Serenity before the demystification of the scourge by Sars-CoV-2

The Pandemic caused by the SARS-CoV-2 virus generated multiple effects at the general level of the world population. Not only in the lethal implications it has for physical health, but also the psychological and emotional consequences that it has left throughout its evolution, since its appearance and categorization as a pandemic on March 11, 2020. This bibliographic review has In order to make a constructive analysis of the coronavirus, no longer seen as a disease that causes death, but with a view to demystifying that negative vision that was built on Covid-19, which is a disease that brought with it many negative implications and radical changes in our models of daily life, but that through advances in technology, medicine and our iron will to improve, as a species we managed to adapt and learned to go hand in hand with SARS-CoV-2, in a new postcovid society that seeks to regain its balance. For this, an exhaustive search was carried out in the available academic information search engines GoogleAcademic and PubMed, feeding the search engines through the words: Covid-19 and implications for health;SARS-CoV-2 and society;society-covid-health;emotional well-being and pandemic;level of emotional satisfaction and postcovid society;perspectives of the new post-pandemic life. The review allows us to highlight a different vision of the disease, no longer from a fatalistic perspective, but from a new evolutionary vision that has allowed us to overcome the self-imposed barriers of Covid-19 and achieve a more balanced society. © 2022 Instituto de Altos Estudios de Salud Publica. All rights reserved.

Main respiratory sequelae of Covid-19: an exploratory review

Covid-19 is an infectious disease that has caused significant rates of morbidity and mortality in the world population, scientific evidence has sought to describe the pathophysiology of SARS-CoV-2. In the initial phase, an acute inflammatory process occurs that begins to be accentuated in the respiratory tract and affects the lungs first and foremost;which, subsequently, can trigger respiratory dysfunctions that persist even after medical discharge, which is considered a persistent symptom. In accordance with the methodology of the exploratory systematic review, this research was carried out whose purpose was focused on finding bibliographic references that support and identify the main respiratory sequelae of Covid-19;For this, a search of the literature was carried out through the PubMed, Scielo, Medline, Web of Science and Scopus databases. The bibliographic investigation was carried out in January 2022, 70 documents were detected, which were subjected to quality evaluation. 38 observational studies, 3 review articles and 1 meta-analysis were included. So far, no consensus has been reached regarding the most important sequela in the post-COVID respiratory field, fundamentally the following stand out: fatigue, dyspnea, chest pain and cough. In addition, a considerable percentage of patients persist with residual pulmonary function abnormalities, suggestive of pulmonary fibrosis, requiring medical assistance even after hospital discharge. It is recommended to continue with research aimed at assessing the sequelae of Covid-19, to obtain clear foundations related to post-infection respiratory functional capacity. © 2022 Instituto de Altos Estudios de Salud Publica. All rights reserved.

Characterization of obstetric patients in the emergency of the Regional Teaching Hospital Ambato.

Introduction: The management of the obstetric patient is a matter of great importance, since it is necessary to guarantee the termination of the pregnancy with satisfactory results for the mother and the child, thus avoiding possible maternal or infant deaths. The general objective of our study was to describe obstetric morbidity and mortality in the emergency department of the Ambato Regional Teaching Hospital during the peak of the COVID-19 pandemic. Methodology: Hospital emergency care records were studied in the period January-September 2020, through an observational, retrospective, descriptive study. In this work, emphasis is placed on the obstetric patient in the period during pregnancy and around childbirth, including the immediate puerperium. Results and Conclusion(s): it was evidenced that in the emergency service of the Ambato Regional Teaching Hospital of a total of 1082 patients treated in the emergency room, 92 of these corre-sponded to obstetric patients. The highest morbidity corre-sponded to eutocic deliveries with 39 patients. In the emergency department, 126 Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests were performed, 92 of them on all the obstetric patients seen in the emergency department, resulting in the virus being identified in 46 patients. The most affected age group in COVID patients was 18 to 33 years old, with overall age of 27 years. COVID morbidity predominated in obstetric patients, in the third trimester of pregnancy, 11 of them with fetal distress. Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.

Synchronous computer-mediated communication in English pronunciation teaching: A case study of Rovira i Virgili University

Remote learning has been in the spotlight since the emergence of the coronavirus pandemic, notably boosting the development of distance learning in the last two years;as universities were obliged to close worldwide and lecturers had to teach online during lockdown, the use of Synchronous Computer-Mediated Communication (SCMC) started to prevail. Pronunciation instruction was not an exception. Indeed, in-person lectures had used technology to support face-to-face (F2F) education by using videos and articles in class. However, educators had to adapt rapidly to teach through video -based platforms. Although much investigation has been conducted on Computer-Assisted Pronunciation Training (CAPT), and researchers currently show more and more interest in the use of new technologies within the pronunciation classroom, little research has been done regarding the teaching methodologies applied in teacher-guided online pronunciation instruction. Along these lines, this study examines English undergraduates' insights who took pronunciation courses remotely at Rovira i Virgili University during the COVID-19 crisis. Findings show that participants were highly satisfied with the adaptation of the course, rating all the activities and methods used above 4 on a scale of 5. Thus, pronunciation can be taught effectively via SCMC, although a larger sample is needed to reach more conclusive results.

Main neurological sequelae of COVID-19: an exploratory review

The purpose of this study is to carry out an exploratory systematic review that allows us to demonstrate the current panorama of the different neurological sequelae caused by COVID-19 in patients. A literature search was performed through the PubMed, Scielo, Medline, Web of Science and Scopus databases. The bibliographic search was carried out in February 2022.60 articles were identified, 10 were duplicates and in the review phase 9 were excluded due to their methodological design;2 articles were discarded due to inconsistencies in the validity of the data collection instruments, therefore, 39 scientific studies were used to obtain data, analyze the results and were subjected to quality evaluation. 33 observational studies, 2 case studies, 3 review articles and 1 meta-analysis were included. Regarding methodological aspects, 92.4% are observational studies (descriptive or analytical or cut-off prevalence), only 3 of them (7.6%) are assumed to be prospective in the directionality of the design. The following neurological sequelae stand out fundamentally: neurovascular syndrome, encephalopathies, migraines, anxiety, depression, olfactory and/or taste dysfunctions, sensory symptomatology, polyneuropathy and myopathy, neuralgia and facial paralysis, the physiopathogenesis of these neurological affections, are mainly associated with the syndrome of systemic inflammatory response resulting from infection with SARS-CoV-2. It is recommended to continue with research aimed at the sequelae of COVID-19, to guide treatment and avoid serious complications from this disease.

Teaching English Pronunciation Online during the COVID-19 Crisis Outbreak

The abrupt emergence of the COVID-19 pandemic in spring 2020 forced tertiary professors to urgently adapt the face-to-face courses they were lecturing to emergency remote teaching. Researchers of different fields have started to investigate and share their thoughts on which are the best methodologies to guarantee a high-quality learning experience while coping with students' anxiety and teachers' lack of technical background. The present study examines the adaptation of an English pronunciation course at Rovira i Virgili university to the online setting imposed by the outbreak of the pandemic. The students who took the course were asked to fill in a satisfaction survey containing multiple choice, Likert scale and open questions on the different measures taken and the general progress of the course. Results show that students were higly satisfied with the adaptation of the course to the online context, and that the methods adopted and tools provided were useful and sufficient to continue with the adequate functioning of the course. Hence, this study is a sample of how to teach pronunciation remotely in particular, and how to successfully adapt a face-to-face university course to emergency remote teaching in general, guaranteeing students' learning and engagement.

Using Machine Learning to estimate the impact of different modes of transport and traffic restriction strategies on urban air quality

Classical pollutant dispersion models, based on the numerical resolution of some approximate form of the momentum, energy and chemical species conservation equations, are usually limited by incomplete descriptions of the atmospheric boundary layer hydrodynamics, partial characterizations of the emission inventories and, often, high computational costs. Using the metropolitan area of Barcelona as benchmark, the Machine Learning aproach presented here alleviates these limitations providing very accurate local predictions of key pollutant concentrations. Originating mostly from Open Data sources, time-series data on road, maritime and air traffic along with meteorological records from October 2017 to June 2021, have allowed, by means of Machine Learning techniques, to create a model capable of estimating the individual contributions of each mode of transport to worsened Air Quality. Also, when used to investigate the impact of recently implemented mitigation measures, model results predict a reduction of approximately 8 μg·m−3 for CO and NOx. In contrast, O3, PM10 and SO2 are found to be unaffected. The COVID-19 lockdown provided an accidental opportunity to improve the model's robustness and predictive capability through unusually low emission rates from transportation. © 2022 The Author(s)

Psychosocial impact of COVID-19 in the area of sexual and reproductive health

Introduction: COVID-19 due to its global dimension and the strong changes it has generated in the dynamics of life has become a phenomenon with repercussions in all social contexts and in individual or collective psychology, to which sexual and reproductive health does not escape. Objective: Make visible the real or potential problems that the current pandemic presupposes in the area of sexual and reproductive health, from a psychosocial approach. Methods: A literature review was carried out from the electronic databases like Google Scholar, central PubMed, LILACS, BIREME, Regional SciELO, using as keywords "SARS-CoV-2" or "COVID-19" and "reproductive sexual health" or "gender violence". The information collected was synthesized in three fundamental themes: Relationships, gender inequities and re-arrangement of services. Conclusions: The current health crisis and the social distancing it imposes could have a negative impact on relationships or structures of gender domination, where women, girls and other vulnerable groups could be disadvantaged. On this topic, as in many others related to COVID-19, although more research is required, there are many issues that need to be addressed from a systemic perspective and with a timely prevention and containment approach. A collective and unprejudiced effort is needed for social, judicial, police and health support, which allows overcoming the current and future consequences of this pandemic in the attention to the problems of sexual and reproductive health.

Neutrsophic Health Analysis in Times of COVID-19

The current COVID-19 pandemic represents a danger for which efforts have been joined to find an effective treatment. This pandemic has evolved so quickly that new data emerge daily on the number of sick and fatal cases. As of September 2021, more than 180 countries with positive COVID-19 cases have been notified to the World Health Organization, including 228,807,631 confirmed cases, including 4,697,099 deaths. So far, the Americas region is the most affected with a total of 88,207,746 confirmed cases, and during this period, Ecuador has reported 246 new infections on average each day, for a total of 507,003 infections and 32,661 deaths. To date, dissimilar methods and treatments have been used to mitigate its effects. However, no effective treatment option has been found against it, generating uncertainty, social panic, and impacts on the population’s mental health as a result of the fear of infection and death. That is why the present work focuses on analyzing and determining the alternatives for the control of detection of the pandemic, through the processing of the neutrosophic TOPSIS method. It offers many benefits in the analysis of neutralities to the study of indeterminacies in the field of Medicine. The processing using neutrosophic methods allowed obtaining the best alternative to fight against COVID-19. © 2022, American Scientific Publishing Group (ASPG). All rights reserved.

Psychosocial impact of COVID-19 in the area of sexual and reproductive health

Introduction:COVID-19 due to its global dimension and the strong changes it has generated in the dynamics of life has become a phenomenon with repercussions in all social contexts and in individual or collective psychology, to which sexual and reproductive health does not escape.

Motivation of university students in educational sciences according to gender, religious culture, and social skills during the COVID-19 pandemic

The current health situation has posed a significant challenge for students and teachers of all educational stages, as they have had to adapt the teaching-learning process to the health restrictions imposed during the COVID-19 pandemic. The aim of this study is to analyze the motivation of university students in education sciences in relation to their gender, religious tendencies, and social skills. A total of 130 university students enrolled in the University of Granada at the Ceuta and Melilla campuses (M = 23.38;SD = 6.95) participated in this research in an ex post facto quantitative study with a descriptive, correlational, and cross-sectional design. The students responded to the adaptation into Spanish of the Situational Motivation Scale of Guay et al. (2000). Among the results, it can be highlighted that the most intrinsically motivated population is female and Catholic. Regarding social skills, sociability, communication, and assertiveness are the skills that most influence student’s degree of motivation. The data drawn from this study demonstrate the usefulness of analyzing students’ motivation to provide them with more individualized teaching, as well as the need to work on students’ social skills. © 2022 Universitat Autonoma de Barcelona. All rights reserved.

BEHAVIOR OF COVID-19 IN THE EMERGENCY OF THE REGIONAL HOSPITAL DOCENTE AMBATO

A study was carried out on the behavior of COVID 19 in the emergency of the Ambato regional teaching hospital, with the general objective of characterizing the behavior of this disease in the emergency service of the Ambato Regional Teaching Hospital, in the period January-September 2020. Studied the records of hospital emergency services in this period, making a cut-off on September 30, 2020. Some qualitative and quantitative statistical variables were included that allowed characterizing the disease in the emergency service at this hospital. Coronavirus disease is defined as a highly contagious viral infection. Manifestations of adult respiratory distress syndrome (ARDS) have been described, requiring mechanical ventilation in most cases. 126 suspected cases of COVID 19 were found in the emergency service of the Ambato Regional Teaching Hospital, of which 61 cases are identified viruses. The sex that predominated was female. The age group most affected was adults from 18 to 59 years old. The risk factor that predominated was pregnancy;the comorbidity found was type II diabetes mellitus and hypertension. Bleeding complications were those with the highest incidence.

Optimal Testing and Containment Strategies for Universities in Mexico amid COVID-19

This work sets out a testing and containment framework developed for reopening universities in Mexico following the lockdown due to COVID-19. We treat diagnostic testing as a resource allocation problem and develop a testing allocation mechanism and practical web application to assist educational institutions in making the most of limited testing resources. In addition to the technical results and tools, we also provide a reflection on our current experience of running a pilot of our framework within the Instituto Tecnológico y de Estudios Superiores de Monterrey (ITESM), a leading private university in Mexico, as well as on our broader experience bridging research with academic policy in the Mexican context. © 2021 ACM.

UNEXPECTED OPPORTUNISTIC INFECTION IN PATIENT WITH SEVERE COVID-19 PNEUMONIA

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: The pathogenesis of the novel coronavirus, Covid-19, was characterized by an overdrive of the immune system that lead to some patients to a life-threatening cytokine storm with severe lung inflammation and multiorgan failure. Considering this pathogenic pathway, the use of high dose systemic steroids, and other immunomodulatory therapy was part of the main therapy. As management evolves, complications have risen, including cardiac, thromboembolic, neurologic and secondary infections. Multiple clinical reports have described complications with bacteria, and fungal infections in different organ systems, most commonly the respiratory track. However, systemic and multiorgan infections have been reported due to severe immunosuppression after viral infection and the use of anti-inflammatory therapy. CASE PRESENTATION: We present the case of an 86-year-old male with a past medical history of benign prostate hypertrophy, hyperlipidemia and hypertension who developed respiratory failure due to severe COVID-19 pneumonia, managed with antiviral therapy and high dose dexamethasone. After initial improvement from the respiratory standpoint, the patient developed persistent fungemia with Candida parapsilosis. There was no evidence of endocarditis. The patient presented with persistent altered mental status after cessation of sedation. Brain imaging revealed a right posterior parietal parafalcine hematoma with surrounding vasogenic edema. Angiogram revealed a saccular aneurysm measuring approximately 5.7 mm in largest dimension located at midline posterior frontal in location in relation to pericallosal arteries. Cerebral arterial aneurysm secondary to systemic fungal infection, knowns as mycotic aneurysms, have been reported in medical literature. DISCUSSION: Aneurysms are an abnormal arterial focal dilation which can become infected, but also aneurysmal degeneration of the arterial wall can occur due to bacteremia or a septic embolus;as seen in mycotic aneurisms. Despite its name, most mycotic aneurysms are caused by bacteria from associated endocarditis. This is a serious complication associated to an elevated morbidity and mortality. Several risk factors predispose to infected aneurysm, these include arterial injury, infection, immunocompromised status, atherosclerosis and pre-existing aneurysms. Fungal infections tend to be rare but may occur in immune suppressed patients or as sequelae of treatment of disseminated fungal disease. CONCLUSIONS: This is an unexpected complication of immunosuppression with systemic steroids in management of COVID-19 pneumonia. Treatment with systemic steroid and thromboembolic complication prevention have helped improve COVID-19 pneumonia patient prognosis, however physicians should be careful as it predisposes patients, especially those with advanced age, to opportunistic infections in unexpected organ and settings. REFERENCE #1: WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Sterne JAC, Murthy S, Diaz JV, Slutsky AS, Villar J, Angus DC, Annane D, Azevedo LCP, Berwanger O, Cavalcanti AB, Dequin PF, Du B, Emberson J, Fisher D, Giraudeau B, Gordon AC, Granholm A, Green C, Haynes R, Heming N, Higgins JPT, Horby P, Jüni P, Landray MJ, Le Gouge A, Leclerc M, Lim WS, Machado FR, McArthur C, Meziani F, Møller MH, Perner A, Petersen MW, Savovic J, Tomazini B, Veiga VC, Webb S, Marshall JC. Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis. JAMA. 2020 Oct 6;324(13):1330-1341. doi: 10.1001/jama.2020.17023. PMID: 32876694;PMCID: PMC7489434. REFERENCE #2: Wu FZ, Lai PH. Evolution and regression of intracranial infectious aneurysm diagnosed by brain computed tomographic angiography. Arch Neurol. 2010 Sep;67(9):1147. doi: 10.1001/archneurol.2010.216. PMID: 20837863. REFERENCE #3: World Health Organization. Corticosteroids for COVID-19: Living guidance. https://www.who.int/publications/i/item/WHO-2019-nCoV-Cor icosteroids-2020.1 DISCLOSURES: No relevant relationships by Onix Cantres-Fonseca, source=Web Response No relevant relationships by Porfirio Diaz-Rodriguez, source=Web Response No relevant relationships by Héctor Nieves, source=Web Response No relevant relationships by Luis Vazquez, source=Web Response

Co-infections and superinfections complicating COVID-19 in cancer patients: A multicentre, international study.

BACKGROUND: We aimed to describe the epidemiology, risk factors, and clinical outcomes of co-infections and superinfections in onco-hematological patients with COVID-19. METHODS: International, multicentre cohort study of cancer patients with COVID-19. All patients were included in the analysis of co-infections at diagnosis, while only patients admitted at least 48 h were included in the analysis of superinfections. RESULTS: 684 patients were included (384 with solid tumors and 300 with hematological malignancies). Co-infections and superinfections were documented in 7.8% (54/684) and 19.1% (113/590) of patients, respectively. Lower respiratory tract infections were the most frequent infectious complications, most often caused by Streptococcus pneumoniae and Pseudomonas aeruginosa. Only seven patients developed opportunistic infections. Compared to patients without infectious complications, those with infections had worse outcomes, with high rates of acute respiratory distress syndrome, intensive care unit (ICU) admission, and case-fatality rates. Neutropenia, ICU admission and high levels of C-reactive protein (CRP) were independent risk factors for infections. CONCLUSIONS: Infectious complications in cancer patients with COVID-19 were lower than expected, affecting mainly neutropenic patients with high levels of CRP and/or ICU admission. The rate of opportunistic infections was unexpectedly low. The use of empiric antimicrobials in cancer patients with COVID-19 needs to be optimized.

Infection Risk in Lymphoproliferative Diseases (LPD) Treated with Targeted Drugs. Geltamo Real-Life Experience

Introduction:Recently there has been a renewal of therapeutic tools for the treatment of lymphoid neoplasms to increase the antitumor efficacy and reduce the toxicity generated by conventional chemotherapies, which adds to the intrinsic immunological dysfunction of the disease itself. To date, few data are published about infection risk of these new drugs, and the need for infectious prophylaxis is unknown. The aim of the study is to analyze the infectious complications in patients with LPD treated with monoclonal antibodies (obinutuzumab, ofatumumab, brentuximab, nivolumab and pembrolizumab), BTK inhibitors (ibrutinib, acalabrutinib) and PI3K inhibitors (idelalisib). Methods: Multicenter retrospective study in patients with LPD treated with targeted therapies (single agents or combination) in 18 Hematology centers in Spain, from the time of their commercial availability to March 2020. Patients in clinical trials were excluded as well as patients with active infections at the beginning of treatment. Results:During the study period, 380 patients were included.Baseline characteristics of the entire cohort are shown in Table 1.Median follow-up was 17.3 months (range 0-103), the longest follow-up corresponding to CLL patients (24 months, range 0-98) and the shortest to LBCL (5 months, range 0-25). Median exposure to target drugs was 8 months (range 0-72).Ibrutinib was administered to 219 patients(1 FL, 147 CLL, 27 MCL, 10 DLBCL, 1 TL and 32 WM, 1 HL),Brentuximab to 49(31 HL, 14 TL and 4 DLBCL) andIdelalisibto 35 patients (16 affected by chronic lymphocytic leukemia - CLL, 15 FL and 1 DLBCL, 1 WM, 1MCL, 1HL).Obinutuzumabcombinations were used in 10 (6 CLL, 3 FL, 1 MCL) and 5 HL patients (of which 4/5 underwent previous BMT) receivedNivolumab. A total number of 237 infectious events occurred in 148/380 patients (38.9%), 39% of which were grade 3 and 54/148 (36.4%) experienced 2 or more infective episodes: of those 54, 21 (38%) had underwent 3 or more lines of therapy and 28 (51%) had hypogammaglobulinemia. Hospitalization was required in 59.2% events. A bacterial cause of infection was reported in 40% of cases, and viral in 16%, including 11/237 (4,6%) SARS-CoV-2 infection. Invasive fungal infection (IFI) occurred in 3.3% (8/237). Noteworthy, no case of PJP was identified. Lung was the most frequent site of infection in 24% of cases (57/237) while the upper respiratory tract was involved in 17% of events (41/237). Urinary tract infections were diagnosed in 10% (24/237). Other sites involved were skin and soft tissue 7%, gastrointestinal tract 5,4%, bloodstream infections 3% and catheter related infections 2,5%. Considering drugs individually, 86 patients that receivedIbrutinib(39.2 %)experienced a total of 137 infectious episodes: 30% bacterial, 19% viral, 5% fungal and 45% clinical and image-based infections;the 17(34.6%of those who received Brentuximab, experienced a total of 16 infectious episodes: 56% bacterial, 37.5% viral infections and one catheter-related sepsis. Of those who receivedIdelalisib,18 (51.4%)experienced a total of 28 episodes: 42% bacterial, 14% viral and 7% fungal. Four patients treated withObinutuzumabcombinations (40%) experienced one infection during treatment (25% bacterial and 75% viral). Only one patient treated withNivolumabexperienced more than three infections, he was also under corticosteroid treatment. Focusing on IFI (Table 2): 7/8 infections were identified in CLL patients, 6 out 7 being on ibrutinib treatment and 1/7 on Idelalisib.Aspergilluswas the fungus most frequently isolated. The targeted drug was discontinued temporarily in 4 patients and indefinitely in 3. Twenty three (6%) patients died due to infection in our series. Conclusions: 1. We identified 38.7% infections in our LPD patients treated with targeted drugs, with a median drug-exposure time of 8 months (range 0-72), with a non-negligible incidence of bacterial infections. 2. The highest rates of infection were found in patients treated with with Idelalisib and Ibrutinib (51.4% and 39.2% respectively). 3. IFI (3.3%) occurr d with low frequency, mostly in CLL patients during ibrutinib treatment, leading to its temporal discontinuation in most of the cases. 4. No case of PJP was identified in our cohort. 5. An analysis to determine risk factors for infection and the optimal monitoring and prophylaxis for these patients is ongoing. [Formula presented] Disclosures: Hernandez-Rivas:Janssen:Membership on an entity's Board of Directors or advisory committees;Abbvie:Membership on an entity's Board of Directors or advisory committees;Roche:Membership on an entity's Board of Directors or advisory committees;AstraZeneca:Membership on an entity's Board of Directors or advisory committees;Gilead:Membership on an entity's Board of Directors or advisory committees;Celgene/BMS:Membership on an entity's Board of Directors or advisory committees;Rovi:Membership on an entity's Board of Directors or advisory committees.Lopez-Guillermo:novartis:Consultancy;celgene:Consultancy, Research Funding;roche:Consultancy, Research Funding;gilead:Consultancy, Research Funding.

Characterization of COVID-19 patients in an intensive care unit

Introduction: At the end of 2019 a new coronavirus caused an epidemic of acute respiratory disease in Wuhan, China. The World Health Organization called this condition coronavirus disease 2019 and declared it pandemic on 11 March 2020. On that same date the first three COVID-19 cases were diagnosed in Cuba.

Association of hypertension with all-cause mortalityamong hospitalized patients with COVID-19

Objective: It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to speci fic mechanisms. The main objective of the study is to analyze whether HT represents an independent risk factor for death as a hard endpoint in patients hospitalized with SARS-CoV-2 in Spain Design and method: Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors Results: The mean age of the study population was 67.5 ± 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles OR: 4.7 and 8.1, p = 0.0001), hypertension was signi ficantly predictive of allcause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensinaldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035) Conclusions: The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization. ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.