Identification of Latent Topics in Patients Surviving COVID-19 in Mexico

With the outbreak of the SARS-CoV-2 o COVID-19 pandemic, multiple studies of risk factors and their influence on patient deaths have been developed. However, little attention is often paid to analyzing patients in risk groups despite the fact that they have been infected and inpatients can survive. In this article, with the dataset available from the Ministery of the health of Mexico, this paper proposes the use of the latent topic extraction algorithm Latent Dirichlet Allocation (LDA) for the study of COVID-19 survival factors in Mexico. The results let us conclude that in the year before strategies for prevention and control of COVID-19, the latent topics support that patients without comorbidities have a low risk of death, compared with the period of 2021, wherein in spite of having some risk factors patients can survive.

Psychological well-being of Mexican adolescent athletes confined by the COVID-19 pandemic

The present pandemic has affected psychological well-being in all areas, but in adolescent athletes, its impact is unknown. The objective of the present research is to determine the perceived psychological well-being, subjective vitality and mental strength of confined Mexican adolescent athletes depending on: sex, age and type of sport, as well as the predictive role of different variables evaluated in the perceived psychological well-being of athletes. 522 high level athletes, 280 men and 242 women, 16 +/- 1y, were administered the Psychological Well-being Scale for Adolescents (BIEPS-J), the Subjective Vitality Scale, and the translation of the Mental Toughness Inventory (MTI). The results showed that 15% of the athletes perceived low psychological well-being, self-acceptance was the most damaged dimension Males showed better perceived psychological well-being, increased vitality and in mental strength (p = 0.003, p = 0.001;p = 0.003). The variables included in the model that best explained the high and low levels of well-being were mental toughness (37%). It is suggested that third generation positive interventions will be implemented in sports care programs after confinement. Furthermore, we consider it necessary to continue exploring variables that can predict the psychological well-being.

Decrease in Invasive Pneumococcal Disease in 7 United States Children's Hospitals during the COVID-19 Pandemic

Background. During the 2020 SARS-CoV-2 pandemic, physical distancing and mask use guidelines were implemented resulting in a decline in the number of infections caused by influenza, respiratory syncytial virus and otitis media. A surveillance analysis from England and Taiwan showed a decline in invasive pneumococcal disease (IPD) (Clin Infect Dis. 2021;72: e65-75 and J Infect. 2021;82:296-297). We hypothesized that COVID mitigation efforts resulted in a decrease in incidence of pediatric IPD within the U.S. during 2020 compared to previous years. Methods. We reviewed all cases of IPD among 7 children's hospitals from the U.S. Pediatric Multicenter Pneumococcal Surveillance Group from 2017-2020. IPD was defined by the isolation of Streptococcus pneumoniae from normally sterile sites (eg. blood, cerebrospinal, pleural, synovial or peritoneal fluid). Pneumococcal pneumonia was defined as an abnormal chest radiograph in the presence of a positive blood, pleural fluid or lung culture. Mastoiditis was identified by positive middle ear, subperiosteal abscess or mastoid bone culture. Serotypes were determined by the capsular swelling method. Hospital admission numbers were obtained for incidence calculations. Statistical analyses were performed using STATA11. A p< 0.05 was considered significant. Results. A total of 410 IPD cases were identified. The cumulative incidence of IPD (0-22 years of age) decreased from 99.2/100,000 admissions in 2017-2019 to 53.8/100,000 admissions in 2020 (risk ratio 0.54, CI: 0.40-0.72, p< 0.00001). Pneumococcal bacteremia and pneumonia decreased significantly in 2020 (p< 0.05), and although not statistically significant, there were fewer cases of meningitis and mastoiditis when compared to previous years (p=0.08) (Figure 1). Sex, race, age or presence of comorbidities were not significantly different between groups. Most common serotypes in 2020 were 35B, 3 and 15B/C (Figure 2). Conclusion. The observed decline in IPD cases during the first year of the SARSCoV-2 pandemic is likely associated with mask use and physical distancing limiting transmission of S. pneumoniae via droplets and viral infections frequently preceding IPD. These precautions might be useful in the future to decrease IPD, especially in high-risk patients.

Impact of SARS-CoV-2 Delta Variant on the Spectrum of Pediatric COVID-19 Disease in Arkansas

Background. Pediatric SARS-CoV-2 infection is generally thought to be asymptomatic or result in mild COVID-19 disease, with a paucity of severe outcomes. However, SARS-CoV-2 variants, notably B.1.617.2 (WHO Delta), have changed the clinical landscape of COVID-19 in the United States. Delta became the dominant variant in Arkansas (AR) the 1st week of July 2021. Schools contributed to pediatric infections during the January 2021 surge in COVID-19 infections even with physical mitigation measures (PMM) that were removed in March 2021. We present preliminary data suggesting a shift in the clinical presentation of children with Delta variant infection. Methods. Pediatric (ages ≤ 18 years) case records for the 3 months representing key inflection points of the COVID-19 Pandemic in AR were reviewed. Outcomes (hospitalizations, ICU admission, mechanical ventilation, death) were recorded by the Arkansas Department of Health (ADH) in a statewide database. Fisher's Exact Test was used with p-values < 0.05 indicating statistical significance. Results. During July 2020, 3,268 pediatric cases were reported to ADH with 55 hospitalizations, 6 ICU admissions, 2 mechanical ventilations, and no deaths. A second peak in January 2021 included 11,735 pediatric cases, a 259.1% increase. Increases were also seen in hospitalizations (n=74), ICU admissions (n= 11), and mechanical ventilations (n=2). No deaths reported. The beginning of an exponential growth in cases during July 2021, before the opening of schools, included 8,031 pediatric cases. Despite 31.6% fewer cases than the previous peak, hospitalizations increased 41.9% (n=105) (p < 0.0001) and included increases in ICU and ventilator use of 68.6% (n=18) (p 0.0016) and 300% (n=8) (p 0.0034), respectively. One pediatric death was reported. (Tbl 1) Conclusion. In the absence of PMM and despite the summer closure of schools, pediatric COVID-19 cases and severe outcomes increased significantly. Initial analysis of the AR July 2021 Delta variant surge indicates a statistically significant increase in pediatric COVID-19 disease and severity as indicated by a proportional increase in hospitalizations, ICU, and ventilator use. Further studies are warranted to better define Delta related childhood disease. Our findings also have implications for school PMM efforts.

The Advisory Committee on Immunization Practices' ethical principles for allocating initial supplies of COVID-19 vaccine - United States, 2020

During the period when the U.S. supply of COVID-19 vaccines is limited, the Advisory Committee on Immunization Practices (ACIP) has been mandated to make vaccine allocation recommendations. In addition to scientific data and implementation feasibility, four ethical principles assist ACIP in formulating recommendations for the initial allocation of COVID-19 vaccine: (1) maximizing benefits and minimizing harms;(2) promoting justice;(3) mitigating health inequities;and (4) promoting transparency. Ethical principles aid ACIP in making vaccine allocation recommendations and state, tribal, local, and territorial public health authorities in developing vaccine implementation strategies based on ACIP's recommendations.