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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-317569

ABSTRACT

Background: Environmental factors play a central role in seasonal epidemics. SARS-CoV-2 infection in Spain has shown a heterogeneous geographical pattern This study aimed to assess the influence of several climatic factors on the infectivity of SARS-CoV-2 and the severity of COVID-19 among the Spanish Autonomous Communities (AA.CC.). Methods: : Data on coronavirus infectivity and severity of COVID-19 disease, as well as the climatic variables were obtained from official sources (Ministry of Health and Spanish Meteorological Agency, respectively). To assess the possible influence of climate on the development of the disease, data on ultraviolet radiation (UVR) were collected during the months before the start of the pandemic. To analyze its influence on the infectivity of SARS-CoV-2, data on UVR, temperature, and humidity were obtained from the months of highest contagiousness to the peak of the pandemic. Results: : From October 2019 to January 2020, mean UVR was significantly related not only to SARS-CoV-2 infection (cumulative incidence -previous 14 days- x10 5 habitants, rho =-0.0,666;p =0.009), but also with COVID-19 severity, assessed as hospital admissions ( rho =-0.626;p =0.017) and ICU admissions ( rho =-0.565;p =0.035). Besides, temperature (February: rho =-0.832;p <0.001 and March: rho =-0.904;p <0.001), was the main climatic factor responsible for the infectivity of the coronavirus and directly contributed to a different spread of SARS-CoV-2 across the Spanish regions. Conclusions: : Climatic factors may partially explain the differences in COVID-19 incidence and severity across the different Spanish regions. The knowledge of these factors could help to develop preventive and public health actions against upcoming outbreaks of the disease.

2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-310911

ABSTRACT

​Background: The development of mRNA vaccines to prevent SARS-CoV-2 has been remarkably successful, with highly effective vaccines available less than one year after confirming the first case. Due to the global burden of COVID-19 on health systems, emergency approval was attained after clinical trials with relatively small sample sizes and short follow-up periods. Limited information exists about the incidence of adverse events following immunisation (AEFI), particularly neurologic ones. Here, we describe the neurologic AEFI reported by recipients of the BNT162b2 mRNA COVID-19 vaccine. Methods: We conducted a prospective observational cohort using de-identified information from a database of all systemic and neurologic AEFI reported to the Mexican Ministry of Health throughout a passive Epidemiological Surveillance System by first-dose vaccine recipients, from December 24, 2020 to February 12, 2021. The cut-off date for this data was February 18, 2021. We performed descriptive analyses on demographics, timing from vaccination to AEFI development, event duration, and current outcome.Findings: Nationwide, 704 003 first-doses were administered;6536 AEFI were reported. Among those, 4258 (65·1%) had at least one neurologic manifestation. Non-serious neurologic AEFI occurred in 99·6%. Headache (62·2%), transient sensory symptoms (3·5%), and weakness (1%) were the most frequent. Thirty-three serious AEFI were reported, of which 17 (2·4/100 000 doses) were neurologic, seven seizures, four functional syndromes, three Guillain-Barré syndrome (GBS) cases, and two of acute transverse myelitis. All GBS cases were related to a gastrointestinal infection before vaccination, 3/7 seizure episodes were related to poor antiepileptic drug compliance, and 2/7 to anaphylactic reactions. At the time of this report, 16/17 cases of serious neurologic AEFI had been discharged with no observed deaths.Interpretation: Our data suggest that the BNT162b2 mRNA vaccine is effective and safe. Their individual and societal benefits outweigh the low-percentage of serious neurologic and non-neurologic AEFI.Funding: Consejo Nacional de Ciencia y Tecnología, México.Declaration of Interest: None to declareEthical Approval: The study was revised and approved by the Ethics and Research Committees of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (Ref. NER-3667-2021) and the Mexican Ministry of Health.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308574

ABSTRACT

Background: . - It is known that patients with COVID-19 are at increased risk of thrombosis. Although COVID-19 infection primarily affects the lower respiratory tract system, emerging reports suggest direct and indirect cardiovascular complications. However, the key mechanisms under thrombosis development at great arterial vessels are still unclear. Case presentation . – We report the cases of 4 patients who were admitted to our hospital and suffered from arterial thrombotic complications. All of them were older than 60 years and only 1 did not have cardiovascular risk factors. It should be noted that days prior to the diagnosis of arterial thrombosis, 3 of the 4 patients were under anticoagulant treatment. It is also interesting that in contrast to already known typical microvascular locations, our patients suffered from large arterial vessels thrombosis. Furthermore, none of them would present with severe respiratory symptoms. Conclusions: . – The underlying mechanism of COVID-19-associated arterial thrombosis remains unclear and might be independent of the cytokine storm that occurs in patients with COVID-19-associated venous thrombosis. Also, the role of anti-platelets agents as prophylactic treatment in high-risk patients remains unclear. Multicenter clinical trials are necessary to clarify these issues.

4.
Iatreia ; 35(1):29-39, 2022.
Article in Spanish | ProQuest Central | ID: covidwho-1662908

ABSTRACT

Introducción: el personal de salud involucrado en la atención odontológica tiene alto riesgo de contagio por exposición constante a aerosoles durante la atención de urgencias. Es necesario incrementar sus medidas de protección personal durante la pandemia por SARS-CoV-2. Objetivo: describir la experiencia de odontólogos, auxiliares y pacientes respecto al uso de un dispositivo de barrera para contención de aerosoles en la atención de urgencias odontológicas. Materiales y métodos: estudio descriptivo de corte transversal con 21 pacientes adultos atendidos por urgencias odontológicas en una institución privada durante el mes de junio en la ciudad de Bogotá. Los 21 pacientes, cinco odontólogos tratantes y cinco auxiliares de odontología diligenciaron un cuestionario estructurado sobre la experiencia con el dispositivo, medidas de bioseguridad implementadas y percepción de seguridad respecto al posible contagio del virus. Resultados: la edad promedio de los pacientes fue 41 años (DE±14). La duración de los procedimientos fue de 45 minutos (DE±12) en promedio. No hubo eventos adversos durante los procedimientos con el uso del dispositivo. El 95 % de los pacientes se sintieron más seguros durante la atención con el uso del dispositivo de barrera. Conclusiones:  a pesar de la muestra limitada, la alta percepción de seguridad respecto al uso del dispositivo en la atención de urgencias odontológicas reportada aquí, sugiere que pueden llegar a complementar las medidas de bioseguridad y equipos de protección personal establecidos por autoridades sanitarias durante la pandemia.Alternate : Introduction: Health personnel involved in dental care are at high risk of contagion from constant exposure to aerosols during emergency care. It is necessary to increase its protection measures during the SARS-CoV-2 pandemic. Objective: Describe the experience of dentists, assistants and patients regarding the use of a barrier device to contain aerosols in dental emergency care. Materials and methods: A descriptive cross-sectional study with 21 adult patients attended by dental emergencies in a private institution during June in the city of Bogotá. The 21 patients, five treating dentists and five dental assistants filled out a structured questionnaire about the experience with the device, the biosafety measures implemented and the perception of safety regarding the possible contagion of the virus. Results: The mean age of the patients was 41 years (SD ± 14). The duration of the procedures was 45 minutes (SD ± 12) on average. There were no adverse events during the procedures with the use of the device. 95% of patients felt safer during care with the use of the barrier device. Conclusions: Despite the limited sample, the high perception of safety regarding the use of the device in dental emergency care reported here suggests that they may complement the biosecurity measures and personal protective equipment established by health authorities during the pandemic.

5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296992

ABSTRACT

ABSTRACT Background Worldwide, it has been observed that there is a strong association between the severity of COVID-19 and with being over 40 years of age, having diabetes mellitus (DM), hypertension and/or obesity. Objective To compare the probability of death caused by COVID-19 in patients with comorbidities during three periods defined for this study as follows: first wave (March 23 to July 12, 2020), interwave period (July 13 to October 25, 2020), and the second wave (October 26, 2020, to March 29, 2021) using the different fatality rates observed in Mexico City. Methods The cohort studied included individuals over 20 years of age. During the first wave (symptomatic), the interwave period, and the second wave (symptomatic and asymptomatic), participants were diagnosed using nasopharyngeal swabs taken in kiosks. Symptomatic individuals with risk factors for serious disease or death were referred to hospital. SARS-CoV-2 infection was defined by real time polymerase chain reaction in all hospitalized patients. All data from hospitalized patients and outpatients were added to the SISVER database. Results The total cohort size for this study was 2,260,156 persons (having a mean age of 43.1 years). Of these, 8.6% suffered from DM, 11.6% from hypertension, and 9.7% from obesity. Of the total of 2,260,156 persons, 666,694 tested positive (29.5%) to SARS CoV-2, (with a mean age of 45). During the first wave, 82,489 tested positive;in the interwave period, 112,115;and during the second wave, 472,090. That is, a considerable increase in the number of cases of infection was observed in all age groups between the first and second waves (an increase of +472% on the first wave). Of the infected persons, a total of 85,587 (12.8%) were hospitalized: 24,023 in the first wave (29.1% of those who tested positive in this period);16,935 (15.1%) during the interwave period, and 44,629 (9.5%) in the second wave, which represents an increase of 85.77% on the first wave. Of the hospitalized patients, there were 42,979 deaths (50.2% of those hospitalized), in the first wave, 11,964 (49.8% of those hospitalized in this period), during the interwave period, 6,794 (40.1%), and in the second wave 24,221 (54.3%), an increase of +102.4% between the first wave and the second. While within the general population, the probability of a patient dying having both COVID-19 and one of the specified comorbidities (DM, obesity, or arterial hypertension) showed a systematic reduction across all age groups, the probability of death for a hospitalized patient with comorbidities increased across all age groups during the second wave. When comparing the fatality rate of hospitalized COVID-19 patients in the second wave with those of the first wave and the interwave period, a significant increase was observed across all age groups, even in individuals without comorbidities. Conclusion The data from this study show a considerable increase in the number of detected cases of infection in all age groups between the first and second waves. In addition, 12.8% of those infected were hospitalized for severe COVID-19, representing an increase of +85.9% from the first wave to the second. A high mortality rate was observed among hospitalized patients (>50%), as was a higher probability of death in hospitalized COVID-19 patients with comorbidities for all age groups during the second wave, although there had been a slight decrease during the interwave period. SUMMARY BOX What is already known? Worldwide the resurging of COVID-19 cases in waves has been observed. In Mexico, like in the rest of the world, we have observed surges of SARS CoV-2 infections, COVID-19 hospitalizations and fatal outcomes followed by decreases leading to local minima. Pre-existing health conditions such as being older, having diabetes mellitus (DM), hypertension and/or obesity has been observed to be associated with an increase in the severity of COVID-19. What are the new findings? Between the first and second w ves, considerable increases were observed in the number of detected cases of infection (+472%), in the number of hospitalized subjects (+85.9%), and the number of hospitalized subjects and deaths (+102.4%) in all age groups. When analysing only hospitalized individuals, with or without comorbidities, the Case Fatality Rate was high (50.2%), the probability of death increased considerably in all age groups between the first and second waves. This increase was more noticeable in those individuals with previously identified comorbidities (DM, hypertension, or obesity). An increased probability of death among individuals without comorbidities was observed between the first and second waves. What do the new findings imply? During the second wave, demand for hospitalization increased, magnifying the impact of age and comorbidities as risk factors. This situation highlights the importance of decreasing the prevalence of comorbidities among the population.

6.
Preprint in English | medRxiv | ID: ppmedrxiv-21266871

ABSTRACT

Comprehensive data on transmission mitigation behaviors and both SARS-CoV-2 infection and serostatus are needed from large, community-based cohorts to identify COVID-19 risk factors and the impact of public health measures. From July 2020-March 2021, approximately 5,500 adults from the East Bay Area, California were followed over three data collection rounds to investigate the association between geographic and demographic characteristics and transmission mitigation behavior with SARS-CoV-2 prevalence. We estimated the populated-adjusted prevalence of antibodies from SARS-CoV-2 infection and COVID-19 vaccination, and self-reported COVID-19 test positivity. Population-adjusted SARS-CoV-2 seroprevalence was low, increasing from 1.03% (95% CI: 0.50-1.96) in Round 1 (July-September 2020), to 1.37% (95% CI: 0.75-2.39) in Round 2 (October-December 2020), to 2.18% (95% CI: 1.48-3.17) in Round 3 (February-March 2021). Population-adjusted seroprevalence of COVID-19 vaccination was 21.64% (95% CI: 19.20-24.34) in Round 3, with Whites having 4.35% (95% CI: 0.35-8.32) higher COVID-19 vaccine seroprevalence than non-Whites. No evidence for an association between transmission mitigation behavior and seroprevalence was observed. Despite >99% of participants reporting wearing masks, non-Whites, lower-income, and lower-educated individuals had the highest SARS-CoV-2 seroprevalence and lowest vaccination seroprevalence. Results demonstrate that more effective policies are needed to address these disparities and inequities.

7.
International Journal of Entrepreneurship ; 25:1-3, 2021.
Article in English | ProQuest Central | ID: covidwho-1370102

ABSTRACT

[...]the need to empirically study the cause-effect relationship exerted by socio-demographic, economic, cultural or political variables on the happiness of entrepreneurs (Ravina-Ripoll et al., 2020). [...]the difficulty of considering the happiness of this human capital as an element that facilitates the creation of innovative and high-quality products or services (Lee, 2019). What factors lead people to be happy entrepreneurs, does the type of business activity that an entrepreneur carries out have an impact on their level of subjective well-being, does the entrepreneurial spirit of individuals have its origin in improving their status quo of psychological and economic happiness, and how can the creation of social value generated by happy entrepreneurs be measured? JUSTIFICATION As is well known, the multidimensional study of the concept of entrepreneurship basically involves the disciplines of sociology, business organization and psychology.

8.
Leukemia ; 35(10): 2885-2894, 2021 10.
Article in English | MEDLINE | ID: covidwho-1253922

ABSTRACT

This study reports on 382 COVID-19 patients having undergone allogeneic (n = 236) or autologous (n = 146) hematopoietic cell transplantation (HCT) reported to the European Society for Blood and Marrow Transplantation (EBMT) or to the Spanish Group of Hematopoietic Stem Cell Transplantation (GETH). The median age was 54.1 years (1.0-80.3) for allogeneic, and 60.6 years (7.7-81.6) for autologous HCT patients. The median time from HCT to COVID-19 was 15.8 months (0.2-292.7) in allogeneic and 24.6 months (-0.9 to 350.3) in autologous recipients. 83.5% developed lower respiratory tract disease and 22.5% were admitted to an ICU. Overall survival at 6 weeks from diagnosis was 77.9% and 72.1% in allogeneic and autologous recipients, respectively. Children had a survival of 93.4%. In multivariate analysis, older age (p = 0.02), need for ICU (p < 0.0001) and moderate/high immunodeficiency index (p = 0.04) increased the risk while better performance status (p = 0.001) decreased the risk for mortality. Other factors such as underlying diagnosis, time from HCT, GVHD, or ongoing immunosuppression did not significantly impact overall survival. We conclude that HCT patients are at high risk of developing LRTD, require admission to ICU, and have increased mortality in COVID-19.


Subject(s)
COVID-19/complications , Hematologic Neoplasms/therapy , Hematopoietic Stem Cell Transplantation/methods , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/virology , Child , Child, Preschool , Female , Follow-Up Studies , Hematologic Neoplasms/epidemiology , Hematologic Neoplasms/virology , Humans , Infant , Male , Middle Aged , Prognosis , Prospective Studies , Survival Rate , Transplantation, Homologous , Young Adult
9.
Interactive Learning Environments ; : 1-14, 2021.
Article in English | Academic Search Complete | ID: covidwho-1189374

ABSTRACT

This paper aims to present empirical evidence that supports and quantifies the relationships among the following features in a Mexican university: interactive collaboration software tools used in online classes, the perceived presence of instructors, student engagement, and student satisfaction with online classes during the COVID-19 lockdown. We collected data from 1417 participants from five different academic programs using a survey method. Data were analyzed using SPSS v25 and WarpPLS. Findings show that the interactive communication tool has a positive impact on perceived instructor presence, which also positively impacts student engagement and satisfaction. These relationships were also found to be true after analyzing each academic program. Therefore, both the interactive communication tool and the instructor play important roles in the online learning process because they positively influence student engagement and satisfaction. Our results are consistent with previous work conducted before the pandemic and contribute to understanding the teaching and learning process during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR] Copyright of Interactive Learning Environments is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

10.
Ocean & Coastal Management ; 208:105588, 2021.
Article in English | ScienceDirect | ID: covidwho-1157639

ABSTRACT

This paper describes the methodology followed to implement social distancing recommendations in the COVID-19 context along the beaches of the coast of Gipuzkoa (Basque Country, Northern Spain) by means of automated coastal videometry. The coastal videometry network of Gipuzkoa, based on the KostaSystem technology, covers 14 beaches, with 12 stations, along 50 km of coastline. A beach user detection algorithm based on a machine learning approach has been developed allowing for automatic assessment of beach attendance in real time at regional scale. For each beach, a simple classification of occupancy (low, medium, high, and full) was estimated as a function of the beach user density (BUD), obtained in real time from the images and the maximum beach carrying capacity (BCC), estimated based on the minimal social distance recommended by the authorities. This information was displayed in real time via a web/mobile app and was simultaneously sent to beach managers who controlled the beach access. The results showed a strong receptivity from beach users (more than 50.000 app downloads) and that real time information of beach occupation can help in short-term/daily beach management. In the longer term, the analysis of this information provides the necessary data for beach carrying capacity management and can help the authorities in controlling and in determining their maximum capacity.

11.
Open Respiratory Archives ; : 100097, 2021.
Article in Spanish | ScienceDirect | ID: covidwho-1144887

ABSTRACT

Resumen La Sociedad Española de Neumología y Cirugía Torácica (SEPAR) ha elaborado este documento de recomendaciones sobre la vacuna COVID-19 en las enfermedades respiratorias con el objetivo de ayudar al personal sanitario en la toma de decisiones sobre cómo actuar en la vacunación por COVID-19 de estos pacientes. Las recomendaciones han sido elaboradas por un grupo de expertos en la materia tras la revisión de la literatura recopilada hasta el 7 de marzo de 2021, y de la información aportada por distintas sociedades científicas, agencias del medicamento y estrategias de organismos gubernamentales hasta esa fecha. Podemos concluir que las vacunas para la COVID-19 no sólo son seguras y eficaces, sino que en aquellos pacientes vulnerables con enfermedades respiratorias crónicas es prioritaria. Además, la implicación activa de los profesionales sanitarios que manejan estas patologías en la estrategia de vacunación es clave para lograr una buena adherencia y coberturas vacunales elevadas. The Spanish Society of Pneumonology and Thoracic Surgery (SEPAR) has elaborated this document of recommendations for COVID-19 vaccination in patients with respiratory diseases aimed to help healthcare personnel make decisions about how to act in case of COVID-19 vaccination in these patients. The recommendations have been developed by a group of experts in this field after reviewing the materials published up to March 7, 2021, the information provided by different scientific societies, drug agencies and the strategies of the governmental bodies up to this date. We can conclude that COVID-19 vaccines are not only safe and effective, but also prior in vulnerable patients with chronic respiratory diseases. In addition, an active involvement of healthcare professionals, who manage these diseases, in the vaccination strategy is the key to achieve good adherence and high vaccination coverage.

12.
Archivos españoles de urología ; 73(5):463-470, 2020.
Article in Spanish | IBECS | ID: covidwho-1016698

ABSTRACT

OBJETIVO: La pandemia provocada por el nuevo coronavirus SARS-CoV-2 ha tenido una elevada repercusión sobre la cirugía mínimamente invasiva (CMI). Ha surgido una importante controversia sobre la realización de CMI durante la pandemia COVID-19. Es prioritario, establecer un consenso sobre la organización y realización con seguridad de la CMI durante la pandemia. MATERIAL Y MÉTODOS: Se realizó una búsqueda web y en PubMed con los términos: "SARS-CoV-2", "COVID19", "COVID19 Urology", "COVID19 Surgery", "COVID19 transmission", "SARS-CoV-2 transmission", "COVID19 and minimally invasive surgery", "SARSCoV-2 and CO2 insuflation". Se realizó una revisión narrativa de la literatura y una síntesis de la evidencia disponible. Se ha utilizado una técnica de grupo nominal modificada, circulando un primer borrador a todos los autores y aprobándose la versión definitiva el día 26 de Mayo de 2020. RESULTADOS: No existe evidencia sobre una mayor exposición a SARS-CoV-2 en CMI respecto a cirugía abierta. La CMI se asocia a una menor estancia hospitalaria por lo que cambiar, sin justificación, la indicaciónde CMI puede retrotraer recursos que podrían ser utilizados para la pandemia COVID-19. Se debe priorizar la CMI según los recursos disponibles y la intensidad de la pandemia en cada momento. Se recomienda realizar despistaje de SARS-CoV-2 mediante cuestionario clínico-epidemiológico y PCR nasofaríngea 72 horas antes de la CMI electiva, para minimizar las complicaciones postoperatorias, evitar la transmisión cruzada entre pacientes y la posible exposición de los profesionales sanitarios. Se recomienda establecer medidas de organización en quirófano, de protección personal, técnica quirúrgica y manejo del CO2 y aerosoles generados para reducir la exposición y riesgos del personal sanitario. CONCLUSIONES: La CMI realizada con las medidasd e seguridad adecuadas para el paciente y profesionales, puede contribuir durante la desescalada a una menor utilización de recursos sanitarios y por tanto, no debe limitarse su utilización o cambiar sus indicaciones OBJECTIVE: SARS-CoV-2 pandemic has high repercussion on urologic minimally invasive surgery (MIS). Controversy about safety of MIS procedures during COVID-19 pandemic has been published. Nowadays, our priority should be create agreement in order to restart and organize MIS with safety conditions for patients and healthcare workers. METHODS: Pubmed and web search was conducted with following terms: "SARS-CoV-2", "COVID19";"COVID19 Urology", COVID19 Surgery", "COVID19 transmission", "SARS-CoV-2 transmission", "COVID19 and minimally invasive surgery""SARS-CoV-2 and CO2 insuflation". A narrative review of available literature and scientific evidence summary was done. A modify nominal group technique was used to achieve an expert consensus. First draft was circulated amongst authors. Definitive document was approved in May 26th. RESULTS: Non evidence supports higher risk of SARSCoV-2 healthcare workers infection with MIS compared to open surgery. MIS is associated with shorter hospital stay than open surgery. Modify MIS indications to open surgery, with no scientific evidence, could spend valuable resources in detriment to COVID-19 patients. MIS indications should be prioritized attending to available resources and pandemic intensity. SARS-CoV-2 screening 72 hours prior to surgery by clinical and epidemiological questionnaire and nasopharyngeal PCR is recommended, in order to prevent nosocomial transmission, professional infections and to minimize postoperative complications. Intraoperative steps should be established to reduce professional exposure to surgical aerosols, including: surgical room reorganization, adequate personal protective equipment, surgical technique optimization and management of CO2 and surgical smoke

13.
Clínica Contemporánea ; 11(3), 2020.
Article in Spanish | ProQuest Central | ID: covidwho-1011706

ABSTRACT

El presente artículo analiza las principales repercusiones del confinamiento decretado durante la crisis del COVID-19 en niños y adolescentes. Se enumeran las principales dificultades y consecuencias que supone para los menores y sus familias, sobre todo si estas medidas se extienden en el tiempo. Exponemos la disposición legislativa posterior por la que en España se ha permitido la realización de salidas eventuales en algunos colectivos vulnerables durante el confinamiento inicial (ej. personas con discapacidad con alteraciones conductuales). Reflexionamos sobre esta normativa y exponemos diversos aspectos que habrían de tomarse en consideración. Razonamos cual creemos que habría de ser la postura del profesional de salud mental con respecto a la realización de salidas y planteamos alternativas para apoyar a las familias más afectadas. Por último, se presenta un sencillo instrumento que permite apoyar el criterio del clínico y se realizan algunas sugerencias de cara al futuro.Alternate abstract: This article analyses the impact of lockdown policies declared during the COVID-19 crisis in children and adolescents. The main difficulties and consequences for kids and their families are listed, especially if the measure extends over time. We expose the subsequent legal framework by some vulnerable people in Spain are allowed to take a walks during the initial lockdown (eg. people with disabilities and behavioral disorders). We reflect on these regulation and present various aspects that should be taken into ac. We reasoned what we think the mental health professional’s position should be with regard to walks and we proposed alternatives to support the most affected families. Finally, a simple instrument is presented to support the clinician’s judgment and some suggestions are made for the future.

14.
Preprint in English | medRxiv | ID: ppmedrxiv-20248328

ABSTRACT

The COVID-19 pandemic has shaken the world since the beginning of 2020. Spain is among the European countries with the highest incidence of the disease during the first pandemic wave. We established a multidisciplinar consortium to monitor and study the evolution of the epidemic, with the aim of contributing to decision making and stopping rapid spreading across the country. We present the results for 2170 sequences from the first wave of the SARS-Cov-2 epidemic in Spain and representing 12% of diagnosed cases until 14th March. This effort allows us to document at least 500 initial introductions, between early February-March from multiple international sources. Importantly, we document the early raise of two dominant genetic variants in Spain (Spanish Epidemic Clades), named SEC7 and SEC8, likely amplified by superspreading events. In sharp contrast to other non-Asian countries those two variants were closely related to the initial variants of SARS-CoV-2 described in Asia and represented 40% of the genome sequences analyzed. The two dominant SECs were widely spread across the country compared to other genetic variants with SEC8 reaching a 60% prevalence just before the lockdown. Employing Bayesian phylodynamic analysis, we inferred a reduction in the effective reproductive number of these two SECs from around 2.5 to below 0.5 after the implementation of strict public-health interventions in mid March. The effects of lockdown on the genetic variants of the virus are reflected in the general replacement of preexisting SECs by a new variant at the beginning of the summer season. Our results reveal a significant difference in the genetic makeup of the epidemic in Spain and support the effectiveness of lockdown measures in controlling virus spread even for the most successful genetic variants. Finally, earlier control of SEC7 and particularly SEC8 might have reduced the incidence and impact of COVID-19 in our country.

15.
Open Respiratory Archives ; 2020.
Article in Spanish | ScienceDirect | ID: covidwho-857051

ABSTRACT

RESUMEN La infección por SARS-CoV-2 puede favorecer el desarrollo de diversas secuelas respiratorias, sobre todo en los pacientes que han sufrido una neumonía grave por COVID-19. Dado el elevado número de pacientes que sufrieron esta infección en un corto periodo de tiempo, se están llevando a cabo numerosas visitas de control post-COVID-19 sin que se haya establecido un protocolo de seguimiento clínico que aconseje sobre las pruebas complementarias a realizar y la frecuencia de las mismas. Este documento de consenso realizado por profesionales de distintas áreas de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), pretende ayudar al profesional clínico a la identificación de las posibles complicaciones respiratorias que pueden aparecen durante los meses posteriores al cuadro agudo de la enfermedad y a protocolizar su seguimiento y las pruebas complementarias a realizar. Se sugieren las exploraciones e intervenciones a realizar en diversos momentos de la evolución post-COVID-19, con unos objetivos concretos. Por un lado, garantizar que los pacientes reciban un seguimiento clínico oportuno, con un cronograma preestablecido teniendo en cuenta la gravedad de la enfermedad y la probabilidad de secuelas a largo plazo;por otro lado, evitar sobrecargas del sistema sanitario llevando a cabo exploraciones y/o consultas en muchos casos innecesarias;por último, definir criterios para derivar a aquellos pacientes con determinadas secuelas específicas establecidas (enfermedad pulmonar intersticial, enfermedad vascular pulmonar o bronquiectasias) a las unidades monográficas correspondientes. ABSTRACT SARS-CoV-2 infection can cause a range of respiratory sequelae, especially in patients who have had severe Covid-19 pneumonia. Given the high number of patients who have developed this infection over a short period of time, numerous post-Covid-19 follow-up visits are being carried out, but no clinical follow-up protocol has been established to advise on the complementary tests to be performed and the frequency of these procedures. This consensus document was drawn up by professionals from different areas of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) in order to assist the clinician in identifying possible respiratory complications that may occur during the months following the acute disease, and to protocolize their follow-up and additional tests to be performed. It recommends examinations and interventions to be carried out at various stages in the post-Covid-19 period, and details the specific objectives of these procedures. Primarily, we aim to ensure that patients receive timely clinical follow-up, following a pre-established schedule that takes into account the severity of the disease and the likelihood of long-term sequelae. Another objective is to avoid overloading the health system by eschewing examinations and/or consultations that are, in many cases, unnecessary. Finally, we define criteria for referring patients with specific established sequelae (interstitial lung disease, pulmonary vascular disease, bronchiectasis) to the corresponding specialized units.

16.
Preprint in English | medRxiv | ID: ppmedrxiv-20136788

ABSTRACT

ObjectiveTo estimate COVID-19 infection incidence rate with severe affectation (requiring hospitalization) in patients with biological treatment due to rheumatoid arthritis (RA), psoriatic arthritis (PsA), spondyloarthritis (SpA), psoriasis (Ps), and inflammatory bowel disease (IBD) and compare it with incidence rate in the general population. MethodsRetrospective observational study based on information provided by two administrative databases. One of these two databases contains information on all patients seen in our hospital and diagnosed with COVID-19 infection between March 4th 2020 and April 26th 2020. The other database contains data from patients seen at Rheumatology, Dermatology and Digestive Departments in our hospital who are currently receiving biological therapy. We calculated the crude and age and sex adjusted incidence in both groups. To compare both groups we calculated the Incidence Rate Ratio. ResultsThere was a total of 2,182 patients with COVID-19 requiring hospitalization. Four patients out of a total of 797 patients receiving biological therapy had contracted COVID-19 and required hospital care. Crude incidence rate of COVID-19 requiring hospital care among the general population was 1.41%, and it was 0.50% among the group receiving biological therapy. Rates adjusted by age and sex in the biological group was 0.45% (CI95% 0.11-4.13). The IRR of the group receiving biological therapy compared to the general population was 0.39 (CI95% 0.14-1, p=0.049). ConclusionFindings suggest that prior use of biological therapy does not associate with severe manifestations of COVID-19, and it is likely to have a protective effect against them when compared to the general population. Key MessagesO_ST_ABSWhat is already known about this subject?C_ST_ABSO_LICovid-19 susceptibility in patients with immune-mediated disorders and receiving treatment with biological therapy is unknown. C_LI What does this study add?O_LISevere manifestation incidence rate in patients with immune-mediated disorders receiving biological therapy treatment is not increased when compared to the general population. C_LIO_LIBiological therapies might protect patients from presenting severe COVID-19 manifestations. C_LI How might this impact on clinical practice?O_LIThese data could be used for current recommendations regarding management of patients receiving biological therapies. C_LI Mini AbstractThe objective of this study is to analyze the incidence rate of severe COVID-19 requiring hospital care for patients receiving biological therapy and to compare it to the general population. Patients treated with biological therapy have crude and adjusted incidence rates under those of the general population. Statement of Human and Animal RightsThis article does not contain any studies involving human participants or animals that were performed by the authors. For this type of study, formal consent was therefore not required.

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