ABSTRACT
Background: Long term evolution of Multisystem Inflammatory Syndrome in children (MIS-C) is poorly understood. In this report, we described the frequency of persistent symptoms and sequels after one-year monitoring in a cohort of MIS-C patients. Method(s): This is a prospective observational study in under-18-aged patients diagnosed with MIS-C between October 2020 and April 2021 in a tertiary hospital. Data from initial episode was obtained from the Spanish national database and the medical history. A standardized phone questionnaire was done one year after the acute episode. As patients pared by age and sex were included with i) history of acute COVID-19, from the same national database, and ii) with peritonitis diagnosis in the electronic medical record. Data was collected using REDCap and analysed with R. Ethics committee approval was obtained. Result(s): A total of 48 patients were included in the study, 16 in each group. Average age at hospitalization was 11,2 years old [IQR: 6,6-14,4] and 52% (23/48) were male. MIS-C patients presented high frequently 94% (15/16) cardiological complications during hospitalization, in contrast with 19% (3/16) of acute COVID-19 patients and 25% (4/16) of peritonitis group (p< 0.01). All of them resolved after a year except the ones associated to hypoxic ischemic encephalopathy in a patient with MIS-C that need ECMO assistance. Summary characteristics during acute episode are shown in Table 1. After one-year follow-up, 88% MIS-C patients suffered one or more symptoms, more frequently: headache (44%), fatigue (38%), insomnia (38%) and concentration problems (38%). A total of 56% of COVID-19 patients presented persisted symptoms, mainly fatigue and concentration problems (19%), and 31% in peritonitis group (19% loss of appetite and abdominal pain), (p< 0.001). MIS-C patients visited more frequently the medical professionals due to emotional change, behaviour or interpersonal relationships after the disease [4/16 (25%) in MIS-C vs. 0/16 (0%) in both control groups, p= 0.028]. Conclusion(s): Majority of MIS-C patients have persistent symptoms one year after acute episode, even with the resolution of cardiological complications. Frequency of long term symptoms in MIS-C patients is significantly higher than in COVID-19 hospitalized and than in a control group of surgical peritonitis patients. Summary characteristics during acute episode.
ABSTRACT
This research aims to determine the differences and similarities in perceptions, experiences, satisfaction, and behaviour intention of travellers who engage with, and appreciate Intangible Cultural Heritage, according to the sociodemographic profile of these travellers. Literature concerning Intangible Cultural Heritage tourists' profile is still scarce, being important for World Heritage Site destinations or places with Intangible Cultural Heritage recognition to identify the tourists attracted by culture and heritage. Thus, the work presented intend to cover the gap identified in this sense, taking as reference the results obtained from fieldwork consisting of a structured questionnaire which was administered to a representative sample of tourists who participated in the Fiesta de los Patios event in Cordoba (Spain), which is recognised as Intangible Cultural Heritage asset. Mann-Whitney and Kruskal-Wallis tests are used to compare groups of the sample according to the sociodemographic profile of the tourists, revealing statistical differences among these groups. The results enable us to analyse the post-COVID tourist, and determine to what extent they are satisfied with the new worldwide situation. This research could be useful both to public agents of tourism promotion and private businesses, whose target audience are tourists attending this type of event. The research unpacks the profile of the visitor, relating their gender, age, educational level, and income to their experiences, perceptions, satisfaction, and behaviour intention. This enables the tourist offer to be adapted, making it more attractive to the potential client.
ABSTRACT
This research aims to determine the differences and similarities in perceptions, experiences, satisfaction, and behaviour intention of travellers who engage with, and appreciate Intangible Cultural Heritage, according to the sociodemographic profile of these travellers. Literature concerning Intangible Cultural Heritage tourists’ profile is still scarce, being important for World Heritage Site destinations or places with Intangible Cultural Heritage recognition to identify the tourists attracted by culture and heritage. Thus, the work presented intend to cover the gap identified in this sense, taking as reference the results obtained from fieldwork consisting of a structured questionnaire which was administered to a representative sample of tourists who participated in the Fiesta de los Patios event in Cordoba (Spain), which is recognised as Intangible Cultural Heritage asset. Mann–Whitney and Kruskal–Wallis tests are used to compare groups of the sample according to the sociodemographic profile of the tourists, revealing statistical differences among these groups. The results enable us to analyse the post-COVID tourist, and determine to what extent they are satisfied with the new worldwide situation. This research could be useful both to public agents of tourism promotion and private businesses, whose target audience are tourists attending this type of event. The research unpacks the profile of the visitor, relating their gender, age, educational level, and income to their experiences, perceptions, satisfaction, and behaviour intention. This enables the tourist offer to be adapted, making it more attractive to the potential client. © 2022, Universidad de Huelva. All rights reserved.
ABSTRACT
Background: There are still scant data on the immunogenicity of SARS-CoV-2 mRNA vaccination in PWH, and no experience in HIV-infected adolescents has been reported. Methods: A prospective ongoing observational study is being conducted in HIV-infected adolescents after the introduction of mRNA vaccination in Spain starting in August, 2021. Blood samples were drawn 3-8 weeks after the second dose of BNT162b2(Pfizer/BioNTech) and CoV-2 mRNA-1273(Moderna) vaccines in 15 HIV-infected adolescents and were compared to 19 matched healthy subjets. Humoral response was assesed by detection of SARS-CoV-2 antibodies by chemiluminescent microparticle immunoassay (CMIA,Alinity® Quant assay-Abbott) to detect IgG against S1 region of the spike protein of SARS-CoV-2 (≥50U/mL considered reactive). T-Cell response to SARS-CoV-2 was measured by an interferon-gamma released assay (IGRA,Euroimmun) of S1 peptide-stimulated T-cells in whole blood (≥200mlU/ml considered reactive). Results: Fifteen HIV-infected adolescents (11female) were included, after administration of mRNA vaccination (13 Pfizer, 2 Moderna). All but 1 were perinatally infected, 10 Caucasian, 3 Latino and 2 from Sub-saharan Africa. Median age was 16.2 years (IQR12.7-19.2) and 14.3 years (IQR12.7-19.2), in patients and controls(p>0.05). Four patients were on CDC-Class C or 3. Median baseline CD4+ count was 703 cells/ul (IQR 596-1098). All were on integrase inhibitors-based ART (13had undetectable viral load). The nadir CD4 was 446 cells/ul (IQR 596-1098). Median interval days since last vaccine dose in HIV-infected adolescents and controls were 33 days(IQR29-49) and 33.5 days(IQR27-45), respectively(p>0.05). All patients and controls had reactive humoral and celular responses. HIV-infected subjects had lower anti-Spike antibodies titers (median:11320U/mL, IQR6074-21518) than controls (median: 30342 AU/mL, IQR9222-38013) (p=0.001). No significant differences were observed in cellular immune responses in HIV-infected adolescents (median 1759mlU/ml, IQR:1613-1856) vs controls (median 1853mlU/ml, IQR1782-1873) (p=0.12). No correlation was observed between quantitative humoral and cellular responses Conclusion: HIV-infected adolescents with good immuno-virologic status show appropriate specific antibody levels and cellular immune responses against SARS-CoV-2 shortly after mRNA vaccination. Although they appear to mount a similar quantitative celular inmune response, the elicited antispike antibody levels was lower than that in healthy controls.
ABSTRACT
Background: SARS-CoV-2 virus has spread worldwide causing a crisis in healthcare systems. We aimed to describe the clinical characteristics and to explore risk factors of death, critical care admission and use of invasive mechanical ventilation in hospitalized patients with SARS-CoV-2 pneumonia in Bogota, Colombia. Methods: We conducted a cross-sectional study of adult patients with laboratory-confirmed SARS-CoV-2 pneumonia. Demographic, clinical, and treatment data were extracted from electronic records. Univariate and multivariable methods were performed to investigate the relationship between each variable and clinical outcome at 28 days of follow-up. Results: Between March 20 and June 30, 2020, 377 adults (56.8% male) were included in the study, of whom 85 (22.6%) died. Non-survivors were older on average than survivors (mean age, 56.7 years [SD 15.8] vs. 70.1 years [SD 13.9]) and more likely male (28 [32.9%] vs. 57 [67.1%]). Most patients had at least one underlying disease (333 [88.3%]), including arterial hypertension (149 [39.5%]), overweight (145 [38.5%]), obesity (114 [30.2%]) and diabetes mellitus (82 [21.8%]). Frequency of critical care admission (158 [41.9%]) and invasive mechanical ventilation (123 [32.6%]) was high. Age over 65 years (OR 9.26, 95% CI 3.29-26.01;p=0.00), ICU admission (OR 12.37, 95% CI 6.08-25.18;p=0.00), and arterial pH higher than 7.47 (OR 0.25, 95% CI 0.08-0.74;p=0.01) were independently associated with in-hospital mortality. Model based on clinical characteristics on admission yielded an area under the receiver operating characteristic curve of 0.869. Discussion and Conclusions: To december 2020, this single-center study is the first report of hospitalized adult patients with SARS-CoV-2 pneumonia in Andean subregion. In this study of in-hospital patients with SARS-CoV-2 pneumonia frequency of death was similar to what has been reported. ICU admission and use of invasive mechanical ventilation was high and most patients had a mild pneumonia at admission, according to CURB-65 and qSOFA scores. Most of our patients had at least one comorbidity. The prevalence of obesity was considerably higher than the overall prevalence in Colombian adults. Further studies may help to understand the impact of high-altitude on Covid-19 outcomes given Bogota is situated at an altitude of 2,640 mamsl . Figure. Receiver ROC curves for (a) the model of age, ICU admission and arterial pH as a predictor of in-hospital mortality (area under the curve 0.869), and (b) the model of age, male sex, peripheral oxygen saturation and white blood cell count as a predictor of invasive mechanical ventilation due to SARS-CoV-2 pneumonia (AUC 0.761).