ZINC ADJUVANT TREATMENT IN SARS-CoV-2: A RANDOMIZED CLINICAL TRIAL

Background: The immune system is highly susceptible to changes of zinc levels and this might imply a different response against infection. Prior evidence suggests some benefit on viral infection prognosis after zinc supplementation. We aim to study the efficacy of zinc supplementation in SARS-CoV-2 infection outcomes. Method(s): This is an unicenter prospective, randomized cliinical trial where unvaccinated individuals with moderate SARS-CoV-2 infection without endorgan failure were randomized to standard of care+oral zinc for 15 days (three times per day a tablet of 83mg of Zn acetate equals to 75 mg of Zn element) (zSoC) (n =37) or standard of care alone (SoC) (n = 34). The primary combined outcome was death due to SARS-CoV-2 or intensive care unit (ICU) admission. Secondary outcomes included length of hospital stay (LoS) and time to clinical stability (defined as: oxygen saturation >94% [FiO2 21%], normalized level of consciousness [baseline], HR < 100rpm, systolic BP >90mm Hg,Temperature < 37.2degreeC). Wilcoxon-Mann-Whitney test generalized Odds ratio (ORs) and 95% confidence intervals (CIs) for differences in outcomes between SoC and zSoC. A logistic regression model was fitted adjusted by age, sex, severity and comorbidity to compare the primary outcome between SoC and zSoC. Result(s): Seventy-one participants were recruited. No significant differences in terms of age, gender and comorbidities nor in SoC were found between groups (Table 1). 14-day Mortality was 2.90 % (2 participants) in the SoC group and none in zSoC. ICU admission rates were, respectively, 8 (23%) and 1 (2.7%) (OR: .098;95% CI .013-.766). The principal combined outcome occurred in 8 participants (23%) in SoC and in 2 (5.4%) in zSoC (OR: 0.18;95% CI .03-.946). In a logistic regression model adjusting by age, sex, comorbidity and severity the OR for the combined outcome in those in zSoC was 0.091 (95% CI: 0.007-0.913;p=0.045). LoS was shorter in zSoC (6.9 days (SD 6.1) vs 12.7 (SD 11.6);p=0.013) respectively. Time to clinical stability was significantly shorter in zSoC (5 days (SD 6.1)) compared to SoC (11.9(SD 9.1));p=0.005. No significant differences in changes in inflammatory markers were found among groups. No severe adverse events were observed during the study. Conclusion(s): Daily zinc supplementation with 240 mg of zinc acetate for 14 days during the acute phase of SARS-CoV-2 infection resulted in lower rates of severity (less death and ICU admission) and faster clinical recovery along with shorter hospital stay.

Digital skills and academic performance in students of a Peruvian technical-productive education institution

In order to reduce contagion by the COVID-19 pandemic, Peruvian educational institutions migrated to digital environments, showing that, even though current generations are skilled in the use of technology for socialization, not all of them use it correctly in their learning. The objective of this article is to determine the relationship between digital competencies and academic performance in students of a Peruvian technicalproductive education institution. For this purpose, the questionnaire of Gutiérrez-Castillo et al. (2017), validated by local experts, was contextualized and applied virtually through the digital platform to a sample represented by 52 students of the specialty of “Computer Operation” of the Technical-productive education center “Tarma” for having the largest number of students at the time of the research. It was obtained as a result that 46% and 44% of the students presented a good or superior level of digital skills and academic performance respectively;in addition, there is a statistically significant positive relationship between digital competences and academic performance (0.572). It is concluded that digital skills are a factor related to academic performance in students of the specialty analyzed, so if a student has greater digital skills, they will present better academic performance © 2022, Revista de Ciencias Sociales.All Rights Reserved.

Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study.

BACKGROUND: This international study aimed to characterise the impact of acute SARS-CoV-2 infection in people with cystic fibrosis and investigate factors associated with severe outcomes. Methods Data from 22 countries prior to 13th December 2020 and the introduction of vaccines were included. It was de-identified and included patient demographics, clinical characteristics, treatments, outcomes and sequalae following SARS-CoV-2 infection. Multivariable logistic regression was used to investigate factors associated with clinical progression to severe COVID-19, using the primary outcome of hospitalisation with supplemental oxygen. RESULTS: SARS-CoV-2 was reported in 1555 people with CF, 1452 were included in the analysis. One third were aged <18 years, and 9.4% were solid-organ transplant recipients. 74.5% were symptomatic and 22% were admitted to hospital. In the non-transplanted cohort, 39.5% of patients with ppFEV1<40% were hospitalised with oxygen verses 3.2% with ppFEV >70%: a 17-fold increase in odds. Worse outcomes were independently associated with older age, non-white race, underweight body mass index, and CF-related diabetes. Prescription of highly effective CFTR modulator therapies was associated with a significantly reduced odds of being hospitalised with oxygen (AOR 0.43 95%CI 0.31-0.60 p<0.001). Transplanted patients were hospitalised with supplemental oxygen therapy (21.9%) more often than non-transplanted (8.8%) and was independently associated with the primary outcome (Adjusted OR 2.45 95%CI 1.27-4.71 p=0.007). CONCLUSIONS: This is the first study to show that there is a protective effect from the use of CFTR modulator therapy and that people with CF from an ethnic minority are at more risk of severe infection with SARS-CoV-2.

COVID-19 vaccination efficacy in cancer patients: An ongoing prospective trial

Background: Cancer patients (pts) have higher risk of severe COVID-19 infection. However, observations are based on non-comparative retrospective studies. Evidence regarding vaccination in cancer pts is limited, but there is enough evidence to support COVID-19 vaccination, even under active treatment. Data on humoral and cellular immune response to antiviral vaccination in cancer pts are scarce. In pts receiving immunosuppressive therapies (IST) like chemotherapy and targeted therapies, seroconversion/protection rates are expected to be lower than general population, but not in pts receiving immune checkpoint inhibitors (ICI). Serum antibodies against an infectious agent may be an immunity indicator. Methods: Prospective observational longitudinal study with the intent of evaluating the humoral response of cancer pts to COVID-19 vaccination. The study includes pts diagnosed in any stage, without or under active treatment, or survivors followed in Hospital Prof. Dr. Fernando Fonseca, in partnership with Instituto Gulbenkian de Ciência. Pts are divided into 4 arms, independently of the vaccine: A – IST;B – ICI;C –Hormone therapy (HT);D – Cancer survivors. Recruitment started in March 2021, expecting at least 50 pts per arm. IgG, IgA and IgM anti-SARS-CoV-2 antibodies ELISA determination in 9 timepoints: before 1st dose and at the 3rd, 6th, 12th, 15th, 24th, 36th, 48th and 60th weeks post 1st dose. Side effects’ questionnaire will be implemented after 1st and 2nd doses. Results: Recruitment is ongoing and a total of 202 pts were enrolled, of which 178 pts have 3-weeks post 1st dose evaluated: 101 in arm A: 11 in B: 31 in C;and 35 in D.The mean age is 61.6 years, with 53.4% females. Regarding vaccines, 55 pts were submitted to ChAdOx1-S/nCoC-19, 5 to Ad26.COV2.S, 89 to BNT162b2 and 12 to mRNA-1273 vaccines. At 3 weeks, 33/97 pts (34%) in arm A, 2/11 pts (18%) in B, 14/28 pts (50%) in C and 15/35 pts (43%) in D already generated anti-spike IgG. Most common side effects were local inflammatory reaction (47%), generalized muscle pain (17%), fatigue (11%), and chills (10%). Conclusions: Efficacy and safety profiles of vaccines against COVID-19 infection in cancer pts is still unknown.This study hopes to assess differences in immunization between pts’ treatment profiles and duration profiles and safety profiles. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Comparative study on Vietnam’s and Philippines' COVID-19 response using historical institutionalism

Purpose: This paper analyzed the healthcare systems of the Philippines and Vietnam prior to the coronavirus disease 2019 (COVID-19) and their strategies on mass testing, contact tracing, quarantine procedures and information dissemination about the pandemic. Design/methodology/approach: Steinmo's (2008) historical institutionalism approach was used in this paper. Secondary data gathering, document analysis and comparative process tracing were employed. Findings: The findings revealed that Vietnam's implementation of its Law on Prevention and Control of Infectious Diseases in 2007, its relatively low-cost healthcare system, its efficient mass testing and contact tracing strategies and its science-based decisions are contributory to its success in handling the pandemic. Meanwhile, the Philippines failure to enact its Pandemic and All-Hazards Preparedness Act in 2013, its costly and dominantly private healthcare system, its heavy focus on strict, long lockdowns and its militarist methods to control the spread of the pandemic were found to be insufficient. Research limitations/implications: Detailed study on the delivery of healthcare services in marginal areas, healthcare spending for COVID-19 positive individuals and information dissemination strategies about the pandemic were not explored. Practical implications: Health institutions can redesign their governance mechanisms by ensuring a cost-effective healthcare system and maximizing resource utilization to ensure efficient management of future pandemics. Moreover, national governments should not compromise their country's healthcare system over the economy during a pandemic. Originality/value: This paper analyzed the countries' history of healthcare governance and its influence in handling COVID-19 compared to previous studies which only focused on the countries' strategies during the pandemic.

The global impact of SARS-CoV-2 in 181 people with cystic fibrosis.

With the growing SARS-CoV-2 pandemic, we need to better understand its impact in specific patient groups like those with Cystic Fibrosis (CF). We report on 181 people with CF (32 post-transplant) from 19 countries diagnosed with SARS-CoV-2 prior to 13 June 2020. Infection with SARS-CoV-2 appears to exhibit a similar spectrum of outcomes to that seen in the general population, with 11 people admitted to intensive care (7 post-transplant), and 7 deaths (3 post-transplant). A more severe clinical course may be associated with older age, CF-related diabetes, lower lung function in the year prior to infection, and having received an organ transplant. Whilst outcomes in this large cohort are better than initially feared overall, possibly due to a protective effect of the relatively younger age of the CF population compared to other chronic conditions, SARS-CoV-2 is not a benign disease for all people in this patient group.