TH-136. Peripheral neuropathies as complication of SARS-Cov-2: a multicenter study in the Andalusian population

Introduction: Since the beginning of the pandemic caused by SARS-Cov-2, we have observed an increase of patients referred for electroneuromyography (ENMG) studies complaining of neuropathic symptoms, and who share in common having suffered from the disease by coronavirus (Covid-19), in its different forms of presentation. Clinical, diagnostic, and epidemiological studies that identify possible risk factors of peripheral neuropathies are needed. Method(s): Retrospective and prospective multicenter study in which neurophysiologists from 10 Andalusian hospitals are currently participating. The risk factors analyzed are age, sex, date of infection, date of onset symptoms in relation to Covid infection, hospital admission, admission to intensive unit care (IUC), time of admission, prone position, if orotracheal intubation needed, body mass index (BMI), personal history of interest, if previously vaccinated and complications. The observed peripheral nervous system involvement, caused both directly and indirectly by the virus, has been taken into account. Result(s): A total of 73 patients with neuropathic involvement. Of this total, 39 polyneuropathies (11 Guillain-Barre syndrome, 1 small fiber and 27 other critical illness polyneuropathies associated with IUC patients, 1 of these with associated myopathy), 13 peroneal neuropathies (4 unilateral, 1 with suprascapular neuropathy concomitant and 7 bilateral), 7 brachial plexopathies, 5 neuropathies of the superior laryngeal nerve (3 with concomitant involvement of the inferior) in patients with a history of orotracheal intubation, 2 neuropathies of the femorocutaneous nerve, 2 mononeuritis multiplex, 2 phrenic neuropathies, 1 vagus nerve neuropathy with no history of orotracheal intubation, 2 axillary neuropathies (1 with associated spinal neuropathy). Conclusion(s): Covid-19 causes involvement of the peripheral nervous system. Possible risk factors include male gender, old age, longer hospital stay, IUC admission, orotracheal intubation, prone position, suffering from previous pathologies, and high BMI. The possible causes that we consider for neuropathic involvement are compressive and positional (more indirectly related to the disease) and inflammatory / immune-mediated as the most direct cause of involvement caused by the SARS-Cov-2 virus. Knowledge of the risk factors is important, for the prevention, early diagnosis, and the correct treatment of these neuropathies. Some patients are left with serious neurological sequelae, with the consequences that this entails (high social and economic costs). Copyright © 2022

TH-126. Preliminary results of an Andalucia-South of Spain multicentric registry of SARS-CoV-2 postvaccination neuromuscular pathology

Introduction: European Medicines Agency (EMA) approved SARS-Cov-2 vaccines that are administered in Andalucia, south of Spain, have a very good clinical efficacy against Covid-19 and safety profile. Secondary effects (SE) associated with these vaccines are mainly mild (arthralgias myalgias), being SE related with the nervous system infrequent (>1/1000 to <1/100) tremor, paraesthesia, dizziness;rare (>=1/10.000 to < 1/1000) peripheral facial palsy, or very rare (<1/10.000) Guillain Barre syndrome (GBS). 85% of the Andalusian population have been already fully vaccinated, so our environment constitutes an ideal observatory for the real-life analysis of possible neuromuscular SE related to this vaccine. Result(s): Multicentric retrospective observational study of postvaccination against SARS-Cov-2 neuromuscular SE. We actively searched in 10 Andalusian hospitals for objective SE referred for electroneurography (ENG) and/or electromyography (EMG) after SARS-Cov-2 vaccination. We have registered 21 patients (12 males/9 females): 4 acute demyelinating polyneuropathies GBS;2 brachial plexopathies (Parsonage Turner type);1 ipsilateral of vaccine injection and one contralateral;1 inferior limb proximal myopathy in the context of a myocarditis;and 1 presented an acute neuromuscular postsynaptic defect Miastenia Gravis;the rest of the patients had distal paraesthesia with normal ENG-EMG. Conclusion(s): Neurophysiological studies in patients with peripheral neurological symptoms after SARS-Cov-2 vaccination are generally normal, but we should keep alert for possible serious and treatable complications that can be diagnosed with ENG-EMG tests. It would be advisable to extend this multicentric study the get a real idea of the performance of SARS-Cov-2 postvaccine ENG-EMG tests. Copyright © 2022

Gait-Based Authentication Using a RGB Camera

This paper focuses on the effectiveness of the gait-based authentication of users by using a camera. The authentication is possible as walking movement is considered a behavioural biometric technology, so it is inherent and individual to each human being. People can be successfully identified by walking 4m in a corridor in the most natural way. Different machine learning models were trained and tested achieving good accuracy rates, particularly good results were achieved with Linear Discriminant Analysis (LDA) with a 97.33% of accuracy. This biometric system allows authentication without contact and using masks which make it safe to users in the current COVID-19 pandemic situation.

Emotional education in the COVID-19 pandemic context

In pandemic times, it is important that people develop social-emotional learning skills in order to deal with stressful situations, and that these are approached with calmness and balanced emotional responses. The objective of this article is to reflect on the role of emotional education in pandemic conditions. Current trends advocate its insertion into teaching curricula, including introducing it as a new vision of the world, with a view to physical and mental well-being. Today, it represents a challenge for all of humanity, in order to strengthen the capacity to face adversity with more resilient positions. It can only be effective from an emotional balance and adequate mental health of the social actors involved.

Outcomes After Vascular Surgery Procedures in Patients with COVID-19 Infection: A National Multicenter Cohort Study (COVID-VAS).

OBJECTIVES: To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic. METHODS: This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across Spain and Andorra between March and May 2020. The primary end point was 30-day mortality. Clinical Trials registry number NCT04333693. RESULTS: The mean age was 70.9 (45-94) and 58 (77.0%) patients were male. Around 70.7% had postoperative complications, 36.0% of patients experienced respiratory failure, 22.7% acute renal failure, and 22.7% acute respiratory distress syndrome (ARDS). All-cause 30-days mortality rate was 37.3%. Multivariate analysis identified age >65 years (P = 0.009), American Society of Anesthesiologists (ASA) classification IV (P = 0.004), preoperative lymphocyte count <0.6 (×109/L) (P = 0.001) and lactate dehydrogenase (LDH) >500 (UI/L) (P = 0.004), need for invasive ventilation (P = 0.043), postoperative acute renal failure (P = 0.001), ARDS (P = 0.003) and major amputation (P = 0.009) as independent variables associated with mortality. Preoperative coma (P = 0.001), quick Sepsis Related Organ Failure Assessment (qSOFA) score ≥2 (P = 0.043), lymphocytes <0.6 (×109/L) (P = 0.019) leucocytes >11.5 (×109/L) (P = 0.007) and serum ferritin >1800 mg/dL (P = 0.004), bilateral lung infiltrates on thorax computed tomography (P = 0.025), and postoperative acute renal failure (P = 0.009) increased the risk of postoperative ARDS. qSOFA score ≥2 was the only risk factor associated with postoperative sepsis (P = 0.041). CONCLUSIONS: Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes <0.6 (x109/L) and LDH >500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality.

[Impact of COVID-19s alarm states in the care of pediatric patients in Primary Care in a health area in northern Spain]. / Impacto de los estados de alarma por COVID-19 en la atención a pacientes pediátricos en Atención Primaria de un área sanitaria del norte de España.

AIM: The SARS-CoV-2 pandemic has meant a global change in the healthcare model, enhancing telematic assistance, specially at the Health Primary Care (PC). There are few studies that relate the attendance of children at the PC to the pandemic of COVID-19. The aim of our study is to describe the impact of the two Spanish states of alarm on the care of children at de PC level. MATERIAL AND METHODS: Retrospective observational study. The PC visits corresponding to pediatric patients (<14 years) from a health area in northern Spain during the first and second states of alarm were analyzed, and compared with their equivalent periods in 2019. RESULTS: During the first state of alarm, home lockdown and school closure were established, and a large decrease in pediatric visits to the health centres was observed (758 vs. 1381 in 2019) at the expense of health check-ups and infectious diseases. This decrease was not observed in the second state of alarm (1375 vs. 1233 in 2019). In both states of alarm, the percentage of telephone assistance increased significantly. CONCLUSIONS: The implementation of alarm states has meant a decrease on the demand of medical care, especially during the first state of alarm, may be owing to the fear of the families of going to the health center and the decrease in the transmissibility of viruses due to home lockdown. The increase of the telematic assistance has been on account of the need of reorganization of health care, wich has proven to be effective.