The impact of a two-year long COVID-19 public health restriction program on mechanical thrombectomy outcomes in a stroke network.

OBJECTIVE: The purpose of this study was to evaluate the impact of COVID-19 pandemic public health restrictions on our drip and ship mechanical thrombectomy program in Santiago Chile. MATERIALS AND METHODS: This was a retrospective analysis of a prospectively collected database comparing two cohorts, one during a two-year period before COVID-19 and the second during the two years of the pandemic at our metropolitan stroke program. RESULTS: A total of 100 patients were included in the pre COVID-19 cohort (cohort 1) and 121 in the COVID-19 cohort (cohort 2). There was a significant difference between cohorts, with older patients, different occlusion sites and higher door to arterial puncture time during the COVID-19 period. A non-significant trend for worse 90-day outcomes and higher mortality was present in cohort 2. There were no statistical differences in safety treatment parameters. CONCLUSIONS: COVID-19 pandemic has had a measurable impact on our mechanical thrombectomy program. Results showed similarities to other reported Latin American series, where less robust health systems could adapt less efficiently compared to developed countries. After two years of public health restrictions, there were changes in the treatment population characteristics, delay in some internal management metrics and a non-significant trend to worse 90-day outcomes and higher mortality.

Morbid Polarization: Exposure to COVID-19 and Partisan Disagreement about Pandemic Response.

The COVID-19 pandemic has affected the lives of all Americans, but the severity of the pandemic has been experienced unevenly across space and time. Some states saw sharp rises in COVID-19 cases in early March, whereas case counts rose much later in the rest of the country. In this article, we examine the relationship between exposure to COVID-19 and citizens' views on what type of measures are required to deal with the crises and how experience with and exposure to COVID-19 is associated with greater partisan polarization. We find consistent evidence of partisan divergence in pandemic-response policy preferences across the first six months of the COVID-19 pandemic: Republicans support national control measures whereas Democrats support welfare policies, and interparty differences grow over time. We find only limited evidence that exposure or experience moderates these partisan differences. Our findings are consistent with the view that Americans interpret the COVID-19 pandemic in fundamentally partisan manner, and that objective pandemic conditions play at most a minor role in shaping mass preferences.

Motivated reasoning in the public domain: Three variations on a theme

The concept of motivated reasoning describes when people's processing of information is driven by prior motivations, such as self-preservation, social-identity threats and worldview maintenance. In the public domain, strong political and social identities shape political and moral debates. In this dissertation I present three papers that address motivated reasoning in the context of three public debates: abortion, hate speech and COVID-19 policies. The first paper examines how abortion attitudes are related to other attitudes not directly related to termination of pregnancy, testing competing ideological explanations abortion attitudes. Across three studies, data show support for the liberal and conservative explanations of abortion attitudes, but the evidence is stronger for the latter. The second paper studies how people judge an ambiguous expression as hate speech, based on the group being targeted and the person's ideology. I found that liberals are particularly attuned to denounce an ambiguous statement as hate speech, and that the target's perceived victimhood partially drives these effects. The third paper studies the relationship between COVID-19 related policies, partisanship and exposure to the virus. No relationship was found between the exposure to the virus and changes in policies: people keep partisan policy views, despite of pathogen threats. All studies confirm the main tenet of themotivated reasoning approach: people's views are often not driven by rational considerations, but rather by motivations to defend their worldview and their social groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Listening to cities during the COVID-19 lockdown: How do human activities and urbanization impact soundscapes in Colombia?

Noise is one of the fastest growing and most ubiquitous type of environmental pollution, with prevalence in cities. The COVID-19 confinement in 2020 in Colombia led to a reduction in human activities and their associated noise. We used this unique opportunity to measure the impacts of noise on urban soundscapes, and explore the effects of urbanization intensity independently of human activity. We launched a community science initiative inviting participants to collect audio recordings from their windows using smartphones. Recordings were taken during severe mobility restrictions (April), and during a period of lightened restrictions (May-June). From the data collected, we measured changes in sound pressure levels (SPL), acoustic structure (soundscape spectro-temporal characteristics), and human perception between the two periods. A 12% increase in human activities had a detectable acoustic footprint, with a significant increase of SPL (2.15 dB, 128% increase), a shift towards dominance of low-frequency broadband signals, and a perceived dominance of human-made over wildlife sounds. Measured changes in SPL and acoustic structure were directly proportional to urbanization; however, perception of these changes was not. This gap may be associated with a masking effect generated by noise or a disconnect of humans from nature in large cities. The mobility restrictions created a chance to better understand the impacts of urbanization and human activities on the soundscape, while raising public awareness regarding noise pollution effects on people and wildlife. Information analyzed here might serve in urban planning in developing countries where urban expansion is occurring in a rapid, unplanned fashion.

Cerebrovascular disease in patients with COVID-19: neuroimaging, histological and clinical description.

Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, specifically acute cerebrovascular disease, has been detected. We present cerebrovascular disease case incidence in hospitalized patients with SARS-CoV-2 infection. Patients were confirmed by microbiological/serological testing, or on chest CT semiology. Available data on co-morbidity, laboratory parameters, treatment administered, neuroimaging, neuropathological studies and clinical evolution during hospitalization, measured by the modified Rankin scale, were analysed. A bivariate study was also designed to identify differences between ischaemic and haemorrhagic subtypes. A statistical model of binary logistic regression and sensitivity analysis was designed to study the influence of independent variables over prognosis. In our centre, there were 1683 admissions of patients with COVID-19 over 50 days, of which 23 (1.4%) developed cerebrovascular disease. Within this group of patients, cerebral and chest CT scans were performed in all cases, and MRI in six (26.1%). Histological samples were obtained in 6/23 cases (two brain biopsies, and four arterial thrombi). Seventeen patients were classified as cerebral ischaemia (73.9%, with two arterial dissections), five as intracerebral haemorrhage (21.7%), and one leukoencephalopathy of posterior reversible encephalopathy type. Haemorrhagic patients had higher ferritin levels at the time of stroke (1554.3 versus 519.2, P = 0.004). Ischaemic strokes were unexpectedly frequent in the vertebrobasilar territory (6/17, 35.3%). In the haemorrhagic group, a characteristic radiological pattern was identified showing subarachnoid haemorrhage, parieto-occipital leukoencephalopathy, microbleeds and single or multiple focal haematomas. Brain biopsies performed showed signs of thrombotic microangiopathy and endothelial injury, with no evidence of vasculitis or necrotizing encephalitis. The functional prognosis during the hospital period was unfavourable in 73.9% (17/23 modified Rankin scale 4-6), and age was the main predictive variable (odds ratio = 1.5; 95% confidence interval 1.012-2.225; P = 0.043). Our series shows cerebrovascular disease incidence of 1.4% in patients with COVID-19 with high morbidity and mortality. We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.

Influence of the COVID-19 outbreak in people with epilepsy: Analysis of a Spanish population (EPICOVID registry).

BACKGROUND: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current COVID-19 outbreak, exploring the possible causes thereof. METHODS: This is an observational, retrospective study based on prospective data collection of 100 successive patients who attended an epilepsy outpatient clinic either face-to-face or telephonically during the months of the COVID-19 outbreak and national state of emergency. RESULTS: One hundred patients were included, 52% women, mean age 42.4 years. During the COVID-19 period, 27% of the patients presented an increase of >50% of seizure frequency. An increase of stress/anxiety (odds ratios (OR): 5.78; p = 0.008) and a prior higher seizure frequency (OR: 12.4; p = 0.001) were associated with worsening of seizures. Other risk factors were exacerbation of depression, sleep deprivation, less physical activity, and history of epilepsy surgery. Three patients had status epilepticus (SE) and one a cluster of seizures. Likewise, 9% of patients improved their seizure control. Reduction in stress/anxiety (OR: 0.05; p = 0.03) and recent adjustment of antiepileptics (OR: 0.07; p = 0.01) acted as protecting factors. CONCLUSIONS: A high proportion of PWE suffered a significant worsening of their seizure control during the months of the COVID-19 pandemic. Emotional distress due to home confinement was the main factor for the change in seizure control. Promoting physical activity and adequate sleep may minimize the potential impact of the pandemic in PWE. Ensuring correct follow-up can prevent decompensation in those PWE at high risk.

Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) has spread worldwide since December 2019. Neurologic symptoms have been reported as part of the clinical spectrum of the disease. We aimed to determine whether neurologic manifestations are common in hospitalized patients with COVID-19 and to describe their main characteristics. METHODS: We systematically reviewed all patients diagnosed with COVID-19 admitted to the hospital in a Spanish population during March 2020. Demographic characteristics, systemic and neurologic clinical manifestations, and complementary tests were analyzed. RESULTS: Of 841 patients hospitalized with COVID-19 (mean age 66.4 years, 56.2% men), 57.4% developed some form of neurologic symptom. Nonspecific symptoms such as myalgias (17.2%), headache (14.1%), and dizziness (6.1%) were present mostly in the early stages of infection. Anosmia (4.9%) and dysgeusia (6.2%) tended to occur early (60% as the first clinical manifestation) and were more frequent in less severe cases. Disorders of consciousness occurred commonly (19.6%), mostly in older patients and in severe and advanced COVID-19 stages. Myopathy (3.1%), dysautonomia (2.5%), cerebrovascular diseases (1.7%), seizures (0.7%), movement disorders (0.7%), encephalitis (n = 1), Guillain-Barré syndrome (n = 1), and optic neuritis (n = 1) were also reported, but less frequent. Neurologic complications were the main cause of death in 4.1% of all deceased study participants. CONCLUSIONS: Neurologic manifestations are common in hospitalized patients with COVID-19. In our series, more than half of patients presented some form of neurologic symptom. Clinicians need to maintain close neurologic surveillance for prompt recognition of these complications. The mechanisms and consequences of severe acute respiratory syndrome coronavirus type 2 neurologic involvement require further studies.