increase the incidence of eating disorders?

Introduction Spanish Governmen declared state of emergency in March 2020 to prevent coronavirus COVID-19 from spreading. During September and October 2020, at Child and Adolescent Psychiatry Unit we have attended patients who presented altered eating behaviors whose onset was during lockdown. We report a series of seven cases of adolescent girls between the ages of 11 and 16, who had no previous history of mental illness. During lockdown, they have presented restriction of food and increased physical exercise, with weight loss. Some of these patients have also presented food binges and purging behaviors. Objectives Review the impact of lockdown on eating behavior, specially on weight loss. Methods Literature review of scientific papers searching in Pubmed. Results There are articles that study the variations in eating habits and exercise ocurred during confinement. Most focus on two trends: on the one hand, increased intake and the tendency to a more sedentary life;on the other hand, the worsening of people with a previous diagnosis of eating disorder. However, there is a third trend for which there are few studies: the new appearance of restrictive eating behaviors, together with increased physical exercise, bingeing and purging. This is the case of the patients we present. These studies describe as a possible cause of these alterations that confinement is a novel situation, which generates stress, social isolation, boredom, anxiety and a feeling of loneliness, which can influence self-concept and eating behaviors. Conclusions Lockdown has favored a change in eating habits and exercise. More studies are needed on new-onset eating disorders.

Prevalence of depression among medical students during the COVID-19 pandemic. A systematic review and meta-analysis

Background: Medical students frequently have depressive symptoms. Thus, the psychological impact of COVID-19 on them should be high. Aim: To conduct a systematic review and meta-analysis on the prevalence of depression in medical students during the COVID-19 pandemic. Material and Methods: MEDLINE via PubMed, Embase and Web of Science were searched for studies reporting the prevalence of depression in medical students, published from December 1, 2019 to December 27, 2020. Results: Eleven studies were included, most of them from Asia. The estimated overall prevalence of depression in medical students was 31% (95% CI: 23%-40%), with lower prevalence rates reported in studies from Asia in general, and China in particular. Conclusions: Our findings indicate that the proportion of medical students with depression during the pandemic was high, and comparable with that reported in other university students.