Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 26
Filter
1.
Transplantation ; 02, 2022.
Article in English | EMBASE | ID: covidwho-2191234

ABSTRACT

BACKGROUND: The original SARS-CoV-2 vaccination regimen (2 doses) induces insufficient short-term response in kidney transplant (KT) recipients. This study assessed the response to a third dose and the long-term immunogenicity after 2 doses in KT. METHOD(S): We analyzed the dynamics of the humoral and cellular response by monitoring SARS-CoV-2 IgG antibodies against the Spike-protein (IgG-Spike) and QuantiFERON SARS-CoV-2 IFN-gamma release assay 6 mo after the second dose (T2) and 28 d after the third dose of mRNA vaccines (T3) to KT and controls (dialysis patients and healthy individuals). RESULT(S): At T2, the percentage of IgG-Spike+ KT and dialysis patients decreased (KT 65.8%-52.6%, hemodialysis 92.6-81.5%, and peritoneal dialysis 100%-90%), whereas 100% of healthy controls remained positive. About the cellular response, the percentage of responders decreased in all groups, especially in KT (22.4%-9.2%, P=0.081). At T3, 92% of KT, 94%-98% of dialysis patients, and 100% of healthy controls were IgG-Spike+. In terms of antibody titers, patients and controls showed a reduction between T2 and T3 and about 80% of dialysis patients and 100% of controls achieved high titers after the third dose (>1479.5 Binding Antibody Units/mL), whereas this percentage was only 50% in KT. With respect to the cellular response, only KT displayed a significant rise after the third dose. CONCLUSION(S): The third dose of mRNA vaccine improves both humoral and cellular responses, but less effectively in KT compared with dialysis patients and healthy controls. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

2.
Archives of Medical Research ; 30:30, 2022.
Article in English | MEDLINE | ID: covidwho-2176470

ABSTRACT

BACKGROUND: Vasoactive peptides play an important role in a wide range of physiological and pathological conditions. Due to its known functions, the calcitonin gene-related peptide (CGRP) has been suggested as a possible modulator of the hyperimmune response in COVID-19 and thus, blocking its action may lessen the pulmonary effects of COVID-19.

3.
Quantitative Finance and Economics ; 6(4):553-569, 2022.
Article in English | Web of Science | ID: covidwho-2155468

ABSTRACT

Context: The context of this paper is the unprecedented global situation which has been and is still experiencing all countries all over the world, due to the pandemic caused by Covid-19 and its variants. Apart from the important problem of health population, all countries are facing a sharp reduction in their main economic indicators: stock indices, GDP (Gross Domestic Product), rates of employment, closing down of businesses, etc. Results: In this paper, we have presented and mathematically analyzed the so-called staggered loans as a useful tool for SMEs to be applied after times of crisis. Moreover, their pros and cons, and the advantages for lenders and borrowers have been highlighted. Specifically, this kind of loan can help solve the problem of the scarce offer of credit due to monetary politics currently addressed to reduce inflation. Policy implications: Taking into account that this economic situation cannot continue for longtime, many countries are thinking about the next stages of the way-out from the crisis in all sectors of affected economies. Purpose: In this research, we seek to provide some information on the characteristics of the so-called staggered loans and the repayment system applied by some microfinance institutions in Latin America. This can help SMEs to obtain the liquidity necessary to reopen and develop their activity. Methods: Methodologically, we have presented risk-based measures able to guarantee the profitability of lenders and control the solvency of lenders and borrowers.

4.
Cephalalgia ; 42(1 Supplement):71-72, 2022.
Article in English | EMBASE | ID: covidwho-2079254

ABSTRACT

Introduction: Calcitonin gene-related peptide (CGRP) a is well-known to be implicated in migraine pathophysiology. Its b isoform, released mainly in the enteric nervous system, has not been as extensively studied. Previous research prompt CGRP has a role in gastrointestinal motility, as well as immune and intestinal blood flow regulation. It is postulated to help peptic ulcer healing, and immune cell migration and regulation in acute gastrointestinal infections. In COVID-19 between 2% and 50% of patients develop diarrhea, and its prevalence increases with the severity of the disease. The pathophysiology of the diarrhea in this infection is not completely clear but CGRP has been proposed to play a role in different aspects of the symptomatology. Inflammatory bowel disease (IBD), known to be associated with migraine, is a chronic gastrointestinal autoimmune disease. Neuropeptides like CGRP might play a role in the complex pathophysiology of the disease, but this has not been well established yet. On the other hand, the most frequent adverse event of new monoclonal antibodies against CGRP for migraine is constipation, which points out that the blockage may affect CGRPbeta release. Objective(s): To assess the role of CGRPbeta in two gastrointestinal disorders: COVID-19 with acute diarrhea;and IBD. Method(s): CGRPbeta were measured by ELISA (CUSABIO, China) in early morning serum samples in patients with IBD at diagnosis, as well as in COVID-19 inpatients experiencing diarrhea. We compared each group with a cohort of healthy controls matched by age and sex. Image: Results: Twenty-six COVID-19 inpatients with diarrhea were included (mean age=62+/-16 years, range 31-91 years;69.2% females) who were matched with 30 healthy controls (mean age=61+/-15 years, range 29-89 years, 66.6% women). Fifty-nine patients with early IBD (mean age 48.9+/-16.4 years, range 21-79 years;62,7% females were matched with 59 healthy controls (mean age 49.0+/-14.9 years, range 23-77 years;62,7% females). While CGRPbeta levels were significantly elevated in COVID-19 patients (6,3+/-2.6 pg/mL) vs controls (4.2+/-2.4 pg/mL) (+26.2%;p<0.01), CGRPbeta levels in patients with IBD were significantly decreased (3.1+/-1.8 pg/mL) as compared to controls (4.8+/-2.6 pg/mL) (-35.4%, p<0.001). Conclusion(s): CGRPbeta seems to exert different actions depending on the underlying conditions. While its increase with diarrhea in COVID-19 patients fits very well with the known acute effects of increase gastrointestinal motility in CGRP infusion in volunteers, the decrease in CGRPbeta levels in IBD confirm a protective role of this peptide in the homeostasis of the intestinal mucosa. These findings may help to explain the role of CGRPbeta in digestive manifestations of migraine and in the constipation seen in migraine patients on CGRP antibodies as well.

5.
American Journal of Transplantation ; 22(Supplement 3):761, 2022.
Article in English | EMBASE | ID: covidwho-2063535

ABSTRACT

Purpose: The evidence regarding the clinical effectiveness of COVID-19 vaccination in kidney transplant (KT) recipients is limited so far. Our purpose is to analyze the characteristics and outcomes of a large series of KT with COVID-19 breakthrough infection and compare them with unvaccinated patients. As a secondary objective, we analyzed the evolution according to the type of mRNA vaccine administered. Method(s): From April to October 2021, KT recipients with COVID-19, included in the COVID-19 registry of the Spanish Society of Nephrology, were analyzed. Data regarding vaccination status and type of vaccine were collected and outcomes of unvaccinated or partially vaccinated patients were compared with fully vaccinated patients. Result(s): Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died (p=.776). In multivariable analysis age and pneumonia were independent risk factors for death, while vaccination status was not related to mortality. These results remained similar when we excluded patients with partial vaccination as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (Moderna) (n=213) showed a significantly lower mortality than those who received BNT162b2 (Pfizer-BioNTech) vaccine (n=121) (16.4% vs. 28.8%, p=.002) (HR: 0.52, CI 95% 0.31-0.85, p=.010). Conclusion(s): COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of an mRNA vaccine, but the mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infection, so it could be considered as the first option in these patients.

6.
Environmental Research ; : 114443, 2022.
Article in English | MEDLINE | ID: covidwho-2049189

ABSTRACT

INTRODUCTION: The Angiotensin-Converting Enzyme 2 (ACE2) is the main receptor of the SARS-CoV-2. There is contradictory evidence on how the exposure to nicotine may module the concentration of soluble ACE2 (sACE2). The aim of this study was to assess the association between nicotine and sACE2 concentrations in saliva samples. METHODS: Pooled analysis performed with data retrieved from two studies (n=634 and n=302). Geometric mean (GM) concentrations of sACE2, both total and relative to the total amount of protein in the sample, were compared according to sociodemographic variables and variables associated to nicotine. Multivariable linear regression models were fitted to explore the associations of sACE2 with nicotine adjusting for sex, age and body mass index. Spearman's rank-correlation coefficients were estimated between the concentrations of nicotine and cotinine, and pack-years, the concentration of relative sACE2 and the isoforms of sACE2. RESULTS: We observed a significant increase of 0.108 and 0.087ng/mul in the relative and absolute salivary sACE2 GM concentrations, respectively, between the lowest and highest nicotine levels. Similar results were observed for cotinine. These associations did not change in the multivariable linear models. There was a low correlation of nicotine and cotinine concentration with the concentration of relative salivary sACE2 (rs=0.153 and rs=0.132, respectively), pack-years (rs=0.222 and rs=0.235, respectively) and with the concentration of isoform 40KDa (rs=0.193 and rs=0.140, respectively). CONCLUSION: Salivary nicotine concentration seems to be limitedly associated with the concentration of sACE2.

7.
COVID-19 Pandemic: Lessons from the Frontline ; : 99-107, 2021.
Article in English | Scopus | ID: covidwho-2048766

ABSTRACT

Responding to the coronavirus disease 2019 pandemic has helped craft a global medical community of medical professional society members and nonmembers alike in ways previously unanticipated. The public-facing elements of medical professional societies include their websites, official organs, and educational elements that have been liberated using a Free Open-Access Medical education approach. Work products including guidelines, blogs, and social media offerings have helped clinicians to prepare for pandemic care or refine existing practices to support outcome excellence. Often, that guidance has flowed from collaborations between medical professional organizations, some of which are novel and might not have occurred outside of a dire global need. Leaders of such organizations have been catapulted into the spotlight by the universal need for information and guidance—including that of one’s home government—and appeared quite regularly in print and digital media as well as live radio broadcasts. Finally, the need to pursue remote medical professional organization work as well as education has developed member and nonmember facilities with a host of digital platforms. Such skill sets have also helped to maintain communication between clinicians and patient's remote family members to support patient- and family-centered care while maintaining shared decision making. The flexibility and innovation that characterize medical professional organizations have been highlighted by the realities of providing pandemic care. © 2022 Elsevier Inc. All rights reserved.

9.
Nephrology Dialysis Transplantation ; 37(SUPPL 3):i722-i723, 2022.
Article in English | EMBASE | ID: covidwho-1915798

ABSTRACT

BACKGROUND AND AIMS: The successive COVID-19 epidemic waves have significantly influenced kidney transplantation (KT) programs. Contact protection together with vaccination are the principal protective tools for KT recipients. We reviewed the impact of COVID-19 infection in KT recipients throughout the different epidemic waves. METHOD: Of 900 active KT recipients in our program, 160 (17.8%) have suffered COVID-19 infection during the six epidemic waves: first (March-August 2020), second (September-December2020), third (January-March 2021), fourth (April-May 2021), fifth (June-September 2021) and sixth (October-December 2021, preliminary data). We compared the clinical evolution and the impact of vaccination. RESULTS: Infected KT recipients were younger in the third and fourth waves (P < 0.001). We observed a higher percentage of pneumonia and hospital admission in the first and fifth waves (P = 0.045, P = 0.016) (Table 1), without differences in ICU admission, and with the disappearance of asymptomatic cases after the third wave. The highest mortality was observed in KT recipients >65 years old infected within the first 6 months after KT (P = 0.006) and overall mortality was higher in the first wave (P = 0.033). Mortality in hospitalized KT recipients and those admitted in the ICU were similar along the 5 waves, without clear impact of vaccination (P = 0.251). On the 5 January 2022, we have already accumulated an incidence of COVID in KT of 3.1% (sixth wave, 77% with booster vaccination), similar to the first wave (3.8%), with 12.5% mortality, similar to second, third and fifth waves, in patients with outcome (53.3%). CONCLUSION: The incidence of COVID-19 in KT recipients has been high in all the waves of the pandemic in Spain. Global mortality has diminished after the first wave, and the time until outcome has increased. The highest mortality occurs in the subgroup of old KT recipients early after KT. Vaccination has not significantly reduced the mortality in KT with Covid who require hospital or ICU admission. (Table Presented).

11.
Doxa Comunicacion ; - (34):139-153, 2022.
Article in Spanish | Web of Science | ID: covidwho-1727374

ABSTRACT

This study focuses on the fear of public speaking, or glossophobia, among postgraduate students in Spain. The main objective is to evaluate the levels of glossophobia in this group, with special attention paid to online public speaking. COVID-19 has forced the online performance of multiple academic activities, including the defence of Master's Theses (MT). A mixed research method (qualitative-quantitative) has been employed by means of a survey (500 responses) of the student body conducted at the time of presentation of their MT (June-July 2020). Fifteen experts had previously validated the questionnaire. The resulting Cronbach's coefficient alpha, which measures its reliability, was 0.82. The main result is that the vast majority of the group is aware of their oratorical weakness. Almost all show interest in improving this competence and consider that presenting the MT has been the greatest speaking challenge in their lives. Among the main conclusions, the need to introduce specific training in public speaking in the students' curriculum stands out. It should be included in the curriculum of postgraduate programs, regardless of their specialty, with particular emphasis on online interactions. Glossophobia has been shown to be transversal and affects all types of students. The proposal made herein is currently non-existent in Spain.

12.
Critical Care Medicine ; 50(1 SUPPL):230, 2022.
Article in English | EMBASE | ID: covidwho-1691884

ABSTRACT

INTRODUCTION/HYPOTHESIS: 2020 was marked by social and political events that substantially disrupted healthcare. The COVID-19 pandemic, lockdown, public health measures, as well as civic and political unrest over racial tensions during an election year could plausibly impact injury care. We hypothesized that increased injuries related to high-risk activities during 2020 was temporally related to sociopolitical unrest and pandemic public health measures. METHODS: Retrospective data from two Level 1 urban, adult trauma centers in different US states (City A population:1.6M, City B:0.21M) were assessed (1/1/2020- 12/31/2020). Calendar months were divided into quartiles and compared to analogous quartiles in years 2016 -2019. Variables studied (demographics, injury mechanisms and outcomes) were compared between years, and across 2020 quartiles, against a backdrop of key sociopolitical events. RESULTS: More patients presented for injury in 2020 (A: n=1057, B: n= 1053) than in prior years (p< 0.05). Compared to 2016-2019, 2020, patients were more often black (A:63.1% vs. 69.8% p< 0.001;B:31.0% vs. 34.3%, p=0.02). Institution A patients were more likely to be male (p=0.002) & younger (p< 0.001) in 2020 vs. 2016-2019. Both institutions noted a steep rise in gunshot wound (GSW) and motor vehicle collision (MVC) injuries following state lockdowns (Fig A, B) with a persistent rise in GSWs until late fall (Fig C). CONCLUSIONS: 2020 was a unique year of sociopolitical unrest interwoven with a pandemic. Most affected populations were young, black males in two different urban centers and primarily involved GSWs and MVCs. Future disaster response planning should consider the drivers of these trends to mitigate their impact, especially in vulnerable populations.

13.
14.
Emergencias ; 33(2):100-106, 2021.
Article in Spanish | Web of Science | ID: covidwho-1498780

ABSTRACT

Objective. To describe the effect of the coronavirus disease 2019 (COVID-19) pandemic on the initiation of cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiopulmonary arrest. To compare the cardiopulmonary arrest caseload during the pandemic to the caseloads in other periods. Methods. Observational, prospective study based on the registry of out-of-hospital cardiopulmonary arrest emergencies the SUMMA112 ambulance service responded to between March 1 and April 30, 2020, in the Spanish autonomous community of Madrid. The registry is a Utstein-style database. The period of March April 2019 was the control period for direct comparison with the 2020 study period and with the January February periods of 2019 and 2020. Results. The responders undertook advanced CPR in 146 of the 313 cardiopulmonary arrest cases registered during March-April, 2020. Of the 87 patients with COVID-19 positive tests, 33 reached the hospital alive. Advanced CPR was not applied in 167 cases;the most frequent reason was prolonged circulatory collapse. Most cases (92.7%) occurred in the home. The emergency dispatchers received more calls in March and April of 2020, but they sent out a similar number of ambulances. Conclusions. Mortality was higher in cases of cardiopulmonary arrest during the COVID-19 pandemic. The percentage of cases with no application of advanced CPR rose;the main reason was the amount of time between collapse and first response. Even though the number of emergency calls increased significantly, the SUMMA112 service did not dispatch more ambulances.

15.
Multiple Sclerosis Journal ; 27(2 SUPPL):767-768, 2021.
Article in English | EMBASE | ID: covidwho-1496069

ABSTRACT

Introduction: Vaccination against COVID-19 has been widely recommended for patients with multiple sclerosis (MS), although the effect of different disease-modifying treatments (DMTs) on said immunization is not well known. Some studies begin to point out a relationship between DMTs of greater efficacy with a lower rate of seroprotection. Objectives: To assess serological response to SARS-CoV-2 vaccination in MS patients receiving disease-modifying treatments (DMTs) in a real-life setting. Methods: Anti-spike protein-based serology was measured in 191 patients with MS and 6 patients with neuromyelitis optica spectrum disorder (NMOSD). Patients were either untreated or under treatment with different DMTs. A group of healthy subjects similarly vaccinated served as control. The percent of subjects that developed protective antibodies, the antibody-titer, and lymphocyte counts were evaluated. Results: Patients and controls were vaccinated with different available vaccines: BNT162b2 (68.6%), mRNA-1273 (5.4%), ChAdOx1-S (20.7%) and Ad26COVS1 (4.3%). Protective serological response was observed in 100% of controls, NMOSD, untreated (n=19), Interferon-beta (n=17), Glatiramer-acetate (n=15), Cladribine (n=11), Dimethyl-fumarate (n=15), Teriflunomide (n=29) and Natalizumab (n=25) patients. 100% was also observed in Alemtuzumab (n=11) patients but none received treatment dose in last year. Serological response was observed in 42%, 44% and 0% of Fingolimod (n=12), Ocrelizumab (n=26) and Rituximab (n=6) patients respectively. Time from the last dosing was related to serological response in anti-CD-20 therapies;age, disease duration, disease phenotype, vaccine used, or lymphocyte counts did not affect humoral response to COVID-19 vaccination. Conclusions: Anti-CD20 therapies and Fingolimod seem to condition a lower humoral response to vaccines against SARS-CoV-2. Vaccination prior initiation of these DMTs medication administration would be recommendable whenever possible.

16.
American Journal of Transplantation ; 21(SUPPL 4):313, 2021.
Article in English | EMBASE | ID: covidwho-1494427

ABSTRACT

Purpose: To better know the impact and characteristics of Covid-19 in renal patients, the Spanish Society of Nephrology set up a voluntary registry in March, 2020 Methods: Retrospective observational study of KT recipients included in the Spanish Covid-19 Registry (1st March to 14th November, 2020). We applied Cox multivariate analysis to identify risk factors for mortality and Kaplan-Meier and log rank survival analysis. Results: 1080 KT with Covid-19 were registered, having 937 (86.1%) their outcome reported (cure or death). Most were men (63.2%), mean age 60 years infected a median of 72 months postransplantation. Death occurred in 204 patients. Multivariate analysis found age, neumonia and KT within the last 6 months before Covid-19 were risk factors for mortality and gastrointestinal symptoms were protective. Survival analysis showed significant increasing mortality risk in four subgroups: age<65 years&postransplant time> 6mo (n=526), age<65×<6mo (n=49), age>65× >6mo (n=325) and age>65×<6mo (n=31)($$graphic). Of 1080 cases, 605 correspond to the first wave (1stW until June2020) and 475 to the second wave (2ndW). In the 2ndW, KT were younger (56.4 vs 61.1yr;p=.000), 15.8% were asymptomatic (p=.000) and presented less pneumonia (50.3% vs. 78%;p=.000). Fever, lymphopenia and respiratory symptoms were less frequent but gastrointestinal symptoms similar (30.9% vs. 34.2%;p=.256). Treatment has changed, with more use of remdesivir (p=.000) and steroids (p=.018), no use of ritonavir/lopinavir, hidroxycloroquine andazitromycin (p=.000), and no treatment in (37.1% vs 6.3% in 1stW, p=.000). Hospitalization decreased (89.2% vs. 63.2%;p=.000) but more KT were admitted to critical care units (14.5% vs 20%;p=.058). We found lower mortality (overall 26.4% vs 14.8%;p=.000, hospitalized 29% vs 23%;p=.088). Multivariate analysis of the 2ndW shows again that age, pneumonia and recent transplant (< 6 months) are mortality risk factors. Conclusions: Over a thousand KT have suffered Covid-19 in Spain with a high mortality rate in the first and second waves, mainly related with age, pneumonia and recent transplantation. The interaction between age and time after transplant has to be considered when selecting recipients in the Covid-19 pandemic.

17.
Nephrology Dialysis Transplantation ; 36(SUPPL 1):i184, 2021.
Article in English | EMBASE | ID: covidwho-1402461

ABSTRACT

BACKGROUND AND AIMS: Coronavirus disease (COVID-19), caused by Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) can lead to significant organ injury. CKD has been associated with increased mortality in previous epidemics, and male sex has been correlated with worse outcomes during COVID-19 in the general population. Our aim was to describe the differential effect of sex as a risk factor for in-hospital mortality among non-dialysis CKD subjects. METHOD: Multicenter, observational cohort study including 136 adult patients with CKD and 136 age- and sex-matched controls who required admission for COVID-19 in three academic hospitals in Spain. Viral infection was confirmed by real-time RTqPCR and/or serologic testing in all cases. Disease severity on admission was classified according to the WHO-China Joint Mission Report on COVID-19. The presence of CKD was defined as sustained eGFR <60 and >15 ml/min/1.73m2 within the 6 months prior to COVID-19 hospitalization. Demographic and clinical data were gathered from medical records. Outcomes were recorded during the following 28 days after admission. We applied Cox proportional hazards models, adjusted for age, sex, hypertension, diabetes and severe or critical disease at presentation. RESULTS: Due to the matched design, no differences were found regarding age and sex between cohorts. CKD patients suffered more frequently from hypertension and diabetes and presented higher 28-day mortality after hospital admission due to COVID-19 compared with age- and sex-matched controls (40.4 vs. 24.3%;P=0.004). In adjusted Cox regression analysis among CKD patients, only age (HR: 1.087, 95% CI: 1.047-1.128) and male sex (HR: 1.883, 95% CI: 1.045-3.391) were independent predictors of 28-day mortality. Comparatively, among patients without CKD, only age acted as an independent predictor for 28-day mortality (HR: 1.082, 95% CI: 1.033- 1.133). None of the variables included in adjusted regression was able to predict ICU admission in any of the cohorts. CONCLUSION: Male sex is associated with increased mortality, but not with ICU admission, after hospitalization due to COVID-19 among non-dialysis CKD patients. That effect was not observed among hospitalized controls without CKD.

18.
Rev Neurol ; 72(s02): S1-S19, 2021 06 30.
Article in English, Spanish | MEDLINE | ID: covidwho-1335600

ABSTRACT

INTRODUCTION: After the European Headache Federation (EHF) Congress, renowned Spanish neurologists specialised in migraine presented the most significant latest developments in research in this field at the Post-EHF Meeting. DEVELOPMENT: The main data presented concerning the treatment of chronic and episodic migraine were addressed, with attention paid more specifically to those related to preventive treatments and real-life experience in the management of the disease. An important review was carried out of the new therapeutic targets and the possibilities they offer in terms of understanding the pathophysiology of migraine and its treatment. An update was also presented of the latest developments in the treatment of migraine with fremanezumab, a monoclonal antibody recently authorised by the European Medicines Agency. Participants were also given an update on the latest developments in basic research on the pathology, as well as an overview of the symptoms of migraine and COVID-19. Finally, the repercussions of migraine in terms of its burden on the care and economic resources of the health system were addressed, along with its impact on society. CONCLUSIONS: The meeting summarised the content presented at the 14th EHF Congress, which took place in late June/early July 2020.


TITLE: I Reunión Post-European Headache Federation: revisión de las novedades presentadas en el Congreso de la European Headache Federation de 2020.Introducción. Tras la celebración del congreso de la European Headache Federation (EHF), reconocidos neurólogos españoles expertos en el tratamiento de la migraña expusieron en la Reunión Post-EHF las principales novedades presentadas en el congreso y relacionadas con ese ámbito. Desarrollo. Se abordan los principales datos presentados relacionados con el tratamiento de la migraña crónica y episódica; concretamente, los relacionados con los tratamientos preventivos y la experiencia en vida real en el manejo de la enfermedad. Se hizo una importante revisión de las nuevas dianas terapéuticas y las posibilidades que ofrecen en cuanto al conocimiento de la fisiopatología de la migraña y su tratamiento. Asimismo, se hizo una actualización de las novedades presentadas en el tratamiento de la migraña con fremanezumab, anticuerpo monoclonal recientemente autorizado por la Agencia Europea de Medicamentos. Se hizo una actualización de las novedades en investigación básica en la patología, así como una relación de los síntomas de migraña y COVID-19. Finalmente, se abordaron las implicaciones de la migraña en la carga sanitaria asistencial y económica, y su impacto en la sociedad. Conclusiones. En la reunión se hizo un resumen del contenido presentado en el 14 Congreso de la EHF, que tuvo lugar a finales de junio y principios de julio de 2020.


Subject(s)
Migraine Disorders/therapy , Antibodies, Monoclonal/therapeutic use , Congresses as Topic , Europe , Humans , Migraine Disorders/drug therapy , Migraine Disorders/etiology , Practice Guidelines as Topic
20.
Topics in Antiviral Medicine ; 29(1):67, 2021.
Article in English | EMBASE | ID: covidwho-1250009

ABSTRACT

Background: SARS-CoV-2 receptor angiontensin-conveting-enzyme 2 (ACE2) is also a protective factor that contributes to reduce inflammation and fibrosis in tissues. An active form of ACE2 can be released from the cell surface by host proteases ADAM17 and TMPRSS2, being the latter also necessary for viral entry. Due to its properties, the administration of soluble recombinant ACE2 has been proposed as a SARS-CoV-2 treatment. Here, we assess the role of ACE2 activity and antiviral immune response at the site of infection in nasopharyngeal swabs of SARS-CoV-2 patients, to unravel its effect on inflammation cascade and infection outcome. Methods: Soluble enzymatic activity of ACE2 was measured in nasopharyngeal swabs at the time of PCR positivity (mean time from symptom=4d) and 3 days after in a cohort of mild SARS-CoV-2 patients (n=40, mean age=42y) and in uninfected controls. Gene expression profiles of ACE2, its proteases, ADAM17 and TMPRRS2, and interferon-stimulated genes (ISGs), DDX58, CXCL10 and IL-6 were also evaluated by RT-qPCR. Results: Both ACE2 activity and mRNA expression decreased significantly during infection course in paired samples of SARS-CoV-2 infected subjects (p=0.048 and p<0.001, respectively), although differences between infected and uninfected subjects were only seen at mRNA level (p<0.001) Importantly, both ACE2 activity and mRNA expression showed a positive correlation with viral load (rho=0.352, p-value=0.0259), suggesting that viral infection is influencing ACE2 function. Similarly, infection downregulates TMPRSS2 expression (pvalue< 0.01), but not ADAM17, further indicating the viral-induced regulation of host receptors. In contrast to ACE2 data, a clear induction of IFN stimulated genes, CXCL10, IL-6 and DDX58 (RIG-I), is observed upon infection (p-value<0.05 in all cases), demonstrating that SARS-CoV-2 induces an antiviral response and suggesting that ACE2 is not an ISG. This increased expression of ISGs is directly linked to viral load (rho=0.6177, p-value<0.0001;rho=0.4026, p-value=0.0110;rho=0.3024, p-value=0.0613, respectively) but it is rapidly reversed during infection course. Conclusion: Overall, our results demonstrate the existence of mechanisms by which SARS-CoV-2 suppress ACE2 expression and function, intracellular viral detection and subsequent ISG induction, offering new insights into ACE2 dynamics and inflammatory response in the human upper respiratory tract that may contribute to understand the early antiviral host response to SARS-CoV-2 infection.

SELECTION OF CITATIONS
SEARCH DETAIL