Guillain-Barre Syndrome Associated with Sars-Cov-2 Infection in Two Pediatric Patients

BACKGROUND AND AIM: In the context of the current SARS-COV2 pandemic, multiple complications derived from infection have been described in the pediatric population;however, neurological involvement is rare. The objective is to describe two pediatric patients hospitalized during the SARS COV2 pandemic, who were admitted due to unspecified neurological symptoms, with a subsequent institutional diagnosis of Guillain Barre syndrome (GBS). METHOD(S): Description of two cases of pediatric patients with a diagnosis of SARS-COV2 infection and neurological symptoms treated at Fundacion Valle del Lili, with an inhospital diagnosis of Guillain Barre syndrome. Demographic data, clinical and pathological variables, treatment, and outcomes were collected and analyzed to describe the cases. RESULT(S): Male patients, 8 and 10 years old respectively, the first patient with no relevant history, patient # 2 with a history of asthma. Patient # 1 with respiratory symptoms associated with marked neurological symptoms, with sudden and progressive deterioration, clinical and electromyographic diagnosis of GBS managed with immunoglobulin and subsequent plasmapheresis. Patient # 2 with intense respiratory symptoms, requiring orotracheal intubation and vasoactive support, with subsequent neurological involvement, diagnosis of GBS, management with plasmapheresis. Both patients with recovery of mobility, rehabilitation and outpatient follow-up. CONCLUSION(S): In summary, these are the first reported cases of GBS associated with SARS-CoV-2 infection in Colombia and the first case report in Latin America describing atypical GBS presentation. Although neurological manifestations of SARS-CoV-2 infection are infrequent, physicians must be aware to establish early diagnostic suspicion of SARS-CoV-2 infection in children with neurological symptoms.

PREVALENCE OF TASTE DISORDERS IN PATIENTS WITH COVID-19 INFECTION AT THE SAN LUIS GRANDE URBAN CENTER

This study aims to determine the prevalence of taste disorders in patients diagnosed positive for COVID 19 infection in the San Luis Grande urban center. For this purpose, a descriptive and cross-sectional study was designed, with a sample of 292 patients through the use of surveys. Through the analysis of the data collected, the presence of several types of taste disorders was observed in the sample analyzed, with a prevalence of ageusia in the study sample. The results suggest that hypogeusia occurred suddenly in 53.3% of the cases reported, while ageusia and dysgeusia appear as symptoms mostly between the first and third day (56.7% and 43.3% respectively). It was also observed that the disorders analyzed had a predominant duration of 8 to 15 days. On the other hand, there was a predominance of reported cases of ageusia (48.03%) in the age groups 18 to 35, a prevalence of cases of hypogeusia in the age groups 36 to 55, while in the age range 56 to 70 there was a predominance of dysgeusia (31.67%).

Frequency of occurrence and predictive validity of olfactory and taste dysfunction in patients with SARS-CoV-2 infection

Background: Olfactory and taste dysfunction (OD and TD) have been considered symptoms of SARS-CoV-2 infection. Although these clinical features may occur prior to the general symptoms of such infection, their presence in specific populations, especially those with mild symptoms, has not been clarified. This study aimed to estimate the frequency of OD and TD, and its predictive validity in patients with SARS-CoV-2 infection detected in primary care. Research question: What is the frequency of OD and TD, and its predictive validity in patients with SARS-CoV-2 infection detected in primary care? Methods: A cross-sectional study was carried out in the Spanish National Health System through an epidemiological survey administered to patients who required an RT-PCR test (real-time polymerase chain reaction in a nasal/pharyngeal swab) to detect SARS-CoV-2. Odds Ratio(OR)(s) were estimated to measure the magnitude of the association between OD or TD, and the presence of SARS-CoV-2 infection. The study sample also calculated the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of these symptoms. Results: Of 1038 patients screened, 209 (20.1%) had SARS-CoV-2 infection. OD and DG were detected in 64.4% (95% CI: 56.0-72.1) and 56.2% (95% CI: 47.9-64.2) of subjects with infection, respectively. The OR for OD and TD was 12.2 (95% CI: 8.26-18.06) and 7.95 (95% CI: 5.48-11.53), respectively. OD showed a sensitivity of 45.0% (95% CI: 37.6-51.5), a specificity of 93.7% (95% CI: 91.8-95.0), a PPV of 64.4% (95% CI: 56.0-72.1), and a NPV of 87.1% (95% CI: 84.7-89.2) while the TD presented a sensitivity of 41.1% (95% CI: 34.4-46.1), a specificity of 91.9% (95% CI: 89.8-93.7), a PPV of 56.2% (95% CI: 48.0-64.2) and a NPV of 86.1% (95% CI: 83.6-88.3). Conclusion: More than half of the subjects with SARS-CoV-2 infection have olfactory or taste dysfunction. These clinical features could be considered of diagnostic utility due to their ability to predict infection in more than half of the cases.

[Validation and adaptation into Spanish of the COVID-19 Anxiety Scale]

Background: Mental health problems derived from the COVID-19 pandemic, including depression, anxiety, and stress, need to be identified. Objective: To validate and adapt the COVID-19 Anxiety Scale (CAS) into Spanish. Material and methods: A cross-sectional study was carried out in a total of 303 individuals who answered the Covid-19 Anxiety Scale. Antibody tests for SARS-CoV-2 were identified as a secondary comparison. Results: It was carried out the cross-cultural validation process recommended by the American Academy of Orthopeadic Surgeon (AAOS). It was obtained a Cronbach's alpha of 0.8493 (with an average interitem covariance of 0.2620). Conclusions: It was achieved a valid Spanish version of CAS to be used in routine clinical practice.

[Occupational health in the COVID-19 era]

Preventive actions have reached a new height in the COVID-19 pandemic and since there is not a specific treatment yet, while the vaccines demonstrate their effectiveness and gradually are applied to the population, preventive measures are still recommended. Among these actions, occupational health faces challenges, since a significant part of the population is economically active and have had to suspend work, and in the current context, return-to-work measures have been implemented. The care and protection of healthcare workers is crucial, given that they are the specific population that takes care for patients infected with SARS-CoV-2 and this increases their exposure to the virus and expands their possibility of suffering from COVID-19, which must be recognized as an occupational disease which must be attended from the prevention of exposure to the care of sequelae and even compensation for death derived from this disease.

Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain

Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F_(2,91) = 3.271;p = 0.042;eta² = 0.067) and self-compassion (F_(2,91) = 6.046;p = 0.003;eta² = 0.117) in the post-test visit, and in self-compassion (F_(2,79) = 3.880;p = 0.025;eta² = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.