Comparison of the first and sixth waves of the SARS-COV-2 coronavirus pandemic in patients with immune-mediated disease.

INTRODUCTION: Recent evidence shows that COVID-19 infection does not have a worse prognosis in patients with immune-mediated inflammatory diseases (IMID), although they develop a worse response to vaccination. OBJECTIVE: To compare the incidence of COVID-19 and clinical features in patients with IMID between the first and sixth waves. METHOD: Prospective observational study of two cohorts of IMID patients diagnosed with COVID-19. First cohort March to May 2020, and second cohort December/2021 to February/2022. Sociodemographic and clinical variables were collected and, in the second cohort, COVID-19 vaccination status. Statistical analysis established differences in characteristics and clinical course between the two cohorts. RESULTS: In total, 1627 patients were followed up, of whom 77 (4.60%) contracted COVID-19 during the first wave and 184 in the sixth wave (11.3%). In the sixth wave, there were fewer hospitalisations, intensive care unit admissions, and deaths than in the first wave (p=.000) and 180 patients (97.8%) had at least one dose of vaccine. CONCLUSION: Early detection and vaccination have prevented the occurrence of serious complications.

[Overcoming the barriers in the approach of the chronic patient]. / Superando las barreras en el abordaje del paciente crónico.

At least one in three adults has multiple chronic conditions. The assistance of patients with chronic conditions is mandatory. This is one of the main tasks of the primary care physicians. The approach in these patients is challenging, as there are many barriers at different levels (sanitary system, healthcare professionals and patients). In addition, COVID-19 pandemic has worsened this situation even more. Therefore, it is necessary to take actions that try to improve this state. For this purpose, with the aim to find solutions/recommendations that may be helpful to attain a better diagnosis, treatment and follow-up of patients with chronic diseases, a group of experts of SEMERGEN have tried to identify the problems in the attention to these patients, searching for potential solutions and areas of improvement. The present document has specifically focused on four prevalent chronic conditions in primary care: dyslipidemia, arterial hypertension, chronic venous disease and depression.

COVID-19 and pregnancy. Review and update / COVID-19 and pregnancy. Review and update / COVID-19 y embarazo. Revisión y actualización

RESUMEN Objetivo . Buscar toda la información y evidencia disponible sobre el SARS-CoV-2 -que surgió en estos primeros 4 meses de 2020y el embarazo. Metodología . Revisión sistemática en las bases de datos PubMed y Google Scholar, hasta el 25 de abril de 2020. Se buscó artículos publicados relacionados con mujeres embarazadas infectadas con SARS-CoV-2. No hubo restricción de idioma. La búsqueda se extendió a las referencias de los artículos encontrados. Resultados . La enfermedad COVID-19 en mujeres embarazadas se caracteriza porque más del 90% de las pacientes evoluciona en forma leve, 2% requiere ingresar a las unidades de cuidados intensivos. Una muerte materna ha sido reportada. La prematuridad es alrededor de 25%, con predominio de recién nacidos prematuros tardíos; aproximadamente el 9% se complica con rotura prematura de membranas; la mortalidad perinatal es baja o similar a la de la población general y no se ha demostrado la transmisión vertical. Conclusiones . Los ginecólogos obstetras deben prepararse para atender cada vez más casos con COVID-19 y, por lo tanto, es necesario tener su conocimiento. La enfermedad evoluciona de la misma manera que en las no embarazadas, genera mayor prematuridad, no se ha demostrado la transmisión vertical, pero hay altas posibilidades de transmisión horizontal durante el parto vaginal.

ABSTRACT Objective : To search for all the information and available evidence on infection with SARS-CoV-2, a virus that appeared during the first 4 months of 2020, and pregnancy. Methods : Systematic review in PubMed and Google Scholar databases until April 25, 2020. We searched for published articles related to pregnant women infected with SARS-CoV-2. There was no language restriction. The search was extended to the references of the articles found. Results : In pregnant women with COVID-19, more than 90% of patients evolve mildly, 2% require intensive care. One maternal death has been reported. Prematurity occurs in approximately 25% of the cases, with predominance of late preterm infants; premature rupture of membranes presents in about 9%. Perinatal mortality is lower or similar to that of the general population, and vertical transmission has not been shown. Conclusions : Obstetrician-gynecologists must prepare to attend more cases with COVID-19 and therefore they need to know this disease. COVID-19 progresses similarly in pregnant and non-pregnant women, although it is associated to prematurity. While vertical transmission has not been demonstrated, horizontal transmission during vaginal birth is very likely.

Pregnant women with coronavirus disease 2019 and intrauterine vertical transmission: a systematic review / Gestantes con enfermedad por coronavirus 2019 y transmisión vertical intrauterina: una revisión sistemática

Resumen Introducción . La enfermedad por coronavirus 2019 (COVID-19) es una enfermedad de las vías respiratorias potencialmente severa, producida por el coronavirus tipo 2 causante del síndrome respiratorio agudo grave (SARS-CoV-2). La transmisión intrauterina de la madre al feto es un motivo de debate. Objetivo. Identificar la evidencia disponible de transmisión vertical intrauterina en la gestante con COVID-19. Metodología. Revisión sistemática utilizando los términos: "Vertical transmission" AND "COVID-19" OR "SARS-CoV-2". Las bases de datos consultadas fueron MEDLINE/PubMed, Science Direct, Clinical Key, LILACS, SciELO, Google Scholar, medRxiv y SciELO Preprints. Resultados . Se identificaron 30 estudios que cumplieron los criterios de selección e incluían 476 gestantes. La infección se encontró en 9 neonatos (1,9%), el hisopado faríngeo en ellos se hizo dentro de las 48 horas del nacimiento. En 4 de ellos no se buscó la presencia del virus en otros tejidos y fluidos maternos, mientras que en los 5 casos restantes se identificó el ARN en la placenta de tres de ellos, en dos se encontró en el líquido amniótico y en uno en el canal vaginal. Los estudios fueron muy heterogéneos; así podemos mencionar la variedad de la población reportada, el número de muestras y momento de la toma en los neonatos, la falta de muestreo en los tejidos y fluidos maternos. Conclusiones . La transmisión vertical intrauterina del SARS-CoV-2 no ha sido demostrada de forma contundente debido a que la mayoría de las gestantes con la enfermedad ha tenido neonatos con la prueba molecular negativa (98,1%). Sin embargo, la heterogeneidad de los estudios tampoco permite descartar esta posibilidad.

ABSTRACT Introduction: Coronavirus disease 2019, also called COVID-19, is a potentially severe respiratory disease originated by the type 2 coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2). Intrauterine transmission from mother to fetus is a matter of debate. Objective: To identify the available evidence of vertical intrauterine transmission in pregnant women with COVID-19. Methodology: A systematic review was performed using the terms: "Vertical transmission" AND "COVID-19" OR "SARSCoV-2" NOT "Review *". The databases consulted were MEDLINE/PubMed, Science Direct, Clinical Key, LILACS, SciELO, Google Scholar, medRxiv and SciELO Preprints. Results: Thirty primary studies met the selection criteria and included 476 pregnant women. Infection was found in 9 neonates (1.9%) in whom pharyngeal swabs were done within 48 hours of birth. In four of them the presence of the virus was not looked for in other maternal tissues and fluids; in the remaining 5 cases, the virus RNA was identified in the placenta of three of them, in two it was found in the amniotic fluid and in one in vaginal secretion. Studies were very heterogeneous, with great variety of the reported population, the number of samples and time of collection in neonates, the lack of sampling in maternal tissues and fluids. Conclusions: Vertical intrauterine transmission of SARS-CoV-2 has not been conclusively demonstrated in pregnant women with COVID-19 as the majority of patients with the disease had newborns with negative molecular test (98,1%). The heterogeneity of the studies does not allow to rule out this possibility either.

Resultado funcional en pacientes con infarto cerebral y COVID-19 en Lima, Perú

Resumen Introducción El COVID-19 puede desencadenar un infarto cerebral por varios mecanismos potenciales, entre ellas, la hipercoagulabilidad. Se han reportado peores resultados funcionales en pacientes con infarto cerebral y COVID-19. Objetivo Determinar la asociación entre resultado funcional y COVID-19 en pacientes con infarto cerebral isquémico. Pacientes y métodos Se realizó un estudio de casos y controles comparando a pacientes ingresados a un centro de referencia neurológico en Perú con diagnóstico de infarto cerebral, antes (controles) y después (casos) del inicio de la pandemia por COVID-19. Hubo 31 casos diagnosticados con COVID-19 y 62 controles. Se utilizaron análisis bivariado y análisis de regresión de Poisson de efectos fijos condicionales. Resultados Los casos tenían glucemia basal más alta (133,5, RIQ: 117,5-174 vs 117, RIQ: 101-130, p=0,033) que los controles, recuentos de neutrófilos más altos (7,91, RIQ: 5,93-9,57 vs. 5,96, RIQ: 4,41-7,79, p=0,008), menor recuento de linfocitos (1,48, RIQ: 1,04-1,8 frente a 1,83, RIQ: 1,26-2,32, p=0,025), mayor relación neutrófilos/linfocitos (5,44, RIQ: 4,0-8,1 frente a 3,29, RIQ: 2,25-6,02, p=0,011), mayor NIH scale/score (NIHSS) (14, RIQ: 9-18 vs. 7, RIQ: 5-11, p=0,000) y mayores puntuaciones de Rankin modificadas al alta (4, RIQ: 4-5 vs. 2, RIQ: 1-4) p=0,001). Siete (21,88%) participantes fallecieron en el grupo de casos vs. 1 (1,56%) en los controles (p=0,014). La odds ratio de un mal resultado funcional al alta fue de 1,344 (IC: 1,079-4,039;p=0,029), ajustada por NIHSS al ingreso. Conclusiones Nuestros hallazgos sugieren que los infartos cerebrales asociados a COVID-19 son más graves, tienen un peor resultado funcional y una mayor mortalidad que los infartos cerebrales no relacionados a COVID-19. Introduction COVID-19 seems to induce ischemic stroke by several potential mechanisms including promoting hypercoagulability, and worse functional outcomes have been reported in patients with stroke and the infection with SARS-CoV-2. Objective Determine the association between functional outcome and COVID-19 in patients with stroke. Patients and methods We performed a case control study comparing patients admitted to a neurological reference center in Peru with a diagnosis of stroke before (controls) and after (cases) the onset of the COVID-19 pandemic. There were 31 cases diagnosed with COVID-19 and 62 controls without COVID-19. Bivariate analysis and conditional fixed-effects Poisson regression analysis were used to evaluate the association between the functional outcome of the stroke and COVID-19. Results Cases had higher baseline serum glucose (133.5, IQR: 117.5-174 versus 117, IQR: 101-130, p=0.033) than controls, higher neutrophil counts (7.91, IQR: 5.93-9.57 versus 5.96, IQR: 4.41-7.79, p=0.008), lower lymphocyte counts (1.48, IQR: 1.04-1.8 versus 1.83, IQR: 1.26-2.32, p=0.025), higher neutrophil/lymphocyte ratios (5.44, IQR: 4.0-8.1 versus 3.29, IQR: 2.25-6.02, p=0.011), higher NIH stroke scale/score (NIHSS) (14, IQR: 9-18 versus 7 IQR: 5-11, p=0.000), and higher modified Rankin scores at discharge (4, IQR: 4-5 versus 2, IQR: 1-4), p=0.001). Seven (21.88%) participants died in the group of cases versus 1 (1.56%) in the controls (p=0.014). The odds ratio of having a bad functional outcome at discharge was 1.344 (CI: 1.079-4.039;p=0.029), adjusted by NIHSS at admission. Conclusions Our findings suggest that ischemic strokes associated with COVID-19 are more severe, have worse functional outcome and higher mortality than non-COVID-19 ischemic strokes.

Families' perceptions of how children with chronic diseases played during the pandemic / O brincar de crianças com doenças crônicas durante a pandemia na percepção da família / El juego de los niños con enfermedades crónicas durante la pandemia en la percepción de la familia

Objetivo: compreender as vivências de familiares de crianças com doenças crônicas sobre o brincar durante a pandemia. Método: estudo qualitativo fundamentado nos pressupostos da Análise da Estrutura do Fenômeno Situado, com 14 familiares que convivem com crianças com doenças crônicas, hospitalizadas em um hospital universitário localizado em Campinas, São Paulo. Os discursos foram obtidos, após aprovação do Comitê de Ética, por meio de entrevista aberta, de julho a setembro de 2021 e analisados segundo o referencial de Martins e Bicudo. Resultados: emergiram três categorias, brincando em outro lugar - as mudanças espaciais; brincando com (sem) outras pessoas ­ as mudanças interacionais e brincando diferente - as mudanças comportamentais. Conclusão: as mudanças ocorreram por necessidade de confinamento nos domicílios, fechamento dos espaços públicos e obrigatoriedade do distanciamento social. Houve aumento maciço do uso das telas pelas crianças, sem controle do tempo de utilização.

Objective: to understand the experiences of relatives of children with chronic diseases as regards playing during the pandemic. Method: this qualitative study of 14 family members living with children with chronic diseases, admitted as inpatients to a university hospital in Campinas, São Paulo, drew on the assumptions of Situated Phenomenon Structure Analysis. After approval by the research ethics committee, open interviews were conducted from July to September 2021 and the resulting data were analyzed with Martins and Bicudo as the frame of reference. Results: three categories emerged: Playing somewhere else ­ spatial changes; Playing with (without) other people ­ interactional changes; and Playing differently ­ behavioral changes. Conclusion: the changes resulted from confinement at home, the closure of public places, and mandatory social distancing. Children's screen use increased massively, with no control of use time.

Objetivo: comprender las experiencias de familiares de niños con enfermedades crónicas sobre el juego durante la pandemia. Método: estudio cualitativo basado en los supuestos del Análisis Estructural del Fenómeno Situado, con 14 familiares que viven con niños con enfermedades crónicas, hospitalizados en un hospital universitario ubicado en Campinas, São Paulo. Las declaraciones fueron obtenidas, previa aprobación del Comité de Ética, a través de entrevista abierta, de julio a septiembre de 2021 y analizadas según la referencia de Martins y Bicudo. Resultados: surgieron tres categorías: Jugando en otra parte ­ los cambios espaciales; Jugar con (sin) otras personas - los cambios en la interacción y; Jugar de manera diferente - los cambios en el comportamiento. Conclusión: los cambios ocurrieron por la necesidad de confinamiento en los hogares, cierre de los espacios públicos y distanciamiento social obligatorio. Hubo un aumento masivo en el uso de pantallas por parte de los niños, sin control sobre el tiempo de uso.

Seroincidencia de anticuerpos IgG del SARS-CoV-2 y factores de riesgo en trabajadores sanitarios asintomáticos del Hospital Departamental de Villavicencio

Objetivo: Estimar la seroincidencia acumulada de inmunoglobulinas (Ig) clase G (IgG) anti-SARS-CoV-2 en trabajadores de la salud asintomáticos y su asociación epidemiológica dentro de las áreas funcionales del Hospital Departamental de Villavicencio (HDV). Metodología: Se llevó a cabo un estudio observacional analítico longitudinal de una cohorte de trabajadores, donde cada 21 días, en tres oportunidades, se midieron IgG anti-SARS-CoV-2 en suero sanguíneo, a través de ELISA indirecto, en una muestra representativa aleatoria (n = 105) de trabajadores sanitarios del hospital (N = 756). Como instrumento de recolección de datos se utilizó una encuesta, donde cada trabajador sanitario declaró no haber sido diagnosticado con COVID-19, e igualmente registró la información sobre las variables independientes: sexo, edad, condición laboral, área funcional y comorbilidades. Resultados: La prevalencia inicial para SARS-CoV-2 entre los trabajadores sanitarios asintomáticos del HDV fue de 9,52 % (IC 95 % 5,25-16,65). La seroincidencia acumulada durante 42 días fue de 12,38 % (IC 95 % 7,38-20,04). El riesgo relativo (RR) se utilizó para establecer los factores de riesgo asociados a las variables independientes. El sexo masculino (RR ajustado = 3,34, IC 95 % 1,98-5,86), obesidad (RR ajustado = 10,98, IC 95 % 1,41-85,98) y sexo femenino (RR ajustado = 2,15, IC 95 % 1,12-4,31) en las áreas funcionales de Hospitalización, Medicina Crítica y Urgencias, respectivamente, son factores de riesgo en el HDV. Conclusión: Un total de 13 de 105 trabajadores sanitarios del hospital seroconvirtieron positivamente para SARS-CoV-2 y fueron asintomáticos durante 42 días de seguimiento epidemiológico. Además, existen factores de riesgo importantes en su exposición a este virus en el HDV.Alternate : Objetivo: Estimar a incidência zero acumulada de imunoglobulinas (Ig) classe G (IgG) anti-SARS-CoV-2 em profissionais de saúde assintomáticos e sua associação epidemiológica dentro das áreas funcionais do Hospital Estadual de Villavicencio (HDV). Metodologia: Foi realizado um estudo observacional analítico longitudinal de uma coorte de profissionais, no qual a cada 21 dias, em três ocasiões mediram-se IgG anti-SARS-CoV-2 em soro sanguíneo, através de ELISA indireto, em uma amostra representativa aleatória (n = 105) de profissionais de saúde do hospital (N =756). Como instrumento de recolecção de dados foi usada uma pesquisa, onde cada profissional de saúde declarou não ter sido diagnosticado com COVID-19, e igualmente registrou a informação sobre as variáveis independentes: sexo, idade, condições de trabalho, área de atuação e comorbidades. Resultados: A prevalência inicial para SARS-CoV-2 entre os profissionais de saúde assintomáticos do HDV foi de 9,52% (IC 95% 5,25-16,65). A incidência zero acumulada durante 42 dias foi de 12,38% (IC 95% 7,38-20,04). O risco relativo (RR) foi utilizado para estabelecer os fatores de risco associados às variáveis independentes. O sexo masculino (RR ajustado 3,34, IC 95% 1,98-5,86), obesidade (RR ajustado 10,98, IC 95% 1,41-85,98) e sexo feminino (RR ajustado 2,15, IC 95% 1,12-4,31) nas áreas funcionais de Internação, Unidade de Terapia Intensiva e Urgências, respectivamente, são fatores de risco no HDV. Conclusão: Um total de 13 de 105 profissionais de saúde do hospital foram detectados positivamente para SARS-CoV-2 e foram assintomáticos durante 42 dias de seguimento epidemiológico. Além disso, existem importantes fatores de risco na sua exposição a este vírus no HDV.Alternate : Objective: To estimate the cumulative seroincidence of anti-sars-CoV-2 immunoglobulin (Ig) class G (IgG) in asymptomatic health care workers and its epidemiological association within the functional areas of the Villavicencio Departmental Hospital (HDV). Methodology: A longitudinal analytical observational study of a cohort of workers was conducted in which anti-SARS-CoV-2 IgG levels in blood serum were measured every 21 days on three occasions using an in irect ELISA in a random representative sample (n = 105) of hospital health workers (N = 756). The data collection tool was a survey in which each healthcare worker indicated that they had not been diagnosed with COVID-19 and provided information on the independent variables: sex, age, job status, functional area, and comorbidities. Results: The baseline prevalence for SARS-CoV-2 among asymptomatic HDV healthcare workers was 9.52% (CI 95% 5.25-16.65). Cumulative seroincidence over 42 days was 12.38% (CI 95% 7.38-20.04). Relative risk (RR) was used to establish the risk factors associated with the independent variables. Male sex (adjusted RR 3.34, CI 95% 1.98-5.86), obesity (adjusted RR 10.98, CI 95% 1.41-85.98) and female sex (adjusted RR 2.15, CI 95% 1.12-4.31) in the functional areas of Hospitalization, Critical Medicine and Emergency, respectively, are risk factors in the HDV. Conclusion: During 42 days of epidemiological follow-up, 13 out of 105 hospital healthcare workers seroconverted positively for SARS-CoV-2 and remained asymptomatic. Additionally, significant risk factors are associated with their exposure to this virus in the HDV.

Why do we vent our emotions and blame others during the coronavirus pandemic? The role of emotional clarity in the United States and South Korea (¿Por qué ventilamos nuestras emociones y culpabilizamos a otras personas durante la pandemia del coronavirus? El rol de la claridad emocional en los Estados Unidos y Corea del Sur)

People have been experiencing more negative affect (NA) during the coronavirus disease 2019 pandemic than prior to its onset. This may increase instances of people venting their emotions and blaming others to relieve the flood of unregulated NA. This study examined individuals' venting and blaming processes within the context of the pandemic and explored the mediating role of emotional clarity across cultures. We conducted an online survey with 210 and 197 participants from the US and South Korea, respectively. The results of the moderated mediation analysis showed that individuals' NA during the pandemic significantly affected their venting and blaming via emotional clarity among US participants. This finding implies that when people in individualistic cultures do not fully understand their emotions, they are more likely to vent to or blame others. This can serve as a potential risk factor for hate crimes during the pandemic. Conversely, the mediation effect of emotional clarity was not significant among South Korean participants, suggesting dissimilar roles played by emotional clarity in individualistic versus collectivistic cultures in managing NA. (English) [ FROM AUTHOR] RESUMEN Las personas han estado experimentando más afectos negativos (AN) durante la enfermedad del coronavirus 2019 que antes de su aparición. Esto puede aumentar los casos de personas que ventilan sus emociones y culpabilizan a los demás para aliviar el flujo de afectos negativos (AN) no regulados. Este estudio analizó los procesos de ventilación emocional y culpabilización de los individuos en el contexto de la pandemia, y estudió el rol mediador de la claridad emocional entre culturas. Realizamos una encuesta online con 210 y 197 participantes de Estados Unidos y Corea del Sur, respectivamente. Los resultados del análisis de mediación moderada mostraron que los AN de los individuos durante la pandemia afectaron significativamente su forma de ventilar sus emociones y culpabilizar a través de la claridad emocional entre los participantes de los Estados Unidos. Este hallazgo implica que cuando las personas de culturas individualistas no conocen plenamente sus emociones, tienen más probabilidades de ventilarlas o de culpabilizar a otros. Esto puede servir como un factor de riesgo potencial para delitos de odio durante la pandemia. Y a la inversa, el efecto de mediación de la claridad emocional no fue significativa entre los participantes de Corea del Sur, lo que sugiere que los roles de la claridad emocional no son similares en las culturas individualistas y en las culturas colectivistas a la hora de gestionar los AN. (Spanish) [ FROM AUTHOR] Copyright of Revista de Psicologia Social 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 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 . (Copyright applies to all s.)

Health and nutrition status of nutritionists during the covid-19 confinement: A gender approach / Estado de salud y nutrición de los/as nutricionistas durante el confinamiento por la covid-19: un enfoque de género

El mundo ha convulsionado por la pandemia ocasionada por el coronavirus (COVID-19) que fuese reportado en diciembre de 2019 desde Wuhan-China, este virus tiene altas tasas de contagio y ocasiona severas enfermedades respiratorias e inclusive la muerte. Ante esta crisis, el confinamiento ha permitido controlar eficazmente la propagación. El impacto negativo sobre el estilo de vida constituye un nuevo factor de riesgo para el estado nutricional y de salud. Objetivo: Describir el estado de salud y nutrición de los/as nutricionistas durante el confinamiento por la covid-19: desde una perspectiva de género. Materiales y métodos: En este contexto, se desarrolló un estudio descriptivo, transversal y enfoque cuantitativo, para indagar algunas variables: sociodemográficas, económicas, condición de salud, y estado nutricional. Se aplicó una encuesta estructurada online dirigida a 359 nutricionistas graduados hasta el 28 de agosto de 2020 en la Universidad Técnica del Norte. Se usaron los correos electrónicos del Sistema Integrado Informático Universitario (SIIU). La muestra aleatoria fue de 136 profesionales, 95% de confianza (error = 6,7%). Resultados: El 79,41% fueron mujeres en su mayoría menores de 30 años y 20,59% hombres mayores de 30 años. El 59,56% tiene empleo, 23,52% en el área de salud. Los ingresos económicos de la mayor parte de hombres superan los 788 dólares. El 38,97% de la muestra tiene sobrepeso y el riesgo cardio metabólico afecta al 71,43% de hombres y 47,22% de mujeres, cerca del 25% poseen al menos una enfermedad crónica como: sobrepeso, hipotiroidismo, depresión/ansiedad e hipertensión arterial. El 32% tuvo familiares con Covid-19 de los cuales un 19,6% fallecieron. Conclusión: Los nutricionistas se han visto afectados en su situación laboral, económica, social y de salud(AU)

The world has been convulsed by the pandemic caused by the coronavirus (COVID-19) that was reported in December 2019 from Wuhan-China, this virus has high rates of contagion and causes severe respiratory diseases and even death. In the face of this crisis, confinement has made it possible to effectively control the spread. The negative impact on lifestyle constitutes a new risk factor for nutritional and health status. Objective: To describe the state of health and nutrition of nutritionists during confinement due to covid-19: from a gender perspective. Materials and methods: In this context, a descriptive, cross-sectional study with a quantitative approach was developed to investigate some variables: sociodemographic, economic, health condition, and nutritional status. An online structured survey was applied to 359 nutritionists graduated until August 28, 2020 at the Universidad Técnica del Norte. The emails of the Integrated University Information System (SIIU) were used. The random sample was 136 professionals, 95% confidence (error = 6.7%). Results: 79.41% were women, mostly under 30 years of age, and 20.59% were men over 30 years of age. 59.56% have a job, 23.52% in the health area. The economic income of most men exceeds 788 dollars. 38.97% of the sample is overweight and cardiometabolic risk affects 71.43% of men and 47.22% of women, about 25% have at least one chronic disease such as: overweight, hypothyroidism, depression/anxiety and high blood pressure. 32% had relatives with Covid-19, of whom 19.6% died. Conclusion: Nutritionists have been affected in their work, economic, social and health situation(AU)

Plague God Image in the Clinic.

This paper selects four dreams before and during COVID-19 which constellated the Plague God image in Chinese culture. The author argues that this shows evidence that the origins of the modern psyche, although hidden, are preserved and living within the ancient anima mundi.

Cet article sélectionne quatre rêves produits avant et pendant la pandémie de COVID-19 et qui montrent la constellation de l'image divine de la peste dans la culture Chinoise. L'auteur soutient que ceci montre la preuve que les origines de la psyché moderne, bien que cachées, sont préservées et vivantes au sein de l'ancien anima mundi.

El presente artículo selecciona cuatro sueños antes y durante la pandemia del COVID-19 que constelan la imagen del dios de la peste en la cultura China. El autor argumenta que esto demuestra que los orígenes de la psique moderna, aunque ocultos, se conservan y viven dentro de la antigua anima mundi.

Lung ultrasound score severity cut-off points in COVID-19 pneumonia. A systematic review and validating cohort.

OBJECTIVES: Our purpose was to establish different cut-off points based on the lung ultrasound score (LUS) to classify COVID-19 pneumonia severity. METHODS: Initially, we conducted a systematic review among previously proposed LUS cut-off points. Then, these results were validated by a single-centre prospective cohort study of adult patients with confirmed SARS-CoV-2 infection. Studied variables were poor outcome (ventilation support, intensive care unit admission or 28-days mortality) and 28-days mortality. RESULTS: From 510 articles, 11 articles were included. Among the cut-off points proposed in the articles included, only the LUS>15 cut-off point could be validated for its original endpoint, demonstrating also the strongest relation with poor outcome (odds ratio [OR]=3.636, confidence interval [CI] 1.411-9.374). Regarding our cohort, 127 patients were admitted. In these patients, LUS was statistically associated with poor outcome (OR=1.303, CI 1.137-1.493), and with 28-days mortality (OR=1.024, CI 1.006-1.042). LUS>15 showed the best diagnostic performance when choosing a single cut-off point in our cohort (area under the curve 0.650). LUS≤7 showed high sensitivity to rule out poor outcome (0.89, CI 0.695-0.955), while LUS>20 revealed high specificity to predict poor outcome (0.86, CI 0.776-0.917). CONCLUSIONS: LUS is a good predictor of poor outcome and 28-days mortality in COVID-19. LUS≤7 cut-off point is associated with mild pneumonia, LUS 8-20 with moderate pneumonia and ≥20 with severe pneumonia. If a single cut-off point were used, LUS>15 would be the point which better discriminates mild from severe disease.

The Transformation of Chinese Cultural Images of the Plague through Chinese Characters, Legends and Folkways.

The human experience of survival from a plague is about distinguishing the sick from the healthy as quickly as possible, establishing a barrier to stop the infection, and protecting healthy people. Nevertheless, the various quarantine rules and the acceptance and compliance of the population are a kind of battle between policy implementers and the public. This paper tries to understand how Chinese cultural attitudes (Henderson, 1984) unconsciously influence the Chinese people to be most cooperative with the strict containment and quarantine measures to confront the COVID-19 pandemic. This article begins with the Chinese characters, exemplified by the four characters of disease and plague, to discuss how the pictograph nature and spatial structural way profoundly shaped the cultural mind. Then, through plague-related Chinese legends, stories and folklore, the paper sets out the Chinese cultural attitudes which are also manifested in the analogical associations between disease, plague and seasons, the balance of the five elements of the universe and ghosts, gods and the government bureaucrats in the Kingdom of the Heaven. All of these approaches are well in line with Jung's method of associative amplification as a way to locate the archetypal wisdom that assures survival.

L'expérience humaine de survivre à la peste est de distinguer les malades des personnes saines aussi vite que possible, d'établir une barrière pour stopper l'infection, de protéger les personnes saines. Cependant les diverses règles sur la quarantaine et l'acceptation et la soumission de la population sont une sorte de bataille entre les personnes qui mettent en œuvre les mesures et le public. Cet article tente de comprendre comment les attitudes culturelles Chinoises (Henderson 1984) ont influencé inconsciemment le peuple Chinois, le rendant plus coopératif en ce qui concerne le confinement strict et les mesures de quarantaine pour faire face à la pandémie de COVID-19. Cet article commence avec les caractères Chinois, illustrés par les quatre caractères de la maladie et la peste, pour discuter comment le pictogramme de la nature et la façon de structurer l'espace ont profondément modelé la pensée culturelle. Ensuite, à travers des légendes, des histoires et le folklore Chinois traitant de la peste, l'article cerne les attitudes culturelles Chinoises. Ces attitudes sont également repérables dans les analogies entre la maladie, la peste et les saisons, l'équilibre des cinq éléments de l'univers, les esprits, les dieux et les bureaucrates gouvernementaux dans le Royaume des Cieux. Toutes ces approches sont bien en accord avec la méthode d'amplification associative de Jung en tant que manière de situer la sagesse archétypale qui permet la survie.

La experiencia humana de sobrevivir a una plaga consiste en distinguir lo antes posible a los enfermos de los sanos, establecer una barrera para detener la infección y proteger a las personas sanas. Sin embargo, las diversas normas de cuarentena y la aceptación y el cumplimiento por parte de la población son una especie de batalla entre los responsables políticos y el público. Este artículo trata de entender cómo las actitudes culturales chinas (Henderson 1984) influyen inconscientemente en el pueblo chino para que sea más cooperativo con las estrictas medidas de contención y cuarentena para hacer frente a la pandemia de COVID-19. El presente artículo comienza con los caracteres chinos, ejemplificados por los cuatro caracteres de la enfermedad y la peste, para analizar cómo la naturaleza pictográfica y la forma estructural espacial moldearon profundamente la mente cultural. A continuación, a través de leyendas, cuentos y folclore chinos relacionados con la peste, el artículo expone las actitudes culturales chinas que también se manifiestan en las asociaciones analógicas entre la enfermedad, la peste y las estaciones, el equilibrio de los cinco elementos del universo, y los fantasmas, los dioses y los burócratas del gobierno en el Reino de los Cielos. Todos estos planteamientos se ajustan bien al método de Jung de amplificación asociativa como vía de acceso a la sabiduría arquetípica que asegura la supervivencia.

Can systemic immune inflammation index at admission predict in-hospital mortality in chronic kidney disease patients with SARS-CoV-2 infection?

BACKGROUND AND AIM: Patients with chronic kidney disease (CKD) are susceptible to SARS-CoV-2 infection and more prone to develop severe disease. It is important to know predictors of poor outcomes to optimize the strategies of care. METHODS: 93 patients with CKD and 93 age-sex matched patients without CKD were included in the study. Data on demographic, clinical features, hematological indices and outcomes were noted and compared between the groups. Neutrophile to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII) (platelet counts×neutrophil counts/lymphocyte counts) and lymphocyte-to-CRP ratio (LCR) were calculated on admission and the association of these markers with disease mortality in CKD patients was identified. RESULTS: CKD patients had higher risk of severe disease, and mortality compared to non-CKD patients (72% vs 50.5%, p=0.003, 36.6% vs 10.8%, p<0.001, respectively) and were more likely to have higher values of immuno-inflammatory indices (leukocyte count, neutrophil, NLR, SII and C-reactive protein, etc.) and lower level of lymphocyte and LCR. Also, higher levels of NLR, SII, PLR and lower level of LCR were seen in CKD patients who died compared to those recovered. In a receiver operating characteristic curve analysis, NLR, SII, PLR and LCR area under the curve for in-hospital mortality of CKD patients were 0.830, 0.811, 0.664 and 0.712, respectively. Among all parameters, NLR and SII gave us the best ability to distinguish patients with higher risk of death. Based on the cut-off value of 1180.5, the sensitivity and specificity of the SII for predicting in-hospital mortality were found to be 67.5% and 79.6%, respectively. The corresponding sensitivity and specificity of the NLR were 85.2% and 66.1%, respectively, at the cut-off value of 5.1. Forward stepwise logistic regression analysis showed that NLR (≥5.1), SII (≥1180.5) and LCR (≤9) were predictors for in-hospital mortality. CONCLUSION: We report for the first time that SII is able to distinguish COVID-19 infected CKD patients of worse survival and it is as powerful as NLR in this regard. As SII is easily quantified from blood sample data, it may assist for early identification and timely management of CKD patients with worse survival.

Update of the prevention and isolation measure recommendations against SARS-COV-2 in dialysis units of Spain: A position paper of the Spanish Society of Nephrology Council.

SARS-CoV-2 pandemic has changed across the last two years. The development and approval of SARS-CoV-2 vaccines and the emergence of new variants has opened up a new scenario. On this regard, Spanish Society of Nephrology (S.E.N.) Council considers that an update of the previous recommendations should be performed. In the present statement, and taking into account the current epidemiological situation, are included updated recommendations of protection and isolation for patients on dialysis programs.

Recommendations of the Spanish Group on Crohn's Disease and Ulcerative Colitis on the importance, screening and vaccination in inflammatory bowel disease patients. / Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa sobre la importancia, el cribado y la vacunación en pacientes con enfermedad inflamatoria intestinal.

Patients with inflammatory bowel disease (IBD) may require different immunosuppressive treatments throughout their illness. It is essential to assess the immunization status of patients at diagnosis or, if this is not possible, at least before the beginning of immunosuppressive therapy and, subsequently, administering the appropriate vaccines. Therefore, the aim of this work is to establish clear and concise recommendations on vaccination in patients with IBD in the different settings of our clinical practice including vaccination in children, during pregnancy, breastfeeding or on trips. This consensus document emphasises the differences between inactivated and attenuated vaccines and the different degrees of immunosuppression and correlates them with the administration of both mandatory and optional vaccines recommended to our patients with IBD. Finally, as a summary, 17 recommendations are established based on the available scientific evidence and expert opinion. A multidisciplinary team with extensive experience in IBD and vaccination, made up of specialists in gastroenterology, paediatrics, nursing and pharmacy, has participated in the preparation of these recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis.

Serological response to vaccines against SARS-CoV-2 in patients with inflammatory bowel disease. / Respuesta serológica a las vacunas frente a SARS-CoV-2 en pacientes con enfermedad inflamatoria intestinal.

OBJECTIVE: To study the serological response (SR) and tolerability of COVID-19 vaccine in patients with inflammatory bowel disease (IBD) and its relation with IBD treatment and type of vaccine. METHODS: Observational, cross-sectional study in patients with IBD vaccinated against COVID-19 without known previous infection. SR was analyzed by the determination of IgG antibodies against the S1 subunit. Safety was studied using a questionnaire to identify adverse effects (AE). RESULTS: 280 patients with IBD were included. Type of vaccines: Comirnaty® 68.8%; Spikevax® 10.8%, Vaxzevria® 18.3%, Ad26.COV2-S® 2.2%. 51.3% had AE, being 100% mild. 65% developed IgG antibodies after vaccination. The SR was higher for vaccines with mRNA technology (100% Spikevax®, 68.5% Comirnaty®) compared to those based on adenovirus vector (38.0% Vaxzevria®, 33.3% Ad26.COV2-S®) (P<.001). In the multivariate analysis, SR was related to age (<60 years; OR: 3.8, 95% CI 1.9-7.0; P<.001). The SR in patients with aminosalicylates was 65.4%, 61.4% with immunosuppressants, 65.8% with anti-TNF, and 68.7% with non-anti-TNF biologicals (P=.9). CONCLUSIONS: One third of patients with IBD did not develop antibodies with the initial vaccination against SARS-CoV-2. The SR to vaccines based on mRNA technology was higher, and it was related to age (higher in younger patients). Immunosuppressants and biologicals did not decrease SR. More than half of the patients presented AD, being mild in all cases.

Salón de belleza versus ‘dispositivo de la persona': cuerpo, enfermedad y sexualidad

En Viajes virales (2012), la escritora Lina Meruane elabora una lectura crítica acerca del corpus literario sobre el SIDA producido en el auge de la epidemia en Latinoamérica. En este libro, Meruane destaca como una de las obras fundamentales sobre este tema la novela Salón de belleza (1994), de Mario Bellatin, que —al poner la enfermedad en discurso— delata el exterminio de la comunidad homosexual latinoamericana, que comprendería el gay pobre afeminado. Narrada en primera persona por el protagonista, un peluquero travesti, la novela gira en torno de este personaje que, en la ausencia de políticas de Estado, convierte a su salón de belleza en un ‘moridero' para acoger a los cuerpos de hombres enfermos y abandonados que, acometidos por una enfermedad contagiosa asociada de forma latente a la homosexualidad y al SIDA, ya no se adecuan a la categoría de persona humana, digna de derechos básicos. Suponiendo un "sujeto de la consciencia” apartado de su cuerpo, conforme ha teorizado Esposito (2009, 2011), la categoría de la persona es valorada en discursos jurídicos, filosóficos y políticos y —sobre todo— sustenta las reivindicaciones de los derechos humanos, contradictoriamente, tan en boga en la contemporaneidad. A la luz de esas ideas, el objetivo de este trabajo es analizar cómo la novela Salón de belleza, al enfocar el cuerpo enfermo y sexualmente disidente, problematiza la eficacia de la categoría de la persona como garantía de derechos, así se revela un dispositivo de exclusión de los cuerpos a servicio de la biopolítica que regula la muerte y separa biológicamente —a partir de la enfermedad, del género y de la sexualidad— a los que merecen vivir de los que merecen morir.Alternate : In Viajes virales (2012), Lina Meruane provides a critical reading of the literary corpus on AIDS, produced at the height of the epidemic in Latin America. In this book, the author highlights the novel Salón de belleza (1994), by Mario Bellatin, as one of the fundamental works on this theme, in which the writing of the disease denounces the extermination of the Latin American homosexual community, which would include the poor effeminate gay. The novel revolves around a cross-dresser hairdresser who, in the absence of public policies, converts his beauty salon into a ‘moridero' to shelter the abandoned bodies of sick men who, affected by a contagious disease indirectly associated with homosexuality and AIDS, no longer fit into the category of human person, worthy of basic rights. In turn, assuming a "universal” and "disembodied” individual, the dispositif of the person, as theorized by Roberto Esposito (2009, 2011), has become the key concept that sustains human rights claims, contradictorily, so popular in contemporaneity. In light of these ideas, the aim of this paper is to analyze how Salón de belleza, by focusing on the sick and sexually dissident body, problematizes the effectiveness of the dispositif of the person to guarantee rights, revealing itself, in reality, as a biopolitical apparatus of exclusion and control of bodies: separating biologically-based on health condition, gender and sexuality- who deserves to live and who must die.Alternate : Em Viajes virales (2012), Lina Meruane elabora uma leitura crítica acerca do corpus literário sobre a Aids produzido no auge da epidemia na América Latina. Neste livro, a autora destaca a novela Salón de belleza (1994), de Mario Bellatin, como uma das obras fundamentais sobre este tema, na qual a doença posta em discurso delata o extermínio da comunidade homossexual latino-americana, que compreenderia o gay pobre afeminado. A novela gira em torno de um cabeleireiro travesti que, na ausência de políticas públicas, converte o seu salão de beleza em um ‘moridero' para acolher os corpos abandonados de homens doentes que, acometidos por uma doença contagiosa associada indiretamente à homossexualidade e à aids, não mais se adequam à categoria de pessoa humana, digna de direitos básicos. Por seu turno, p essupondo um indivíduo "universal” e "descorporificado”, a categoria de pessoa, conforme teorizou Roberto Esposito (2009, 2011), tornou-se o conceito-chave que sustenta as reivindicações dos direitos humanos, contraditoriamente, tão em voga na contemporaneidade. À luz dessas ideias, o objetivo deste trabalho é analisar de que modo Salón de belleza, ao pôr em foco o corpo doente e sexualmente dissidente, problematiza a eficácia da categoria de pessoa como garantidora de direitos, revelando-se, em realidade, um dispositivo biopolítico de exclusão e controle dos corpos: separando biologicamente -a partir da doença, do gênero e da sexualidade- quem merece viver e quem deve morrer.

Serological response to vaccines against SARS-CoV-2 in patients with inflammatory bowel disease

Objective To study the serological response (SR) and tolerability of COVID-19 vaccine in patients with inflammatory bowel disease (IBD) and its relation with IBD treatment and type of vaccine. Methods Observational, cross-sectional study in patients with IBD vaccinated against COVID-19 without known previous infection. SR was analyzed by the determination of IgG antibodies against the S1 subunit. Safety was studied using a questionnaire to identify adverse effects (AE). Results 280 patients with IBD were included. Type of vaccines: Comirnaty® 68.8%;Spikevax® 10.8%, Vaxzevria® 18.3%, Ad26.COV2-S® 2.2%. 51.3% had AE, being 100% mild. 65% developed IgG antibodies after vaccination. The SR was higher for vaccines with mRNA technology (100% Spikevax®, 68.5% Comirnaty®) compared to those based on adenovirus vector (38.0% Vaxzevria®, 33.3% Ad26.COV2-S®) (P < .001). In the multivariate analysis, SR was related to age (<60 years;OR: 3.8, 95% CI 1.9–7.0;P < .001). The SR in patients with aminosalicylates was 65.4%, 61.4% with immunosuppressants, 65.8% with anti-TNF, and 68.7% with non-anti-TNF biologicals (P = .9). Conclusions One third of patients with IBD did not develop antibodies with the initial vaccination against SARS-CoV-2. The SR to vaccines based on mRNA technology was higher, and it was related to age (higher in younger patients). Immunosuppressants and biologicals did not decrease SR. More than half of the patients presented AD, being mild in all cases. Resumen Objetivo Estudiar la respuesta serológica (RS) y tolerabilidad frente a la vacuna COVID-19 en pacientes con enfermedad inflamatoria intestinal (EII) y su relación con el tratamiento de la EII y tipo de vacuna. Métodos Estudio observacional, transversal en pacientes con EII vacunados contra COVID-19 sin infección previa conocida. La RS se analizó mediante la determinación de anticuerpos IgG frente a la subunidad S1. La seguridad se estudió mediante cuestionario para identificación de efectos adversos (EA). Resultados Se incluyeron 280 pacientes con EII. Tipo de vacunas: Comirnaty® 68,8%;Spikevax® 10,8%, Vaxzevria® 18,3%, Ad26.COV2-S® 2,2%. Un 51,3% tuvo EA, siendo el 100% leves. Un 65% desarrolló anticuerpos IgG tras la vacunación. La RS fue superior para vacunas con tecnología ARNm (100% Spikevax®, 68,5% Comirnaty®) frente a las basadas en vector con adenovirus (38,0% Vaxzevria®, 33,3% Ad26.COV2-S®) (P < ,001). En el análisis multivariante la RS se relacionó con la edad (<60 años;OR: 3,8, IC 95% 1,9–7,0;P < ,001). La RS en pacientes con aminosalicilatos fue del 65,4%, 61,4% con inmunosupresor, 65,8% con anti-TNF y 68,7% con biológicos no anti-TNF (P = ,9). Conclusiones Un tercio de pacientes con EII no desarrolló anticuerpos con la pauta vacunal inicial frente a SARS-CoV-2. La RS a las vacunas basadas en tecnología ARNm fue superior, y estuvo relacionada con la edad (mayor en pacientes más jóvenes). Los inmunosupresores y biológicos no disminuyeron la RS. Más de la mitad de los pacientes presentaron EA, leves en todos los casos.

Common Mental Disorders During the COVID-19 Pandemic: Frequency and Associated Factors

This study aimed to assess the frequency and associated factors of symptoms of common mental disorders in the Brazilian population at the beginning of the coronavirus disease 2019 (COVID-19) pandemic. A sample of 1,482 adults, with a mean age of 34.68 years (SD = 13.66 years), 76.8% female, answered a sociodemographic questionnaire, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Mindful Attention and Awareness Scale. Atypical high levels of symptoms of common disorders were observed, as well as self-mutilation, suicidal ideation, and suicide attempts. The mindful trait was the main factor negatively associated with both anxiety and depression symptoms. Worse financial conditions and non-normative sexual orientation predicted symptoms of anxiety and depression, but no differences were found between the group that followed and the one that did not follow the social distancing measures. From the high clinical indices, the pandemic effect can be inferred, but longitudinal studies could help understand long-term effects.Alternate : Este estudio tuvo como objetivo evaluar la frecuencia y factores asociados a los síntomas de trastornos mentales comunes en la población brasileña al comienzo de la pandemia de coronavirus disease 2019 (COVID-19). Una muestra de 1.482 adultos, con edad media de 34,68 años (DE = 13,66), 76,8% mujeres, respondieron un cuestionario sociodemográfico, la Escala Depresión, Ansiedad y Estrés – 21 (Depression, Anxiety, and Stress Scale-21 [DASS-21]) y la Escala de Atención y Conciencia Plena. Se observaron niveles altos atípicos de trastornos comunes, así como automutilación, ideación suicida e intentos de suicidio. La atención plena fue el principal factor asociado negativamente tanto a los síntomas de ansiedad como a los síntomas de depresión. La peor situación económica y orientación sexual no normativa predijeron síntomas de ansiedad y depresión, pero no se encontraron diferencias entre el grupo que siguió y el que no siguió las reglas del distanciamiento social. A partir de los altos índices clínicos, se puede inferir el efecto pandémico, pero estudios longitudinales podrían ayudar a comprender los efectos a largo plazo.Alternate : Este estudo teve por objetivo avaliar a frequência de sintomas de transtornos mentais comuns e os fatores associados a eles na população brasileira no início da pandemia da coronavirus disease 2019 (Covid-19). Uma amostra de 1.482 adultos, com idade média de 34,68 anos (DP = 13,66), 76,8% do sexo feminino, respondeu a um questionário sociodemográfico, à Escala de Depressão, Ansiedade e Estresse – 21 (Depression, Anxiety, and Stress Scale-21 [DASS-21]) e à Escala de Atenção e Consciência Plena. Foram observados níveis elevados e atípicos de transtornos comuns, bem como automutilação, ideação suicida e tentativas de suicídio. O traço mindful foi o principal fator associado negativamente tanto a sintomas de ansiedade quantos a sintomas de depressão. Pior condição financeira e orientação sexual não normativa predisseram sintomas de ansiedade e depressão, mas não foram encontradas diferenças entre o grupo que seguiu e o que não seguiu as regras do distanciamento social. O efeito pandêmico pode ser inferido a partir dos níveis clínicos elevados, mas estudos longitudinais podem ajudar a compreender efeitos de longo prazo.

Impact of digital transformation on tropical health / Impacto de la transformación digital en la salud tropical

La Transformación Digital (TD) es todo un proceso que busca optimizar la relación usuario­organización, mejorando así los procesos y el desempeño. Con la llegada de la pandemia COVID-19 a principios del año 2020, cuando fue necesario acelerar la inclusión de las Tecnologías de Información y Comunicación (TIC) para continuar ofreciendo los servicios sanitarios, se constituye el sistema peruano de TD como un sistema funcional; con normas, principios y procedimientos; y con técnicas e instrumentos para ordenar las actividades del sector público y con miras a su optimización. Se planteó una investigación de carácter descriptivo para conocer el impacto de la transformación digital en la salud tropical del Perú. Para ello se determinaron el impacto en la gestión de datos, gobernanza, e intercambio de conocimiento e innovación digital de 4 enfermedades metaxénicas y 3 zoonóticas seleccionadas a partir del análisis de los distintos componentes de la sala virtual de situación de salud del Centro Nacional de Epidemiología, Prevención y Control de Enfermedades del Perú. Los datos fueron analizados bajo el Sistema de Información para la Salud (IS4H) de la OPS que permitió valorar la interoperabilidad de los procesos relacionados con la categorización de estas nosologías. Para todos los factores evaluados: gestión de datos, innovación, gestión y gobernanza y gestión e intercambio de conocimiento, los resultados, en general, estuvieron alrededor de la media (3 puntos, en una escala del 1 al 5), siendo el valor más alto (3,3 puntos) para la gestión y gobernanza, y el valor más bajo (2,7 puntos) para la innovación. Se necesita un enfoque más holístico en la salud pública para asegurarse de que se proporcione una respuesta eficaz frente a las enfermedades tropicales. Si los sistemas de salud se colocan en el medio de la acción, esto permitiría tener mayores posibilidades de hacer frente a estas enfermedades mediante el uso adecuado de las herramientas modernas que logren complementar el enfoque tradiciona(AU)

Digital Transformation (TD) is a whole process that seeks to optimize the user-organization relationship, thus improving processes and performance. With the arrival of the COVID-19 pandemic at the beginning of 2020, when it was necessary to accelerate the inclusion of Information and Communication Technologies (ICT) to continue offering health services, the Peruvian DT system was established as a functional system; with norms, principles and procedures; and with techniques and instruments to order the activities of the public sector and with a view to their optimization. A descriptive investigation was proposed to know the impact of digital transformation on tropical health in Peru. For this, the impact on data management, governance, and exchange of knowledge and digital innovation of 4 metaxenic and 3 zoonotic diseases selected from the analysis of the different components of the virtual health situation room of Centro Nacional de Epidemiología, Prevención y Control de Enfermedades of Peru. The data were analyzed under PAHO's Information System for Health (IS4H), which made it possible to assess the interoperability of the processes related to the categorization of these nosologies. For all the factors evaluated: data management, innovation, management and governance, and knowledge management and exchange, the results, in general, were around the average (3 points, on a scale from 1 to 5), with the highest value being highest (3.3 points) for management and governance, and the lowest value (2.7 points) for innovation. A more holistic approach to public health is needed to ensure that an effective response to tropical diseases is provided. If health systems are placed in the middle of the action, this would allow them to have greater possibilities of dealing with these diseases through the appropriate use of modern tools that manage to complement the traditional approach(AU)