ABSTRACT
Social isolation and generalized confinement in many countries has caused a decrease in physical activity (PA) and an increase in levels of stress, anxiety and depression. Purpose in life is part of people's psychological well-being, and having a clear purpose allows them to face adversities. In this sense, the influence of PA on psychological well-being in situations of confinement makes it necessary for educational and governmental entities to study and promote it. The objective of this work has been to evaluate the incidence with a PA intervention program (Move yourself at home) on the purpose in life during a period of mandatory confinement due to COVID-19. 360 university students participated divided into three groups, control (Sedentary, Sed), and experimental (group with low physical activity, BAct, and physically active, Act). The experimental groups were conducted on a PA intervention program for 11 weeks, from the beginning to the end of the mandatory confinement. A weekly online questionnaire was collected, recording the level of PA (min / week) and the results of the PIL test (purpose in life). The level of PA decreased significantly at the beginning of the confinement and increased significantly in the flexibilization phases. The intervention program was able to help maintain the PA level in participants. PA has a positive effect on the purpose in life and practicing some physical exercise on a regular basis could be a crucial tool to face a state of mandatory confinement. ©Copyright: Federación Española de Asociaciones de Docentes de Educación Física.
ABSTRACT
This paper examines the rapid introduction of AI and automation technologies within essential industries amid the COVID-19 pandemic. Drawing on participant observation and interviews within two sites of waste labor in the United States, we consider the substantial effort performed by frontline workers who smooth the relationship between robotics and their social and material environment. Over the course of the research, we found workers engaged in continuous acts of calibration, troubleshooting, and repair required to support AI technologies over time. In interrogating these sites, we develop the concept of "patchwork": human labor that occurs in the space between what AI purports to do and what it actually accomplishes. We argue that it is necessary to consider the often-undervalued frontline work that makes up for AI's shortcomings during implementation, particularly as CSCW increasingly turns to discussions of Human-AI collaboration. © 2023 Owner/Author.
ABSTRACT
The suspension of face-to-face classes due to COVID-19 in Uruguay on 13 March 2020 meant that very quickly the teaching staff of the Faculty of Humanities and Educational Sciences (FHCE) of the University of the Republic had to adapt to the implemen-tation of virtual teaching. The aim of this article is to systematize the changes in university teaching in some courses of the FHCE during 2020, giving account of the perceptions of teachers about that first year of transition of modality. The methodological approach was carried out through the systematization of experiences, according to Jara (1994, 2019). Under this approach, the following were identified: a) main problems and challenges in the transition from the face-to-face classroom to the virtual classroom;b) pedagogical decisions regarding the adaptation of courses to the new format;c) methodologies applied between the first and second semester, and d) elements to be maintained or adapted in the return to face-to-face teaching. To this end, we worked with unstructured interviews, documentary records, categorization and triangulation of information related to the experiences and adaptations to the new scenario. The conclusions include contributions on the role of the teacher, pedagogical decisions, institutional tensions and teaching methodolo-gies, their regulatory support, evaluation, and the reconfigurations necessary in a post-pandemic context.
ABSTRACT
Background: the impact tasks carried out by medical sciences students constituted an essential factor in the confrontation with COVID-19. Objective: to characterize the medical science students work in the confrontation with COVID-19 in Cienfuegos. Methods: observational, descriptive and cross-sectional study from February to September 2021. The universe consisted of 1815 Dentistry and Medicine students who were fighting against COVID-19. The whole universe was studied. Variables such as the municipality of origin, members of the Student Helpers Movement, impact task, place where they worked and multiple tasks were also analyzed. Descriptive statistical techniques were used. Results: the average age was 20.6 years and the female sex predominated (70%). The medical career was the most represented (96.0%). The Cienfuegos municipality had the highest student participation (49.4%). All students were incorporated into at least one impact task. 99.8% contributed to the active research in the community. The task with the greatest impact for first-year students was research (90%), while vaccination was in the remaining academic years. Conclusions: medical science students from Cienfuegos joined different impact tasks in the fight against COVID-19, which contribute to their comprehensive training and show the sense of duty that characterizes health personnel trained in the country.
ABSTRACT
The COVID-19 pandemic has exposed poverty and exacerbated social inequality. Our role as academics is to illuminate these social issues to help policy makers address them adequately. Hence, we conducted this ethnographic study situated within the discourse urban-rural divide to assess the Philippine Basic Education-Learning Continuity Plan (BE-LCP), a COVID-19 education response, through the help of three teachers who, like us, the researchers, have been exposed to the rural and urban areas in Sindangan, Zamboanga del Norte. In our effort to promote social justice and equity in education, we have privileged the voices of those in the marginalized rural sector. We interviewed the teacher key actors, conducted autoethnography and participant observation, and studied secondary sources available. Data sources were triangulated, and data transcripts were analysed through thematic analysis, drawing on relevant theories and literature. Interrelated social factors instigated by the government's biased past policies are (a) socioeconomic impact of COVID-19, (b) digital divide, (c) school location, and (d) parental education. While the pandemic affected urban and rural residents, the latter felt a severe impact. This study underscores the teacher agency in the BE-LCP policy: Teachers recommended monitoring learning outcomes, attending to low-performing learners, supporting home-based learning, and providing teaching resources. © 2023 National Institute of Education, Singapore.
ABSTRACT
Background: Neoplastic pericardial effusion (NPE) is a serious complication that occurs in the setting of advanced oncological disease and is associated with a high recurrence rate. Currently, pericardiocentesis (PCT) remains the first therapeutic option and the use of percutaneous balloon pericardiotomy (PBP) is limited to the treatment of recurrences. However, it is not known whether some aspects of the procedure during PBP lead to different outcomes in terms of survival and recurrence, and no such patients have been included in studies during COVID-19 pandemic. Purpose(s): The aim is to analyses the success, complications and recurrence rate (defined as recurrence of NPE requiring PCT, PBP or surgical pericardial window (SPW) of both procedures (BP) in order to establish the optimal entry treatment for these patients. Method(s): This research analyzed the clinical characteristics and prognostic factors of patients with severe pericardial effusion of neoplastic etiology who underwent PBP during the COVID-19 pandemic. A prospective study was conducted involving 23 patients admitted between January 2020 and January 2022 for severe NPE who underwent PCT or PBP as initial treatment of NPE. Result(s): We included 23 patients, 62.9% were male with a mean age of 51.2+/-14.9 years NPE was the first manifestation of the oncological process in 12 patients (52.1%) with lung cancer being the most frequently associated primary cancer (58.7%) followed by breast cancer in 12.7% of cases. A total of 26 procedures were performed, 10 PCT, 15 PBP, 1 SPW, with tumors cells identified in the pericardial fluid in 13.0% of cases. PCT was used as an entry point in 10 patients (43.5%), 6 patients were COVID-19 positive and PCT was performed as the first treatment. While PBP was chosen as the first therapeutic option in 13 patients (56.5%) (2 Re-PBP). The initial efficacy of the procedure was 93.1% and 92.2% respectively (p=0.88), with 1 complication occurring in the PBP group but not requiring scheduled SPW. In the former group, the percentage of recurrences was higher (34.7%;8 recurrences in 10 patients) compared to patients treated with upfront PBP (8.6%;2 recurrences in 13 patients), p=0.09. In addition, only one patient had to resort to surgery. When analyses according to the BP. used, the recurrence rate was 4.0 times higher for PCT (34.7 vs. 8.6% recurrences), although without reaching statistical significance (p=0.16). Conclusion(s): The PBP is a simple, safe and effective technique for the treatment of NPE during the COVID-19 pandemic, in our series it was associated with a lower recurrence rate. Therefore, it could replace PCT in these patients during the COVID-19 pandemic as optimal first line treatment, providing better quality of life and reducing the need for re-interventions. (Figure Presented).
ABSTRACT
Sustainable energy economics in Latin America has become relevant due to the region's dependence on the oil market and the disruption caused by the COVID-19 pandemic. A systematic review of the ten major economies in the region based on gross domestic product is conducted. We primarily analyze production performance of hydro, wind, and solar energies, in terms of total gigawatt hours produced, current participation levels in energy matrices, and total installed capacity. Current and future trends and legal frameworks for each technology and country are discussed. Our analyses indicate that Latin America and the Caribbean can potentially increase the usage of renewable energy sources given a plethora of natural resources, favorable geographical and climatic conditions, and existing large-scale hydro installations to counteract the inconsistency of wind and solar projects. Therefore, governments in the region must overhaul sustainable policies to increase awareness and reduce energy dependence on foreign powers. © 2023 The Author(s). Published by Cambridge University Press on behalf of the Latin American Studies Association.
ABSTRACT
Introduction and Objectives: Among the WHO, goals for 2030 are to detect >90% of people with HCV and link >80% to treatment. Our institution serves an open population without social security. This study aimed to describe the detection strategy that was carried out in the open population, using two-step HCV detection tests at "Hospital General de Mexico" from January to December 2021. Material(s) and Method(s): The study was conducted in an open population that transits for our hospital for any reason and agreed to take the risk factor questionnaire and the rapid test for the detection of anti-HCV antibodies (RT);those who were reactive underwent viral load (PCR to detect HCV-RNA). Descriptive statistics and the statistical package STATA v.14 were used. Result(s): In 2021, 33,523 subjects were screened;71.5% were women, mean age of 47+/-10 years. Reported at least one risk factor for HCV 53.5%. The most frequent risk factors were: Multiple sexual partners (MSP)/sexually transmitted diseases (STDs) 36.2%, tattoos/piercings 26.7%, surgery before 1995 20.2%, transfusion before 1994 5.4%, health workers after accidental puncture 4.2%. Of the 33,523, 0.7% were reactive in the RT;of them, the PCR was positive in 57.9% (prevalence of viremia= 0.4%). Among the viremic, the risk factors identified were: blood transfusion before 1995 37%, MSP/STDs 35%, surgery before 1995 30%, tattoos/piercings 30%, and drugs 3.5%. Of all viremic, 134 (100%) were linked to attention at the Mexican health sector;114 (85.1%) without insurance treated at our hospital;89 (78%) received DAAs at our institution in 2021 and have completed the time to assess SVR12, per protocol the SVR12 rate was 97.7% (2 failures), by intention to treat SVR12 was 93.2% (2 failures, 1 missing, three deaths from COVID-19). The remaining 25 patients detected in 2021 (22%) and without eligibility continued the protocol for treatment with DAAs during the year 2022. Conclusion(s): The prevalence of HCV was similar to that previously reported. Traditional risk factors such as transfusion or surgery are still very prevalent. Timely diagnosis of HCV allows treatment to be linked to an optimal level of SVR12 in accordance with the WHO goals.Copyright © 2023
ABSTRACT
INTRODUCTION: The role of the central and peripheral nervous system in the generation of migraine is not well understood. Our aim was to determine whether peripheral trigeminal nerve stimuli, such as nasopharyngeal swabs, could trigger migraine attacks. SUBJECTS AND METHODS: A survey was sent to 658 doctors, nurses and medical students, asking about the presence of headache suggestive of migraine after carrying out a SARS-CoV-2 swab test, their previous history of migraine, and demographic and headache-related characteristics. Those who tested positive or had associated clinical signs and symptoms of COVID were excluded. RESULTS: A total of 377 people were recruited, 309 of whom were included in the sample. Forty-seven (15.2%) reported headache suggestive of migraine after the swab test and 42 (89.4%) of them had a previous history of migraine. The risk of developing migraine was higher in the subgroup of patients with a history of headache suggestive of migraine - odds ratio: 22.6 (95% confidence interval: 8.597-59.397); p < 0.001. No differences were found between the main characteristics of attacks suggestive of migraine before and after the swab test, except for a lower percentage of associated aura afterwards (42.8% vs. 26.1%; p = 0.016). Individuals with previous attacks suggestive of migraine with a frequency of more than two episodes per month had a higher risk of developing a headache suggestive of migraine after the test - odds ratio = 2.353 (95% confidence interval: 1.077-5.145); p = 0.03. CONCLUSIONS: Nasopharyngeal swabbing may trigger migraine attacks, with a greater likelihood in individuals with a higher frequency of previous migraines. This would confirm the idea that peripheral stimuli on the trigeminal nerve can trigger migraine attacks in individuals with migraine, according to their degree of trigeminovascular sensitisation.
TITLE: Estimulación periférica del nervio trigémino mediante frotis nasofaríngeo como posible desencadenante de migraña.Introducción. La implicación del sistema nervioso central y periférico en la generación de la migraña no se conoce bien. Nuestro objetivo fue determinar si estímulos periféricos sobre el nervio trigémino, como el frotis nasofaríngeo, podrían desencadenar ataques de migraña. Sujetos y métodos. Se envió una encuesta a 658 médicos, enfermeras y estudiantes de medicina, preguntando por la presencia de cefalea sugestiva de migraña tras la realización de un frotis para la determinación del SARS-CoV-2, su historia previa de migraña, y sobre características demográficas y relacionadas con la cefalea. Los que tenían resultado positivo o que asociaban sintomatología de COVID fueron excluidos. Resultados. Se reclutó a 377 personas y se incluyó a 309. Cuarenta y siete (15,2%) refirieron cefalea sugestiva de migraña tras la realización del frotis, de las cuales 42 (89,4%) tenían historia previa de migraña. El riesgo de desarrollarla fue mayor en el subgrupo de pacientes con cefalea sugestiva de migraña previa razón de probabilidad: 22,6 (intervalo de confianza al 95%: 8,597-59,397); p < 0,001. No hubo diferencias entre las características principales de los ataques sugestivos de migraña previos y los desencadenados tras la prueba, excepto un porcentaje menor de aura asociada tras el frotis (42,8% frente a 26,1%; p = 0,016). Los individuos con ataques sugestivos de migraña previos con frecuencia superior a dos episodios mensuales presentaron mayor riesgo de desarrollar una cefalea sugestiva de migraña tras el test razón de probabilidad = 2,353 (intervalo de confianza al 95%: 1,077-5,145); p = 0,03. Conclusiones. El frotis nasofaríngeo podría desencadenar ataques de migraña, más probablemente en individuos con mayor frecuencia de migrañas previas. Esto confirmaría que estímulos periféricos sobre el nervio trigémino pueden desencadenar ataques de migraña en individuos con migraña, de acuerdo con su grado de sensibilización trigeminovascular.
Subject(s)
COVID-19 , Migraine Disorders , Humans , SARS-CoV-2 , Migraine Disorders/diagnosis , Migraine Disorders/etiology , Headache/etiology , Trigeminal NerveABSTRACT
Background: The development of depression and anxiety symptoms during long COVID may partly result from the biopsychosocial effects of COVID-19 that impact mental health, rather than from the infection alone. Aim: The present study examined the association of anxiety, depression, stress, and psychological distress levels with sociodemographic factors and symptom severity during and three months after the acute phase of COVID-19. Methods: This cross-sectional study included 119 participants with a positive SARS-CoV-2 qPCR test. Three months after the acute phase of infection, participants completed an online survey to collect clinical information and sociodemographic data, followed by completion of the Impact of Event Scale-Revised, Depression, Anxiety, and Stress scales. Results: During and after infection, fatigue was the most frequently reported symptom. After the acute phase of COVID-19, substantial numbers of participants presented moderate to severe psychological distress (28.5%), severe to extremely severe depression (26.05%), and severe to extremely severe stress (31.09%). Female patients presented higher stress scores than males, while individuals who reported having lost a loved one presented high psychological distress, anxiety, and depression. The presence of physical symptoms after COVID-19 and other factors such as being a woman, being married, having children, or living with someone who suffers from a disease increased vulnerability to depression, stress, and anxiety. Conclusions: There are psychological consequences for survivors of COVID-19 associated with sociodemographic factors. Clinical strategies are needed to provide mental health care for individuals with long COVID symptoms. © 2022 IACFS/ME.
ABSTRACT
An approach based on fractal scaling analysis to characterize the organization of the Covid-19 genome sequences is presented in this work. The method is based on a multivariate version of the fractal rescaled range analysis implemented on a sliding window scheme to detect variations of long-range correlations over the genome sequence domains. As a preliminary step, the nucleotide sequence is mapped in a numerical sequence by following a Voss rule, resulting in a multichannel sequence represented as a binary matrix. Fractal correlations, quantified in terms of the Hurst exponent, depending on the region of the sequence, where the Covid-19 genome sequences are predominantly random, with some patches of weak long-range correlations. The analysis shows that the regions of randomness are more abundant in the Covid-19 sequences than in the primitive SARS sequence, which suggests that the Covid-19 virus possesses a more diverse genomic structure for replication and infection. The analysis constrained to the surface glycoprotein region shows that the Covid-19 sequence is less random as compared to the SARS sequence, which indicates that the Covid-19 virus can undergo more ordered replications of the spike protein. The Omicron variation exhibits an interesting pattern with some randomness similarities with the other SARS and the Covid-19 genome sequences. Overall, the results show that the multivariate rescaled range analysis provides a suitable framework to assess long-term correlations hidden in the internal organization of the Covid-19 genome sequence. © 2023
ABSTRACT
The focus of this case study is the implementation of a pedagogical strategy to adapt the laboratory practices of the Pharmacology course in a Peruvian public university, where animals such as rats and mice are routinely used. Amid the COVID-19 pandemic, and the consequent virtualisation of the teaching-learning process, several academic challenges were posed. The 'Practical Seminars' have arisen as a pedagogical proposal that allows faculty to adapt to the conditions of society. They are designed based on selected articles that reflect experiments with drugs, where selected information is adapted, such as graphs, images and even videos. By posing analysis questions allows for students' previous knowledge to be checked;thus promoting an applied critical attitude to clinical situations. With this resource the faculty tried to recreate a significant space for self-learning. The results of students' partial evaluation reflects a performance similar to that of previous years of the course, with teaching staff accepting this modality well. Finally, a space for analysis was generated, in addition to dispensing with the use of experimental animals. Copyright © 2020 FIP.
ABSTRACT
Introduction: Sars-cov2 infection is commonly associated with acute kidney injury (AKI) which may be observed in up to 40% of cases. Pathogenesis of AKI during COVID-19 is yet not perfectly understood. Many risk factors have been proposed associated with AKI occurrence during COVID-19 infection. To date there is still limited data of AKI progression and long-term outcomes among these patients. We aim to describe risk factors for development of AKI and the progression of their renal function up to six months after hospital discharge. Methodology: This is a retrospective observational study in a tertiary car nephrology department in Barcelona, Spain. We evaluated data from 71 hospitalized patients with AKI occurrence during COVID-19 infection between 1st of March and 30th May 2020. Analysis of baseline characteristic, need of renal replacement therapy (RRT) and inflammatory parameters has been performed. Result(s): Of 71 patients (74,6% males;median age 71,9+/-11,15 years), 43 (60,6%) needed admission in the intensive care unit (ICU) for hemodynamic/respiratory support and 34 (47,9%) died during hospitalization. 13 (18,3%) needed RRT. 3 (23%) patients requiring RRT died during COVID-19 infection and 9 (69,2%) partially recovered renal function. Baseline serum creatinine of patients without RRT need during follow-up was 0,90+/-0,16 mg/dl with a peak serum creatinine 2,8+/-1,5 mg/dl. Patients that needed RRT support had a baseline serum creatinine 0,98+/-0,87 mg/dl and a peak serum creatinine of 4,34+/-3,35 mg/dl. Creatinine at discharge was of 1,5+/-0,59 mg/dl in the group of patients needing RRT and 1,2+/-0,52 mg/dl. At six months follow-up no significant differences were found in creatinine levels from discharge (p=0,65). Very poor correlation was observed between inflammatory parameters and serum creatinine peak levels (Dimer D levels and Serum creatinine peak R2=0,034;C reactive protein and creatinine peak levels R2=0,15 and Interleukin 6 and creatinine peak levels R2=0,042). Conclusion(s): COVID-19 infection is associated with AKI with and increased risk of chronic kidney disease after infection is resolved. No differences between renal function at discharge and at 6 months of follow-up was observed. No correlation between the studied inflammatory parameters and the worsening of renal function was observed.
ABSTRACT
Social isolation and widespread confinement in many countries has caused a decrease in physical activity (PA) and an increase in levels of stress, anxiety and depression. The purpose in life is part of the psychological well-being of people, and having a clear purpose allows them to face adversity. In this sense, the influence of PA on psychological well-being in confinement situations makes it necessary to study and promote it by educational and government entities. The objective of this work was to evaluate the incidence of an intervention program with PA (Move at home) on the purpose in life during a period of mandatory confinement due to COVID-19.360 university students divided into three groups participated: control (Sedentary, Thirst), and experimental (group with low physical activity, BAct, and physically active, Act). The experimental groups underwent a PA intervention program for 11 weeks, from the beginning to the end of the mandatory confinement. A weekly online questionnaire was collected, recording the PA level (min/week) and the results of the PIL test (purpose in life). The PA level decreased significantly at the beginning of the confinement and increased significantly in the easing phases. The intervention program was able to contribute to maintaining the PA level in the participants. Physical activity has a positive effect on purpose in life and the practice of some physical exercise on a regular basis could be a crucial tool to face a state of mandatory confinement.
ABSTRACT
Background: The development of depression and anxiety symptoms during long COVID may partly result from the biopsychosocial effects of COVID-19 that impact mental health, rather than from the infection alone. Aim(s): The present study examined the association of anxiety, depression, stress, and psychological distress levels with sociodemographic factors and symptom severity during and three months after the acute phase of COVID-19. Method(s): This cross-sectional study included 119 participants with a positive SARS-CoV-2 qPCR test. Three months after the acute phase of infection, participants completed an online survey to collect clinical information and sociodemographic data, followed by completion of the Impact of Event Scale-Revised, Depression, Anxiety, and Stress scales. Result(s): During and after infection, fatigue was the most frequently reported symptom. After the acute phase of COVID-19, substantial numbers of participants presented moderate to severe psychological distress (28.5%), severe to extremely severe depression (26.05%), and severe to extremely severe stress (31.09%). Female patients presented higher stress scores than males, while individuals who reported having lost a loved one presented high psychological distress, anxiety, and depression. The presence of physical symptoms after COVID-19 and other factors such as being a woman, being married, having children, or living with someone who suffers from a disease increased vulnerability to depression, stress, and anxiety. Conclusion(s): There are psychological consequences for survivors of COVID-19 associated with sociodemographic factors. Clinical strategies are needed to provide mental health care for individuals with long COVID symptoms. Copyright © 2022 IACFS/ME.
ABSTRACT
Introduction: As of August 27th, 2021, the diagnosed cases of COVID 19 in Spain are 4 758 003 with a prevalence of 10.03%. 68.4% of the Spanish population is fully vaccinated Objectives: Primary: To compare the prevalence of COVID infection in a cohort of patients with schizophrenia to patients with a dual diagnosis of schizophrenia and substance use disorder Secondary: To compare the rate of fully vaccinated patients diagnosed with schizophrenia with and without a coexisting substance use disorder. Method(s): Retrospective descriptive study. The population in study is made up of patients with schizophrenia (46) and dual diagnosis schizophrenia (28) (following DSM 5 criteria) Confirmed cases were those cases with positive PCR Results: There was not a stadistically significant difference in the prevalence of COVID 19 infection between both groups of patients. The prevalence of COVID infection among the dual diagnosis schizophrenia was 3.57% compared to 6.5% in those without coexisting substance abuse disorder. Relative to vaccination rate, we didn't find a stadistically significant difference between both groups. However, there was a higher vaccination rate in the dual diagnosis schizophrenia group (82.12%) compared to the non-dual diagnosis schizophrenia group (69.56%) Conclusion(s): The prevalence of COVID 19 infection in the dual diagnosis schizophrenia cohort is 3.57% and in the group of patients with schizophrenia without substance abuse disorder is 6,5%. In those with dual diagnosis schizophrenia the vaccination rate was un 82.12%. It was 69.56% in those without coexisting substance abuse disorder.
ABSTRACT
Introduction: Emergency use authorization and mass vaccination programs worldwide have lowered the burden of the COVID-19 pandemic. Vaccine complications not previously seen in clinical studies continue to manifest. We present a case of membranous nephropathy (MN) following the SARS-CoV-2 vaccination with successful treatment. Case Description: Our patient is a 58-year-old woman with past medical history of hypothyroidism seen at a nephrology clinic for evaluation of new onset symptoms of dyspnea, severe bilateral pedal edema, and proximal muscle weakness for 4 months. The patient had 3+ proteinuria and microscopic hematuria on urinalysis obtained by primary care provider. She also had a rapid decline in serum albumin to 2.2 g/dL and new onset hypercholesteremia at 415 mg/dL. Before initial presentation, she had normal labs and no symptoms. Upon presentation to our nephrology clinic, the patient had proteinuria of 2,360 mg/day on a 24-hour urine collection, random urine protein-to-creatinine ratio (UPCR) of 5,459 mg/g and random urine albumin-to-creatinine ratio (UACR) of 3,539 mg/g. She had no risk factors for chronic kidney disease. The only recent change in the health management of the patient was the administration of two doses of the SARS-CoV-2 vaccine several weeks prior to presenting with her initial symptoms 4 months ago. The phospholipase A2 receptor (PLA2R) antibody was elevated at 287 IU/mL. Serological tests for other sources of proteinuria were negative. Renal biopsy performed was consistent with primary MN. The patient was started on rituximab infusion given 2 weeks apart based on Mentor Trial. Additional treatment included apixaban, sulfamethoxazole/ trimethoprim DS, losartan, and L-carnitine. After two doses of rituximab, she had resolution of dyspnea, pedal edema and muscle weakness. Repeat labs revealed UPCR to 1000 mg/g, UACR to 629 mg/g, improvement of PLA2R to 8 IU/mL. Our patient achieved immunological remission and partial clinical remission. Discussion(s): This case illustrates a potential association of the SARS-CoV-2 vaccination and autoimmune mimicry leading to MN. We hope that this will help clinicians become aware of a potential complication not widely recognized and an effective management strategy. We hope further investigations of this possible association are performed as more cases are discovered.
ABSTRACT
The SARS-CoV-2 pandemic has been an unprecedented event in recent history, a public health crisis, which has tested humanity as a species. The actions of the scientific professionals have stood out during the pandemic, whose joint efforts identified and began the careful study of its pathophysiology and the means to combat it. During the initial phases, and in the absence of scientific evidence, procedures and recommendations were developed based on plausibility and the desire to offer a therapeutic option and compassionate management. The subsequent course, with multicentre research works, demonstrated the limitation of many previous recommendations, ruling out therapeutic options and confirming the essential actions for the management of this crisis, leaving clear recommendations for future outbreaks, epidemics or pandemics: trained healthcare professional, suitable resources, development of protocols based on evidence-based medicine and government strategies in the health services, to change the evolution of the pandemic. © 2021 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo