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5.
Human Review International Humanities Review / Revista Internacional de Humanidades ; 11(Monografico):1-13, 2022.
Article in Spanish | Scopus | ID: covidwho-2206388

ABSTRACT

After the COVID-19 pandemic, learning content virtualization has been promoted by educational institutions, leading to the development of audiovisual resources to support teaching. These materials often consist of videos of variable duration envisaged as a complement to other training strategies in order to facilitate the acquisition of specific learning contents. This work presents a collaborative experience among teachers for audiovisual content generation, tailored to the specific contents of different math-related basic subjects in five different engineering degrees at the University of Cantabria. © GKA Ediciones, authors.

6.
Circulation Conference: American Heart Association's ; 146(Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2194395

ABSTRACT

Introduction: Current estimates show that, globally, there are 531 million cases and 6.3 million deaths due to COVID-19. Studies have shown that COVID-19 could lead to deep vein thrombosis (DVT) resulting in increased morbidity and mortality. In this study we sought to estimate the prevalence of DVT among COVID-19 hospitalizations as well as its effects on hospital outcomes using a large administrative database. Hypothesis: The adverse in-hospital outcomes of COVID-19 will be significantly higher among DVT hospitalizations. Method(s): We conducted a retrospective analysis of the 2020 California State Inpatient Database. All hospitalizations with age 18 and above and primary diagnosis of COVID-19 were included for the study. They were classified into those with and without DVT. The main outcomes of the study were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission. Length of stay >=75th percentile was grouped as prolonged length of stay. Multivariate logistic regressions with covariate adjustments were conducted to compare COVID-19 related outcomes between those with and without DVT. Result(s): We included a total of 94,114 primary COVID-19 hospitalizations for the analysis. Among them 1575 (1.7%) had DVT. The prevalence of mortality (27.5% versus 11.1%, P<0.001), prolonged length of stay (62.2% versus 27.8%, P<0.001), vasopressor use (7.9% versus 2.1%, P<0.001), mechanical ventilation (36.2% versus 9.7%, P<0.001), and ICU admission (35.7% versus 9.3%, P<0.001) were significantly higher among those with DVT. After adjusting for covariates, regression analysis showed that those with DVT had significantly greater odds for mortality (aOR, 2.34, 95% CI: 2.07-2.65), prolonged length of stay (aOR, 3.51, 95% CI: 3.16-3.91), vasopressor use (aOR, 4.23, 95% CI: 3.78-4.74), mechanical ventilation (aOR, 2.90, 95% CI: 2.38-3.53), and ICU admission (aOR, 4.32, 95% CI: 3.85-4.84). Conclusion(s): In our cohort, only few COVID-19 hospitalizations had a diagnosis of DVT. However, among those with DVT, the risk for adverse outcomes were significantly higher. Since DVT among COVID-19 is uncommon but associated with adverse hospital outcomes, healthcare providers should promptly monitor for DVT and manage it.

7.
Circulation Conference: American Heart Association's ; 146(Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2194394

ABSTRACT

Introduction: According to recent global estimates there are nearly 530 million cases and 6.3 million deaths due to novel coronavirus disease 2019 (COVID-19) pandemic. Studies have shown that COVID-19 disproportionately affects males than females. In this study we looked at differences in in-hospital outcomes of COVID-19 based on sex using a larger administrative database. Hypothesis: The adverse in-hospital outcomes of COVID-19 will be significantly higher among males. Method(s): This was a retrospective analysis of the California State Inpatient Database 2020. All COVID-19 hospitalizations with age 18 years and above were included for the analysis. These hospitalizations were classified into males and females. The main outcomes of the study were inhospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission. Any length of stay >=75th percentile value for the entire cohort was considered as prolonged length of stay. Logistic regression analyses after adjusting for covariates were used to compare COVID-19 related outcomes between males and females. Result(s): A total of 95,180 primary COVID-19 hospitalizations were included for the analysis. Of these 52465 (55.1%) were males and 42715 (44.9%) were females. Among these hospitalizations, mortality (12.4% versus 10.1%, P<0.001), prolonged length of stay (30.6% versus 25.8%, P<0.001), vasopressor use (2.6% versus 1.6%, P<0.001), mechanical ventilation (11.8% versus 8.0%, P<0.001), and ICU admission (11.4% versus 7.8%, P<0.001) were significantly higher among males. Logistics regression analysis showed that males had significantly greater odds for mortality (aOR, 1.38, 95% CI: 1.32-1.44), prolonged length of stay (aOR, 1.35, 95% CI: 1.31-1.39), vasopressor use (aOR, 1.59, 95% CI: 1.51-1.66), mechanical ventilation (aOR, 1.62, 95% CI: 1.47- 1.78), and ICU admission (aOR, 1.58, 95% CI: 1.51-1.66). Conclusion(s): Adverse outcomes such as mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission were independently associated with male sex. These findings could be due differences to both biological and social factors between the sexes. Future studies should explore these factors to efficiently control COVID-19.

8.
Academia-Revista Latinoamericana De Administracion ; 2023.
Article in English | Web of Science | ID: covidwho-2191297

ABSTRACT

PurposeThe importance of workers in labour-intensive industries, such as tourism, is undeniable. In this sense, it has been investigated for decades from various methodological approaches. However, in the academic literature on tourism, the partial least squares-structural equation modelling (PLS-SEM) technique has hardly been used.Design/methodology/approachTherefore, this work uses that technique to contrast which factors define the employees' wages in the Spanish tourism industry. Additionally, an importance-performance map analysis (IPMA) analysis is carried out, which provides informed decision-making.FindingsThus, the main results obtained are the verification and measurement of the relationships of Human Capital, Labour Conditions and Market with Wages, and the relation between Human Capital and Labour Conditions. Besides, the improvement points in each variable are identified. Especial emphasis is given to those related to Human Capital and, partially, to the Market.Research limitations/implicationsHowever, there are certain limitations to this study. Mainly, as the indicators used are given by the 2018 Salary Structure Survey, they are stiff and so the design of the model turns to be more difficult.Originality/valueConsidering the turning point that the temporary cessation of the tourism industry activity due to the COVID-19 pandemic has been, it is essential to take advantage of it to identify and correct existing deficiencies. Therefore, this work aims to be a base document for the identification of these problems.

9.
Open Forum Infectious Diseases ; 9(Supplement 2):S473-S474, 2022.
Article in English | EMBASE | ID: covidwho-2189765

ABSTRACT

Background. In November 2020, the FDA issued an Emergency Use Authorization (EUA) for casirivimab-imdevimab (CAS-IMD) for the treatment of mild to moderate coronavirus disease 2019 (COVID-19) in certain high-risk patients. CAS-IMD is a monoclonal antibody cocktail that binds to COVID-19 spike protein receptor. Delta was the predominant strain in the US at the time. The purpose of this study is to evaluate if CAS-IMD administration to COVID-19 patients in the emergency department (ED) resulted in fewer hospitalizations and re-admissions. Methods. A retrospective chart review was conducted at Cleveland Clinic Martin Health which is composed of 3 hospitals and 1 free-standing ED. Patients with COVID-19 who met criteria for CAS-IMD in the ED from June 2021 to December 2021 were randomized into those who received CAS-IMD and those who did not. Patients were excluded if they had COVID-19 symptoms for >10 days or met EUA exclusion criteria for CAS-IMD. Cases and controls were matched by propensity score which was calculated by a logistic regression model including age, body mass index (BMI), sex, race and comorbidities. The primary outcome was the percentage of patients discharged from the ED who were hospitalized for COVID-19-related symptoms within 30 days. Secondary outcomes included number of CAS-IMD infusion-related reactions, ED return rate and subset analyses of severity of illness in the hospitalized. Statistical analyses were performed using two-sample t test or Wilcoxon rank sum test for continuous variables based on distribution, and Chi-square test or Fisher's exact test for categorical variables. Conditional logistic regression was used to compare the odds of hospitalization between groups. Results. Patients (N = 176) were matched 1:1 in each group. Eleven (12.5%) of the case group were hospitalized within 30 days of ED discharge vs. 36 (40.9%) in the control group. The odds of hospitalization in the CAS-IMD group were 81% lower than the control group (OR 0.19, 95% CI: 0.081-0.46, p< 0.001). After adjustment of covariates, the adjusted odds ratio remained significant (OR 0.12, 95% CI: 0.025-0.57, p=0.008). Conclusion. CAS-IMD use for mild-to-moderate COVID-19 infection in ED patients was associated with a lower incidence of hospitalization.

10.
Open Forum Infectious Diseases ; 9(Supplement 2):S473, 2022.
Article in English | EMBASE | ID: covidwho-2189764

ABSTRACT

Background. Severe coronavirus disease 2019 (COVID-19) is associated with respiratory failure as well as thromboembolic and cardiovascular complications from dysregulated immune responses. Baricitinib (BAR), a Janus kinase (JAK) inhibitor, and tocilizumab (TZB), a monoclonal anti-interleukin-6 (IL-6) receptor antibody, earned Emergency Use Authorizations (EUA) from the Food and Drug Administration (FDA) for the treatment of COVID-19. This study aims to compare the effects of BAR and TZB in severe COVID-19. Methods. A retrospective chart review of patients admitted to Cleveland Clinic Martin Health with COVID-19 having received TZB or BAR was completed between 07/01/20 to 12/31/21. Exclusion criteria included patients who had received both agents in the same admission, received fewer than 5 doses of remdesivir, or were pregnant. The primary objective was to evaluate in-hospitalmortality. For secondary outcomes, hospital length of stay (LOS), intensive care unitLOS, readmission due to respiratory-related causes, progression to mechanical ventilation (MV) and CRP levels upon discharge or death were assessed. Safety outcomes were described by incidences of superimposed bacterial infections, thrombosis, and herpes simplex virus reactivation. Results. After adjustment of sex and CRP level, the odds of death in TZB was 86% higher than that of BAR group (OR 1.86, 95%CI 1.17-2.96, p=0.009). TZB group had more females (45% vs. 34%, p=0.036) and longer LOS (median [IQR]: 15 [10,23] vs. 13 [9,20], p=0.0390). TZB group had more organ support (47% vs. 29%, p< 0.001), more ICU admission and longer ICU LOS, moreMVprogression and longer duration of MV (36% vs. 22%, p=0.007;0[0,9] vs. 0[0,2], p< 0.001). TZB had more additional source of infection (25% vs. 16%, p=0.043) and more positive microbiology from blood (10% vs. 3%, p=0.009). Conclusion. Our findings suggest that BAR may have lower rates of in-hospital mortality when compared to TZB. TZB was also found to have higher needs for organ support. Superimposed infections, thrombosis, and HSV reactivation were similar in both groups. Larger randomized studies comparing these agents are needed.

11.
Blood Cancer Journal ; 13(1):8, 2023.
Article in English | MEDLINE | ID: covidwho-2185781

ABSTRACT

The long-term clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has been little explored. A prospective multicenter registry-based cohort study conducted from December 2020 to July 2022 by the Spanish Transplant and Cell Therapy group, was used to analyze the relationship of antibody response over time after full vaccination (at 3-6 weeks, 3, 6 and 12 months) (2 doses) and of booster doses with breakthrough SARS-CoV-2 infection in 1551 patients with hematological disorders. At a median follow-up of 388 days after complete immunization, 266 out of 1551 (17%) developed breakthrough SARS-CoV-2 infection at median of 86 days (range 7-391) after full vaccination. The cumulative incidence was 18% [95% confidence interval (C.I.), 16-20%]. Multivariate analysis identified higher incidence in chronic lymphocytic leukemia patients (29%) and with the use of corticosteroids (24.5%), whereas female sex (15.5%) and more than 1 year after last therapy (14%) were associated with a lower incidence (p < 0.05 for all comparisons). Median antibody titers at different time points were significantly lower in breakthrough cases than in non-cases. A serological titer cut-off of 250 BAU/mL was predictive of breakthrough infection and its severity. SARS-CoV-2 infection-related mortality was encouragingly low (1.9%) in our series. Our study describes the incidence of and risk factors for COVID-19 breakthrough infections during the initial vaccination and booster doses in the 2021 to mid-2022 period. The level of antibody titers at any time after 2-dose vaccination is strongly linked with protection against both breakthrough infection and severe disease, even with the Omicron SARS-CoV-2 variant.

12.
Enfermeria Intensiva ; 2022.
Article in English, Spanish | Scopus | ID: covidwho-2178439

ABSTRACT

Aims: To identify risk factors present in patients with dysphagia in a population of critically ill patients. Methods: Case series of a cohort of patients recruited in the intensive care unit (ICU) until hospital discharge. Patients who gave consent and met the inclusion criteria were recruited. The Volume-Viscosity clinical examination method was used for the screening of dysphagia. An uni- and bivariate statistical analysis was performed using odds ratio (OR) to detect risk factors for dysphagia. Outcomes: 103 patients were recruited from 401 possible. The mean age was 59,33±13,23, men represented 76,7%. The severity of the sample was: APACHE II (12,74±6,17) and Charlson (2,98±3,31). 45,6% of patients showed dysphagia, obtaining significant OR values (p<0,050) for the development of dysphagia: older age, neurological antecedents, COVID19, long stay in ICU and hospitalization, and the presence of tracheotomy. COVID19 patients represented 46,6% of the sample, so an analysis of this subgroup was performed, showing similar results, with a Charlson risk (OR:4,65;95% CI:1,31-16,47;p=0,014) and a hospital stay (OR: 8,50;95%CI: 2,20-32,83;p<0,001). On discharge from the ICU, 37,9% of the population still had dysphagia;12,6% maintained this problem at hospital discharge. Conclusions: Almost half of our patients developed dysphagia. Clinical severity and the presence of tracheotomy were risk factors. We observed in patients with dysphagia a longer stay in both ICU and hospitalization. © 2022 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC)

13.
Enfermería Intensiva ; 2022.
Article in English | ScienceDirect | ID: covidwho-2165272

ABSTRACT

Resumen Objetivos Determinar los factores de riesgo presentes en los pacientes con disfagia en relación con una población de pacientes críticos. Método Serie de casos de una cohorte de pacientes reclutados en la unidad de cuidados intensivos (UCI) hasta el alta hospitalaria. Se reclutaron a aquellos pacientes que dieron su consentimiento y cumplían los criterios de inclusión. El método de exploración clínica Volumen-Viscosidad fue utilizado para la detección de la disfagia. Se realizó un análisis estadístico uni- y bivariante, a través del odds ratio (OR) para detectar los factores de riesgo en la disfagia. Resultados 103 pacientes fueron reclutados de 401 posibles. La media de edad fue de 59,33±13,23;los hombres representaban el 76,7%. La gravedad media fue: APACHE II (12,74±6,17) y Charlson (2,98±3,31). Un 45,6% de los pacientes desarrollaron disfagia, obteniendo valores significativos de OR (p<0,050) para el desarrollo de disfagia: la mayor edad, los antecedentes neurológicos, COVID19, la alta estancia en UCI y hospitalización y la presencia de traqueotomía. Los pacientes COVID19 representaban el 46,6%, por lo que se realizó un análisis de este subgrupo observando resultados similares, con un riesgo de Charlson (OR:4,65;IC95%: 1,31-16,47;p=0,014) y una estancia hospitalaria (OR: 8,50;IC95%: 2,20-32,83;p<0,001). Al alta de UCI, el 37,9% de la población presentaba todavía disfagia, y mantenía este problema al alta hospitalaria el 12,6%. Conclusiones Casi la mitad de nuestros pacientes presentaron disfagia. Fueron factores de riesgo la gravedad clínica y la presencia de traqueotomía. Se observó en estos pacientes una mayor estancia tanto en UCI como en hospitalización. Aims To identify risk factors present in patients with dysphagia in a population of critically ill patients. Methods Case series of a cohort of patients recruited in the intensive care unit (ICU) until hospital discharge. Patients who gave consent and met the inclusion criteria were recruited. The Volume-Viscosity clinical examination method was used for the screening of dysphagia. An uni- and bivariate statistical analysis was performed using odds ratio (OR) to detect risk factors for dysphagia. Outcomes 103 patients were recruited from 401 possible. The mean age was 59,33±13,23, men represented 76,7%. The severity of the sample was: APACHE II (12,74±6,17) and Charlson (2,98±3,31). 45,6% of patients showed dysphagia, obtaining significant OR values (p<0,050) for the development of dysphagia: older age, neurological antecedents, COVID19, long stay in ICU and hospitalization, and the presence of tracheotomy. COVID19 patients represented 46,6% of the sample, so an analysis of this subgroup was performed, showing similar results, with a Charlson risk (OR:4,65;95% CI:1,31-16,47;p=0,014) and a hospital stay (OR: 8,50;95%CI: 2,20-32,83;p<0,001). On discharge from the ICU, 37,9% of the population still had dysphagia;12,6% maintained this problem at hospital discharge. Conclusions Almost half of our patients developed dysphagia. Clinical severity and the presence of tracheotomy were risk factors. We observed in patients with dysphagia a longer stay in both ICU and hospitalization.

17.
European journal of public health ; 32(Suppl 3), 2022.
Article in English | EuropePMC | ID: covidwho-2101623

ABSTRACT

Background Different socioeconomic aspects have been related to mortality from COVID-19. For this reason, the objective of this study was to analyze the association between the Multidimensional Poverty Measure at the municipal level (MPM) and the clinical outcome of mortality in the resident population of Colombia with a diagnosis of COVID-19. Methods Observational, non-concurrent cohort study of confirmed cases of COVID-19 reported in Colombia by August 2021. The main outcome variable was mortality from COVID-19, and the main exposure variable was MPM. The covariates included in the analysis were patient's sex, age, and municipality of residence. Unadjusted and adjusted logistic models were used using balanced random samples of deaths and recovered patients, calculating odds ratios (OR) and 95% confidence interval ranges (CI). Results In total, 4,194,538 cases of COVID-19 were included in the analysis, of which approximately 3% died. According to the adjusted multivariate analysis, it was found that patients who live in municipalities with an MPM between 20 to 40%, 41 to 60%, 61 to 80% and more than 80% had an OR of 1.6 (95% CI 1.4 to 1.8), 1.6 (95% CI 1.3 to 1.9), 1.7 (95% CI 1.2 to 2.5), and 2.2 (95% CI 0.7 to 7.8), respectively, for mortality from COVID-19 compared with an MPM of less than 20%. When analyzing the data according to sex for the MPM from 20 to 40%, 41 to 60%, 61 to 80% and more than 80%, an OR for women of 1.7 (95% CI 1.5 to 2.0), 1.8 (95% CI % 1.5 to 2.1), 1.9 (95% CI 1.3 to 2.6) and 2.8 (CI 0.9 to 10.1) respectively. For men an OR of 1.5 (95% CI 1.3 to 1.7), 1.4 (95% CI 1.2 to 1.7), 1.6 (95% CI 1.1 to 2.3) and 1.9 (95% CI 0.6 to 6.0) respectively compared to a MPM less than 20%. Conclusions The risk of mortality from COVID-19 in Colombia is increased in populations with higher MPM. Social determinants of health have an important effect on the outcomes of COVID-19. Key messages Only a few studies exist in South America on social determinants in health and COVID-19. This study provides evidence to understand the impact of poverty measures on mortality in COVID-19 patients. Multidimensional poverty measure at the municipal level was associated with increased COVID-19 mortality in a large cohort of patients from the Colombian population.

18.
Acta Colombiana de Cuidado Intensivo ; 22:S1-S10, 2022.
Article in English, Spanish | Scopus | ID: covidwho-2094965

ABSTRACT

Introduction: The inclusion of non-invasive ventilatory support systems in the management of ARDS in adults during the current pandemic, has been a lifeline given the lack of resources in the current international health situation. Systems such as the high flow nasal cannula have proven not to be just a temporary ventilatory system while awaiting invasive mechanical ventilation, on the contrary it has been shown that the high flow nasal cannula is an effective therapy tool in ARDS. Objective: To provide an easy guideline for the management of high-flow cannulas in hospitalized patients with severe pneumonia due to ATS criteria secondary to SARS COV2-COVID 19. Materials and methods: This is a prospective, single-centre observational study, including 59 patients, all with a diagnosis of SARS-CoV-2-related pneumonia between January and April 2021. The patients were initially managed in an intermediate care unit with high nasal cannula flow (HFNC). Results: We were able to show that there is a statistically significant correlation between age > 65 years and respiratory rate ≥28 and mortality;likewise, between age > 50 years, NEWS > 6 and again a respiratory rate ≥28 with treatment failure. Conclusions: HFNC in respiratory failure related to coronavirus disease 2019 should become a viable management alternative, particularly in settings with limited access to intensive care unit resources, taking the indications into account and recognizing that a high percentage of patients who receive it can be successfully weaned without the need for invasive mechanical ventilation. © 2022 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo

19.
Revista Latinoamericana De Estudios De Familia ; 14(1):51-72, 2022.
Article in Spanish | Web of Science | ID: covidwho-2072281

ABSTRACT

The objective of this paper is to analyze the socio-family aspects affecting mental health in Social Work students of the Fundacion Universitaria Juan de Castellanos during the confinement caused by Covid-19. Regarding the methodology, a descriptive study was carried out with a sample of 119 students. The instruments used were a socio-family characterization questionnaire, the Suicide Risk questionnaire, the family Apgar test, and the SRQ. The results show that university students present mental health conditions due to symptoms of depression and anxiety, in addition to difficulties due to academic activities and confinement. The role of the family is highlighted as a protective factor against the pandemic. An adequate family functioning is perceived by the students when they have coping strategies against crises. However, it is necessary to strengthen the response capacity for accompanying university students and families with higher level of vulnerability.

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