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Children with cancer in low- and middle-income countries were disproportionately impacted by the COVID-19 pandemic, but little is known about how adolescents and young adults (AYAs) with cancer were affected. Sixty-seven physicians and nonphysician providers were interviewed about their experiences caring for AYAs with cancer in Latin America. Quotes related to the COVID-19 pandemic were identified and grouped into themes. Barriers from the COVID-19 pandemic included limited space, restrictions on travel, reduced funding, limited staff, limited services, and changes to treatment. However, improvements to care that arose from the COVID-19 pandemic included better access to distance learning and telemedicine.
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BACKGROUND: Obesity increases the severity of coronavirus disease 2019 illness in adults. The role of obesity in short-term complications and post-acute sequelae in children is not well defined. OBJECTIVE: To evaluate the relationship between obesity and short-term complications and post-acute sequelae of SARS-CoV-2 infection in hospitalized paediatric patients. METHODS: An observational study was conducted in three tertiary hospitals, including paediatric hospitalized patients with a confirmatory SARS-CoV-2 RT-PCR from March 2020 to December 2021. Obesity was defined according to WHO 2006 (0-2 years) and CDC 2000 (2-20 years) growth references. Short-term outcomes were intensive care unit admission, ventilatory support, superinfections, acute kidney injury, and mortality. Neurological, respiratory, and cardiological symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms were considered as post-acute sequalae. Adjusted linear, logistic regression and generalized estimating equations models were performed. RESULTS: A total of 216 individuals were included, and 67 (31.02%) of them had obesity. Obesity was associated with intensive care unit admission (aOR = 5.63, CI95% 2.90-10.94), oxygen requirement (aOR = 2.77, CI95% 1.36-5.63), non-invasive ventilatory support (aOR = 6.81, CI95% 2.11-22.04), overall superinfections (aOR = 3.02 CI95% 1.45-6.31), and suspected bacterial pneumonia (aOR = 3.00 CI95% 1.44-6.23). For post-acute sequalae, obesity was associated with dyspnea (aOR = 9.91 CI95% 1.92-51.10) and muscle weakness (aOR = 20.04 CI95% 2.50-160.65). CONCLUSIONS: In paediatric hospitalized patients with COVID-19, severe short-term outcomes and post-acute sequelae are associated with obesity. Recognizing obesity as a key comorbidity is essential to develop targeted strategies for prevention of COVID-19 complications in children.
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COVID-19 , Superinfecção , Adulto , Humanos , Criança , COVID-19/complicações , COVID-19/epidemiologia , SARS-CoV-2 , Síndrome de COVID-19 Pós-Aguda , Obesidade/epidemiologia , Estudos de Coortes , Estudos RetrospectivosRESUMO
Contiene: el documento muestra que la estructura del comercio exterior boliviano persiste en su especialización e productos primarios, que los saldos comerciales en el sector de la manufactura expresan elevados deficits, mostrando una oferta exportable reducida y poco diversificada con productos que no tienen mercacdos importantes en la CAN y en el Mercosur.
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BolíviaRESUMO
Contiene: 1. Patrón de inserción internacional de Bolivia. 2. Evaluación y perspectivas de política.
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Contiene: 1. El Mercado Común del Sur. 2. El comercio de Bolivia con el Mercosur. 3. El acuerdo de Bolivia con el Mercosur. 4. Reflexiones finales.
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MercosulRESUMO
Contiene: 1. El entorno internacional. 2. Forma de inserción de Bolivia al comercio mundial. 3. La modalidad de inserción y las relaciones internacionales de Bolivia. 4. Las condiciones de competitividad. 5. Experiencias de países exitosos. 6. Perpectivas y recomendaciones de políticas públicas.
