BIOLOGIC TREATMENT SUSPENSION AND ASSOCIATED FACTORS IN PATIENTS WITH RHEUMATIC DISEASES DURING THE COVID-19 PANDEMIC: DATA FROM MEXICAN ADVERSE REGISTRY (BIOBADAMEX)

BackgroundThe COVID-19 pandemic triggered serious challenges in the treatment of chronic diseases due to the lack of access to medical attention. Patients with rheumatic diseases (RD) must have adequate treatment compliance in order to reach and maintain remission or low activity of their diseases. Treatment suspension because of non-medical reasons might lead to disease activation and organ damage.ObjectivesIdentify the frequency of biologic treatment (bDMARD) suspension in patients with RD during the COVID-19 pandemic and determine the associated factors for suspension.MethodsIn this study we included all patients registered in the Mexican Biologics Adverse Events Registry (BIOBADAMEX), that started bDMARD before March 2019 and suspended treatment during the COVID-19 pandemic. We used descriptive statistic to analyze baseline characteristics and main treatment suspension causes. We used Chi[2] and Kruskal Wallis tests to analyze differences between groups.ResultsA total of 832 patients patients registered in BIOBADAMEX were included in this study, 143 (17%) suspended bDMARD during the COVID-19 pandemic. The main causes of suspension were inefficacy in 54 (38%) patients, followed by other motives in 49 (34%) patients from which 7 (5%) was loss of medical coverage. Adverse events and loss of patients to follow up were the motive in 16 (11%) and 15 (11%) patients respectively.When we compared the group that suspended bDMARD with the non-suspenders (Table 1), we found statistical differences in patient gender, with 125 (87%) female patients that suspended bDMARD, with a median age of 52 (42-60) years, and a treatment duration of 3.8 years.ConclusionIn our study we found that 17% of patients with RD suspended bDMARD treatment during the COVID-19 pandemic and that non-medical motives such as lack of patients follow up and loss of medical coverage due to unemployment were important motives. These results are related to the effect of the pandemic on other chronic diseases.Table 1.Patients baseline characteristicsPatients that did not suspended bDMARD during pandemic (n = 689)Patients that suspended bDMARD during pandemic (n = 143)pFemale gender, n(%)549 (79.7)125 (87.4)0.02Age, median (IQR)55 (45 – 63)52 (42 – 60)0.04Body mass index, median (IQR)26.4 (23 – 30.4)27.23 (24.2 – 30.46)0.13Social security, n(%)589 (85.5)128 (89.5)0.2Diagnosis0.7- Rheumatoid arthritis444 (64.4)97 (67.8)- Juvenil idiopathic athritis29 (4.2)2 (1.4)- Ankyosing sponylitis93 (13.5)19 (13.3)- Psoriasic arthritis43 (6.2)6 (4.2)- Systemic lupus erithematosus32 (4.6)9 (6.3)- Others48 (6.9)10 (6.9)Disease duration, median (IQR)11 (7 – 19.5)12 (6 - 18)0.95Comorbidities, n(%)305 (44.3)73 (51)0.08Previos biologic, n(%)249 (36.1)60 (42)0.1Treatment at pandemic iniciation, n(%)0.8 - Etanercept a34 (4.9)5 (3.5)- Infliximab a24 (3.5)5 (3.5)- Adalimumab130 (18.9)22 (15.4)- Rituximab a61 (8.9)25 (17.5)- Abatacept76 (11)20 (14)- Tocilizumab82 (11.9)18 (12.6)- Certolizumab92 (13.4)28 (19.6)- Rituximab b7 (1)0- Golimumab36 (5.2)5 (3.5)- Tofacitinib14 (2)1 (0.7)- Infliximab b4 (0.5)2 (1.4)- Etanercept b31 (4.5)6 (4.2)- Baricitinib12 (1.7)1 (0.7)- Belimumab5 (0.7)1 (0.7)- Secukinumb8 (1.2)3 (2.1)Steroids use, n(%):254 (36.9)57 (39.9)0.2Steroids dose (mg), median (IQR)6 (5 – 10)6 (5 – 10)0.47DMARD use, n(%):538 (78.1)118 (82.5)0.1Treatment duration, median (IQR)5.06 (4.04 – 5.78)3.82 (3.35 – 4.95)0.001Suspension motive, n(%)NA- Inefficacy-54 (37.8)- Adverse event-16 (11.2)- Pregnancy-2 (1.4)- Loss of patient-15 (10.5)- Remission-7 (4.9)- Others-49 (34.2)Adverse events, n(%):102 (14.8)24 (16.8)0.3- Severe, n(%)13 (1.9)5 (3.5)0.4a original, b biosimilarREFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsVijaya Rivera Teran: None declared, Daniel Xavier Xibille Friedmann: None declared, David Vega-Morales: None declared, Sandra Sicsik: None declared, Angel Castillo Ortiz: None declared, Fedra Irazoque-Palazuelos: None declared, Dafhne Miranda: None declared, Iris Jazmin Colunga-Pedraza: None declared, Julio Cesar Casasola: None declared, Omar Elo Muñoz-Monroy: None declared, Sandra Carrilo: None declared, Angélica Peña: None declared, Sergio Duran Barragan: None declared, Luis Francisco Valdés Corona: None declared, Estefanía Torres Valdéz: None declared, Azucena Ramos: None declared, Aleni Paz: None declared, ERICK ADRIAN ZAMORA-TEHOZOL: None declared, Deshire Alpizar-Rodriguez Employee of: Scientific Advisor in GSK México.

Reclassification of COVID-19 Related ICD-10 Codes in Mexico: A Real-World Data Analysis of 1,937,360 Hospital Discharges from the Ministry of Health

Objectives: To estimate the reclassification of COVID-19 related ICD-10 codes from admission to discharge using Real-World Data (RWD) from the 2020 Mexican Ministry of Health (MoH) hospitals discharge dataset. Method(s): In this retrospective study, we analyzed all COVID-19 related discharges in the 2020 MoH open database, according to ten ICD-10 codes that the WHO associated with COVID-19. Reclassification was defined as those COVID-19 related cases who were discharged with a different ICD-10 code compared to their ICD-10 admission code. Result(s): From a total of 1,937,360 discharges reported in the MoH's 2020 database 63,740 (3.3%), mostly men (60.8%), with a median age of 56 years, were discharged with a COVID-19 related ICD-10 code and 12,945 of these were reclassified (20.3%). Although "2019-nCoV acute respiratory disease" (U071) had the greatest frequency of reclassified discharges (12,013, 22.3%), the "other coronavirus as the cause of diseases classified elsewhere" (B972) was associated with the greatest reclassification proportion (68, 74.7%) followed by "pneumonia case confirmed as due to COVID-19" (J128) (26.0%). Codes with lower percentages were "acute respiratory distress syndrome due to COVID-19" (J80X) and "acute respiratory failure due to COVID-19" (J960) with 6.3% and 3.8%, respectively. From 63,740 discharges, 50.7% were due to clinical improvement, followed by death (38.2%), transfer to another unit (5.2%) and voluntary discharge (3.3%). The J960 code had the highest mortality (67%) followed by codes J80X (59.7%) and U071 (35.5%). Conclusion(s): In our RWD analysis, we identified that 1 in 5 COVID-19 discharges were admitted with different diagnoses, highlighting the enormous challenges faced by the Mexican MoH during the global health crisis to establish an accurate COVID-19 diagnosis and coding. Given that this is the first reclassification analysis in Mexico, the conduction of future studies is essential to gain more insights on the consequences of reclassification at a health system level.Copyright © 2023

Procalcitonin as a Prognostic Marker of Complicated Appendicitis

Introduction: Acute appendicitis is the most common cause of acute abdominal pain as well as one of the most frequently performed procedures in general surgery. Different prognostic laboratory markers have been studied to identify patients with complicated appendicitis and it is unknown whether the level of procalcitonin in adults could be used as a predictive marker. From a cut-off point, Does procalcitonin have predictive value for complicated appendicitis? Methods: Prospective, observational study. Patients from the Civil Hospital of Guadalajara with a diagnosis of Appendicitis, presurgical laboratory studies and Procalcitonin, and undergo appendectomy in this institution. A calculated sample was obtained based on the surgeries performed annually. Result(s): 80 appendicectomies were performed in the 12-month period (2021;COVID pandemic) obtaining: 37 patients with uncomplicated appendicitis (Phase I and II) 43 patients with complicated appendicitis (Phase III and IV) The procalcitonin levels of both groups were analyzed to demonstrate differences between them, Mann-Whitney U test gives us as a result a p value <0.05. For the cut-off point at the most suitable procalcitonin level for this sample we decided to use the Yauden index method in the analysis of the ROC curve: it is observed that the cut-off point with a sensitivity of 72.1% and a specificity of 81.1% for the sample is 0.305. Conclusion(s): Procalcitonin has been shown to be a useful marker for discriminating the severity of appendicitis and that the best cutoff point for this sample is 0.3 ng/dl.

CLINICAL CHARACTERISTICS OF PEDIATRIC PATIENTS WITH RHEUMATIC DISEASES UNDER TREATMENT WITH BIOLOGICAL THERAPY: INFORMATION FROM BIOBADAMEX

BackgroundThe advent of biologic treatment (bDMARD) in childhood rheumatic diseases (RD) has changed their evolution and prognosis. Evidence is robust for diseases such as juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE), but in other diseases we still have to learn which is the ideal therapy, time to discontinuation and the potential adverse events (AE) in short and long term.ObjectivesIdentify the clinical and treatment characteristics of pediatric patients with rheumatic diseases with bDMARD treatment and describe the development of AE.MethodsBIOBADAMEX is a prospective ongoing cohort of Mexican patients with RD using bDMARDs since 2016. We included all patients younger than 18 years of age registered in BIOBADAMEX. Descriptive statistics were used for the baseline characteristics and the Chi-square test to analyze the differences between the characteristics of the groups in relation to the development of AE.ResultsA total of 45 patients were included, 31 (69%) of them female, mean age of 13.3 (±3.6) years. (Table 1).The most frequent diagnosis was JIA 25 (56%), followed by SLE 9 (20%), uveitis 5 (11%), polymyositis/dermatomyositis and hidradenitis 2 (4%) respectively;systemic sclerosis and CINCA 1 patient (2%) respectively. The mean duration disease in years was 4.67 (±2.1). Nine patients (20%) used a biologic prior to the current;23 (51%) patients had comorbidities.The most frequent bDMARDs used was Adalimumab (ADA) in 17 (38%) patients followed by Rituximab in 15 (33%) and Tocilizumab in 10 (22%), Infliximab, Abatacept and Canakinumab were used in one patient respectively.When compared by groups, ADA and Tocilizumab were the most used bDMARDs in JIA, Rituximab the only one used in SLE and PM/DM, and ADA the only one for uveitis.15 patients discontinued biological treatment, 4 (27%) due to AE. 82% used an additional synthetic DMARD, being methotrexate the most used in 48% of patients. Steroids were used by 21 (47%) of the patients with a median dose of 10mg (IQR 5 - 25).Fifteen AEs were recorded: 7 (47%) were infections, 5 of these (71%) were COVID;allergies and neutropenia in 2 (13%) patients respectively. By disease infections were more frequent in patients with JIA and Uveitis;neutropenia only occurred in patients with JIA (p 0.95). 87% of the AEs were non-serious, 1 patient with JIA presented a severe AE and one patient with SLE a fatal AE associated with COVID (p 0.93), with no statistically significant difference between groups.ConclusionJIA is the most frequent indication to use bDMARD as worldwide reported. The AE in this analysis are similar to previous registries in terms of the prevalence of infections, in our group the most frequent infectious complication was COVID, being fatal in one patient related with rituximab in SLE. Our study did not find statistically significant differences in the development of AE between diseases;however, they will continue to be reported and the number of patients in the registry will increase.References[1] Sterba,Y.et al. Curr Rheumatol Rep 2016;18,45[2] Fuhlbrigge RC, et al. 2021;47(4):531-543.Table 1.Baseline CharacteristicsBaseline characteristics (n = 45)n%Female, n(%)3168.9Age, media (SD)13.3 (±3.6)Index Body Mass, media (SD)19.6 (±4.9)Dx n(%)n %- JIA25 55.6- SLE9 20- PM/DM2 4.4- Uveitis5 11.1- Hidradenitis2 4.4- Systemic sclerosis1 2.2- CINCA1 2.2Disease duration(years) media (IQR)4.67±2.1Current treatment n(%)n %- Infliximab1 2.2- Adalimumab17 37.8- Rituximab15 33.3- Abatacept1 2.2- Tocilizumab10 22.2- Canakinumab1 2.2Treatment duration (months) median (IQR)4.5 (0.56 – 36.9)Treatment suspension, n(%)15 (33.2)Months to suspension, median (IQR)0.66 (0.46 – 1)Discontinue cause, n(%)n %- Inefficacy1 6.6- Remission1 6.6- Side effects4 26.6- Others5 33.3- Unknown4 26.6Steroids use, n(%):21 46.7Steroids dose (mg), median (IQR)10 5 – 25DMARDs use n(%):37 82.2AE, n(%):15 33.3By disease:AE TypeInfectionAllergyNeutropeniaOtherChi2JIA31230.95SLE1101Uveitis3000Acknowledgements:NIL.Disclosure of InterestsSamara Mendieta: None declare , Alfonso Torres: None declared, Fedra Irazoque-Palazuelos: None declared, Sandra Sicsik: None declared, Iris Jazmin Colunga-Pedraza: None declared, Daniel Xavier Xibille Friedmann: None declared, Deshire Alpizar-Rodriguez Employee of: Scientific advisor in GSK-Mexico, VIJAYA RIVERA TERAN: None declared.

COVID-19 IN PATIENTS WITH RHEUMATIC IMMUNE-MEDIATED INFLAMMATORY DISEASES IN AMERICA: DIFFERENCES AND SIMILARITIES BETWEEN MEXICO AND ARGENTINA

BackgroundPatients with immune-mediated rheumatic diseases (IRD) have poorer outcomes of SARS-CoV-2 infection compared to the general population.ObjectivesTo assess and compare clinical course, severity and complications of SARS-CoV-2 infection in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) from Mexico and Argentina.MethodsData from both national registries, CMR-COVID (Mexico) and SAR-COVID (Argentina), were combined. Briefly, adult IRD patients with SARS-CoV-2 infection were recruited between 08.2020 and 09.2022 in SAR-COVID and between 04.2020 and 06.2022 in CMR-COVID. Sociodemographic data, comorbidities, and DMARDs were recorded, as well as clinical characteristics, complications, and treatment for SARS-CoV-2 infection. Descriptive analysis. Chi square, Fisher, Student T, Mann Whitney U tests and multiple logistic regression analyses were performed.ResultsA total of 3709 patients were included, 1167 (31.5%) from the CMR-COVID registry and 2542 (68.5%) from the SAR-COVID registry. The majority (82.3%) were women, with a mean age of 50.4 years (SD 14.4). The most frequent IRD were rheumatoid arthritis (47.5%) and systemic lupus erythematosus (18.9%). Mexican patients were significantly older, had a higher female predominance and had higher prevalence of rheumatoid arthritis, antiphospholipid syndrome, and axial spondyloarthritis, while the Argentine patients had more frequently psoriatic arthritis and ANCA-associated vasculitis. In both cohorts, approximately 80% were in remission or low disease activity at the time of infection. Mexicans took glucocorticoids (43% vs 37%, p<0.001) and rituximab (6% vs 3%, p<0.001) more frequently. They also reported more comorbidities (48% vs 43%, p=0.012).More than 90% of patients presented symptoms related to SARS-CoV-2 infection. The frequency of hospitalization was comparable between the groups (23.4%), however, the Mexicans had more severe disease (Figure 1) and a higher mortality rate (9.4% vs 4.0%, p<0.0001). After adjusting for risk factors, Mexicans were more likely to die due to COVID-19 (OR 2.2, 95%CI 1.5-3.1).ConclusionIn this cohort of patients with IRD from Mexico and Argentina with SARS-CoV-2 infection, the majority presented symptoms, a quarter were hospitalized and 6% died due to COVID-19. Mexicans presented more severe disease, and after considering risk factors they were two times more likely to die.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsCarolina Ayelen Isnardi Grant/research support from: SAR-COVID is a multi- sponsor registry, where Pfizer, Abbvie, and Elea Phoenix provided unrestricted grants. None of them participated or infuenced the development of the project, data collection, analysis, interpretation, or writing the report. They do not have access to the information collected in the database, Deshire Alpizar-Rodriguez: None declared, Marco Ulises Martínez-Martínez: None declared, Rosana Quintana: None declared, Ingrid Eleonora Petkovic: None declared, Sofia Ornella: None declared, Vanessa Viviana Castro Coello: None declared, Edson Velozo: None declared, David Zelaya: None declared, María Severina: None declared, Adriana Karina Cogo: None declared, Romina Nieto: None declared, Dora Aida Pereira: None declared, Iris Jazmin Colunga-Pedraza: None declared, Fedra Irazoque-Palazuelos: None declared, GRETA CRISTINA REYES CORDERO: None declared, Tatiana Sofía Rodriguez-Reyne: None declared, JOSE ANTONIO VELOZ ARANDA: None declared, Cassandra Michele Skinner Taylor: None declared, INGRID MARIBEL JUAREZ MORA: None declared, Beatriz Elena Zazueta Montiel: None declared, Atzintli Martínez: None declared, Cesar Francisco Pacheco Tena: None declared, Guillermo Pons-Estel: None declared.

The PHH-1V HIPRA vaccine: a new tool in the vaccination strategy against COVID-19.

OBJECTIVE: Vaccination against SARS-CoV-2 is essential to mitigate the personal, social and global impact of the coronavirus disease (COVID-19) as we move from a pandemic to an endemic phase. Vaccines are now required that offer broad, long-lasting immunological protection from infection in addition to protection from severe illness and hospitalisation. Here we present a review of the evidence base for a new COVID-19 vaccine, PHH-1V (Bimervax®; HIPRA HUMAN HEALTH S.L.U), and the results of an expert consensus. METHODS: The expert committee consisted of Spanish experts in medicine, family medicine, paediatrics, immunology, microbiology, nursing, and veterinary medicine. Consensus was achieved using a 4-phase process consisting of a face-to-face meeting during which the scientific evidence base was reviewed, an online questionnaire to elicit opinions on the value of PHH-1V, a second face-to-face update meeting to discuss the evolution of the epidemiological situation, vaccine programmes and the scientific evidence for PHH-1V and a final face-to-face meeting at which consensus was achieved. RESULTS: The experts agreed that PHH-1V constitutes a valuable novel vaccine for the development of vaccination programmes aimed towards protecting the population from SARS-CoV-2 infection and disease. Consensus was based on evidence of broad-spectrum efficacy against established and emerging SARS-CoV-2 variants, a potent immunological response, and a good safety profile. The physicochemical properties of the PHH-1V formulation facilitate handling and storage appropriate for global uptake. CONCLUSIONS: The physicochemical properties, formulation, immunogenicity and low reactogenic profile of PHH-1V confirm the appropriateness of this new COVID-19 vaccine.

Place Branding for Immigrant and Refugee Integration and Receptivity Amid the COVID-19 Pandemic: Responses of U.S. Cities in the "Welcoming America” Network

Despite vacillating national discourses on immigration policy and complications of the COVID-19 pandemic in 2020, a growing number of cities continue affiliating with the international "welcoming movement.” The welcoming movement consists of a transnational network of municipalities in partnership with nonprofit and nongovernmental organizations, the private sector, and other sectors of society that are implementing receptivity plans, policies, practices, and branding initiatives. Within this context, how are welcoming cities responding to the COVID-19 pandemic as one example of their place branding practices? Through a qualitative scan of municipalities' primary documents, policies, plans, websites, and municipal leaders' public pronouncements, this study contributes to understanding of immigrant receptivity processes and intersections with municipal place branding practices amid a pandemic by assessing their pandemic responses within a nationwide network of Welcoming Cities in the United States. Although there are burgeoning welcoming cities networks in other immigrant-receiving societies, this network was selected because they are the first, most established and comprehensive national network of cities with over 100 municipal affiliates. The findings offer scholarly and applied insights regarding place branding practices for immigrant and refugee integration and receptivity. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Accelerating Tuberculosis Preventive Treatment among Tanzanians Living with Hiv

Background: People living with HIV (PLHIV) bear 20 times higher risk of acquiring tuberculosis (TB) compared to people without HIV. The World Health Organization recommends TB preventive treatment (TPT) for PLHIV to reduce this risk. However, according to the 2020 Global TB Report, only half of PLHIV were started on TPT globally in 2019, with the lowest coverage observed in low-income countries including Tanzania, where TPT provision is part of the standard of care for eligible PLHIV in Tanzania. We describe programmatic efforts to scale up TPT in 11 regions accounting for half of the 1.5 million PLHIV on ART in Tanzania. Method(s): Starting in 2018, PEPFAR, through the U.S. Centers for Disease Control and Prevention (CDC), supported the Government of Tanzania to accelerate TPT provision by: (1) training and mentoring healthcare workers, (2) integrating isoniazid into supply chain plans at the regional level, and (3) convening quarterly meetings at national and regional levels for program and supply chain monitoring and coordination. Additionally, CDC launched focused regional support interventions, with TPT among its priorities, aiming to facilitate real-time data-driven site monitoring, increased accountability, and on-the-ground coordination with local health authorities and implementing partners. We analyzed routine programmatic data reported in PEPFAR's data reporting system for fiscal years (FY) FY2018 through FY2021. Result(s): The number of PLHIV of all ages who initiated TPT increased from 67,510 in FY2018 to 268,909 in FY2019. Despite coinciding with the COVID-19 pandemic, the initiation numbers in FY2020 were sustained at 264,465 and dropped by about one-third in FY2021 (182,823) compared to the previous year. TPT completion rates among those initiated also showed a positive trend;38% in FY2018, 85% in FY2019, 90% in FY2020, and 91% in FY2021. Conclusion(s): Our findings demonstrate substantial acceleration of TPT initiation and a significant increase in TPT completion rates over the four-year period in 11 regions in Tanzania. The policy of once-in-a-lifetime TPT for PLHIV means fewer people are eligible for TPT over time, which might account for lower numbers of PLHIV initiated on TPT in FY2021. Completion remained high among those who initiated TPT. The strategic shift focusing on capacity building, supply chain strengthening, and site-level monitoring may have contributed to the improvements in TPT initiation and completion.

The Securitization of the Covid-19 Pandemic at the Organization of American States

The current paper is aimed to contribute to the International Relation ' s research agenda related with international security ' s studies linked to health. It analyzes the incorporation process of covid-19 pandemic in the Organization of American States ' security agenda, as an international health crisis, using the securitization theory and through the speech analysis. Likewise, it was used descriptive and analytic generalization methods to support the interpretation of the data obtained. As results, it was possible to confirm that, since the establishment of multidimensional security ' s concept in 2003 by the OAS, the incorporation of issues related to health at the hemispheric security agenda is increasingly frequent, being HIV/aids the first precedent. In addition, the covid-19 pandemic is positioned as a new paradigmatic example in international security studies and, therefore, as a clear antecedent for the analysis of future similar phenomena resulting from health crisis.

Long-term effects of coronavirus disease 2019 on the cardiovascular system: The CV COVID-19 registry

Background: Patients with COVID-19 have an increased risk of cardiovascular adverse events during the acute phase. However, the long-term cardiovascular outcomes are unknown. Objective(s): We aimed to determine the long-term effects of COVID-19 in the cardiovascular system. Method(s): This is a multicenter, observational, retrospective registry conducted at 17 centers in Spain and Italy. Consecutive patients older than 18 years who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 in the participating institutions were included. Patients were classified into two groups, according to the results of the RT-PCR: COVID-19 positive or negative. The primary outcome was cardiovascular (CV) death at 1-year. The secondary outcomes included acute myocardial infarction, stroke, heart failure hospitalization, pulmonary embolism, and serious cardiac arrhythmias at 1-year. Outcomes were compared between the two groups. An independent clinical event committee adjudicated events. Result(s): A total of 4427 patients were included, 3578 (80.8%) patients with COVID-19 and 849 (19.2%) without COVID-19. COVID-19 patients were older, had a higher rate of classical cardiovascular risk factors, except for active smoking, and had fewer comorbidities. At a median time of 13.5 (IQR 11.8-15.8) months, after an adjustment by baseline characteristics, there was no difference in CV death (1.4% vs. 1.1%;HR 1.03 [0.49-2.18];p=0.941) between patients with COVID-19 and without. However, COVID- 19 patients experienced higher rate of venous thromboembolism (VTE) (3.9% vs. 0.6%, HR 6.11 [2.46-15.16];p=0.001), major bleeding (2.9% vs. 0.5%, HR 5.38 [1.95-14.84];p=0.001), and serious cardiac arrhythmias (2.6% vs. 0.9%, HR 2.25 [1.07-4.73];p=0.033). During follow-up, between discharge and end of follow-up, COVID-19 patients did not experience a higher risk of adverse cardiovascular outcomes (composite of CV death, any MI, ischemic stroke, systemic arterial thrombosis, VTE, heart failure hospitalization, or any serious arrhythmia) compared to patients without (HR 0.80;[0.53-1.21];p=0.298). Conclusion(s): At 1-year follow-up, COVID-19 was not associated with an increased risk of cardiovascular death but with a higher risk of VTE events, major bleeding, and serious cardiac arrhythmias. COVID-19 was not associated with a higher risk of adverse cardiovascular events during follow-up.

IMPACT OF THE COVID-19 PANDEMIC ON THE USE OF ICT TOOLS IN SCIENCE AND TECHNOLOGY EDUCATION

This article analyzes the self-concept about digital competence in university professors of Sciences, Health Sciences and Engineering and the impact that the COVID-19 pandemic has had on the Information and Communication Technologies (ICT) use habits of professors in these areas. For this purpose, a survey designed by the authors was completed by 340 university professors in the aforementioned areas. Based on the answers obtained from this survey, a descriptive quantitative analysis of the assessments of the self-concept of digital competence and training of the participants, of the didactic use of ICT and the frequency of their use before and after the pandemic has been carried out. The results showed that the digital competence of the professors is intermediate, but their training is valued as low, especially in Sciences and Health Sciences. The assessment of ICT is very good. The pandemic has caused a generalized increase in the use of ICT, mainly in Health Sciences, which is the area in which university students were most reluctant to use them. In addition, a gender gap which did not exist before the pandemic has been generated favoring females in the use of ICT in Science and Engineering. An age-based digital gap that existed before the pandemic has also been corrected in Health Sciences © Article's contents are provided on an Attribution-Non Commercial 4.0 Creative commons International License. Readers are allowed to copy, distribute and communicate article's contents, provided the author's and JOTSE journal's names are included. It must not be used for commercial purposes. To see the complete licence contents, please visit https://creativecommons.org/licenses/by-nc/4.0/

Applications of digital and smart technologies to control SARS-CoV-2 transmission, rapid diagnosis, and monitoring

Digital and smart technologies have been widely used during the coronavirus disease 2019 (COVID-19) pandemic to control severe acute respiratory syndrome coronavirus 2 transmission, to perform rapid diagnosis, and for monitoring. Although the pandemic has caused economic, social, and diverse health problems, it has spurred developers of digital and smart technologies to fight the disease. Science and technology sectors constituting mainly of data science, machine learning, and artificial intelligence are contributing toward controlling the COVID-19 pandemic. Robots and smart technologies along with IoT (Internet of Things) structures have been digitizing the fight against the pandemic, which has enormous gains in terms of reducing contamination/transmission. This chapter provides a detailed revision about such technologies, describing and discussing their advantages, disadvantages, and limitations. We concluded that some of these innovative solutions, as they require the patient's personal information, are concerning authorities and researchers about ethical issues, such as data safety and personal privacy. Modern technologies have contributed to improving people's lives, presenting a significant advantage in helping people to control this infection. © 2023 Elsevier Inc. All rights reserved.

Covid-19 and the Christian Churches. Representations produced about the pandemic among Catholics, Protestants and Pentecostals in the Colombian context. 2020-2021

Through digital ethnographic monitoring and the application of a survey directed at Christian churches in the department of Santander, the aim is to portray, compare, and explain the main emerging representations of the coronavirus during the first year and a half of the pandemic in the Colombian religious context. The interpretative similarities between currents revolved around: the pandemic as an instrument of God, human vulnerability and its dependence on the divine, the opportunity for conversion, the use of faith as resistance in the face of the crisis, and the normalization of the pandemic as another human suffering. In a second moment emerged particular reflections of several religious currents, among them: the pandemic as a product of man, the reproduction of the discourse of self-care, the questioning of scientific recommendations, the eschatological interpretations of the moment and some treatments towards the effects of the virus © 2023, Revista Colombiana de Sociologia.All Rights Reserved.

Clinical Characteristics of Hemodialysis Patients Hospitalized with Covid-19: A Case Series of 70 Cases from Dominican Republic

Introduction: The Coronavirus disease (COVID-19) is more severe in patients with pre-existing comorbidities;therefore, dialysis patients fall into this category. Not to mention the risk among patients receiving in-center dialysis, since they are known to be at higher risk of contracting this disease. Information about the clinical characteristics among hemodialysis patients with COVID-19 in Latin America and low-and middle-income countries are limited. Considering the importance of this topic, the aim of this study was to describe the clinical characteristics along with the outcome of 70 hemodialysis patients hospitalized for COVID-19. Method(s): This is a retrospective study in chronic hemodialysis patients hospitalized with COVID-19. All patients diagnosed with COVID-19 from March 2020 to January 2022 are included. Result(s): The mean age of the patients was 58 (range 19-87), where 65.7% were male. The most prevalent comorbidities were hypertension (98.6%) and type 2 diabetes (54.3%). The most common presenting symptoms were dyspnea (71.4%), fever (68.6%) and cough (58.6%). In addition of abnormal pulmonary auscultation in most patients (78.6%). Lymphocytopenia and elevated inflammatory markers as procalcitonin, erythrocyte sedimentation rate (ESR), D-dimer and C-reactive protein (CRP) were the main prevalent lab findings. At admission 90.1% had ground- glass abnormalities in the CT findings, being CO-RADS 3 the most frequent category between these patients. The average hospital stay was 8.51+/- 6.39 days;35.7% of these patients were admitted to the ICU and only 4 (5.7%) required mechanical ventilation. Therapeutic management included statins and antithrombotic therapy for all the patients at prophylactic doses. Treatment options were remdesivir, corticosteroids, hydroxychloroquine, antibiotics, and other immunosuppressant drugs. A total of 8 (11.4%) patients died during hospitalization and 62 (88.6%) were discharged. Conclusion(s): Even though dialysis patients are at higher risk of death, especially in developing countries, our findings suggest that the mortality rate were lower in comparison with other studies in Latin America and similar to some developed countries. The use of statins and antithrombotic prophylaxis in all hospitalized patients seems to be associated with a lower risk of death in conjunction with other therapeutic regimens according to the guidelines. No significant adverse effects were observed with remdesivir in these patients, so we believe that its use is beneficial in conjunction with the use of statins and antithrombotic prophylaxis, based on the patient's requirements. No conflict of interestCopyright © 2023

Covid-19 Infection in Kidney Transplant Recipients: A Single-Center Case Series of 10 Cases from Dominican Republic

Introduction: The coronavirus disease 2019 (COVID-19) has caused tremendous impact globally due to the significant morbidity and mortality caused by this virus. It is currently known that the probability of becoming seriously ill from this disease is higher in older adults, in people with pre-existing comorbidities, and those with a suppressed immune state. Therefore, transplant patients are not the exception. Considering the importance of this topic and the scarce information on the outcome of this type of patients, especially in Latin America, this series of cases is focused on our experience with 10 kidney transplant patients hospitalized for COVID-19. Method(s): We retrospectively reviewed the medical records of kidney transplant patients hospitalized for SARS-CoV-2 (COVID-19) between April 2020 and May 2021. Result(s): The age range of the patients was 41 to 68 years, where 8 of these were men. The most common admission symptoms were fever (80%), dyspnea (70%), myalgia/arthralgia (50%), and headache (50%). The most prevalent laboratory findings were lymphocytopenia and increased inflammatory markers such as D-dimer, LDH, procalcitonin, erythrocyte sedimentation, and ferritin. General management included supportive treatment, statins, and antithrombotic therapy, while the specific treatment options were hydroxychloroquine, antivirals, corticosteroids, Intravenous Immunoglobulin, tofacitinib, and convalescent plasma. All the patients improved and were discharged. Two of them went to the ICU and only one required mechanical ventilation. The majority of the patients (70%) remained with their baseline immunosuppression without dose reduction or suspension. Conclusion(s): Kidney transplant recipients are more susceptible to infections, along with increased disease severity. At the same time their immunosuppressed state may reduce the inflammatory response following this type of infection. Decisions were based on stopping or attenuating the viral load and the systemic inflammation caused by this virus, but at the same time protecting against acute allograft rejection and the coinfection with other pathogens. Our findings suggest that the use of statins and antithrombotic prophylaxis in all hospitalized transplant patients may be beneficial to reduce the risk of mortality in patients with COVID-19 infection. Also, the maintenance of immunosuppressive therapy was not associated with worse outcomes. No conflict of interestCopyright © 2023

Empathy, Social Media and Mental Health Indicators in Colombian' Social Crises

Evidence suggests that social crises impact mental health. However, empathy and access to information through social media might moderate its effect. This research examines the impact of empathy and social media usage and their relation to mental health among Colombians in two social crises: 1) the COVID-19 outbreak and 2) the Colombian national strike along 2021. Data from 314 adults were collected via eight online questionaries. Results indicated that participants in both crises spent vast amount of time in social media sites;positive association between usage of social media networks, anxiety, and traumatic stress measures;negative association between empathy and mental health indicators;and lower well-being and mental health indicators in participants that spent more time in social media sites. Moreover, regression analyses revealed that participants spending more time in social media with high empathy indicators and lower educational level are more likely to report worse mental health measures. In summary, this study has found that empathy moderates the relationship between social media usage and mental health in both social crises © 2022, Universitas Psychologica.All Rights Reserved.

The impact of the COVID-19 pandemic on poverty and inequality in Mexico

The objective is to quantify the effect of the COVID-19 pandemic on employment, poverty and inequality in Mexico. The methodology is based on a probit model to identify individuals at risk of employment loss, whose earnings are set to zero in ENIGH 2018 to match changes in employment and earnings observed in between December 2019 and the May 2020 according to ENOE and ETOE surveys, respectively. MEXMOD, Mexico's microsimulation model, is used to simulate tax-benefit policies based on the pre-COVID and COVID-scenarios. The results show that there was a loss of 12.1 million jobs. Poverty reached 60.16% and extreme poverty reached 29.73%;inequality grew 8.2%. It is recommended to strengthen social policy with extra funding (taxing the rich) to achieve greater redistribution. The limitation is that income distribution is held constant as we do not have ENIGH 2020. The originality is to offer timely measures of poverty and inequality using microsimulation techniques to overcome the lack of data during the pandemic. The research concludes that there are not automatic stabilizers to cope COVID-19 negative effects and cash-transfers are not sufficient to do so. © 2021 The Author(s).

Mathematical model optimized for prediction and health care planning for COVID-19. / Modelo matemático optimizado para la predicción y planificación de la asistencia sanitaria por la COVID-19.

OBJECTIVE: The COVID-19 pandemic has threatened to collapse hospital and ICU services, and it has affected the care programs for non-COVID patients. The objective was to develop a mathematical model designed to optimize predictions related to the need for hospitalization and ICU admission by COVID-19 patients. DESIGN: Prospective study. SETTING: Province of Granada (Spain). POPULATION: COVID-19 patients hospitalized, admitted to ICU, recovered and died from March 15 to September 22, 2020. STUDY VARIABLES: The number of patients infected with SARS-CoV-2 and hospitalized or admitted to ICU for COVID-19. RESULTS: The data reported by hospitals was used to develop a mathematical model that reflects the flow of the population among the different interest groups in relation to COVID-19. This tool allows to analyse different scenarios based on socio-health restriction measures, and to forecast the number of people infected, hospitalized and admitted to the ICU. CONCLUSIONS: The mathematical model is capable of providing predictions on the evolution of the COVID-19 sufficiently in advance as to anticipate the peaks of prevalence and hospital and ICU care demands, and also the appearance of periods in which the care for non-COVID patients could be intensified.

Clinical Benefit of Oral sabizabulin for Hospitalized Adults with CoVID-19 on Supplemental Oxygen

Background. Sabizabulin is an oral, novel microtubule disruptor with dual antiviral and anti-inflammatory activities. A randomized, multicenter placebo-controlled Phase 3 clinical trial was conducted in hospitalized moderate-severe COVID-19 patients at high-risk for acute respiratory distress syndrome (ARDS) and death. Patients were randomized (2:1) to sabizabulin 9mg or placebo oral daily dose (up to 21 days). In a planned interim analysis, sabizabulin treatment resulted in a 55.2% relative reduction in mortality compared to placebo. Methods. The primary endpoint was all-cause mortality up to day 60. Key secondary endpoints were days in intensive care unit (ICU), on mechanical ventilation, and in hospital. Randomization was stratified by oxygen requirement at baseline (WHO 4 = supplemental oxygen, WHO 5 = NIV/forced oxygen, WHO 6 = mechanical ventilation). TheWHO4 patients also were required to have at least one comorbidity (Asthma, Chronic Lung Disease, Diabetes, Hypertension, Severe Obesity (BMI >=40), >=65 years of age, in a nursing/long-term care facility, or immunocompromised). A post-hoc analysis of the key efficacy outcomes inWHO4 at baseline patients with a comorbidity was conducted. Results. A total of 88 patients classified as WHO 4 with a baseline comorbidity underwent randomization (59 sabizabulin/29 placebo). Baseline characteristics were similar. Sabizabulin treatment resulted in a 22.4 absolute percentage point and 81.2% relative reduction in deaths compared to the placebo (odds ratio 6.22, 95% CI [1.58 to 24.48], p=0.0090). Mortality rate was 5.2% (3 of 58) for sabizabulin versus 27.6% (8 of 29) for placebo. Key secondary endpoints: sabizabulin treatment resulted in relative reductions of 74.7% in days in ICU (p=0.0021), 80.7% in days on mechanical ventilation (p=0.0019), and 39.8% in days in hospital (p=0.0191) vs placebo. Conclusion. Statistically and clinically significant reductions in mortality, days in the ICU, on mechanical ventilation, and in the hospital were observed in the sabizabulin treated compared to placebo hospitalized COVID-19 WHO-4 patients with at least one comorbidity suggesting that the antiviral action of sabizabulin contributes early in the prevention of COVID-19 progression to ARDS and death. (Figure Presented).

Outbreak and Management of COVID-19 and Infection Prevention Control Practices at a Community Living Center in Veterans Administration Hospital, North Texas

Background. The increase in SARS-CoV-2 cases due to the omicron wave led to significant utilization of healthcare resources and reduced acute care hospital beds at the Veterans Administration Hospital, North Texas Health Care System (VANTHCS). As a result, veterans with non-severe disease were managed at a VANTHCS community living center (CLC) during a COVID-19 outbreak. Methods. Veterans residing at the CLC with laboratory-confirmed cases of SARS-CoV-2 (the virus that causes COVID-19) by polymerase chain reaction diagnosed from January 1 to February 15, 2022, were included in the descriptive analysis. We described resident characteristics and outcomes and infection control practices (IPC) implemented to control the outbreak. Resident data was ascertained from the COVID-19 facility dashboard and medical record system. Results. From January 1-February 15, 2022, 33 adults residing at the CLC were diagnosed COVID-19. Most infections (93.9%) occurred between January 12-24 (figure 1). The median age was 76 years [interquartile range, 71-80 years] and 30 (90.9%) were men and 25 (75.8%) were white and 5 (15.2%) African American (table 1). Among the total cases, 9 (27.3%) resided in the dementia unit. Nineteen of 33 (57.6%) were asymptomatic. Overall, 28 (84.8%) were documented to be fully vaccinated against SARS-CoV-2 and 24 (72.7%) were boosted. Obesity, ischemic heart disease, chronic obstructive pulmonary disease, and stroke were the most common comorbidities. Residents were cohorted based on COVID-19 results. A multidisciplinary team was convened, and staff were fit tested for appropriate personal protective equipment (PPE) and received refresher training on hand hygiene, donning and doffing of PPE. Most residents were determined to have mild or moderate COVID-19 and managed at the CLC while 7 (21.2%) were hospitalized in the acute care hospital. For management of COVID-19, 11 (33.3%) received dexamethasone and 25 (75.8%) received remdesivir. Overall, 32 (97%) residents survived while one hospice resident was transferred to acute care and died;only 1 resident required ICU admission. Epidemic curve of laboratory-confirmed coronavirus disease 2019 (COVID-19) disease at a Community Living Center, Veterans Administration Hospital, North Texas Health Care System, January-February 2022. Table 1 Epidemiological Characteristics, and Outcomes of Laboratory-confirmed COVID-19 cases (N=33) Abbreviation: BMI, body mass index;COPD, Chronic Obstructive Pulmonary Disease;ESRD, end stage renal disease 1Other comorbidity (asthma n=1 and chronic liver disease n=2) Conclusion. It is feasible to administer COVID-19therapies to high-risk residents with mild-moderate disease in a CLC with a multidisciplinary team and IPC strategies.