ABSTRACT
Approximately two years ago, the Coronavirus was declared a worldwide pandemic by the WHO and despite the fact that today the situation is different, a vaccine could be found that would reduce the impact on deaths and contagion, it will be an anecdote that will remain in the memory of all those who lived and were contemporary to the situation. This event not only directly affected health, but also had very large consequences in terms of economics, the completely collapsed health and education systems and without many tools to deal with this situation. In this article, the effects of the pandemic on education, training, teaching work and student learning will be exposed, mainly because it is very possible that, in several years, the wounds that the pandemic left in education being one of the deepest and most affected. The virtual learning modalities that were used in this context were ICT and for this, not only the teaching commitment to use this didactic tool, but also a State that guaranteed access to receive connectivity and monitoring of the right to quality education taking decisions that arise directly in the educational system, teacher training and student learning. © Este es un artículo en acceso abierto, distribuido bajo los términos de una licencia Creative Commons (.
ABSTRACT
BACKGROUND: We performed a nationwide population-based retrospective study to describe the epidemiology of bacterial co-infections in coronavirus disease 2019 (COVID-19)-hospitalized patients in Spain in 2020. We also analyzed the risk factors for co-infection, the etiology and the impact in the outcome. METHODS: Data were obtained from records in the Minimum Basic Data Set (MBDS) of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health and annually published with 2 years lag. COVID-19 circulated in two waves in 2020: from its introduction to 31st June and from 1st July to 31st December. The risk of developing a healthcare-associated bacterial co-infection and the risk for in-hospital and intensive care unit (ICU) mortality in co-infected patients was assessed using an adjusted logistic regression model. RESULTS: The incidence of bacterial co-infection in COVID-19 hospitalized patients was 2.3%. The main risk factors associated with bacterial co-infection were organ failure, obesity and male sex. Co-infection was associated with worse outcomes including higher in-hospital, in-ICU mortality and higher length of stay. Gram-negative bacteria caused most infections. Causative agents were similar between waves, although higher co-infections with Pseudomonas spp. were detected in the first wave and with Haemophilus influenzae and Streptococcus pneumoniae in the second. CONCLUSIONS: Co-infections are not as common as those found in other viral respiratory infections; therefore, antibiotics should be used carefully. Screening for actual co-infection to prescribe antibiotic therapy when required should be performed.
ABSTRACT
Case Diagnosis: A 10-year-old boy with postvaccination Guillain-Barre Syndrome (GBS) and Bell's Palsy Case Description or Program Description: A 10-year-old white Hispanic boy without significant past medical history presented to the emergency room (ER) with new right facial droop two weeks following his second dose of the Pfizer COVID-19 vaccine. He was diagnosed with Bell's Palsy and received a five-day course of steroids. He returned to the ER ten days later with a four-day history of bilateral lower extremity pain, weakness, and progressively worsening gait. His examination was notable for less than antigravity strength throughout the major muscle groups of both lower limbs, in which he also had impaired light touch sensation and areflexia. Setting(s): Pediatric unit of acute care hospital Assessment/Results: Cerebrospinal fluid analysis was notable for elevated protein levels. In the setting of areflexia in the bilateral lower limbs, a presumptive diagnosis of GBS was made and a 5-day course of intravenous immunoglobulin (IVIg) was initiated, with improvement. At time of discharge, he was able to ambulate independently without use of an assistive device. Discussion (relevance): Both GBS and Bell's palsy have been reported following vaccinations. This case is unique in that both occurred sequentially in a pediatric patient within 1 month of the second dose of the Pfizer COVID-19 vaccine. Conclusion(s): Neurological complications of the COVID-19 vaccine include both Bell's Palsy and GBS, which as in this case, may occur sequentially. Prompt initiation of IVIg, steroids, and rehabilitation may result in good recovery.