Mild sensory symptoms during SARS-CoV-2 infection among healthcare professionals⋆ Estudio de clínica sensitiva leve durante la infección por SARS-CoV-2 en población sanitaria

Introduction It is not yet possible to estimate the proportion of patients with COVID-19 who present distinguishable classical neurological symptoms and syndromes. The objective of this study is to estimate the incidence of sensory symptoms (hypoaesthesia, paraesthesia, and hyperalgesia) in physicians who have presented the disease at Hospital Universitario Fundación Alcorcón (HUFA) in Madrid;to establish the relationship between sensory symptoms and the presence of other signs of infection;and to study their association with the severity of COVID-19. Methods We conducted a descriptive, cross-sectional, retrospective, observational study. HUFA physicians who presented SARS-CoV-2 infection between 1 March and 25 July 2020 were included in the study. A voluntary, anonymous survey was distributed via corporate email. Sociodemographic and clinical characteristics were collected from professionals with PCR- or serology-confirmed COVID-19. Results The survey was sent to 801 physicians and we received 89 responses. The mean age of respondents was 38.28 years. A total of 17.98% presented sensory symptoms. A significant relationship was found between the presence of paraesthesia and cough, fever, myalgia, asthaenia, and dyspnoea. A significant relationship was also found between paraesthesia and the need for treatment and admission due to COVID-19. Sensory symptoms were present from the fifth day of illness in 87.4% of cases. Conclusions SARS-CoV-2 infection can be associated with sensory symptoms, mostly in severe cases. Sensory symptoms often appear after a time interval, and may be caused by a parainfectious syndrome with an autoimmunity background.

Mild sensory symptoms during SARS-CoV-2 infection among healthcare professionals.

INTRODUCTION: It is not yet possible to estimate the proportion of patients with COVID-19 who present distinguishable classical neurological symptoms and syndromes. The objective of this study is to estimate the incidence of sensory symptoms (hypoaesthesia, paraesthesia, and hyperalgesia) in physicians who have presented the disease at Hospital Universitario Fundación Alcorcón (HUFA) in Madrid; to establish the relationship between sensory symptoms and the presence of other signs of infection; and to study their association with the severity of COVID-19. METHODS: We conducted a descriptive, cross-sectional, retrospective, observational study. HUFA physicians who presented SARS-CoV-2 infection between 1 March and 25 July 2020 were included in the study. A voluntary, anonymous survey was distributed via corporate email. Sociodemographic and clinical characteristics were collected from professionals with PCR- or serology-confirmed COVID-19. RESULTS: The survey was sent to 801 physicians and we received 89 responses. The mean age of respondents was 38.28 years. A total of 17.98% presented sensory symptoms. A significant relationship was found between the presence of paraesthesia and cough, fever, myalgia, asthaenia, and dyspnoea. A significant relationship was also found between paraesthesia and the need for treatment and admission due to COVID-19. Sensory symptoms were present from the fifth day of illness in 87.4% of cases. CONCLUSIONS: SARS-CoV-2 infection can be associated with sensory symptoms, mostly in severe cases. Sensory symptoms often appear after a time interval, and may be caused by a parainfectious syndrome with an autoimmunity background.

Severity of COVID-19 infection in prostate cancer patients and effect of ADT on disease presentation

Introduction & Objectives: The TMPRSS2 protein has been found to be involved as a critical host cell factor in severe acute respiratory syndrome caused by coronavirus 2(SARS-CoV-2). The production of this protein is regulated by the androgen receptor (AR), also in non-prostatic tissues, including the lung. There is the speculation that androgen deprivation therapy (ADT) may protect patients affected by prostate cancer (PC) from SARS-CoV-2 infection. Our goal is to analyze the severity of COVID-19 in PC patients and the possible influence of ADT on this infection. Materials & Methods: Retrospective study of patients treated for COVID-19 between March 15th and May 15th 2020 in our institution who had previous diagnosis of PC. Patients were divided into two: Those treated with ADT during the infection or the year before, and those who were not treat with ADT on that period. Differences between groups in demographic characteristics, parameters of PC disease, risk factors for SARS-CoV-2 pneumonia, the presence of severe COVID-19 and mortality rates were analyzed. Results: During the study period, a total of 1365 patients were treated in our center for COVID-19 documented with positive PCR. From a total of 1349 subjects registered in our PC database, 156 were on ADT treatment and 1193 were not. Out of the total, 61 (4.52%) PC patients suffered from COVID-19, 11 (18.0%) belonged to the ADT group and 50(82.0%) to the non-ADT group. The mean age of the series was 77.6 years (SD:7.7). The cumulative incidence recorded of COVID-19 in total PC patients was 4.5% (95%CI: 3.5-5.8). Demographic variables, comorbidities and risk factors for infection were quite homogeneous in both groups. Although a worse tendency was observed in the non-ADT group, no statistically significant differences were found in any of the variables analyzed. Regarding the influence of ADT on the course of the disease, no statistically significant differences were found neither in the exitus rate (27.3% vs. 34.0%;p 0.481), nor in the presence of severe COVID-19: need for intubation or ICU admission(0% vs 6.3%;p 0.561) and need for corticoid treatment, interferon beta or tocilizumab (60% vs. 34.7%;p 0.128). In the univariate analysis, treatment with ADT was not found to be a protective factor for worse clinical evolution (RR 1.11;95%CI 0.67-1.85;p=0.68) or exitus (RR 0.8;95%CI 0.28-2.27;p=0.68). We also found no statistically significant differences when multivariate analysis adjusted for clinically relevant comorbidities was performed. Conclusions: In our study, the use of ADT has not been shown to be a protective factor against serious COVID-19. In view of the results published to date, more research in this area is definitely needed to draw firm conclusions.

Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIALS AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n = 20419) was higher than among Spaniards (n = 131599): 8.81 and 6.51 and per 1000 inhabitants, respectively (p <  .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found in people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p =  .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p <  .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p <  .001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.

[Strategy for planning and execution of a large-scale SARS-CoV-2 seroprevalence study on teaching hospital workers during a pandemic situation]. / Estrategia de planificación y ejecución de un estudio a gran escala de seroprevalencia de SARS-CoV-2 en trabajadores de un hospital universitario durante una situación de pandemia.

OBJECTIVE: To describe the planning and execution process of a massive seroprevalence study for SARS-CoV-2 in professionals of the Hospital Universitario Fundación Alcorcón (HUFA) (Spain). METHODS: A description is presented of the plan designed and developed at the HUFA for the execution of the extraction of the samples for serology from all the professionals who worked in the hospital between 14 and 29 April 2020. A descriptive analysis of the participation of the professionals in the study is carried out. Extraction areas, health personnel, and execution times were planned. A total of 2326 extractions were assigned to health personnel, the remaining extractions were assigned to workers from external companies. RESULTS: A total of 2641 workers (90.5%) out of 2918 candidates participated in the study. The professional category most analysed was nursing with 28.3% (n = 590). The percentage of compliance with schedule planning was 28.6%. Up to a maximum of 298 daily extractions were planned. The busiest day was the 4th day of the study with 399 extractions. CONCLUSIONS: The organising of such a large study, with a 100% coverage of those who worked in the hospital, and with such a great response from the workers involved, has led to obtaining results of high reliability in the seroprevalence study carried out. Although the percentage of participation was very high, the level of compliance with the planning was low.

[Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain]. / Riesgo de COVID-19 en españoles y migrantes de distintas zonas del mundo residentes en España en la primera oleada de la enfermedad.

INTRODUCTION AND OBJECTIVES: Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS: We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS: The crude cumulative incidence among migrants (n = 20,419) was higher than among Spaniards (n = 131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p < .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p = .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p < .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p < .001). CONCLUSIONS: Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.