ABSTRACT
Background and Importance After the rise of telemedicine with the COVID-19 pandemic, a telepharmacy consultation has been implemented in our hospital in the pharmacy outpatient area, sending medicines to community pharmacies within a population area of 600,000 inhabitants. Aim and Objectives The purpose of this study is to analyse the medication errors (ME) that have occurred during a specific period of time, throughout the process of medication delivery. The aim is finding causes and possible improvements. Material and Methods We carried out a retrospective descriptive study. The errors that occurred between January 2021 and August 2022 (20 months) in the telepharmacy process were analysed, taking into account everything from the preparation in the hospital pharmacy to the collection of the medication by the patient in the community pharmacy. The MEs were collected in a local database. We described date, personal data of the patient, codes assigned to the single shipping route and destination community pharmacy, type of error and step in which the ME was detected. Results In the period studied, a total of 69 MEs were recorded. We break them down into the following types: 20 cases with a quantitative lack of medication (28.99%), 19 cases in which a different medication was sent (27.54%), 15 with another patient's medication (21.74%), 10 with medicine with wrong dose (14.49%), 2 cases in which the medicine was not sent (2.90%) and another 2 in which the medicine was sent badly packaged (2.90%), 1 case in which the one in which the misidentified medicine was sent (1.45%) and 1 case in which a larger quantity was sent (1.45%). 48 MEs were detected by the patient (69.56%), 15 were detected in the community pharmacy (21.74%), 4 were detected in the hospital pharmacy (5.80%) and 2 cases were detected during the transportation of the medication (2.90%). None of the errors detected had consequences for the patient to our knowledge. Conclusion and Relevance Among the MEs detected, the most common were those related to a quantity defect or lack of a medication and those in which a different medication was sent. In general, they are errors that could be avoided by automating processes that are currently carried out manually.
ABSTRACT
Introduction: In the SARS COV2 pneumonia acute-phase reactants, such as ferritin levels (FL), are elevated due to cytokine storm and hemophagocytic lymphohistocytosis. No direct relation between radiographic pulmonary involvement and blood levels of ferritin has been proved. In this study we try to identify this relation. Material(s) and Method(s): We carried on a descriptive retrospective matched cohort study of patients diagnosed with COVID-19 from 07/01/20 to 12/31/20 who were reviewed in PostCOVID consult. For quantifying the severity of pneumonia, a score was calculated by adapting and simplifying the Radiographic Evaluation of Pulmonary Edema (RALE) scale proposed by Warren et al (2018). We chose more severe X-rays at diagnosis and the FL at that time and at 6 weeks. Statistical studies were performed with SPSS (v25). Result(s): The analysed sample was 130 patients (70 men) with average age 62yrs. The 96% required hospitalization. FL at diagnosis were high, in men 1.080mug/l (IQR=1.036) and in women 629mug/l (IQR=816), p=0.003. No significant differences were found when analysing by age groups (<54, 55-75 and >75yrs). When we compared FL and severity of Xr affectation with SCORE RALE (SR) at diagnosis, we obtained p=0.007 for mild-severe comparison. No other comparisons with statistical significance were obtained. The median of FL at review normalized regardless of the initial SR (global decrease 66%), with no differences observed between groups. Conclusion(s): - The patients in our study had high FL at diagnosis, being higher in men, and were normalized at control. - Patients with severe radiographic affectation had higher median of ferritin at diagnosis compared to the ones with mild affectation.
ABSTRACT
Background: TNF and its receptors (TNFR1 and TNFR2) have been implicated in the severity of COVID-19. But it has not been explored the association of genetic variants with cytokine levels. Aim(s): We assessed the association of TNF (rs1800629, rs361525), TNFRSF1A (rs767455, rs1800693), and TNFRSF1B (rs1061622, rs3397) single nucleotide variants with TNF, TNFR1, and TNFR2 plasma levels in patients with severe COVID-19. Method(s): The study included 334 severe COVID-19 hospitalized patients in Mexico's Instituto Nacional de Enfermedades Respiratorias. Blood sampling was performed among the first seven days since patients' admission. Cytokine levels were determined using ELISA and Taqman assays for genotyping. Kruskal-Wallis test was performed in RStudio v.1.3.1073. Result(s): Patients with TT or GT genotype (TNFRSF1B rs1061622) exhibited higher sTNFR1 levels than those carrying GG (1,580 and 1,499 pg/ml vs 1,031 pg/mL). For TNF rs1800629 and rs361525 the higher TNFR2 levels were observed among patients homozygous for the common allele (rs1800629 GG=3,993 pg/mL vs AG+AA=2,881 pg/mL;rs361525 GG=3,996 pg/mL, AG=3,919 pg/mL, and AA=1,935 pg/mL). Higher levels of both receptors were related with more severe forms of COVID-19. Conclusion(s): TNFRSF1B rs1061622, and TNF rs1800629 and rs361525 affect the TNFR1 and TNFR2 levels implicated in the severity of COVID-19.
ABSTRACT
OBJECTIVE: The incidence of COVID-19 infections among health professionals during the sixth wave has suffered an exponential increase, mainly due to the rapid community transmission caused by the Omicron variant. The main objective of the study was to evaluate the time to negativization in COVID-positive health professionals during the sixth wave, according to the PDIA result;and secondarily, to evaluate the possible influence of other factors (previous infection, vaccination, sex, age, job position) on the time to get negative status. METHODS: A descriptive, longitudinal, observational and retrospective study was carried out at Infanta Sofia University Hospital (Madrid, Spain). Made from the registry of the Occupational Risk Prevention Service of suspected or confirmed cases of SARS-COV-2 infection in health professionals, during the period between November 1, 2021 and February 28, 2022. Bivariate comparisons were made using Mann Whitney, Kruskal Wallis or Chi-square test (or exact test) according to variables. Subsequently, logistic regression (explanatory model) was performed. RESULTS: The cumulative incidence of SARS-COV-2 infection in health professionals was 23.07%. The mean time to become negative was 9.94 days. Only the history of previous SARS-COV-2 infection had a statistically significant influence on the time to negativization of PDIA. The variables vaccination, sex and age had no effect on the time to negativization of PDIA. CONCLUSIONS: Professionals with a history of COVID-19 infection present lower times of negativization than those who had not have the disease. The results of our study confirm the immune escape of the vaccine against COVID-19, since more than 95% of those infected had received a complete vaccination schedule.
ABSTRACT
The regulation of inflammation is a complex pathophysiological process that depends on the production of oxygenated lipid derivatives essential polyunsaturated fatty acids, like omega-3 and omega-6, among which are the lipoxins resolvins and protectins, called specialized pro-resolving lipid mediators (SPM). Their activity is associated with the control of respiratory infection processes to modulate the production of proinflammatory cytokines, avoiding damage due to inflammation-associated necrosis, reducing microbial loads, and promoting tissue remodeling. Therefore, we review some of the biochemical, physiological and immunological aspects of SPM in the regulation of inflammation in respiratory infections.Copyright © 2022, Instituto Nacional de Enfermedades Respiratorias. All rights reserved.
ABSTRACT
BACKGROUND AND AIM: Pediatric Early Warning Systems (PEWS) are evidence-based interventions that improve early identification of deterioration in resource-limited hospitals. While PEWS can be successfully implemented in these settings, little is known about their sustainability postimplementation. This study evaluates staff perspectives on the importance of, and challenges to, sustaining PEWS. METHOD(S): We conducted semi-structured interviews of PEWS implementation leaders and hospital directors at 5 pediatric oncology centers sustaining PEWS in Latin America. Interviews were conducted in Spanish, transcribed, and translated into English. A code book was developed combining a priori and inductively derived codes. Transcripts were independently coded by 2 coders achieving a kappa of 0.8-0.9. Thematic content analyses explored staff perceptions on PEWS sustainability. RESULT(S): We interviewed 71 staff including physicians (45%), nurses (45%), and administrators (10%). Participants emphasized the importance of sustaining PEWS for continued patient benefit. However, participants reported a range of challenges sustaining PEWS, including fluctuations in human and material resources needed for PEWS, staff turnover and insufficient training, difficulty achieving new leadership buy-in, lack of internal systems to promote ongoing monitoring of PEWS, and the COVID-19 pandemic (Table 1). Together, these challenges resulted in multiple impacts, ranging from a small reduction in PEWS quality to complete disruption of PEWS use resulting in loss of benefits to patient outcomes in some units. CONCLUSION(S): While sustainability of evidence-based interventions like PEWS is valued by staff in resourcelimited hospitals, participants reported multiple challenges to sustainability resulting in reduced patient benefit. Future work should focus on identifying factors that promote intervention sustainability in these settings. (Table Presented).
ABSTRACT
INTRODUCTION: Novel coronavirus SARS-COV-2 is primarily spread via droplets with respiratory involvement being the most common presentation. Approximately 14% of patients with COVID-19 pneumonia will progress to develop ARDS which is associated with high mortality. Pulmonary vasodilators have been shown to improve oxygenation in severe ARDS. Inhaled epoprostenol (iEPO) promote pulmonary vasodilation by decreasing intracellular calcium and possess anti-inflammatory and antiplatelet effects which may be beneficial in C-ARDS. METHOD(S): This was a retrospective cohort study that was IRB approved and included patients diagnosed with COVID-19 ARDS who received inhaled epoprostenol during period of 3/1/2020 and 12/31/2021. Patients that met study inclusion criteria were classified as responders or non-responders based on percent change of 10% or more in PaO2/FiO2 (PF) ratio post iEPO. The primary outcome was to compare the incidence of in-hospital mortality between both groups. Secondary outcomes included mechanical ventilation duration, ICU and hospital length of stay (LOS) and adverse events. RESULT(S): 148 patients were included in the analysis and based on post iEPO arterial blood gas (ABG) were classified as responders (n=87) and non-responders (n=61). Baseline characteristics were similar between both groups except for a lower weight and more prone positioning utilized in the responder group. Post iEPO PF ratio was significantly higher in the responder group compared to non-responder (158.69 vs. 107.67, p< 0.001) with similar duration of therapy in both groups (5.44 vs. 6.04 days, p=0.51). There was no difference in in-hospital mortality between responders and non-responders (69% vs. 72.1% p=0.68). There was no difference noted in ICU LOS, hospital LOS and duration of mechanical ventilation between both groups. A multivariable regression analysis was performed and noted no association between variables evaluated and response to inhaled epoprostenol therapy. CONCLUSION(S): Despite over 50% of patients in cohort responding to iEPO as demonstrated by significant improvement in oxygenation there was no difference in patient outcomes noted in responders as compared to nonresponders.
ABSTRACT
A subset of cancer patients is particularly vulnerable to SARS-Cov-2 infection;however, real-world outcomes-based data on primary central nervous system tumor patients is sparse. This retrospective case series describes a cohort of adult glioma patients seen at Stanford Cancer Center between 1/20/2020 through 5/24/2022 who contracted SARS-Cov-2. We identified 18 patients with a diagnosis of glioma, with a median age of 54 years, who were infected with Covid-19. One patient contracted Covid-19 twice during this two-year period. Of these patients, four had pathology confirmed low-grade glioma, defined as oligodendroglioma or astrocytoma WHO grade 2, and 14 patients had high-grade glioma, defined as astrocytoma or glioblastoma WHO grade 4. Median KPS at time of infection was 70. Six individuals had notable cardiovascular comorbidities including coronary artery disease, obesity, and/or diabetes. All but one patient was vaccinated against Covid- 19, and 6 were taking dexamethasone at the time of infection. Three patients required hospital admission for management of Covid-19 symptoms, although none required ICU-level of care. None died from Covid-related complications;however, two died from complications of their underlying cancer at the end of study. Our data suggest that glioma patients seen at Stanford Cancer Center do not experience an exceptionally high Covid-19 infectivity, hospitalization, or mortality rate, especially when compared to other vulnerable populations such as lung cancer patients. High vaccination rates, fairly low prevalence of cardiovascular comorbidities, and adherence to pandemic precautions among this cohort may have contributed to these results.
ABSTRACT
Objectives: The COVID-19 pandemic dramatically highlighted health inequities and the differential impact that vaccination can have on health, depending on social advantage. In a non-pandemic setting, vaccination can improve equity, but this broader value of vaccination is not currently considered in health economic analysis despite equity being a policy priority in many countries. Method(s): A panel of health economists and policy experts convened to discuss how to capture the equity dimension of the value of vaccination. This was conceptualized using a distributional cost-effectiveness analysis framework with four steps leading to differential health impact: (i) differences in vaccine preventable disease incidence;(ii) differences in the vaccination uptake;(iii) differences in health effects;and (iv) differences in health opportunity costs. The concept was illustrated by a retrospective modelling exercise of 4-component meningococcal serogroup B (4CMenB) infant vaccination against serogroup B invasive meningococcal disease (MenB) in England, for which an existing model was adapted. Five social groups were analysed based on Index of Multiple Deprivation Quintiles (IMDQ). Result(s): 4CMenB infant vaccination disproportionately prevented MenB cases among more deprived groups: of all prevented cases, 40.3% were among the most deprived IMDQ (accounting for 25.9% of the target population <5 years of age) and 78.1% among the three most deprived IMDQs. Vaccination had a positive, though small, net equity benefit, and the direction of equity impact was robust to sensitivity analyses varying the distribution of uptake, MenB carriage prevalence, and assumptions related to life expectancy and utility stratified by IMDQ. Conclusion(s): Within a national immunisation programme, 4CMenB vaccination improves health equity by preventing disproportionately more cases in more socially disadvantaged groups. The health equity impacts of vaccination can be captured in health economic evaluation although there is a need to improve the evidence base and develop more user-friendly equity impact measures. Copyright © 2022
ABSTRACT
In Honduras, as in the rest of the world, the COVID-19 pandemic caused significant changes in the dynamics of higher education. In this context, understanding the impact of educational economic stimuli as mechanisms of equity, inclusion and reduction of student dropout becomes important. The present study analyzed the incidence of student scholarships on academic and socioeconomic aspects of students at the National Autonomous University of Honduras (UNAH) in the context of the pandemic during the first semester of 2021. The study applies a mixed approach and includes a sample of 747 students who answered an ad hoc survey and 26 students which participa-ted in interviews. The results show a higher prevalence of female students, with low socioeconomic income and from large families, among other socioeconomic factors that are analyzed. In addition, the findings systematize the contribution of scholarships as dropout reduction mechanisms and their link with different spheres of life of the student community. Finally, the results are discussed in the light of previous literature and the practical and institutional implications are analyzed in terms of future research and the implementation of comprehensive equity and dropout reduction policies. © 2022, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.
ABSTRACT
Introduction: Community-acquired pneumonia due to COVID-19 has been a recent and frequent cause of admission to intensive care units worldwide. Its rapid expansion and high number of cases mean that there are many open questions regarding its management, treatment and prognosis. One of these is the performing of a tracheostomy in patients affected by this pneumonia admitted to intensive care. Material and methods: A retrospective, observational study was carried out on all the patients admitted to the Intensive Medicine Department at a University Hospital with the clinical or analytical diagnosis of COVID-19 pneumonia. An analysis was performed on all patients that required mechanical ventilation connection and tracheostomy during their management. Results: A total of 37 patients were analysed, of whom 70.3% (26/37) were male. The mean age was 59.4±9.4, and the APACHE II score was 14.8±4.67. The mean number of days of mechanical ventilation prior to the performing of the tracheostomy was 11±2.66. On 3 occasions it was done during the first week, and on 31 occasions during the second. Percutaneous tracheostomy was performed in 86.5% (32/37) of the cases, and 17 (46%) patients were decannulated. The mean number of days from tracheostomy to decannulation was 17.7±10.6 days, with 16 of these 17 patients having been discharged from the hospital. In the study sample, the type of technique was not associated with a higher mortality or complication rate. Conclusions: The results are presented on 37 patients who required a tracheostomy as part of the management of COVID-19 pneumonia in a University Hospital, as well as a description of the technique performed and prognosis. © 2020 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
ABSTRACT
"Introduction: The significant effects on mental health and the increase in psychosocial risks of health personnel during the COVID-19 pandemic have required the development of strategies that help control it, which are consistent with the complexity of this problem, which involves different levels of analysis. Objective: To propose a protocol for the management of the psychological safety of health personnel during health emergencies. Methods: An action research was conducted at ""Lucía Íñiguez Landín"" Hospital in Holguín, Cuba. The protocol was developed and implemented during four phases of the COVID-19 health emergency. The Delphi method of experts was used for content validation. Results: The protocol completes the management cycle by planning, organizing, implementing and evaluating the actions carried out to fulfill the purpose of developing reasonable psychological safety at the individual level, the safe behavior of the work teams and thereby contributing to the resilience and sustainability of the institution. The validation process during COVID-19 verified its content validity and the relevance of its use in similar situations that might arise in the future. Conclusions: The management of psychological safety in health emergencies, through a theoretically and methodologically based protocol of a multidisciplinary, preventive and systemic nature, opens a new perspective for diagnosis, psychological intervention at the level of individual, of work team in areas of high hospital risk and organization, while allowing the evaluation of the actions carried out. © 2022, Editorial Ciencias Medicas. All rights reserved."
ABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by SARS-CoV-2, which can potentially cause severe acute respiratory syndrome and cause the death of the patient. Objective: To present a patient with COVID-19 associated with aggravated preeclampsia, in a preterm pregnant woman. Clinical case: A 25-year-old patient with a gestation of 35.2 weeks, a history of apparent health that was received since her arrival at the intensive care unit, referred for being positive for COVID-19, with respiratory symptoms of an associated lung disease, as high blood pressure figures, without other symptoms. Through physical examination and complementary humoral studies, an aggravated preeclampsia and oligohydramnios were diagnosed due to rupture of the ovular membranes. She was treated and compensated;Induction was started and during the procedure a risk of loss of fetal well-being was diagnosed, so it was decided to perform an urgent cesarean section. A healthy newborn was received. The patient did not present post-surgical complications and was treated according to current standards for cases of severe mother with COVID-19;she had a favorable evolution. Conclusions: The early diagnosis and treatment of a pregnant woman with COVID-19 and associated preeclampsia allows a satisfactory evolution of the mother-fetus binomial. © 2022, Editorial Ciencias Medicas. All rights reserved.
ABSTRACT
With the appearance of the COVID 19 pandemic, a suspension of face-to-face activities in the university educational field was established in Argentina in March 2020. The teaching-learning process (EA) in the basic area of dental careers became virtual. In this context of adaptation to the virtual EA process, a diversity of problems arose that conditioned its normal development. In addition to these difficulties for the students, there is scarce academic training for the new entrants of this year who have completed their secondary-level studies in 2020. The objective of this work was to identify, interpret, analyze and diagnose the integral situation of the student population in the context of a pandemic, to know the socio-demographic characteristics, academic backgrounds, different technological applications that they use, computer, technological and socio-affective problems;willingness to maintain virtuality;teacher performance. A descriptive, cross-sectional, observational, retrospective, and qualitative-quantitative study was developed. A mixed semi-structured survey using a Google form, 245 students studying Histology and Embryology, the first year of the Dentistry career of the UNR years 2020 and 2021, voluntary and anonymous, with multiple single answer options, with an expected non-response rate of less than 25%. It was available for 10 calendar days. The modality adopted was multiple choice of a single answer. An analytical comparison was made with a study carried out with similar characteristics for students in the 2020 cycle. The most obvious difficulties manifested in this analytical study are based on socio-demographic problems, with the majority of the students residing outside the city of Rosario. Socio-economically, their academic performance has seriously worsened, because in many situations they are family support. In the previous training of the middle school, it was evidenced that the virtuality of the closing of the cycle was deficient in the pre-university preparation. In relation to the socio-affective, a feeling of dissatisfaction and anguish prevails. Furthermore, technological inaccessibility in many situations acted unfavorably. In comparison, the problems maintain a similarity, but in 2021 there is a marked increase in the academic dropout rate, as well as a decrease in academic performance.
ABSTRACT
Background: The majority of children with exposure to SARSCoV-2 virus have mild disease. However severe diseases such as Multisystem inflammatory syndrome (MISC) and pneumonia do occur in children. Currently, there are no established biomarkers that can predict progression to severe disease in children exposed to the virus. MicroRNAs (miRNAs) are non-coding RNAs that can be found in saliva and are thought to play a role in the regulation of inflammation following an infection. Our objective was to compare the miRNA profile in saliva of children with or without severe disease due to SARS-CoV-2 infection. Methods: This prospective observational study was supported by the National Institutes of Health (NIH) RADx Program. Children ≤ 18 years of age presenting to two tertiary care children's hospitals with symptoms of SARS-CoV-2 infection (confirmed by PCR test, serology or epidemiological link) were enrolled between 03/29/2021 and 04/30/2021. Severe infection was defined as any of the following within 30 days of testing: MISC or Kawasaki disease diagnosis, requirement for oxygen > 2L, inotropes, mechanical ventilation or ECMO, or the occurrence of death. Informed consent and a saliva swab were obtained at the time of SARS-CoV-2 diagnosis (DNA Genotek, Ottowa Canada), and RNA was extracted (Qiagen, Germantown, MD). Small RNA species (<50 base pairs) were interrogated via shotgun sequencing (HiSeq 2500, Illumina, San Diego, CA) and miRNAs were quantified through alignment to the human genome (GRCh38). RNA features with sparse counts (<10 in 90% of samples) were filtered, and the data was quantile normalized and mean-center scaled. Salivary miRNA levels were compared between those with severe and non-severe SARS-CoV-2 infection using Wilcoxon tests with Benjamini Hochberg multiple testing corrections. In addition, a logistic regression analysis was used to identify miRNA pairs that could best discriminate severe cases based on a Monte Carlo 100-fold cross-validated area under receiver operating characteristic curve (AUROC). Results: Samples from 33 children were analyzed. Median age was 3 (3, 10) years and 54.5% were males. Of the total, 29 were RT PCR positive, 4 had a positive serology and 6 children had severe infection. Seven miRNAs displayed significant differences (Fold change >2, FDR adjusted p < 0.1) among children with severe SARS-CoV-2 infection (Table). All seven miRNAs were up-regulated in severe SARS-CoV-2 cases. A logistic regression using a single ratio of miR-296-5p/miR-378j yielded 1.0 AUROC for differentiating children with severe infection (Figure). Conclusion: In this interim analysis of salivary miRNA in childhood SARS-CoV-2 infection, we found a differential expression of 7 salivary miRNAs in children with severe infection. Ongoing work will seek to validate these findings and explore the role of miRNA in predicting severe SARS-CoV-2 infection in children. Receiver operating characteristic curve and box plot displaying the complete differentiation of severe and non- severe SARSCoV-2 cases using a ratio of miR-296-5p and miR-378j levels in saliva.
ABSTRACT
BACKGROUND AND AIMS: Acute kidney injury (AKI) is a common complication among patients hospitalized with COVID-19. The incidence of AKI is estimated to be around 5%-80%, according to the series, but data on renal function evolution is limited. Our main objective was to describe the incidence of AKI in patients with SARS-CoV-2 infection;secondarily, we analysed the severity of AKI and medium-term renal function evolution in these patients. METHOD: A retrospective observational study that included patients hospitalized a single hospital, diagnosed with SARS-CoV-2 infection, who developed AKI (March- May 2020). We register clinical and demographic characteristics, creatinine upon admission and prior to discharge, as well as creatinine and CKD-EPI glomerular filtration rate (eGFR) after at least 3 months after discharge. CKD was defined according to KDIGO stages based on the eGFR (G3-G5). The KDIGO classification was used to define and classify AKI. Recovery of kidney function was defined as difference in at discharge or post-hospitalization creatinine < 0.3 mg/dL with respect basal creatinine. The clinical follow-up ranged from admission to death or end of study. RESULTS: Of 258 patients hospitalized with SARS-CoV-2 infection, AKI occurred in 73 (28.3%). 63% (n = 46) were men;the mean of age was 69 years (57-76). DRA severity: 35 (48%) KDIGO-1, 15 (21%) KDIGO-2 and 23 (31%) KDIGO-3. The mean stay was associated with the severity of AKI: 7 days (3-11) for KDIGO-1, 11 days for KDIGO-2 (5-22) and 12 days (8-35) for KDIGO-3 (P = .02). The stage of CKD established differences in the severity of AKI: 66.6% (n = 6) of the patients with CKD G4-G5 presented AKI-KDIGO 3 versus only 25.0% (n = 4) in the CKD-G3 patients (P = .02). Admission to the ICU was more frequent in KDIGO 2-3 versus KDIGO-1 [39% (n = 15) versus 9% (n = 3);P < .01]. Of the 48 patients discharged, 30 (62.5%) had recovered their baseline renal function upon discharge. Only 2 are still on RRT after 8 months (2.7% of all patients). Of the 25 patients died (34% of patients with AKI) with a median time of 3 days from DRA diagnosis (1-8). Renal function of 35 patients was monitored, which correspond to 19 (54%) KDIGO- 1, 8 (23%) KDIGO-2, 8 (23%) KDIGO-3 stages. In these patients, analytical control starting 3 months after hospitalization revealed FG 66 (SD 30;56-76) mL/min/1.73 m2. We have not found differences in renal function between pre- and posthospitalization in related test. A total of 77% (n = 37) of discharged patients recovered their baseline renal function in the post-hospitalization control. CONCLUSION: The incidence of AKI in the context of COVID-19 in our series was 28.3%, with an associated mortality of 34.2%. Most of the patients presented with AKI KDIGO 1 (47.9%). The severity of AKI is associated with a longer hospital stay, admission to the ICU and the requirement for RRT. The advanced stages of CKD preadmission showed more severity of AKI. The maintenance in TRS in our series has been 2.7%. Patients who were discharged for recovery/improvement of COVID-19 had normalized kidney function during subsequent follow-up, regardless of the severity of the AKI developed on admission for COVID-19. (Figure Presented).
ABSTRACT
The purpose of the study was to analyze Facebook publications and perceptions of users, expressed in their comments, about the drug ivermectin during the COVID-19 pandemic in Peru. The publications and their comments were selected by manual search using the terms “ivermectin” and “#ivermectin” in July 2020. Interpretation of publications and their comments was performed by conventional qualitative content analysis with inductive processing and supported by scientific literature. A total 17 publications were retrieved from the period extending from 18 May to 7 July 2020. These were classified into five topics: rumors (58.8%), based on scientific evidence (11.8%), caution (11.8%), production of the drug (11.8%) and confrontation (5.9%). Paradoxically, 70.0% of the rumors were spread by mass media pages. Comments, on the other hand, were classified into four topics based on user perceptions: ivermectin as “effective cure” (64.8%), request for information about ivermectin (25.3%), against the use of ivermectin (6.3%) and other treatments (3.6%). As a conclusion, it was found that more than half of the information about ivermectin circulating in Facebook publications is classified as “rumors”, and most is spread by mass media pages. Analysis of the comments found that user perception considers ivermectin to be the “effective cure” against COVID-19. © 2022, Centro Nacional de Informacion de Ciencias Medicas. All rights reserved.