Symptoms of Anxiety in Mothers During the COVID-19 Lockdown: A Structural Equation Model Approach.

The COVID-19 global pandemic has forced millions of people to stay confined at home, increasing symptoms of anxiety and stress levels. Women who are also mothers, for their part, not only face the demands of motherhood but must combine working life with family life locked down in their homes. Main objective was to develop an explanatory model of the psychological consequences of COVID-19 and parental and perceived stress in mothers. A total of 261 mothers were evaluated coinciding with the lockdown imposed by the Spanish Government. The model displayed adequate indices and it was found that symptoms of anxiety in mothers increased the levels of perceived stress. The model allows to understand the close relationships between the psychological consequences of lockdown and stress in mothers. Understanding these relationships will help to prepare and direct psychological interventions in this population in the case of a possible new surge.

Aeroallergen immunotherapy associated with reduced risk of severe COVID-19 in 1095 allergic patients.

Introduction: Allergen immunotherapy (AIT) brings along changes in the immune system, restoring dendritic cell function, reducing T2 inflammation and augmenting the regulatory cell activation. Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, interferes with the immune system causing immune suppression during the first phase and over-activation in more advanced disease. We decided to explore the interaction of both in a real-world observational trial. Methods: We registered COVID-19 outcomes in patients with allergic disorders in Latin America, treated with and without AIT. The registry was conducted during the first 1.3 years of the pandemic, with most of the data collected before COVID-19 vaccination was concluded in most countries. Data collection was anonymous via a web-based instrument. Ten countries participated. Results: 630/1095 (57.6%) of the included patients received AIT. Compared to patients without AIT, those treated with AIT had a reduced risk ratio (RR) for COVID-19 lower respiratory symptoms (RR 0.78, 95% CI: 0.6703-0.9024; p = 0.001662) and need for oxygen therapy (RR 0.65, 95% CI: 0.4217-0.9992; p = 0.048). In adherent patients on maintenance sublingual immunotherapy/subcutaneous immunotherapy (SLIT/SCIT) the RR reduction was larger [RR = 0.6136 (95% CI 0.4623-0.8143; p < 0.001) and RR: 0.3495 (95% CI 0.1822-0.6701; p < 0.005), respectively]. SLIT was slightly more effective (NS). We excluded age, comorbidities, level of health care attendance, and type of allergic disorder as confounders, although asthma was related to a higher frequency of severe disease. When analyzing patients with allergic asthma (n = 503) the RR reduction favoring AIT was more pronounced with 30% for lower respiratory symptoms or worse (RR 0.6914, 95% CI 0.5264 to 0.9081, p = 0.0087) and 51% for need of oxygen therapy or worse (RR 0.4868, 95% CI 0.2829-0.8376, p = 0.0082). Among severe allergic patients treated with biologics (n = 24) only 2/24 needed oxygen therapy. There were no critical cases among them. Conclusion: In our registry AIT was associated with reduced COVID-19 severity.

Genomic Comparative Analysis of Two Multi-Drug Resistance (MDR) Acinetobacter baumannii Clinical Strains Assigned to International Clonal Lineage II Recovered Pre- and Post-COVID-19 Pandemic.

BACKGROUND: After the emergence of COVID-19, numerous cases of A. baumannii/SARS-CoV-2 co-infection were reported. Whether the co-infecting A. baumannii strains have distinctive characteristics remains unknown. METHODS AND RESULTS: A. baumannii AMA_NO was isolated in 2021 from a patient with COVID-19. AMA166 was isolated from a mini-BAL used on a patient with pneumonia in 2016. Both genomes were similar, but they possessed 337 (AMA_NO) and 93 (AMA166) unique genes that were associated with biofilm formation, flagellar assembly, antibiotic resistance, secretion systems, and other functions. The antibiotic resistance genes were found within mobile genetic elements. While both strains harbored the carbapenemase-coding gene blaOXA-23, only the strain AMA_NO carried blaNDM-1. Representative functions coded for by virulence genes are the synthesis of the outer core of lipooligosaccharide (OCL5), biosynthesis and export of the capsular polysaccharide (KL2 cluster), high-efficiency iron uptake systems (acinetobactin and baumannoferrin), adherence, and quorum sensing. A comparative phylogenetic analysis including 239 additional sequence type (ST) 2 representative genomes showed high similarity to A. baumannii ABBL141. Since the degree of similarity that was observed between A. baumannii AMA_NO and AMA166 is higher than that found among other ST2 strains, we propose that they derive from a unique background based on core-genome phylogeny and comparative genome analysis. CONCLUSIONS: Acquisition or shedding of specific genes could increase the ability of A. baumannii to infect patients with COVID-19.

Case study of children's narratives in videochats: contributions to the analysis of technology-mediated interactions / Estudio de caso de narrativas infantiles en videollamadas: Aportes al análisis de interacciones mediadas por tecnología

Resumen El aislamiento social preventivo y obligatorio por la pandemia del SARS-CoV-2 condujo a las familias a buscar alternativas para mantener el vínculo con sus parientes no convivientes. Una de ellas fue la videollamada, cuyo carácter audiovisual habilita nuevas maneras de comunicación (Ames et al., 2010; Ballagas et al., 2009; McClure y Barr, 2017) que podrían modificar las interacciones en las que adultos/as y niños/as participan y colaboran en la construcción de distintos tipos de discursos. La narración constituye una de las primeras y más relevantes formas de discurso en la infancia que permite reconstruir y comunicar la propia experiencia. En este trabajo se realizó un análisis de caso de 31 narrativas que tuvieron lugar en cinco videollamadas en las que participaban una misma niña residente de la Ciudad de Buenos Aires y sus familiares, pertenecientes al corpus "Contextos naturales de interacción en los hogares en los que los/as niños/as usan tempranamente tecnología"[1], a fin de caracterizar las interacciones que contribuyen a la configuración de las narrativas infantiles en contextos mediados por tecnología. Los resultados mostraron una mayor presencia de narrativas personales y de futuro, frente a pocas de ficción; mientras que estas últimas fueron en su totalidad autorreguladas, la cantidad de narrativas hetero y autorreguladas fue similar para los otros dos tipos de narrativas. Se identificaron distintas estrategias a las que, en el marco de videollamadas, la niña recurrió para participar en la construcción de narrativas.

Abstract The preventive and compulsory social isolation established in Argentina due to the SARS-CoV-2 pandemic led families to look for alternatives to maintain the bond and communicate with their non-cohabitant relatives. One of these alternatives was the use of videochat. Videochat enables new ways of audiovisual communication (Ames et al., 2010; Ballagas et al., 2009; McClure & Barr, 2017) that could affect the interactions in which adults and children collaborate in the construction of different types of discourses. Narratives are one of the first and most relevant forms of discourse, it allows for the reconstruction and communication of one's experience and is one of the ways in which thought is configured. In this work, a case study was conducted of the narratives produced during videochat conversations of a four-year-old girl with non-cohabiting relatives. The aim was to characterize the interactions that help in the configuration of children's narratives during technology-mediated situations. The research question were: (a) how do technology-mediated interactions allow the child to narrate about past and future events and to create fictional narratives?; (b) how does the child participate in the construction of those narrative in the context of these technology-mediated situations? Five videos of videochat interaction belonging to a single four year old girl were selected from the corpus "Contextos naturales de interacción en los hogares en los que los/as niños/as usan tempranamente tecnología". This corpus gathers different technology-mediated interactions collected during daily activities in the home of children aged 0 to 6 years. First, 31 narratives in which the girl participated were identified. Subsequently, used the constant comparative method was used (Strauss & Corbin, 1998) as well as analysis tools developed within the framework of interactive sociolinguistics (Gumperz, 1982, 1984); also, concepts developed in previous research (Arrúe et al., 2014; Labov, 1972; Rosemberg et al., 2010; Stein et al., 2020) were heuristically recovered to answer the research questions. Of the 31 narratives produced in the interactions, 14 were related to personal experience, 13 were of future events, and 4 were fiction narratives. Regarding the posed questions, results showed that children do in fact create personal, future and fictional narratives in technology-mediated interactions with adults. Technology also enables children to decide how much they want to participate in interactions: they can lead the narrative, or they can back off to a yes-or-no answer kind of participation. The child relies on the possibility to share visual information, beyond audio, to provide both events and context information. This interactive and multimodal aspect of videochats was also found to enable the girl to turn to present adults both to scaffold her narrative production and to resolve doubts about unknown words. Even though there are methodological limitations to this study, this first approach to narratives in technology-mediated interactions shows the richness that this type of interaction can have for the development of children's language.

The Impact of Biosecurity on Biological and Psychosocial Risks for Health Workers of COVID Hospitals in Guadalajara, Jalisco, Mexico.

BACKGROUND: Some data support that health care workers (HCWs) must have sufficient and good quality personal protective equipment (PPE) and the necessary training to manage COVID patients to avoid contagion that can lead to death. The objective of this study was to determine the relationship between biosafety on the biological risks of SARS-CoV-2 and risks of fatigue, anxiety, or depression in health workers who care for patients in COVID hospitals, from September 2020 to August 2021. MATERIAL AND METHODS: The questionnaire used in this study (Q6S64I) consisted of 6 spheres: Sociodemographic aspects, working conditions; Personal Protection Equipment; safety and health; training and knowledge about COVID-19, the form of transport, and personal health conditions. The answers were online. The Goldberg questionnaire (EADG) measures anxiety and depression, and the questionnaire measures fatigue (Barrientos-Gutiérrez et al.) (PSSF). RESULTS: In total, 76.5% of the HCWs were doctors, 25.2% worked in the emergency services, 79.3% received PPE from their institution, 82.9% cared for COVID-19 patients, and 27.9% tested positive for COVID-19. The PPE provided by the employer was 80%, but the quality was deficient, insufficient, and associated with a relative risk of 4.6. A total of 99% acquired better PPE on their own. The exposure to COVID-19 and the surgical mask provided by the institution had an associated relative risk of 2.8 for the HCWs. A total of 39% of the HCWs reported being calm. CONCLUSIONS: PPE, risk exposure, and safety at work were significantly associated with drowsiness and heaviness, difficulty concentrating, anxiety, and depression.

Psychological and quality of life effects of vaccination against COVID-19 in patients with systemic autoimmune diseases.

To verify the psychological and quality of life benefits of vaccination against COVID-19 in patients with systemic autoimmune diseases. In this study, levels of psychological stress, psychopathological symptoms, quality of life, and satisfaction with life were compared in patients with systemic autoimmune diseases vaccinated against COVID-19 (n = 132) versus unvaccinated patients (n = 254). To this end, we used the Perceived Stress Scale (PSS), Symptom Checklist-90-Revised (SCL-90-R), EUROQoL-5Q health questionnaire, and Satisfaction with Life Scale (SWLS), respectively. Statistically significant differences were found with better scores in the vaccinated group in the following quality of life dimensions: mobility (p ≤ 0.010), domestic activities (p ≤ 0.004), pain/discomfort (p ≤ 0.001), and anxiety/depression (p≤ 0.005). The scores were also significantly higher in the vaccinated group for the total values of quality of life (p ≤ 0.001), health status self-assessment on the EUROQoL-5Q (p ≤ 0.043), and satisfaction with life (p ≤ 0.015). In addition, the unvaccinated group presented higher scores with clinically pathological levels in depression and psychoticism for somatizations (p ≤ 0.006), depression (p ≤ 0.015), anxiety (p ≤ 0.003), and phobic anxiety (p ≤ 0.001). Finally, participants vaccinated with the complete regimen showed better levels of psychological well-being than those who were not vaccinated or those that had not completed the vaccination regimen. Our results reflect and confirm the positive effects reported elsewhere of the COVID-19 vaccine in autoimmune patients with systemic diseases, both in terms of quality and satisfaction with life as well as psychopathological symptoms and perceived stress. These benefits increased as the patients completed their vaccination schedule.

Kidney Transplantation during the First Year of COVID-19 Pandemic in Our Center.

INTRODUCTION: SARS-CoV2 pandemic has altered the normal activity in our day-to-day life. During the most critical moments of the pandemic at the hospital, attendance and programmed activities had to be reduced to a minimum, including kidney transplants. Hospitals with this kind of activity had to suspend or restructure it due to the decrease in the number of donors with a solid organ donation profile, the lack of knowledge as to whether the disease could be transmitted through transplantation or the risk that was believed to be associated with the admission of patients with end-stage chronic kidney disease or immunosuppressive treatment. METHODS: A retrospective review of all patients who had received a kidney transplant at Doctor Peset University Hospital in Valencia was performed from March 2020 to March 2021. The objective was to study the safety of kidney transplantation and the incidence of COVID-19 disease in kidney transplant patients during this pandemic period. RESULTS: 56 cases of kidney transplantation were included, most of them male with an average age of 56 years old, and variable comorbidity such as hypertension, dyslipidemia, an average body mass index of 26 and undergoing renal replacement therapy by hemodialysis. Regarding the organ donors, more than 50% were male patients and the donation was in encephalic death. The average cold ischemia time was 15 hours. Postoperative complications were mostly graded I and II in the Clavien-Dindo classification. 5.4% of the recipients had passed the SARS-CoV2 infection prior to the transplant and 5.4% were infected with COVID-19 after the transplant. CONCLUSION: In our experience, the current kidney transplant program seems viable and safe, even during periods of health emergencies.

Enseñanza de la química mediada por TIC: Un cambio de paradigma en una educación en emergencia

El siguiente artículo busca presentar la intervención que se realizó con los estudiantes de primer semestre del programa de enfermería y bacteriología de la Universidad Católica de Manizales en la enseñanza de la química mediada por las TIC. Dichos programas se ofertan de manera presencial, pero a raíz de la contingencia del COVID-19 se ofertaron de manera virtual con apoyo de las TIC. Para dicho proceso se llevó a cabo una encuesta inicial para identificar la precepción que tienes los estudiantes sobre la asignatura de química, la enseñanza a través de las TIC y el uso de laboratorios virtuales y simuladores para favorecer las prácticas de laboratorio. En ese sentido, se pudo analizar el cambio que se obtuvo una vez finalizado el semestre académico donde los estudiantes dieron una respuesta satisfactoria a la enseñanza de la química y las prácticas de laboratorio mediante el uso de las TIC como herramienta pedagógica.Alternate : The following article seeks to present the intervention that was carried out with the students of first semester of the program of nursing and bacteriology of the Catholic University of Manizales in the teaching of chemistry mediated by ICT. These programs are offered in person, but because of the contingency of COVID-19 they were offered in a virtual way with ICT support. For this process, an initial survey was carried out to identify the understanding that students have about the subject of chemistry, teaching through ICT and the use of virtual laboratories and simulators to promote laboratory practices. In this sense, it was possible to analyze the change that was obtained after the end of the academic semester where students gave a satisfactory response to the teaching of chemistry and laboratory practices using ICT as a pedagogical tool.Alternate : O próximo artigo busca apresentar a intervenção que se realizou com os estudantes de primeiro semestre do programa de enfermagem e bacteriologia da Universidade Católica de Manizales no ensino da química mediada pelas TIC. Estes programas são oferecidos presencialmente, mas, na sequência da contingência do COVID-19, são oferecidos virtualmente com o apoio das TIC. Para esse processo foi realizada uma pesquisa inicial para identificar a percepção que tem os estudantes sobre a disciplina de química, o ensino através das TIC e o uso de laboratórios virtuais e simuladores para favorecer as práticas de laboratório. Nesse sentido, foi possível analisar a mudança que se obteve após o término do semestre acadêmico, onde os estudantes deram uma resposta satisfatória ao ensino da química e do estágio de laboratório, utilizando as TIC como ferramenta pedagógica.

Online cognitive behavioural therapy as a psychological vaccine against stress during the COVID-19 pandemic in pregnant women: A randomised controlled trial.

The COVID-19 pandemic has affected the population's levels of stress and anxiety due to its contagious nature and the uncertainties generated by its novelty. One population that is especially vulnerable to these psychological consequences are pregnant women. This is why the objective of this study was to test the efficacy of an online stress management programme of a cognitive behavioural nature on pregnant women during the COVID-19 pandemic, in Spain. The trial was controlled and randomised, with a total of 207 pregnant women divided into three groups: the Online Cognitive Behavioural Therapy group (o-CBT) (N = 70); the Online Psychological Support group (o-PS) (N = 69); and the Usual Care group (UC) (N = 68). To test the therapy's efficacy, the women's resilience, perceived stress, pregnancy-specific stress and psychopathological symptoms were assessed before and after the intervention. The o-CBT and o-PS consisted of a programme of 8 group sessions (one per week). The results showed that pregnant women who participated in the o-CBT group presented lower rates of pregnancy-specific stress and perceived stress, as well as greater resilience and lower anxiety, depression and obsessions-compulsions symptoms. These data show the efficacy of the treatment programme and thus confirm the importance of implementing these types of interventions during a woman's pregnancy, especially over periods of major stress, such as during a pandemic.

Resilience, stress and anxiety in pregnancy before and throughout the pandemic: a structural equation modelling approach.

The present study explored and compared the link between resilience and pregnancy-related stress, perceived stress, and anxiety, employing two structural equation models. One model focused on pregnant women before the outbreak of the pandemic, and the other on pregnancies throughout the pandemic. For this purpose, a total sample of 690 women during their pregnancy were collected: the Pre-Pandemic Group (P-PG) was composed of 341 pregnant women evaluated prior to the pandemic; and 349 pregnant women assessed at the time of the pandemic constituted the Pandemic Group (PG). The resilience, pregnancy-related stress, perceived stress, and anxiety symptomatology of the women were assessed. For both samples, resilience was found to lower levels of pregnancy-specific stress, as well as general perceived stress, and anxiety symptomatology. Furthermore, pregnancy-specific stress and perceived stress showed a covariance relationship and, that these, in turn, increased the anxiety. Moreover, the PG showed greater levels of pregnancy-specific stress, anxiety, somatisations, and obsessions-compulsions, while the P-PG presented higher perceived stress levels.

Sarcopenia as potential biological substrate of long COVID-19 syndrome: prevalence, clinical features, and risk factors.

BACKGROUND: Severe clinical pictures and sequelae of COVID-19 disease are immune mediated and characterized by a 'cytokine storm'. Skeletal muscle has emerged as a potent regulator of immune system function. The aim of the present study is to define the prevalence of sarcopenia among COVID-19 survivors and the negative impact of sarcopenia on the post-acute COVID-19 syndrome and its related risk factors. METHODS: A total of 541 subjects recovered from COVID-19 disease were enrolled in the Gemelli Against COVID-19 Post-Acute Care between April 2020 and February 2021. They underwent a multidisciplinary clinical evaluation and muscle strength and physical performance assessment. RESULTS: Mean age was 53.1 years (SD 15.2, range from 18 to 86 years), and 274 (51%) were women. The prevalence of sarcopenia was 19.5%, and it was higher in patients with a longer hospital stay and lower in patients who were more physically active and had higher levels of serum albumin. Patients with sarcopenia had a higher number of persistent symptoms than non-sarcopenic patients (3.8 ± 2.9 vs. 3.2 ± 2.8, respectively; P = 0.06), in particular fatigue, dyspnoea, and joint pain. CONCLUSIONS: Sarcopenia identified according to the EWGSOP2 criteria is high in patients recovered from COVID-19 acute illness, particularly in those who had experienced the worst clinical picture reporting the persistence of fatigue and dyspnoea. Our data suggest that sarcopenia, through the persistence of inflammation, could be the biological substrate of long COVID-19 syndrome. Physical activity, especially if associated with adequate nutrition, seems to be an important protective factor.

Acinetobacter baumannii response to cefiderocol challenge in human urine.

Cefiderocol (CFDC) is a novel chlorocatechol-substituted siderophore antibiotic approved to treat complicated urinary tract infections (cUTI) and hospital-acquired and ventilator-acquired pneumonia (HAP/VAP). Previous work determined that albumin-rich human fluids increase the minimum inhibitory concentration (MICs) of Acinetobacter baumannii against CFDC and reduce the expression of genes related to iron uptake systems. This latter effect may contribute to the need for higher concentrations of CFDC to inhibit growth. The presence of human urine (HU), which contains low albumin concentrations, did not modify MIC values of two carbapenem-resistant A. baumannii. Levels of resistance to CFDC were not modified by HU in strain AMA40 but were reduced in strain AB5075. Expanding the studies to other carbapenem-resistant A. baumannii isolates showed that the presence of HU resulted in unmodified or reduced MIC of CDFC values. The expression of piuA, pirA, bauA, and bfnH determined by qRT-PCR was enhanced in A. baumannii AMA40 and AB5075 by the presence of HU in the culture medium. All four tested genes code for functions related to recognition and transport of ferric-siderophore complexes. The effect of HU on expression of pbp1, pbp3, blaOXA-51-like, blaADC, and blaNDM-1, genes associated with resistance to ß-lactams, as well as genes coding for efflux pumps and porins was variable, showing dependence with the strain analyzed. We conclude that the lack of significant concentrations of albumin and free iron in HU makes this fluid behave differently from others we tested. Unlike other albumin rich fluids, the presence of HU does not impact the antibacterial activity of CFDC when tested against A. baumannii.

COVID-19 infection characteristics and outcomes in a predominantly Latino community hospital.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and claimed millions of lives. Several studies have attempted to understand the relationship between COVID-19 infection and health disparities. The aim of the current work was to evaluate the pre-admission health characteristics, symptomatology, diagnostic abnormalities, treatment measures and clinical outcomes of the community served by our institution, with a sub-analysis of our Hispanic community. Methods: This is a single-center, cross-sectional cohort study of patients with COVID-19 admitted from 15 March 2020 to 30 April 2020 to MacNeal Hospital. A retrospective chart review was performed including patients >18 years and a positive nasopharyngeal SARS-CoV-2 PCR. Demographical data, comorbidities, clinical data, treatment regimen, and patient outcomes were collected. Results: A total of 257 patients were included in the study of which 60.4% were identified as Hispanic. The median age at admission of Hispanic patients was significantly lower compared to non-Hispanic patients (56.6 vs. 65.7 years, p<0.01). Non-Hispanic patients had lower prevalence of hypertension, coronary artery disease, and chronic lung disease. Most common at presentation were shortness of breath (69.6%), cough (69.2%), and fever (64%). Hypertension was the most common comorbidity (53.6%). Approximately 89% of the patients received antibiotics, 40.4% hydroxy-chloroquine, 13.2% steroids, and 6% tocilizumab. Twenty six percent required mechanical ventilation (MV), and over half of them (56.7%) were Hispanic. The strongest factors associated with MV were smoking (OR 2.97, 95%CI 1.01-8.69), CRP >10 mg/dL (OR 4.53, 95%CI 1.49-13.38) and D-dimer >1.5 mcg/mL (OR 3.63, 95%CI 1.31-10.05). An oxygen saturation of >90% on room air on presentation was a protective factor when predicting intubation (OR 0.11, 95%CI 0.03-0.33). The overall 30-day mortality rate was 17.1% (n=44); 11.9% in the Hispanic group vs 26.3% in the non-Hispanic group (p<0.003). Conclusions: Our review of consecutive patients admitted with COVID-19 demonstrated that over half of patients were of Hispanic descent. Interestingly enough, despite being significantly younger and healthier, the need for mechanical ventilation in the Hispanic group was not significantly different compared to the non-Hispanic group. However, the Hispanic group had a lower mortality rate.

Trombocitopenia trombótica inmunitaria inducida por la vacuna SARS-CoV-2 durante el embarazo

Resumen La vacunación contra la enfermedad por coronavirus 2019 es la estrategia más efectiva para acabar con esta pandemia. Se han notificado alrededor de 50 casos de trombocitopenia y trombosis venosa relacionados por la vacuna COVID-19 de vector adenoviral en todo el mundo. No se han reportado casos en la población gestante en la literatura mundial. Presentamos el caso de una mujer hispana de 25 años con un embarazo de 31 semanas, sin enfermedades previas. Fue inmunizada con la vacuna ChAdOx1 nCoV-19;días después, desarrolló convulsiones tónico-clónicas, trombosis masiva de miembros y hemorragia intracerebral;se descartaron enfermedades hipertensivas relacionadas al embarazo, entidades reumatológicas y hematológicas. Se obtuvo un resultado positivo por ELISA para anticuerpos del complejo anti-heparina-factor plaquetario 4 (PF4), concluyendo el diagnóstico de trombocitopenia inmune trombótica inducida por vacuna, causada por la vacuna COVID-19 de vector adenoviral. Esta nueva entidad se caracteriza por la presencia del factor plaquetario 4, no dependiente de heparina. Vaccination against coronavirus disease 2019 is the most effective strategy to end this pandemic. Around 50 cases of thrombocytopenia and venous thrombosis related to the adenoviral vector COVID-19 vaccine have been reported worldwide. No cases have been reported in the pregnant population in the world literature. We present the case of a 25-year-old Hispanic woman with a 31-week pregnancy and no previous illnesses. She was immunized with the ChAdOx1 nCoV-19 vaccine;days later, she developed tonic-clonic seizures, massive limb thrombosis, and intracerebral haemorrhage;hypertensive diseases related to pregnancy, rheumatological and haematological entities were ruled out. A positive result for anti-heparin-platelet factor 4 (PF4) complex antibodies was obtained by ELISA, concluding the diagnosis of vaccine-induced thrombotic immune thrombocytopenia, caused by an adenoviral vector COVID-19 vaccine. This new entity is characterized by the presence of platelet factor 4, which is not heparin dependent.

Trombocitopenia trombótica inmunitaria inducida por la vacuna SARS-CoV-2 durante el embarazo SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia during pregnancy

La vacunación contra la enfermedad por coronavirus 2019 es la estrategia más efectiva para acabar con esta pandemia. Se han notificado alrededor de 50 casos de trombocitopenia y trombosis venosa relacionados por la vacuna COVID-19 de vector adenoviral en todo el mundo. No se han reportado casos en la población gestante en la literatura mundial. Presentamos el caso de una mujer hispana de 25 años con un embarazo de 31 semanas, sin enfermedades previas. Fue inmunizada con la vacuna ChAdOx1 nCoV-19;días después, desarrolló convulsiones tónico-clónicas, trombosis masiva de miembros y hemorragia intracerebral;se descartaron enfermedades hipertensivas relacionadas al embarazo, entidades reumatológicas y hematológicas. Se obtuvo un resultado positivo por ELISA para anticuerpos del complejo anti-heparina-factor plaquetario 4 (PF4), concluyendo el diagnóstico de trombocitopenia inmune trombótica inducida por vacuna, causada por la vacuna COVID-19 de vector adenoviral. Esta nueva entidad se caracteriza por la presencia del factor plaquetario 4, no dependiente de heparina.

Stress and Psychopathology Reduction in Pregnant Women through Online Cognitive Behavioural Therapy during COVID-19: A Feasibility Study.

BACKGROUND: The global pandemic has affected the psychological health of the population, including pregnant women. Due to the difficulty of offering conventional therapies to reduce stress in this population, studies are needed to show the effect of online therapies. Therefore, the objective was to test the effect of online cognitive behavioural therapy in pregnant women during the pandemic on the main variables of stress and psychopathology. METHODS: The sample consisted of 16 pregnant women who participated in a weekly cognitive behavioural intervention for 8 weeks. Prenatal concerns, general stress, stress vulnerability, resilience and psychopathology were assessed. RESULTS: The results show a reduction in prenatal concerns, perceived stress, stress vulnerability and psychopathology, as well as an increase in resilience. CONCLUSIONS: Online cognitive behavioural intervention may be effective in pregnant women, so it is important to conduct a randomised controlled trial to certify these findings.

Giving birth during a pandemic: From elation to psychopathology.

OBJECTIVE: To compare the postpartum psychopathological symptoms of women who gave birth before the pandemic with those who gave birth during the pandemic. METHODS: A total of 212 women participated in the study, of which 96 gave birth before the pandemic and 116 during the pandemic. Psychopathological symptoms, postpartum depression, perceived stress, and resilience were evaluated. RESULTS: Women who gave birth during the pandemic had higher scores on somatization, obsessions and compulsions, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, and psychoticism. In addition, perceived stress was the common predictor of an increase in these symptoms. CONCLUSION: Postpartum is a complicated period in a woman's life. Many psychological adaptations take place and women may be subject to psychological alterations during this period. In addition, women who gave birth during the COVID-19 crisis may show greater psychological vulnerability, due to the specific situation experienced during the pandemic. The COVID-19 pandemic may have played a role in the increase in psychopathological symptoms after childbirth. Detecting possible symptoms postpartum plays a crucial role, because it allows intervening and preventing the development of psychopathologies.

The psychological impact of the COVID-19 pandemic on pregnant women.

The aim was to examine the psychological effects caused by the COVID-19 pandemic on pregnant women, as well as the factors influencing these effects. The study design was cross-sectional and the participants were 200 pregnant women. The first group called the Pandemic Group (PG) included 100 women who were evaluated with psychological assessment instruments during the COVID-19 pandemic. The second group titled Pre-Pandemic Group (PPG) consisted of 100 women who were evaluated prior to the pandemic. Perceived stress, prenatal concerns and psychopathological symptoms were evaluated and compared. Pandemic Group scored significantly higher than Pre-Pandemic Group in the depression dimension of the SCL-90, in the phobic anxiety dimension, and in the Perceived Stress Scale. In addition, insomnia, along with having recently suffered the loss of a loved one explained 25% of the score variance in the depression dimension of the SCL-90. Insomnia also explained 13% of the variance of the results found in the Perceived Stress Scale. The fear of contagion by COVID-19 increased the scores obtained in the phobic anxiety dimension, explaining 11% of the variance. Thus, the COVID-19 pandemic could produce an increase in psychopathological symptomatology and stress, which can lead to negatively affecting pregnant women's mental health.

[Confinement variables by COVID-19 predictors of anxious and depressive symptoms in pregnant women]. / Variables del confinamiento por COVID-19 predictoras de sintomatología ansiosa y depresiva en mujeres embarazadas.

BACKGROUND AND OBJECTIVES: The appearance of a highly contagious disease forced the confinement of the population in almost all parts of the world, causing an increase in psychological problems, with pregnant women being a particularly vulnerable group to suffer negative consequences. The aim of this research was to check which confinement or psychological stress variables are related to the increase of anxious and depressive symptoms in pregnant women, as a consequence of the pandemic caused by the COVID-19. MATERIALS AND METHODS: The sample was composed of 131 pregnant women who experienced the confinement imposed by the Government of Spain on March 14, 2020. Sociodemographic, obstetric, confinement related and psychological variables were collected. RESULTS: Perceived stress, pregnancy-specific stress, as well as insomnia are predictive variables in most anxious (obsessions and compulsions, anxiety and phobic anxiety) and depressive symptoms related to COVID-19. CONCLUSIONS: It is important to focus future psychological interventions in this population on stress control and sleep monitoring, since these variables influence the increase of anxiety and depression.