Paradigms of immunization management: the use of quantitative methods as decision support in times of Covid-19 in the state of Rio de Janeiro

The state of Rio de Janeiro has come to be considered the state with the highest lethality rate, with one death for every 20 infected by the "new virus", according to bulletins from the Ministry of Health (BRASIL, 2021). The first phase of the vaccination campaign against the disease in the state had only 488,320 doses of the immunizer. Given the scarcity of resources, public managers had the challenge of prioritizing the distribution of vaccines among age groups in order to minimize the impacts of mortality. Therefore, it became imperative to identify to which age group the initial vaccine supply should have been prioritized in the state of Rio de Janeiro. The objective of the research is to provide information to support the problems encountered by the public administration regarding the management of immunizers. The study area is the state of Rio de Janeiro, where data from the main epidemiological observatory sites in the state of Rio de Janeiro at the beginning of the covid-19 pandemic were used, using statistical techniques such as tabular and parametric description, measures of central tendency, percentages, and the linear interpolation method to calculate the population estimate by age. The distribution of the first batch of vaccines was simulated proportionally across the respective age groups. The study variables were lives saved and years saved, and simulations of 81 scenarios were performed, distributing the vaccines among the 10 possible age groups. The results obtained showed that by concentrating the application of available vaccines in the older population, a greater number of lives saved are obtained, regardless of the effectiveness of the immunization. As for the variable years saved, it can be seen that the population between 70 and 79 years old is the one that presents the best result in relation to the other age groups. It is suggested that further studies be carried out to empirically estimate the efficacy against death of available vaccines, due to the existence of an increasingly robust database.

Interpersonal violence in a city of Parana: a study about the epidemiological profile of victims and characterization of dental trauma

The socioeconomic context and population vulnerability are directly associated with violence in the country. In Brazil, the Criminal Code provides the illicit act and punishes the aggressor who offends the physical aggression from a person. Interpersonal violence is an illegal act and is associated with the vulnerability of victims. Therefore, the study of the epidemiological profile of victims of interpersonal violence is needed to alert the population about their susceptibility. The present study aimed to design the epidemiological profile of victims of bodily injury from interpersonal violence in the region of Maringa, in the state of Parana, and to study the characterization of dental injuries in terms of permanent weakness and deformity. Four thousand nine hundred sixty-two reports performed between 2018 and 2020 were analyzed using descriptive statistics. Data collected included: sex, age, marital status, the region affected by the bodily injury, type of dental trauma, and responses to "weakness" or/and "permanent deformity". During the period studied, there was a prevalence of female victims (57.8%), white skin color (80.2%), aged between 21 and 30 years (24.9%), single (54.9%), and the most affected region was the upper limbs (32.1%). Regarding bodily injuries with dental involvement, 67 cases were reported, male victims were prevalent (60.3%), and dental fracture was highlighted with 54.4% of examined injuries. The implementation of the Forensic Dentistry Centre took place in August 2019 at the Medico-Legal Institute of Maringa. Also, with the interruption of expert activities in 2020 - due to the COVID-19 pandemic - relevant outcomes regarding permanent weakness were observed. The epidemiological profile of victims is characterized by the female sex, white skin color, the age group from 21 to 30 years old, and singles. Regarding dental trauma, male victims, and dental fractures were prevalent. Furthermore, there was an increase in the classification of "permanent weakness", as well as a slight increase in cases of "further assessment required" for permanent deformity.Copyright © 2023 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.

Collaboration strategies for COVID-19 vaccination: Experience of an Allergy and Clinical Immunology Department from a tertiary hospital

Background: Vaccination plays an essential role in controlling SARS-CoV- 2 pandemics. Due to initial concerns about hypersensitivity reactions (HR) to these new vaccines, our department, in articulation with Primary Healthcare Services (PHS) has developed several strategies to support COVID-19 vaccination. This work aims to describe those strategies and report the results. Method(s): The strategies developed for COVID-19 vaccination, from March to December 2021, included: 1) telephone support for health professionals (TS for HP) from the Vaccination Centres (VC), 2) priority appointments (PA) of patients classified as a higher risk for HR, 3) hospital vaccination of high-risk patients as defined by the national health authority. A retrospective and descriptive analysis of the support activity developed and from the data of patients vaccinated at the hospital in the same period were performed. Result(s): During the considered period, our department screened 1618 patients: 420 (26%) through telephone support for HP (TS for HP) from VC and 1198 (74%) at priority appointments (PA). After TS for HP, community vaccination (CV) was recommended in 87% (n = 364) of cases and a PA was advised in 13% (n = 56). Of the patients evaluated in PA, 80% were recommended CV, with restriction of the vaccine to administer in 28% of them. We always found an option to vaccine all. At the hospital were vaccinated 178 patients, 83% (n = 147) women, median age (P25-75) 61 (46-76) years. Hospital vaccination criteria were: past history of multiple drug HR (n = 93;52%), HR to vaccines (n = 46;26%), HR to the 1st dose of anti-SARS- CoV- 2 vaccine (n = 30;17%), idiopathic anaphylaxis (n = 10;6%) and systemic mastocytosis (n = 2;1%). 15% of patients (n = 26) performed skin tests with vaccines, which were negative in 25 and inconclusive in 1 case. 145 (82%) were first shots, 32 (18%) second shots, and one booster shot. Only one patient had a mild immediate reaction (2nd booster vaccination), promptly treated with antihistamine and corticosteroid. Conclusion(s): The collaboration strategies adopted by our department allowed the vaccination of 1618 patients and avoided vaccination delays in most of the VC contacts. In our sample, hospital vaccination of patients at higher risk for HR was safe.

Role of 1-minute sit-to-stand in the diagnosis of Long COVID

Introduction: Current literature on 1-minute sit-to-stand (1-STS) role in COVID-19 focuses on its ability to predict need for hospitalization or home discharge, but not Long COVID diagnosis where gaps in knowledge are recognized in NICE Long COVID guidelines. Aim(s): Assess 1-STS role in Long COVID definition. Method(s): Prospective ongoing cohort of post COVID-19 patients referred to body plethysmography at a university tertiary hospital. Result(s): Thirty-two patients were analyzed (53.1% male, mean 54 years-old), of whom 15 (46.9%) fulfilled Long COVID criteria. Of these, the most common symptoms were insomnia and/or excessive fatigue (n=8, 53.3%) and dyspnea (n=4, 26.7%). Long COVID patients had higher body mass index (29.7+/-6.0 vs 26.2+/-3.3Kg/m2;p=0.043). Patients with and without Long COVID were similar regarding age (p=0.827), hospitalization due to COVID-19 (p=0.811) or smoking history (p=0.234). Parameters of the 1-STS most associated with Long COVID were lower heart rate (HR) at 30' (89.1+/-14.0 in Long COVID vs 105.9+/-14.3bpm for no Long COVID criteria;p=0.002) and at 60' (99.3+/-24.0 vs 120.8+/-13.9bpm;p=0.004), as well as lower SpO at 60' (94.5+/-4.4 vs 97.1+/-1.6%;p=0.046). The parameter with the highest predictive power for Long COVID was HR at 60'(AUC=0.808;p=0.003), and when <80bpm revealed 90% sensitivity and 99% specificity in this study population. Decline of SpO during 1-STS was tendentially greater in those with Long COVID, yet without significance (-2.7+/-4.4 vs -0.8+/-1.4%;p=0.093). Conclusion(s): Lower final SpO and HR on 1-STS, as well as 30' HR, were associated with the occurrence of Long COVID. Final HR<80 bpm in a post COVID-19 setting might be the best 1-STS predictor of Long COVID.

Effect of psychosocial safety climate and organizational justice on affective commitment: A study in the Algarve hotel sector during the COVID-19 pandemic

Through the lens of the Job Demands-Resources (JD-R) model, this study aimed to analyze how psychosocial safety climate and organizational justice were related to: (a) work engagement through positive psychological capital (PsyCap);and (b) affective commitment through work engagement, in a sample of 217 hospitality workers of the Algarve (Portugal). Using structural equation modeling (SEM), it was observed that PsyCap partially mediated the relationship between organizational justice and work engagement, and that work engagement partially mediated the association between psychosocial safety climate and organizational justice, and affective commitment. The theoretical and practical implications of these results are discussed. © 2022 Taylor & Francis Group, LLC.

Evaluation of an Online English Reading Strategies Course Taught at the Beginning of the Pandemic Period

Given the new social scenario due to the Covid-19 pandemic, in which teaching practices are carried out under the condition of constant adaptation, this article aims to analyze the activities developed in a Basic English Reading Strategies Course offered as an optional subject to undergraduate students in a multicampus university. We present the students' final averages to discuss their level of reading comprehension and performance in the course and propose a reflection on online teaching to undergraduate students during the pandemic period, in which Emergency Remote Education (ERE) was adopted as an alternative measure to contain damage in education. Based on the study done through bibliographic review and a survey answered by two hundred students, we came to the conclusion there is still some need for interaction maintenance between students and teachers during the isolation period, as well as the synchronous class model for the success of the subject.

Older people's social representations of their social isolation during the COVID-19 pandemic

Background: Isolation is adopted worldwide during the different phases of the pandemic in an at-tempt to flatten the contagion curve and protect vulnerable groups. Objective: To discuss the social representations of older people about their social isolation during the COVID-19 pandemic. Methodology: Qualitative research based on the structural approach of social representations. 117 elderly people who sought immunization for influenza in a Brazilian Basic Health Unit in 2020 par-ticipated. Sociodemographic data and evocation technique were collected. Prototypical analysis was carried out after lexicographic, semantic reconciliation and co-occurrence testing in the EVOC and Iramuteq software. Results: The representations were aimed at “distancing” and anchored in the justifications “neces-sary-safe, make-possible, stay-home, limit-exit, danger-disease and prevention” that reflected the process of building social representations. Conclusion: The representations were objectified by distancing and anchored in the expressed justifications necessary-safe, make-possible, stay-at-home, limit-out, danger-disease and prevention, which reflected the process of construction of representations in a knowable perspective. © 2022, Escola Superior de Enfermagem de Coimbra. All rights reserved.

[Translated article] Sexually Transmitted Infections During the First Wave of the COVID-19 Pandemic in Spain☆ Infecciones de transmisión sexual (ITS) durante el estado de alarma por la pandemia de COVID-19 en España

Objective To describe changes in sexually transmitted infection (STI) diagnoses during the first wave of the COVID-19 pandemic in Spain. Material and methods We collected demographic, chronological, and clinical data for all patients seen for a possible STI at Hospital La Paz, Centro Sanitario Sandaval, and Centro de Diagnóstico Médico in Madrid and Hospital Costa del Sol in Malaga between March 14, 2020 and June 30, 2020. Results We identified 674 STI diagnoses. The median age of the patients was 33 years. Most cases were observed among people aged 30 to 40 years and among men who have sex with men. The most common diagnoses were proctitis (36.5%), syphilis (16%), nongonococcal (13.3%) and gonococcal (11.3%) urethritis, genital herpes (8.8%), vulvovaginitis/cervicitis (8.3%), and genital warts (4.2%). A microbiologically confirmed diagnosis was on record for 77% of cases. The main microorganisms identified were Chlamydia trachomatis (35.7%), Neisseria gonorrhoeae (31.4%), and Treponema pallidum (17.2%). The number of STI diagnoses increased after the easing of lockdown restrictions, which resulted in greater freedom of movement and more consultations. On comparing the 2019 and 2020 STI registries from Centro Sanitario Sandoval and Hospital La Paz for the period March to June, we observed reductions (of up to 81%) in all STI diagnoses. Conclusions Physical distancing and movement restrictions appear to have resulted in a reduction in the incidence of STIs, although these measures did not completely eliminate sexual risk behaviors.

Portuguese immunoallergology clinical experience in patients with severe atopic dermatitis under dupilumab treatment

Background: Dupilumab has been recently approved for treatment in patients with severe AD in Portugal-until now there is no published data regarding Portuguese experience in Allergy centers. Method: Cross sectional clinical and laboratory assessment of 33 patients (pts) with moderate to severe AD treated with dupilumab (dupi) for at least 16 weeks (W): prospective evaluation of severity scores (SCORAD-Scoring Atopic Dermatitis, EASI-Eczema Area and Severity Index, P-VAS-Pruritus Visual Analogic Scale), report of adverse events up to 52 weeks of treatment. SCORAD and EASI were assessed in 23 pts at W52, P-VAS in 21 pts at W52. Results: Of the 33 pts, 18 were female (55%) with a mean age (SD, range) of 35.3 years (13.2, 15-60). In 16 pts the age of onset was before 2 years old, mean (SD) disease duration 28.1 years (12);94% patients had a diffuse pattern of skin lesions;97% of pts had allergic rhinitis, 82% asthma, 52% conjunctivitis and 30% food allergy. Median total IgE at baseline was of 6313 U/ml (P25-P75: 2842-12491) with a 76% reduction at W52 in 16 pts. Median eosinophil count at baseline was 520 eosinophils/mm3 (P25-P75: 270-740). Before starting dupi 29 pts had been treated with cyclosporine. At the beginning, 15 pts were under oral corticosteroids, 14 under oral systemic immunosuppressive drugs (all pts but two stopped both until W12 of dupi) and 5 switched from omalizumab. At baseline, median SCORAD and EASI were 69.3 and 24.2 points. At W16, W36 and W52, median SCORAD was 27.4, 22.3 and 21.5, and median EASI 5.3, 4.1 and 2.1. At W16, the EASI-50, EASI-75 and EASI-90 were achieved by 91%, 61% and 18% pts, and at W52, by 87%, 70% and 52% pts. The mean percentage of SCORAD reduction at W16 and W52 was 55% and 73%;and of EASI was 76% and 82%. At W16 and W52, an improvement of ≥4 points in P-VAS was achieved by 77% and 95% pts. There was a mean reduction of P-VAS at W2, W4, W16 and W52 of 2.6;3.6;4.7 and 6.3 points, respectively. Conjunctivitis was reported in 10 (30%) pts, two of them with keratoconjunctivitis and blepharitis, without needing to interrupt treatment;two pts also had facial erythema. One patient had COVID, and dupilumab scheme treatment was maintained. Conclusion: The majority of AD patients had a significant and consistent improvement in all the severity scores, after one year of treatment with dupilumab. No relevant adverse events were reported.

Linseed allergy in an infant: A rare but increasing allergen

Case Report: With the growing trend of incorporating seeds in diet, hypersensitivity reactions have been progressively occurring but are rarely suspected. Linseed is a plant from the Linaceae family, and its seeds are increasingly used in bread. Despite being identified as an allergen capable of causing anaphylaxis, case reports are scarce. Female infant, 11 months old, with atopic dermatitis (AD), has been under cow's milk (CM) avoidance diet in the last 3 months due to CM allergy. At 10 months old, 15 minutes after ingesting a maze and sweet potato's bread, a perioral, axillar, and ear's pruriginous erythema developed, as well as nasal, palpebral, and malleolar angioedema. It was medicated with second-generation H1 antihistamine with symptom resolution after 6 hours. She avoided that bread and tolerated wheat bread. Prick to prick tests were positive for the suspected bread but negative for maze flour and raw and cooked sweet potato. After a detailed analysis of the bread's composition, linseed was identified, and prick to prick tests were positive with it. Due to COVID-19 restrictions, the patient has not yet performed oral challenge. A linseed allergy was the most likely diagnosis. Thus, we recommended avoiding this seed or any food that can contain it. Crossreactivity with other foods (wheat, peanut, rapeseed) and rape pollen is poorly understood, and its clinical relevance has not yet been determined. Hence, we did not perform any further investigation. This was a rare finding, and we did not find any report on infancy. This case should raise awareness for a growing trend of seed hypersensitivity. Therefore, this group of foods should be taken into account while we're investigating suspected allergic reactions to cereals and other grains.

Respiratory function in asthmatic patients after SARScoV-2 infection

Background: According to current evidence, the lungs are the most affected organ in SARS-CoV-2 infection. Recent data shows impairment of carbon monoxide diffusing capacity, decreased total lung capacity, and restrictive ventilatory defect in COVID-19 adult patients. Data in children are lacking. Our goal was to characterize clinically and demographically the pediatric population with asthma that tested positive for SARS-CoV-2 in our hospital during 2020 and evaluate the pulmonary function after the infection. Method: Cross-sectional study performed in Hospital Dona Estefânia, from March 2nd to December 31st, 2020. All pediatric asthmatic patients (<18 years) who tested positive for SARS-CoV-2 (RT-PCR test) were included. Asthma diagnosis was based on a previous physician's diagnosis or parent-reported history. A convenience sample of the asthmatic patients performed spirometry and carbon monoxide diffusing capacity (DLCO). Results: We were able to identify 20 asthmatic patients [50% male;median age: 10.5 years old (P25- 75: 9- 14.5)]. Atopic comorbidities were present in 75% ( n = 15) (rhinitis the most frequent). According to GINA, 11 (55%) had mild and 9 (45%) moderate asthma. Five patients (25%) needed hospital admission because of COVID-19 infection, 3 had asthma exacerbation, and 3 had COVID-19 pneumonia. Nine of the 20 patients performed spirometry and DLCO after COVID-19 infection. Respiratory function was performed few months after the infection [median=3 months (P25- 75: 2- 6.5)]. In our sample, we found 2 patients with obstructive ventilation impairment and small airway dysfunction. We didn't find any statistically significant difference between de FVC, FEV1, FEV1/FVC ratio, FEF25- 75, and peak expiratory flow (PEF) before and after COVID-19 infection. There were 2 asthmatics with impaired DLCO (65.1% and 64.7%). Conclusion: Two patients showed obstructive ventilation, but it could be due to the variable airflow limitation of asthma, and 2 had DLCO impairment. We didn't find any statistically significant difference between respiratory function before and after COVID-19 infection. However, this is a small sample, and further evaluations with larger populations are needed.

Sexually Transmitted Infections During the First Wave of the COVID-19 Pandemic in Spain.

OBJECTIVE: To describe changes in sexually transmitted infection (STI) diagnoses during the first wave of the COVID-19 pandemic in Spain. MATERIAL AND METHODS: We collected demographic, chronological, and clinical data for all patients seen for a possible STI at Hospital La Paz, Centro Sanitario Sandaval, and Centro de Diagnóstico Médico in Madrid and Hospital Costa del Sol in Malaga between March 14, 2020 and June 30, 2020. RESULTS: We identified 674 STI diagnoses. The median age of the patients was 33 years. Most cases were observed among people aged 30 to 40 years and among men who have sex with men. The most common diagnoses were proctitis (36.5%), syphilis (16%), nongonococcal (13.3%) and gonococcal (11.3%) urethritis, genital herpes (8.8%), vulvovaginitis/cervicitis (8.3%), and genital warts (4.2%). A microbiologically confirmed diagnosis was on record for 77% of cases. The main microorganisms identified wereChlamydia trachomatis (35.7%), Neisseria gonorrhoeae (31.4%), and Treponema pallidum (17.2%). The number of STI diagnoses increased after the easing of lockdown restrictions, which resulted in greater freedom of movement and more consultations. On comparing the 2019 and 2020 STI registries from Centro Sanitario Sandoval and Hospital La Paz for the period March to June, we observed reductions (of up to 81%) in all STI diagnoses. CONCLUSIONS: Physical distancing and movement restrictions appear to have resulted in a reduction in the incidence of STIs, although these measures did not completely eliminate sexual risk behaviors.

OBJETIVO: Describir los cambios en el comportamiento de las ITS durante la situación de alerta sanitaria por la pandemia SARS-CoV-2. MATERIAL Y MÉTODOS: Se recogieron datos demográficos, cronológicos y clínicos de todos los pacientes que solicitaron atención médica por ITS en los hospitales La Paz y Costa del Sol, y los Centros Sandoval y de Diagnóstico Médico entre el 14/03/2020 y el 30/06/2020. RESULTADOS: Documentamos 674 casos de ITS. La mediana de edad fue de 33 años. El mayor porcentaje de casos se dio en el rango de 30-40 años y en hombres que tenían sexo con hombres. Los diagnósticos más frecuentes fueron: proctitis (36,5%), sífilis (16%), uretritis no gonocócica (13,3%) y gonocócica (11,3%), herpes genital (8,8%), vulvovaginitis/cervicitis (8,3%) y condilomas (4,2%).En 77% de los casos hubo confirmación microbiológica, siendo los microorganismos más frecuentes Chlamydia trachomatis (35,7%), Neisseria gonorrhoeae (31,4%) y Treponema pallidum (17,2%).Se constató un incremento del número de casos de ITS tras el desconfinamiento, explicable por las mayores libertades y el aumento de consultas. Comparando los registros de ITS del Centro Sandoval y el Hospital La Paz en los cuatrimestres de marzo a junio de 2019 frente a 2020, se observó una disminución en 2020 de todos los diagnósticos, de hasta un 81% menos que en 2019. CONCLUSIONES: Las medidas de distanciamiento y limitación de movilidad aparentemente generaron una disminución de la incidencia de ITS, pero sin llegar a una inhibición completa de las conductas sexuales de riesgo.

Portuguese National Health Service on Instagram: University students' perception of @sns_pt content in the COVID-19 pandemic

This article addresses the perceptions of university students about the Portuguese National Health Service (NHS) on Instagram (IG), which is the main profile of the country's government on the platform. Young people are the largest audience of this social media (SM), which has been considered as a tool to promote public health. Therefore, this study aims at identifying how young adults perceive the content available in @sns_pt regarding health and well-being topics. The qualitative methodology was used, and a survey was carried out with undergraduate students from the University of Aveiro. It was applied digitally in June 2020, 90 days after the World Health Organization (WHO) announced the new coronavirus pandemic. The survey presents 15 questions, divided into three axes: consumption of SM, use of IG, and posts evaluation. A total of 39 valid questionnaires were obtained. The sample is made up of students between the ages of 19 and 45 years old, being 61.5% female and 38.4% male. The results obtained show that @sns_pt is known by 43.5% of the respondents and 12.8% follow the account. Also, 10.2% reported having accessed the profile for the first time after the pandemic started. The posts focused on images attracted the attention of students, as well as the contents regarding the users' routines. © 2021 AISTI.

[Sexually Transmitted Infections During the First Wave of the COVID-19 Pandemic in Spain]. / Infecciones de transmisión sexual (ITS) durante el estado de alarma por la pandemia de COVID-19 en España.

OBJECTIVE: To describe changes in sexually transmitted infection (STI) diagnoses during the first wave of the COVID-19 pandemic in Spain. MATERIAL AND METHODS: We collected demographic, chronological, and clinical data for all patients seen for a possible STI at Hospital La Paz, Centro Sanitario Sandoval, and Centro de Diagnóstico Médico in Madrid and Hospital Costa del Sol in Malaga between March 14, 2020 and June 30, 2020. RESULTS: We identified 674 STI diagnoses. The median age of the patients was 33 years. Most cases were observed among people aged 30 to 40 years and among men who have sex with men. The most common diagnoses were proctitis (36.5%), syphilis (16%), nongonococcal (13.3%) and gonococcal (11.3%) urethritis, genital herpes (8.8%), vulvovaginitis/cervicitis (8.3%), and genital warts (4.2%). A microbiologically confirmed diagnosis was on record for 77% of cases. The main microorganisms identified were Chlamydia trachomatis (35.7%), Neisseria gonorrhoeae (31.4%) and Treponema pallidum (17.2%). The number of STI diagnoses increased after the easing of lockdown restrictions, which resulted in greater freedom of movement and more consultations. On comparing the 2019 and 2020 STI registries from Centro Sanitario Sandoval and Hospital La Paz for the period March to June, we observed reductions (of up to 81%) in all STI diagnoses. CONCLUSIONS: Physical distancing and movement restrictions appear to have resulted in a reduction in the incidence of STIs, although these measures did not completely eliminate sexual risk behaviors.

An Advertising Overflow Attack against Android Exposure Notification System Impacting COVID-19 Contact Tracing Applications

The contact tracing mobile Apps are one of the many initiatives to fight the COVID-19 virus. These Apps use the Exposure Notification (EN) system available on Google and Apple’s operating systems. However, contact tracing applications depend on the availability of Bluetooth interfaces to exchange proximity identifiers that, if compromised, directly impact the effectiveness of the apps. This paper discloses and details the Advertising Overflow attack, a novel internal Denial of Service (DoS) attack targeting the EN system on Android Operating System (OS) devices. The attack is performed by a malicious App that occupies all the Bluetooth advertising slots in an Android device, effectively blocking any advertising attempt of EN. The impact of the disclosed attack and other already disclosed DoSbased attacks, namely Battery Exhaustion and Storage Drain, was tested using two target smartphones and other six smartphones as attackers. The results show that the Battery Exhaustion attack imposes a battery discharge rate 1.95 times superior to the baseline. Regarding the Storage Drain, the storage usage increased more than 30 times the baseline results. The results of the novel attack reveals that a malicious App is able to block the usage of Bluetooth advertising by any other App by any chosen time period, canceling the operation of the EN system and compromising the efficiency of any COVID’s contact tracing App based on EN. CCBY

Retrospective study for the characterization of COVID-19 in renal cancer (COVID-REN) patients treated with antiangiogenics or immunotherapy and outcome comparison with non-infected cases

Background: Cancer is recognized as a major risk factor for severe COVID19. However little is known about the impact of oncologic treatments in the evolution of the disease. On the other hand, the influence of SARS-CoV2 in cancer response remains to be established. We aim to determine both aspects in renal cancer patients receiving different therapeutic options. Methods: We designed a retrospective casecontrol study to compare the outcome of patients with advanced renal cancer who developed COVID19 under antiangiogenic treatment (cohort A [ChA]) vs immunotherapy (alone or in combination: cohort B [ChB]) vs matched controls (cohort C [ChC]). Controls were renal cancer patients who were not infected during the period of study. One control per case was selected regarding age, gender, kidney cancer histology and type of treatment. Results: From May 20 to Feb 21, 80 patients were recruited. We present the first 55 patients included (15 ChA, 16 ChB and 20 ChC, 4 patients were screening failure) from 13 centers in Spain. Median age was 62 (range 25 to 88) overall and 62 (range 44 to 88) in Ch A, 64,5 (range 42 to 83) in ChB and 61 (range 41 to 77) in ChC. 38 patients were male and 13 were female. Overall 45 cases were clear cell carcinoma (13 ChA, 14 ChB and 18 ChC), 4 papillary (1 ChA, 2 ChB and 1 ChC), 1 chromophobe (ChA) and 1 unclassified (ChC). Median number of prior lines of treatment was 2 (range 1 to 6) overall, (1 [range 1 to 4] in ChA, 2 [range 1 to 4] in ChB and 2 [range 1 to 6] in ChC). 25 patients required treatment interruptions (8 in ChA [32%], 14 in ChB [56%] and 3 [12%] in ChC). 9 patients were hospitalized (4 in Ch A, 5 in ChB and none in ChC) for a median of 10 days (range 4 to 16) overall (7 [range 4 to 14] in ChA and 12 [range 5 to 16] in ChB). No patient required ICU admission. Best tumor response was complete or partial (CR+PR) in 25 patients (5 [20%] in ChA, 9 [36%] in ChB and 11 [44%] in ChC). Clinical benefit (CR+PR+stable disease) was observed in 38 patients (11 [28,9%] in ChA, 10 [26,3%] in ChB and 17 [44,7%] in ChC). One patient in ChB died (due to COVID19). Updated results will be presented. Conclusions: Patients with renal cancer who developed COVID19 held treatment more frequently and presented lower clinical benefit rates than non infected cases. Patients receiving immunotherapy required more frequent dose interruptions and longer hospitalizations than cases on antiangiogenics. These results point to an impact of SARS-CoV2 in renal cancer outcome. Therapies administered to treat renal cancer, could play a role in the evolution of COVID19.