ABSTRACT
Background. Over 5.74 million COVID-19 cases have been reported in Mexico as of May 1, 2022. Determining the impact of COVID-19 on functional status is essential to assess health services needs. The Post-COVID-19 Functional Status Scale (PCFS) is a patient-reported tool that evaluates functional status over time after COVID-19, listing a wide range of functional limitations. We aimed to assess the functional status of Mexican patients after recovery from COVID-19. Methods. This cross-sectional study was conducted fromApril 11 to May 1, 2022, through an online survey that included demographic and clinical data, PCFS grades 0-4 and persistent symptoms. We included Mexicans aged >=18 years who recovered from COVID-19 (>=14 days since diagnosis), who resided in Mexico and agreed to participate. We posted the survey on Facebook and Twitter. We performed a descriptive analysis of demographic and clinical variables and assessed the relationship between symptoms and PCFS grade. Statistical analyses were conducted in Stata/SE 17.0. Results. Of 959 respondents, 838 (87%) met inclusion and exclusion criteria. Mean age was 40 (IQR 34-46) years, 82% were female, and 40% lived in Mexico City. COVID-19 diagnosis ranged from March 21, 2020, to April 7, 2022, and mean days since diagnosis was 276 (IQR 91-480) days. Most (796, 95%) were treated as outpatients. In PCFS, 338 (40%) had no functional limitations (grade 0), 266 (32%) had negligible functional limitations (grade 1), 154 (18%) had slight functional limitations (grade 2), 44 (5%) had moderate functional limitations (grade 3), 12 (2%) had severe functional limitations (grade 4) and 24 (3%) had missing PCFS data. Overall, 654 (78%) completed the persistent symptoms section. Among them, 57% presented fatigue, 46% impaired concentration, and 10% were asymptomatic (Figure 1). Of those with >12 weeks since diagnosis, 88% (499/564) had at least one symptom. Conclusion. Although most participants had mild COVID-19 at diagnosis, we found a high prevalence of persistent symptoms (90%) and functional limitations (60%) after recovery, revealing the devastating impact of COVID-19 on quality of life. The PCFS may be a valuable and simple tool to screen patients who could benefit from referral to rehabilitation programs, particularly in resource-limited settings.
ABSTRACT
The Coronavirus disease 2019 (COVID-19) pandemic revealed our need for reliable tools to evaluate patients with skin disease virtually. Thus far, there has not been a study that has attempted to score the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), a validated outcome measure of skin activity and damage, from photographs. In this study, patients were prospectively recruited during routine clinic visits and skin regions used in scoring the CDASI were photographed by research staff using two iPhone cameras (an iPhone 8 and iPhone 11). Two dermatologists served as the raters. The in-person CDASI assessment was scored by rater 1 at the clinic visit and the photographs were scored at a later date by both rater 1 and rater 2. Of the 34 patients participating in the study, 82.3% were female, 85.3% were Caucasian with a mean age of 54 years (SD=12). For the total activity score, the intraclass correlation coefficient (ICC) between rater 1’s in-person assessment compared to photograph assessment was 0.806 (95% CI 0.649-0.898 p<0.001) and was 0.822 (95% CI 0.675-0.907 p<0.001) between rater 2 and the in-person assessment. For the total damage score, the ICC between rater 1 and the in-person assessment was 0.54 (95% CI 0.254-0.739 p=0.004) and was 0.601 (95% CI 0.338-0.778 p<0.001) between rater 2 and the in-person assessment. The reliability was interpreted as “excellent” for skin activity, an important measure in clinical trials for dermatomyositis. Photographs may be a useful tool for evaluating clinical trial patients in the future. More research is needed to determine innovations for improving our ability to evaluate skin activity through photographs such as the use of a color checker card or color correction algorithm.
ABSTRACT
Cruise tourism is currently one of the fastest-growing tourism modalities in Andalusia, in addition to being an important settlement as a port of call and base for large companies, where large ships are also repaired and transformed. This article has carried out a study of the possibilities and employment options in the cruise sector;and it is concluded that these are extensive, although there is a lack of specific, specific, and technical training in the sector. Specifically, the possibilities currently offered by the establishment of the cruise industry in Andalusia are motivated by its cultural, tourist, and gastronomic potential. Therefore, with an appropriate policy within the naval sector industry, employment opportunities for Andalusian professionals can be specified in an effective and tangible way, who also have to overcome the challenges they face after COVID-19. © 2021, Universidade de Aveiro. All rights reserved.
ABSTRACT
The COVID-19 crisis has had repercussions, both in Spanish society and in its institutions. This is the case of the Congress of Deputies, obliged to adapt its operation to the situation of the pandemic and affecting, consequently, the work of the traditional media, in charge of covering parliamentary activity. In this context in which information is key, social networks come to adopt a fundamental role as a social communication channel. This research studies the online communication of the Lower House from March 10, 2020, with the announcement of the suspension of parliamentary activity, until April 30, when the de-escalation process is finalized. The main objective was to know what use the Congress has made of its social networks: Facebook and Twitter, during this period of crisis, while the reaction that such content has generated in the user community is valued. As demonstrated in this article, the Congress of Deputies fails to implement a communication at the height of the state of crisis generated by COVID-19.
ABSTRACT
Purpose: Covid-19 pandemic has especially affected kidney transplant (KT) recipients, who are more vulnerable than the general population due to their immunosuppressive status and added comorbidities. The objetic of this study was to determine risk factors related to infection and mortality from Covid-19 in KT. Methods: We included 53 KT who had PCR-confirmed COVID-19 infection between march 21st and november 24th, from a total of 2030 KT. Outcomes related to patient survival were analyzed. Results: 39 (73%) patients were men, with a mean age of 56±15 years old. Median time after KT where the infection took place was 104 months (IQR: 55-160). One patient was infected 40 days after transplant. 90% were on Tacrolimus therapy and 79% on MMF. 81% of patients were hypertensive, 36% diabetic and 19% had ischemic heart disease. 65% were on ARAII treatment. Clinical presentation consisted on pneumonia (64%), fever (55%), cough (70%), dyspnoea (45%), lymphopenia (66%) and gastrointestinal symptoms (36%). 21% required intubation and admission in ICU. 8 patients were asymptomatic. 18% received Hydroxychloroquine therapy plus Azithromycin, 11% Tocilizumab, 11% Ritonavir-Lopinavir, 59% steroids, 7.7% Remdesivir and 13.5% convalescent plasma. Immunosuppression was reduced in all symptomatic patients. 10 patients (19%) died. Table 1 compares the characteristics of these patients with those who survived. Conclusions: We concluded that mortality in KT is very high, more than reported in general population. Risk factors are patient age, time after KT, baseline renal function, the presence of pneumonia, as well as higher CRP levels at the time of diagnosis. More experience is needed to optimize our protocols and therapy for Covid-19 in KT.
ABSTRACT
BACKGROUND AND AIMS: Covid-19 pandemic has especially affected kidney transplant (KT) recipients, who are more vulnerable than the general population due to their immunosuppressive status and added comorbidities. The objetic of this study was to determine risk factors related to infection and mortality from Covid-19 in KT. METHOD: We included 53 KT who had PCR-confirmed COVID-19 infection between march 21st and november 24th, from a total of 2030 KT. Outcomes related to patient survival were analyzed. RESULTS: 39 (73%) patients were men, with a mean age of 56±15 years old. Median time after KT where the infection took place was 104 months (IQR: 55-160). One patient was infected 40 days after transplant. 90% were on Tacrolimus therapy and 79% on MMF. 81% of patients were hypertensive, 36% diabetic and 19% had ischemic heart disease. 65% were on ARAII treatment. Clinical presentation consisted on pneumonia (64%), fever (55%), cough (70%), dyspnoea (45%), lymphopenia (66%) and gastrointestinal symptoms (36%). 21% required intubation and admission in ICU. 8 patients were asymptomatic. 18% received Hydroxychloroquine therapy plus Azithromycin, 11% Tocilizumab, 11% Ritonavir-Lopinavir, 59% steroids, 7.7% Remdesivir and 13.5% convalescent plasma. Immunosuppression was reduced in all symptomatic patients. 10 patients (19%) died. Table 1 compares the characteristics of these patients with those who survived. CONCLUSION: We concluded that mortality in KT is very high, more than reported in general population. Risk factors are patient age, time after KT, baseline renal function, the presence of pneumonia, as well as higher CRP levels at the time of diagnosis. More experience is needed to optimize our protocols and therapy for Covid- 19 in KT.