Tomographic scale for the assessment of COVID-19 severity at the National Respiratory Diseases Institute

Introduction: The pandemic of SARS-CoV-2 (COVID-19) has caused high rates of morbidity and mortality. The use of adequate diagnostic methods to identify the evolution of this disease is necessary;computerized tomography (CT) is of the main tools by image, with sensitivity of 96-99%. Different studies have created scales to evaluate the extent and severity of lung disease from COVID-19, with a variability in the results. Objective: To evaluate the use of a tomographic scale (TS) to determine the severity of lung affectation in COVID-19. Material and methods: Analytical cross-sectional study including patients with confirmed diagnosis of COVID-19 and initial CT. ATS was used to evaluate the lung affectation, to identify pulmonary pattern and to establish the state of the disease. Statistical analysis consisted in descriptive and analytical statistics (ROC curve). Results: 151 patients, mean age 50 years. The predominant pulmonary pattern was «crazy paving» (46%), identified in the phase of progression. The area under the ROC curve was 0.831 (95% CI: 0.764-0.898), with a cut-off value of 16.5 to discriminate the severe from non-severe affectation, with sensitivity 84% and specificity 74%. Conclusion: The use of TS in initial CT showed an acceptable sensitivity to identify the severity of the disease.

Analysis of teachers' experiences with virtual learning spaces: the case of the International University of Ecuador UIDE

With the expansion of COVID-19, the Universidad Internacional del Ecuador UIDE, with other colleges around the world, faced forward to the virtual model education, trying with this to secure access to higher education from their students. The follow work analyses what were the university community teachers perceptions around this new model of education, starting with the first impressions and their development. Based on mixed methods of investigation, set about a first exploration in a quantitative vision and enriched with qualitative methods based on speech analysis, this for trying to understand the complexity of the subjects' participations in these spaces. The conclusions of this work are the dragged use of the platforms impact in a positive way in the perceptions of them, also, the needed of complementary this with other tolls and social networks, and, for least, the need to incorporate in the students and teachers' formation these specific capacities.

IN VITRO MODEL OF THE IMMUNOMODULATORY EFFECT OF WHARTON'S JELLY DERIVED MESENCHYMAL STEM CELLS (WJ-MSCS) IN PULMONARY FIBROBLASTS SPHEROIDS INFECTED WITH HUMAN CORONAVIRUS 229E (HCV 229E)

Patients infected with the SARS-Cov2 virus have been severely affected [1]. The high rate damaged reported by the effects of this virus is due mainly to a storm pro-inflammatory cytokines production that is triggered by immune response overexpression [2]. Thus, research on this virus has become a high priority for public health [3]. However, biosafety regulations hinder rapid advancements on this research line. Therefore, it is essential to find an in vitro model that provides a close approximation to the actual SARS-Cov2 infection. The developed model is based on the detection of anti-inflammatory cytokines produced by Wharton's jelly derived mesenchymal stem cells (WJ-MSCs) as a response of HCV-229E infection at a lung spheroid. For this purpose, a co-culture of lung fibroblast spheroid (MRC-5) constituted in human collagen type 1, infected with HCV229E, and human peripheral blood leukocytes were grown for 3 days, pursuing the generation of the pro-inflammatory signaling cascade. Subsequently, WJ-MSCs were co-cultured within the previous described environment. As a result, it was demonstrated that WJ-MSCs play an immunomodulatory role against HCV-229E infection. After 72 h of WJMSCs exposure a significant decrease in pro-inflammatory cytokines IL(1,2,6,7) and TNF α was observed. Additionally, a very marked increase in anti-inflammatory cytokines such as IL(4,10,11,13) and TGF-β was detected. We conclude that this model could be used for COVID-19 research and other similar respiratory syndromes without the manipulation of the actual virulent strand, this would aid in the understanding of mechanism behind the disease and the use WJMSCS such as therapy.

The neurological spectrum of COVID-19 infection in hospitalized versus outpatient care

Background and aims: Neurological symptoms are reported in over 30% of COVID-19 hospitalized patients. However, systematic studies reporting these manifestations in ambulatory patients are still missing. We aim to characterize and compare neurological phenotypes in hospitalized and ambulatory COVID-19 patients. Methods: Retrospective study in patients with laboratory confirmation of SARS-CoV-2 infection in a tertiary hospital in the North of Portugal, between March 1st and April 30th. Data from hospitalized patients was collected through electronic medical records;ambulatory patients' data was collected using a structured telephonic survey. Results: From a total of 283 patients hospitalized in this period with COVID-19, 116 (40.9%) had at least one neurological manifestation. Mean age was 64 years (20- 100) and 58.6% were women (n=68). The most frequent manifestation was headache (24.7%), followed by myalgia (15.5%) and hyposmia (10.6%). Other neurological manifestations were reported in <10%. In this period, from 488 ambulatory patients infected with COVID-19, all but one reported at least one neurological manifestation (n=487). Mean age was 50.3 years (18-93) and 63% were women (n=307). Myalgia was the most frequent symptom (71.1%), followed by anosmia (65.4%), disgeusia (62.9%) and headache (58.4%). EPR302 Sleep disorders and cognitive complaints were also frequent (39.9% and 17.4%). Hypertension, diabetes, cardiovascular, lung and kidney disease were more prevalent in hospitalized patients. Conclusion: In the 1st systematic evaluation of neurological symptoms in outpatient COVID-19 patients we found an extremely high rate of neurological manifestations, suggesting neurological involvement is not dependent on COVID-19 disease severity. Host susceptibility and viral characteristics may drive the neurological phenotype.

Neuro-COVID in the northern Portuguese population

Background and aims: COVID-19 related acute neurological phenotypes have been reported in over 30% of hospitalized patients. However, multicentric studies providing a population-based overview are still lacking. Methods: We conducted a retrospective multicentric study in five hospitals in Northern Portugal, between March 1st and June 30th 2020. Patient e-records were systematically revised using a standardized form to identify neurological manifestations stratified by type and severity. Results: From a total of 13,144 persons diagnosed with COVID-19 in the northern region, 2,795 (21.3%) required hospitalization. We reviewed a sample of 1,261 (45.1%) hospitalized patients and found a rate of 362 neurological manifestations per 1000 admitted COVID-19 patients, estimating a total of 1009 hospitalized patients with a neurological manifestation in the Northern Region. Patients with neurologic manifestations were younger (p=0.002), and the most frequent neurological symptoms were headache (13.4%), delirium (10.1%) and impairment of consciousness (9.7%). We observed a rate of 7.8 severe neurological events per every 1000 COVID-19 infected patients, including stroke, seizures, Guillain-Barre syndrome and myelopathy. The fatality among patients with neurological manifestations was 19.8%, and 15.6% had a modified Rankin Scale of 4-5 at hospital discharge. Conclusion: We characterized the population of hospitalized COVID-19 patients from the northern region of Portugal and found that neurological symptoms are common and associated with a high degree of disability. CNS involvement with criteria for in-hospital admission was observed in a significant proportion of patients. Neurology support is highly relevant in the multidisciplinary care of COVID-19 patients.

CT findings in COVID-19 lung disease, initial experience at instituto nacional de enfermedades respiratorias ismael cosío villegas, ciudad de México

Introduction: The SARS-CoV-2 pandemic is a major public health problem worldwide, with high morbidity and mortality rates. Computed tomography (CT) is essential in the diagnostic process given its high sensitivity. Objective: To describe the tomographic findings in COVID-19 lung involvement. Material and methods: Analytical crosssectional study. Patients attended at the INER, CDMX, with a current operational definition of a suspected case for COVID-19, who had a specific RT-PCR test and chest CT in the initial evaluation. A descriptive and analytical analysis was performed using the Student’s χ2 and t tests. The Epi-Info version 7 program was used. Results: 56 patients were analyzed, with an average age of 51 years, 61% were male. 52% presented comorbidities, with diabetes mellitus being the most frequent. The symptoms that were mostly observed were fever, cough and headache. The tomographic pattern that predominated was mixed, with a subpleural and bilateral location. Conclusion: The pulmonary tomographic spectrum of the studied population was characterized by two main patterns: Mixed type (areas of ground glass consolidation) and crazy paving.