ABSTRACT
The current situation derived from the COVID-19 crisis is generating unprecedented challenges throughout the educational community, although higher education institutions have demonstrated their ability to adapt very quickly and with great flexibility to the crisis. Since the beginning of the pandemic, students are experiencing new learning environments and employing a broad set of resources whose impact on their overall learning has yet to be discovered and is being investigated. There are also many unknowns to solve about how the lockdown has affected them. This research provides new evidences on this unprecedented phenomenon about aspects related to their learning and their effect on confinement in a Graphic Engineering subject through a cross-sectional survey conducted with a students' group (n = 264) during the pandemic period using triangulation of data analysis. A quantitative comparison of the final marks of the students has also been made between the emergency situation and the one before the confinement. The results show a clear and direct relationship between academic performance of the students in pandemic period and variables such as the degree of attention, the time spent on assigned tasks and the conditions of the workspace. The best evaluated training activities are the project and the exercise videos. In general, women are more satisfied with their academic performance and evaluate the practices more positively than men. Although the responses of women have been found to have somewhat more variability than those of men, no meaningful results can be extracted. Final marks and the marks of the autonomous learning competence of the subject increased slightly at the beginning of the pandemic period compared to previous periods, but in the following quarter of confinement the marks were maintained or even decreased with respect to the pre-pandemic period. Finally, the study identifies best practices that will be of value for distance teaching and engineering education beyond the pandemic situation.
ABSTRACT
Background: Patients with inflammatory rheumatic diseases (IRD) infected with SARS-CoV-2 may be at risk to develop a severe course of COVID-19 due to the immune dysregulation or the influence of immunomodulating drugs on the course of the infection. For a better understanding of SARS-CoV-2 infections in patients with IRD and due to the high incidence of COVID-19 in Madrid from the beginning of this pandemic infection in Spain, the Society of Rheumatology from Madrid (SORCOM) established a registry (REUMA-COVID SORCOM) shortly after the beginning of the pandemic in Spain. Objectives: To determine factors associated with severity of infection with SARS-CoV-2 in patients with inflammatory rheumatic diseases in Madrid Methods: The REUMA-COVID SORCOM registry is a multicenter, retrospective, observational cohort study conducted in Madrid, a SORCOM initiative. All rheumatology departments from Madrid were invited to participate. The study includes patients with IRD presenting with a confirmed or highly suspected diagnosis of COVID-19 between March 1, 2020, and November 10, 2020. We consider severe infection death or need of hospitalization. Inclusion criteria was having an IRD and at least 1 of the following 4 criteria: (1) a biologically confirmed COVID-19 diagnosis based on a positive result of a SARS-CoV-2 polymerase chain reaction (PCR) test on a nasopharyngeal swab;(2) Detection of IgM or IgG anti SARSCoV2 in a symptomatic or asymptomatic patients (3)typical thoracic computed tomography (CT) abnormalities (ground-glass opacities) in epidemic areas;(4) COVID19-typical symptoms in an epidemic zone of COVID-19. Results: As of November 10, 2020, 417 patients with IRD were included in the REUMA-COVID SORCOM registry. 5 patients were discharged for incomplete data. Of 412 patients (mean age 57 years, 87.4% Caucasian race, 66.3% female) 174 need hospitalization (42.2%) and 33 patients died (18.4% mortality in hospitalized patients). 82.3% had comorbidities. 234 (56.8%) patients were classified as inflammatory arthropathy, 133 (32.3%) had connective tissue diseases (CTD). 41.1% of the patients had a large history of IRD (≥ 10 years). 10.4% of patients had previously pulmonary involvement. The study includes 143 patients taking Methotrexate, 89 patients taking anti-TNFα therapy and 27 Rituximab. In the univariant analysis, no differences were seen in the severity of COVID-19 infection in patients taking methotrexate. 63% of the all patients taking Rituximab included in the registry need hospitalization and 22% of them died. Hypertension, COPD or cardiovascular disease was associated with hospitalization. Independent factors associated with COVID-19 hospitalization in the multivariate analysis was: age (≥62 years), male sex, IMC ≥30, previous cardiovascular comorbidities and the IRD disease duration (≥ 10 years). Independent factors associated with COVID-19 related death was: age (≥ 62 years), having a CTD diagnose, pulmonary involvement before infection and chronical GC treatment. Conclusion: Patients with IRD represent a population of particular interest in the pandemic context because the baseline immunological alteration and the treated with immunosuppressants agents they receive, comorbidities and the well-known risk of severe infection. Older age, male sex, cardiovascular comorbidities were factors associated with high risk of hospitalization in IRD patients. CTD diseases, previously pulmonary involvement and chronical GC treatment with more than 10mg/day were associated with high risk of death. Neither anti TNF-α treatment nor Methotrexate were risk factor for hospitalization or death COVID-19 related in IRD patients.
ABSTRACT
Background: SARS-CoV-2 virus is a novel coronavirus that causes COVID-19 disease, which in its most severe form produces life-threatening atypical pneumonia and ARDS. Coronaviruses induce dysregulation of the immune system resulting in a cytokine storm syndrome with activation of the macrophage mediated mainly by IL-1 and IL-6. Although there is no specific treatment to date, researchers have explored novel approaches through targeting both IL-6 and IL-1. Anakinra is a recombinant human IL-1 receptor antagonist that prevents IL-1β and IL-1α binding and therefore blocks signal transduction. Its high bioavailability, rapid action, relatively short half-life and good safety profile make it a promising drug. Objectives: Analyse the experience of administering Anakinra for severe forms of COVID19 in patients hospitalised at a tertiary hospital. Methods: Retrospective single-center study in which all patients admitted for COVID-19 and treated with Anakinra from April 1st to the end of the 1st wave (July 2020) were included. Medical records were reviewed to collect demographic, clinical and lab test data, using Brescia-COVID respiratory severity scale, SaFi, CRP, Ferritin, LDH and lymphocytes. Variables were assessed at baseline, 72h and 7 days after treatment initiation. Descriptive statistical analysis was performed, including a sub-analysis of patients who received anakinra as the only biological treatment. Results: 54 patients were included, of which 37 male (68.5%) with a median age of 69.5 years (36-94). Comorbidities were lung disease 14 pts (25.9%), cardiovascular disease 39 pts (72.2%), Diabetes Mellitus 11 pts (20.4%), kidney disease and rheumatic disease each in 6 pts (11.1%), and immunosuppression 13 pts (24.1%). Each patient received a mean of 4.85 doses of anakinra (± 3.96). Other therapies included low-dose steroids (70.3%);high-dose steroids: 1mg/kg (87%), bolus (24%), Tocilizumab (57.4%), Infliximab (24.1%), Lopinavir/Ritonavir (48%), Hydroxychloroquine (94.4%), and Azithromycin (79.6%). Mortality was 22% overall, 75% due to COVID19, 8.3% due to infectious complications and 16.7% due to non-infectious complications. In the group receiving Anakinra as only biological drug, mortality accounted for 17.9% of patients, 75% due to COVID19 and 25% to non-infectious complications. No adverse effects related to anakinra were observed Conclusion: Anakinra in severe SARS-CoV-2 infection offers respiratory improvement and partial lab tests improvement. No adverse effects were observed.
ABSTRACT
With over 575,000 deaths and about 13.3 million cases globally, the COVID-19 pandemic has had a terrible impact globally during the 6 months since cases were first detected in China. Conscious of the many challenges presented in settings with abundance of resources and with robust health systems, where mortality has been significant and transmission difficult to control, there was a logical concern to see how the virus could impact African countries, and their fragile and weak health systems. Such an anticipated "tsunami", with potentially devastating consequences, seems however to not have yet arrived, and African countries, albeit witnessing an increasing degree of autochthonous transmission, seem to this day relatively unaffected by the pandemic. In this article we review the current situation of the pandemic in the African continent, trying to understand the determinants of its slow progress. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of Asociacion Espanola de Pediatria. This is an open access article under the CC BY-NC-ND license.