Real-world evidence with a retrospective cohort of 15,968 Andalusian COVID-19 hospitalized patients suggests 21 new effective treatments and one drug that increases death risk.

Despite the extensive vaccination campaigns in many countries, COVID-19 is still a major worldwide health problem because of its associated morbidity and mortality. Therefore, finding efficient treatments as fast as possible is a pressing need. Drug repurposing constitutes a convenient alternative when the need for new drugs in an unexpected medical scenario is urgent, as is the case with COVID-19. Using data from a central registry of electronic health records (the Andalusian Population Health Database, BPS), the effect of prior consumption of drugs for other indications previous to the hospitalization with respect to patient survival was studied on a retrospective cohort of 15,968 individuals, comprising all COVID-19 patients hospitalized in Andalusia between January and November 2020. Covariate-adjusted hazard ratios and analysis of lymphocyte progression curves support a significant association between consumption of 21 different drugs and better patient survival. Contrarily, one drug, furosemide, displayed a significant increase in patient mortality.

Assessing the impact of SARS-CoV-2 lineages and mutations on patient survival

After more than two years of COVID-19 pandemic, SARS-CoV-2 still remains a global public health problem. Successive waves of infection have produced new SARS-CoV-2 variants with new mutations whose impact on COVID-19 severity and patient survival is uncertain. A total of 764 SARS-CoV-2 genomes sequenced from COVID-19 patients, hospitalized from 19th February 2020 to 30st April 2021, along with their clinical data, were used for survival analysis. A significant association of B.1.1.7, the alpha lineage, with patient mortality (Log Hazard ratio LHR=0.51, C.I.=[0.14,0.88]) was found upon adjustment by all the covariates known to affect COVID-19 prognosis. Moreover, survival analysis of mutations in the SARS-CoV-2 genome rendered 27 of them significantly associated with higher mortality of patients. Most of these mutations were located in the S, ORF8 and N proteins. This study illustrates how a combination of genomic and clinical data provide solid evidence on the impact of viral lineage on patient survival.

Resilience requires change. Assessing Pehuenche responses to climate change impacts in Southern Chile.

Indigenous peoples are one of the most vulnerable groups to climate change. Although many communities are already responding to these impacts, inequitable structures impose barriers to their capacity to recover and adapt. Through the case of the Pehuenche people of Southern Chile, this article addresses the question of what is the relationship between resilience and adaptation to climate change. From an ethnographic approach, the article characterizes the construction process of the contextual vulnerability of Pehuenche communities and evaluates their responses to cope with climate change impacts. Fieldwork was conducted in two stages between 2017 and 2019. Results show that current Pehuenche vulnerability to climate change is an ongoing process influenced by the state rather than a consequence of this phenomenon. Although Pehuenche communities are responding to climate change impacts, their resilience is constrained by the incidence of state policy. Identifying themselves as herders, Pehuenche responses aim to restore the conditions for livestock instead of changing the factors that make them vulnerable. Most of their responses can be considered maladaptation because they reinforce vulnerability by reproducing practices that damage their social capital and cause more pressure on the territory. A critical review and reformulation of the policy implemented at the local level are mandatory to strengthen community resilience.