Long-term Health-related Quality of Life in Working-age COVID-19 Survivors: A Cross-sectional Study.

BACKGROUND: Most working-age (18-64) adults have been infected with SARS-CoV-2, and some may have developed post-COVID-19 condition (PCC). However, health-related quality of life (HRQOL) greater than 2 years following infection remains uncharacterized. METHODS: In this cross-sectional study, COVID-19 survivors from throughout British Columbia (BC), Canada, completed a questionnaire greater than 2 years post-infection. PCC status was self-reported, and HRQOL was assessed using the EuroQol 5-dimension 5-level (EQ-5D-5L) instrument. We compared HRQOL in those with current PCC, those with recovered PCC, and those without a history of PCC. Iterative proportional fitting was used to weight analyses to be representative of COVID-19 survivors in BC. Multivariable regression models were used to adjust for confounders. RESULTS: Of the 1,135 analyzed participants, 19.2% had current PCC, and 27.6% had recovered PCC. Compared to those without a history of PCC, participants with recovered PCC had a similar weighted mean EQ-5D health utility (adjusted difference -0.02 [95%CI -0.03, 0.00]), but those with current PCC had a lower health utility (adjusted difference -0.08 [95%CI -0.12, -0.05]). Compared to those without a history of PCC, participants with current PCC were more likely to report problems with mobility (adjusted odds ratio (aOR) 6.00 [95%CI 2.88-12.52]), self-care (aOR 5.96 [95%CI 1.84-19.32]), usual activities (aOR 8.00 [95%CI 4.27-14.99]), pain/discomfort (aOR 4.28 [95%CI 2.46-7.48]), and anxiety/depression (aOR 3.45 [95%CI 1.90-6.27]). CONCLUSIONS: In working-age adults who have survived greater than 2 years following COVID-19, HRQOL is high among those who have never had PCC or have recovered from PCC. However, individuals with ongoing symptoms of PCC have lower HRQOL and are more likely to have deficits in multiple functional domains. These findings underscore the importance of implementing targeted healthcare interventions to improve HRQOL in adults with long-term PCC.

Healthcare workers' knowledge and risk perception regarding the first wave of COVID-19 in Khyber Pakhtunkhwa, Pakistan: an online cross-sectional survey.

Background: Increased COVID-19 transmission among the populace may be caused by healthcare workers (HCWs) who lack knowledge, awareness, and good preventive practices. Additionally, it may cause elevated stress levels, anxiety, poor medical judgement, and situational overestimation. Objectives: The present survey aimed to assess knowledge and risk perception regarding COVID-19 among HCWs in Khyber Pakhtunkhwa (KP), Pakistan. Methodology: A web-based online, pre-tested questionnaire comprising 26 items was circulated via social media in April 2020 amongst HCWs in major tertiary care facilities in KP. Results: The study's results, revealing both the commendable knowledge levels among HCWs about COVID-19 and their heightened risk perception, highlight the critical need for targeted interventions to address the potential impact on self-protective behaviour and mental health within this vital workforce. This insight is important for designing strategies that not only enhance HCWs' well-being but also ensure the continued effectiveness of healthcare delivery during pandemics. The percentage mean score (PMS) of COVID-19 knowledge was 85.14±10.82. Male HCWs and those with an age older than or equal to 32 years demonstrated a higher knowledge score (85.62±11.08; P=0.032 and 87.59±7.33, P=0.021, respectively). About 76% of HCWs feared contracting COVID-19. Nearly 82% of respondents were mentally preoccupied with the pandemic and also terrified of it. 'Of these, 81% were nurses, 87% had a job experience of 6-8 years and 54.45% were frontline workers. Feelings of panic and concern about the pandemic were found to be more in HCWs who were physicians above the age of 32, and who had 3-5 years of work experience. HCWs' overall risk perception was found to be significantly different between males (7.04±2.26) and females (8.01±1.97), job experience of 6-10 years (8.04±177) with 3-5 years and younger than or equal to 2 years job experience (7.18±2.43,6.93±2.22), respectively, and between frontline HCWs (7.50±2.10) and non-frontline HCWs (6.84±2.40). Conclusion: HCWs demonstrated good knowledge about COVID-19. As the risk perception of COVID-19 among HCWs is high, it can raise concerns about their self-protective behaviour, and mental health. These issues need to be addressed.

Design and implementation of a digital textbook about physical agents as a learning resource in the training process of Chilean physical therapy students in the context of the COVID-19 pandemic

The COVID-19 pandemic has had a strong impact on education, forcing the implementation of distance learning methodologies using information and communication technologies (ICT). The digital textbook is a didactic resource used to guide the training process of students; besides, its interactivity allows systematic work, favoring metacognition and the construction of self-learning. The aim of this paper is to describe, through a descriptive cross-sectional design, the design, review, digitization and implementation phases of a digital textbook about physical agents as a learning resource to support distance education in the training process of physical therapy students enrolled in the physical agents course offered by Universidad Andres Bello in Santiago, Chile, in the context of the human mobility restriction measures implemented due to the COVID-19 pandemic. The textbook consists of thirteen thematic sections and once it was reviewed and validated by peers and by the editorial committee of the university it was digitalized and indexed into the digital resource database of the university, where it was made available to the entire cohort of students enrolled in the physical agents course during the first semester of2020 (n=115).The digital textbook was successfully implemented as a didactic resource to guide the autonomous and distance learning of students during the time human mobility restriction measures were established in Chile due to the pandemic. Future studies should focus on reporting the students' satisfaction and perception of this tool and its effect on learning outcomes in order to obtain effective feedback.

La pandemia por COVID-19 ha tenido un fuerte impacto en la educación, por lo que ha sido necesario implementar metodologías de aprendizaje a distancia basadas en tecnologías de la información y las comunicaciones (TIC). El libro de texto digital es un recurso didáctico utilizado para guiar el proceso de formación de los estudiantes; además, su interactividad permite el trabajo sistemático, lo que favorece la metacognición y la construcción del aprendizaje autónomo. El objetivo de este estudio fue describir, mediante un diseño transversal descriptivo, las fases de diseño, revisión, digitalización e implementación de un libro de texto digital sobre agentes físicos como recurso de aprendizaje para apoyar la educación a distancia en el proceso de formación de estudiantes de fisioterapia inscritos en el curso de Agentes Físicos ofrecido por la Universidad Andrés Bello en Santiago, Chile, en el contexto de las medidas de restricción de movilidad humana implementadas por la pandemia por COVID-19. El libro de texto consiste de 13 secciones temáticas y, una vez revisado y validado por pares y por el comité editorial de la universidad, fue digitalizado e indexado en la base de datos de recursos digitales de la universidad, donde se puso a disposición de toda la cohorte de estudiantes matriculados en el curso durante el primer semestre de 2020 (n=115). El libro de texto digital se implementó satisfactoriamente como recurso didáctico para guiar el aprendizaje autónomo y no presencial de los estudiantes en el periodo en que se instauraron las medidas de restricción de la movilidad humana en Chile debido a la pandemia. Estudios futuros deben centrarse en reportar la satisfacción y percepción de los estudiantes con esta herramienta y su efecto en los resultados del aprendizaje para obtener una retroalimentación efectiva.

Profile of neurological manifestations in patients with COVID-19: Review of the literature published during the first six months of the pandemic

Introduction: Several studies describing different neurological manifestations in patients with COVID-19 were published during the first six months of the pandemic. Objective: To collect and synthesize the scientific evidence published within the first six months after COVID-19 was declared a pandemic on neurological manifestations in patients infected with SARS-CoV-2, as well as their prevalence and variations in specific populations. Materials and methods: A literature search was conducted in PubMed/MEDLINE using the following search strategy: types of study: any study describing neurological manifestations in COVID-19 patients; publication period: March 11-August 31, 2020; publication language: English; search terms and search equation: (("COVID-19") AND "Neurologic Manifestations"). Results: The initial search yielded 388 records, of which 79 met the eligibility criteria and were included for full analysis. Most studies were case reports (50.63% individual case reports and 18.99% case series), while only 30.38% were analytical studies, with cross-sectional studies being the most common (n=25). The most frequently described neurological manifestation was smell and/or taste disorder (43.04%), followed by peripheral neuropathy (20.25%), seizures (8.86%), encephalitis (7.59%), and delirium (5.06%). Other manifestations reported to a lesser extent included headache, myositis, stroke, and transverse myelitis. Conclusion: Most neurological manifestations reported have a favorable progress, occur in young patients without any comorbidity, and are unrelated to the severity of the disease. Other manifestations such as delirium and epileptic seizures occur more frequently in people with a history of dementia or epilepsy, respectively. Finally, some manifestations such as Guillain-Barré syndrome and stroke may cause several sequelae.

Introducción. Durante los primeros seis meses de la pandemia por COVID-19 se publicaron varios estudios que describen diferentes manifestaciones neurológicas en pacientes con esta enfermedad. Objetivo. Recopilar y sintetizar evidencia científica publicada en los seis meses posteriores a la declaración de la pandemia por COVID-19 sobre manifestaciones neurológicas en pacientes infectados con SARS-CoV-2, así como sus variaciones y frecuencia en poblaciones específicas. Materiales y métodos. Se realizó una búsqueda de la literatura en PubMed/Medline mediante la siguiente estrategia de búsqueda: tipos de estudio: cualquier estudio que describiera manifestaciones neurológicas en pacientes con COVID-19; periodo de publicación: marzo 11 a agosto 31, 2020; idioma de publicación: inglés; términos y ecuación de búsqueda: (("COVID-19") AND "Neurologic Manifestations"). Resultados. La búsqueda inicial arrojó 388 registros, de los cuales 79 cumplieron los criterios de elegibilidad. La mayoría de los estudios fueron reportes de caso (50.63% fueron reportes individuales de caso y 18.99%, series de casos), mientras que solo 30.38% fueron estudios analíticos, siendo los estudios transversales los más frecuentes (n=20). La manifestación neurológica descrita más frecuentemente fue la alteración de olfato y/o gusto (43.04%), seguida de neuropatía periférica (20.25%), convulsiones (8.86%), encefalitis (7.59%) y delirium (5.06%). Otras manifestaciones reportadas en menor proporción fueron cefalea, miositis, accidente cerebrovascular (ACV) y mielitis transversa. Conclusión. La mayoría de las manifestaciones neurológicas de la COVID-19 reportadas tienen una evolución favorable, ocurren en pacientes jóvenes sin comorbilidades y no tienen relación con la severidad de la enfermedad. Otras manifestaciones, como delirium y crisis epilépticas, se presentan con mayor frecuencia en población con antecedente de demencia o epilepsia, respectivamente. Por último, algunas manifestaciones como el síndrome de Guillain-Barré y los ACV pueden causar secuelas.

Academic stress and sleep quality during the COVID-19 pandemic among medical students from a university of Peru / Estrés académico y calidad del sueño en tiempos de pandemia por COVID-19 en estudiantes de medicina de una universidad del Perú

Abstract Introduction: Sleep quality is an important factor for both the physical and mental health of medical students. Objective: To evaluate the association between academic stress and sleep quality among medical students enrolled in a university of Lima (Peru) during the COVID-19 pandemic. Materials and methods: Analytical cross-sectional study carried out in 410 medical students from the School of Human Medicine of Universidad Ricardo Palma, who, in October and November 2020, were administered the Spanish version of the Pittsburgh Sleep Quality Index, the SISCO SV-21 Academic Stress Inventory, and a sociodemographic and habits questionnaire via Google Forms. Bivariate and multivariate analyzes were performed to identify factors associated with poor sleep quality and academic stress, using prevalence ratios (PR) with a 95% confidence interval and a significance level of p<0.05. Results: 97.32% of students presented with "academic stress" and 90.48% had "poor quality of sleep". Factors associated with "poor quality of sleep" were "high levels of academic stress" (aPR: 2.433; 95%CI: 1.619-3.657; p=0.000), "not living with relatives" (aPR: 1.264; 95%CI: 1.107-1.443; p=0.001), and "working in addition to studying" (aPR: 1.106; 95%CI: 1.012-1.209; p=0.026). Additionally, "female biological sex" (aPR: 1.178; 95%CI: 1.090-1.273; p=0.000) and "place of birth Lima" (aPR: 0.929; 95%CI: 0.882-0.979; p=0.006) were significantly associated with "academic stress." Conclusion: Having high levels of academic stress, not living with relatives, and working in addition to studying were factors associated with poor sleep quality among the study population during the COVID-19 pandemic.

Resumen Introducción. La calidad del sueño es un factor importante para la salud física y mental de los estudiantes de medicina. Objetivo. Evaluar la asociación entre el estrés académico y la calidad del sueño en estudiantes de medicina de una universidad de Lima, Perú, en tiempos de pandemia por COVID-19. Materiales y métodos. Estudio transversal analítico realizado en 410 estudiantes de Medicina de la Facultad de Medicina Humana de la Universidad Ricardo Palma, a quienes, entre octubre y noviembre de 2020, se les aplicó la versión en español del Índice de calidad del sueño de Pittsburgh, el Inventario de Estrés Académico SISCO SV-21 y una ficha sociodemográfica y de hábitos mediante Google Forms. Se realizaron análisis bivariados y multivariados para identificar los factores asociados a la mala calidad del sueño y al estrés académico utilizando razones de prevalencia (RP) con un intervalo de confianza del 95% y un nivel de significancia p<0.05. Resultados. El 97.32% de los estudiantes presentó "estrés académico" y el 90.48% tuvo "mala calidad del sueño". Los factores asociados a "mala calidad del sueño" fueron "altos niveles de estrés académico" (RPa: 2,433; 95%CI: 1.619-3.657; p=0.000), "no vivir con familiares" (RPa: 1,264; 95%CI: 1.107-1.443; p=0.001) y "trabajar además de estudiar" (RPa: 1,106; 95%CI: 1.012-1.209; p=0.026). Adicionalmente, "sexo biológico femenino" (RPa: 1,178; 95%CI: 1.090-1.273; p=0.000) y "lugar de nacimiento en Lima" (RPa: 0,929; 95%CI: 0.882-0.979; p=0.006) se asociaron significativamente al "estrés académico". Conclusión. Tener altos niveles de estrés académico, no vivir con familiares y trabajar además de estudiar fueron factores asociados con presentar una mala calidad del sueño en la población de estudio en tiempos de pandemia por COVID-19.

Physicians' perspectives and future vision on disability assessments by phone during the COVID-19 pandemic: a cross-sectional survey.

BACKGROUND: Physicians, who perform disability assessments for the Dutch Social Security Institute, were urged to conduct phone consultations from their homes to prevent the spread of COVID-19. The purpose of the study was to evaluate the perspectives of physicians regarding phone consultations during the COVID-19 pandemic. Additionally, to explore physicians' views on a more widespread future use of phone consultations in the context of work disability assessments. METHODS: An electronic survey conducted from June to August 2020 included 41 statements categorized into themes previously identified in both the literature on physicians' phone consultations and emerging from daily practice. All 1081 physicians working at the Dutch Social Security Institute were invited by e-mail to participate in the survey. Participants indicated on a 5-point Likert scale whether they strongly disagreed, disagreed, neither agreed nor disagreed, agreed or strongly agreed with the statements. The collected data were analysed using descriptive statistics. RESULTS: In general, physicians had become accustomed to perform phone consultations. Negative experiences included difficulties in getting an impression of patients and assessing patients' functional limitations. About half of physicians found that phone consultations took more effort, 61% asked more questions due to no direct patient observations. According to 67%, it is mostly necessary to perform an in-person consultation to adequately assess functional limitations of a patient with persistent medically unexplained physical symptoms. A great majority did not prefer telephone consultations to in-person consultations. However, more than half of physicians perceive a greater preference for phone consultations in the future than previously. 56% thought that replacement of in-person consultations with phone consultations in the future might lead to more complaints. CONCLUSIONS: Perspectives and future views varied among physicians performing disability assessments by phone. A majority of physicians experienced difficulties with different aspects of the assessment. Despite these difficulties, most physicians support to continue the wider use of phone consultations. To improve remote disability assessments it is required to gain more insights into conditions under which a phone assessment can be as diligent as an in-person assessment.

Addressing vaccine hesitancy and resistance for COVID-19 vaccines.

The COVID-19 vaccine rollout has had various degrees of success in different countries. Achieving high levels of vaccine coverage is key to responding to and mitigating the impact of the pandemic on health and aged care systems and the community. In many countries, vaccine hesitancy, resistance, and refusal are emerging as significant barriers to immunisation uptake and the relaxation of policies that limit everyday life. Vaccine hesitancy/ resistance/ refusal is complex and multi-faceted. Individuals and groups have diverse and often multiple reasons for delaying or refusing vaccination. These reasons include: social determinants of health, convenience, ease of availability and access, health literacy understandability and clarity of information, judgements around risk versus benefit, notions of collective versus individual responsibility, trust or mistrust of authority or healthcare, and personal or group beliefs, customs, or ideologies. Published evidence suggests that targeting and adapting interventions to particular population groups, contexts, and specific reasons for vaccine hesitancy/ resistance may enhance the effectiveness of interventions. While evidence regarding the effectiveness of interventions to address vaccine hesitancy and improve uptake is limited and generally unable to underpin any specific strategy, multi-pronged interventions are promising. In many settings, mandating vaccination, particularly for those working in health or high risk/ transmission industries, has been implemented or debated by Governments, decision-makers, and health authorities. While mandatory vaccination is effective for seasonal influenza uptake amongst healthcare workers, this evidence may not be appropriately transferred to the context of COVID-19. Financial or other incentives for addressing vaccine hesitancy may have limited effectiveness with much evidence for benefit appearing to have been translated across from other public/preventive health issues such as smoking cessation. Multicomponent, dialogue-based (i.e., communication) interventions are effective in addressing vaccine hesitancy/resistance. Multicomponent interventions that encompasses the following might be effective: (i) targeting specific groups such as unvaccinated/under-vaccinated groups or healthcare workers, (ii) increasing vaccine knowledge and awareness, (iii) enhanced access and convenience of vaccination, (iv) mandating vaccination or implementing sanctions against non-vaccination, (v) engaging religious and community leaders, (vi) embedding new vaccine knowledge and evidence in routine health practices and procedures, and (vii) addressing mistrust and improving trust in healthcare providers and institutions via genuine engagement and dialogue. It is universally important that healthcare professionals and representative groups, as often highly trusted sources of health guidance, should be closely involved in policymaker and health authority decisions regarding the establishment and implementation of vaccine recommendations and interventions to address vaccine hesitancy.

Concerns among people who use opioids during the COVID-19 pandemic: a natural language processing analysis of social media posts.

BACKGROUND: Timely data from official sources regarding the impact of the COVID-19 pandemic on people who use prescription and illegal opioids is lacking. We conducted a large-scale, natural language processing (NLP) analysis of conversations on opioid-related drug forums to better understand concerns among people who use opioids. METHODS: In this retrospective observational study, we analyzed posts from 14 opioid-related forums on the social network Reddit. We applied NLP to identify frequently mentioned substances and phrases, and grouped the phrases manually based on their contents into three broad key themes: (i) prescription and/or illegal opioid use; (ii) substance use disorder treatment access and care; and (iii) withdrawal. Phrases that were unmappable to any particular theme were discarded. We computed the frequencies of substance and theme mentions, and quantified their volumes over time. We compared changes in post volumes by key themes and substances between pre-COVID-19 (1/1/2019-2/29/2020) and COVID-19 (3/1/2020-11/30/2020) periods. RESULTS: Seventy-seven thousand six hundred fifty-two and 119,168 posts were collected for the pre-COVID-19 and COVID-19 periods, respectively. By theme, posts about treatment and access to care increased by 300%, from 0.631 to 2.526 per 1000 posts between the pre-COVID-19 and COVID-19 periods. Conversations about withdrawal increased by 812% between the same periods (0.026 to 0.235 per 1,000 posts). Posts about drug use did not increase (0.219 to 0.218 per 1,000 posts). By substance, among medications for opioid use disorder, methadone had the largest increase in conversations (20.751 to 56.313 per 1,000 posts; 171.4% increase). Among other medications, posts about diphenhydramine exhibited the largest increase (0.341 to 0.927 per 1,000 posts; 171.8% increase). CONCLUSIONS: Conversations on opioid-related forums among people who use opioids revealed increased concerns about treatment and access to care along with withdrawal following the emergence of COVID-19. Greater attention to social media data may help inform timely responses to the needs of people who use opioids during COVID-19.

Just a bad flu? Tackling the "infodemic" in Ireland through a comparative analysis of hospitalised cases of COVID-19 and influenza.

OBJECTIVES: COVID-19 infection has been compared to seasonal influenza as an argument against non-pharmacological population-based infection control measures known as "lockdowns". Our study sought to compare disease severity measures for patients in Ireland hospitalised with COVID-19 against those hospitalised with seasonal influenza. STUDY DESIGN: This is a retrospective population-based cohort study. METHODS: COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes from the Irish national hospitalisation dataset. The occurrences of key metrics of disease severity, length of stay, intensive care admission, ventilatory support, haemodialysis and in-hospital mortality were measured and compared between the two groups using odds ratios with 95% confidence intervals (CIs), stratified by age. RESULTS: Hospitalised COVID-19 episodes had a mean length of stay more than twice as long as hospitalised influenza episodes (17.7 days vs 8.3 days). The likelihood of all measures of disease severity was greater in COVID-19 episodes, and the odds of in-hospital mortality were five-fold higher in this group compared with seasonal influenza episodes (OR 5.07, 95% CI 4.29-5.99, P < 0.001). Greater likelihood of increased disease severity was observed for COVID-19 episodes in most age groups. CONCLUSIONS: COVID-19 is a more severe illness than seasonal influenza in hospitalised cohorts. It is imperative that public health professionals ensure that evidence-based advocacy is part of the response to COVID-19 to tackle a dangerous "infodemic" that can undermine public health control measures.

Effects of COVID-19 confinement measures on training loads and the level of well-being in players from Chile women's national soccer team / Efectos de las medidas de confinamiento por COVID-19 en el grado de bienestar y la carga de entrenamiento de las jugadoras de la selección nacional de fútbol de Chile

Abstract Introduction: Due to the current COVID-19 pandemic, many countries have implemented control and prevention measures, such as compulsory lockdowns, affecting all spheres of life. Since the field of professional soccer is no exception, such measures may have a negative impact on the player's well-being and their perceived training loads. Objective: To determine the impact of COVID-19 lockdown measures on the training load and the well-being of female professional soccer players in Chile. Materials and methods: Exploratory, cross-sectional, descriptive study conducted on 32 players of the Chile women's national soccer team. The perception of training load and the level of well-being were assessed by means of the rating of perceived exertion (RPE) scale and a questionnaire developed in 2010, respectively. Both the administration of the questionnaire and the permanent monitoring of the RPE records were carried out in two periods of 12 weeks: regular preparatory phase (12/12/2019-10/03/2020) and lockdown (16/03/2020-07/06/2020). Data were analyzed using descriptive statistics and the Wilcoxon test was used to determine if there were significant differences between periods. Results: Significant differences (p<0.05) and threshold effect sizes (ES)=1.2, 2.0 and 4.0 (large, very large, and extremely large, respectively) were found between both periods in all variables evaluated by the well-being questionnaire (except for sleep quality): muscle soreness and stress level (ES=1.9), perceived fatigue (ES=2.5), general well-being (ES=2.4), and mood (ES=4.2). No differences were found regarding the perception of the training load (ES=0.1) between both periods. Conclusions: The level of well-being among the participants was negatively affected by the compulsory lock-down. Therefore, coaching staffs should continue to monitor the level of the well-being of professional soccer players during the lockdown, both individually and collectively. Even though the perception of training load was not affected, it is not possible to state that a more extended period of confinement will not reduce it, resulting in a drop in performance.

Resumen Introducción. Debido a la actual pandemia por COVID-19, muchos países tomaron medidas de control y prevención como el confinamiento obligatorio, afectando todas las esferas de la vida. Ya que los futbolistas profesionales no son una excepción, este tipo de medidas puede tener un impacto negativo en su bienestar y en su percepción sobre las cargas de entrenamiento. Objetivo. Determinar los efectos de las medidas de confinamiento por COVID-19 en la carga de entrenamiento y el grado de bienestar de jugadoras de fútbol profesional de Chile. Materiales y métodos. Estudio transversal, exploratorio-descriptivo realizado en 32 jugadoras de la Selección Nacional de Fútbol de Chile. El grado de bienestar y la carga de entrenamiento se evaluaron mediante un cuestionario desarrollado en 2010 y mediante la escala de percepción subjetiva del esfuerzo (PSE) y el volumen de entrenamiento expresado en minutos, respectivamente. Ambas evaluaciones se realizaron en 2 periodos de 12 semanas : periodo preparatorio regular (12/12/2019-10/03/2020) y periodo de confinamiento (16/03/2020-07/06/2020). Los datos se analizaron mediante estadística descriptiva y la prueba de Wilcoxon se utilizó para determinar si hubo diferencias significativas entre ambos periodos. Resultados. Se encontraron diferencias significativas (p<0.05) y umbrales de tamaño del efecto (TE) iguales a 1.2, 2.0 y 4.0 (grande, muy grande y extremadamente grande, respectivamente) entre ambos periodos en todas las variables evaluadas por el cuestionario de bienestar (a excepción de calidad de sueño): dolor muscular y nivel de estrés (TE=1.9), fatiga percibida (TE=2.5), bienestar general (TE=2.4) y estado de ánimo (TE=4.2). No se observaron diferencias en la PSE (TE=0.1) entre ambos periodos. Conclusiones. El confinamiento obligatorio afectó negativamente el grado de bienestar de las participantes, por lo que es necesario que los cuerpos técnicos monitoreen constantemente, de manera individual y colectiva, el grado de bienestar de los futbolistas profesionales durante estos periodos; si bien la percepción en la carga de entrenamiento no se vio afectada, no es posible asegurar que un periodo mayor de confinamiento no la disminuya y esto resulte en una baja del rendimiento.

Recommendations for providing nutritional care to COVID-19 inpatients. A literature review / Recomendaciones para la atención nutricional hospitalaria en pacientes con COVID-19. Revisión de la literatura

Resumen Introducción. La enfermedad por coronavirus 2019 (COVID-19) puede llevar a la hospitalización de los pacientes en los casos más graves; por tanto, es necesario establecer recomendaciones teórico-prácticas de intervención nutricional hospitalaria. Objetivo. Identificar las recomendaciones dirigidas a los equipos de salud hospitalarios para brindar atención nutricional a pacientes hospitalizados mayores de 18 años e infectados con COVID-19. Materiales y métodos. Se realizó una revisión de la literatura en PubMed mediante la siguiente estrategia de búsqueda: periodo de publicación: diciembre 1 de 2019 a marzo 21 de 2020; idiomas de publicación: inglés y chino; términos de búsqueda: "Coronavirus Infection", "Severe Acute Respiratory Syndrome" y "Nutrition for Vulnerable Groups". Resultados. Se identificaron 283 artículos en la búsqueda inicial, de los cuales se seleccionaron 6 para analizar las prácticas de atención nutricional hospitalaria. Las áreas de investigación de estas publicaciones fueron soporte nutricional; evaluación de intervenciones para abordar y disminuir la severidad de las complicaciones pulmonares y hepáticas, y efectos de antioxidantes y ácidos grasos omega-3 en adultos con síndrome de dificultad respiratoria aguda. Conclusión. Las recomendaciones para la atención nutricional hospitalaria en pacientes con COVID-19 se basan en procesos de cuidado nutricional y en la gestión de los servicios de alimentación; según estas recomendaciones, se deben establecer estrategias de evaluación de riesgo nutricional, realizar intervenciones de soporte nutricional que reduzcan el riesgo de desnutrición y vigilar los riesgos asociados a la administración del soporte nutricional y las alteraciones metabólicas asociadas a esta enfermedad.

Abstract Introduction: Coronavirus disease (COVID-19) may require the hospitalization of patients in the most severe cases. Therefore, it is necessary to establish theoretical and practical recommendations for nutritional interventions at hospitals. Objective: To identify recommendations given to hospital health care teams for providing nutritional care to inpatients over 18 years of age infected with COVID-19. Materials and methods: A literature review was conducted in PubMed using the following search strategy: publication period: December 2019 to March 2020; publication language: English and Chinese; search terms: "Coronavirus Infection", "Severe Acute Respiratory Syndrome" and "Nutrition for Vulnerable Groups". Results: A total of 283 articles were retrieved after completing the initial search, of which 6 were selected to analyze nutrition care practices in the hospital setting. The areas of research of these publications were nutritional support, the evaluation of interventions aimed to manage and reduce the severity of pulmonary and hepatic complications, and the effects of antioxidants and omega-3 fatty acids in adults with acute respiratory distress syndrome. Conclusion: Recommendations for providing nutritional care to COVID-19 inpatients are based on nutritional care processes and food service management. According to these recommendations, nutritional risk assessment strategies should be established, nutritional support interventions aimed at reducing the risk of malnutrition should be carried out, and the risks associated with the administration of nutritional support, as well as COVID-19-re-lated metabolic disorders, should be monitored.