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Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the practical prevention guide for CAP through vaccination in Spain developed in 2016 and updated in 2018, based on available vaccines and evidence through bibliographic review and expert opinion. The arrival of COVID-19 as a new cause of CAP and the recent availability of safe and effective vaccines constitutes the most significant change. Vaccines against pneumococcus, influenza, pertussis and COVID-19 can help to reduce the burden of disease from CAP and its associated complications. The available evidence supports the priority indications established in this guide, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice., (Copyright © 2021 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

A high proportion of people who have suffered from COVID-19 report, after recovery from the acute phase of the disease, clinical manifestations, both subjective and objective, that continue beyond 3 weeks or even 3 months after the original clinical disease. There is still no agreed nomenclature to refer to this condition, but perhaps the most commonly used is post-COVID syndrome. The Scientific Committee on COVID of the Madrid College of Physicians (ICOMEM) has discussed this problem with a multidisciplinary approach in which internists, infectious disease specialists, psychiatrists, pneumologists, surgeons, geriatricians, pediatricians, microbiologists, family physicians and other specialists have participated, trying to gather the existing information and discussing it in the group. The clinical manifestations are very variable and range from simple fatigue to persistent fibrosing lung lesions with objective alterations of pulmonary function. Post-COVID syndrome seems to be particularly frequent and severe in adults who have required admission to Intensive Care Units and has a peculiar behavior in a very small group of children. The post-COVID syndrome, which undoubtedly exists, is at first sight not clearly distinguishable from clinical manifestations that which occur after other acute viral diseases and after prolonged stays in ICUs due to other diseases. Therefore, it offers excellent research opportunities to clarify its pathogenesis and possibly that of other related entities. It is possible that progressively there will be an increased demand for care among the millions of people who have suffered and overcome acute COVID for which the health authorities should design mechanisms for the agile management of care that will possibly require well-coordinated multidisciplinary groups. This paper, structured in questions on different aspects of the post-COVID syndrome, attempts to stage the current state of this problem., (©The Author 2021. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals., Objetive: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic., Methods: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale., Results: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items., Conclusions: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date., (Copyright © 2020 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.)

Similar to many other countries, journalistic production in China during the first half of 2020 was dominated on a thematic level by the COVID-19 pandemic. The trend included the mouthpiece of the Central Committee of the Chinese Communist Party (CCP), Renmin Ribao. Its news and commentary articles, which are widely republished by other media, influence the country’s political life, and contribute to the process of meaning generation in the news discourse and to the CCP’s effort to align Chinese citizens to official narratives. Renmin Ribao can therefore provide a relevant source to investigate the relationship between political power and the COVID-19 pandemic, starting from the hypothesis that the paper’s narrative would aim at discursively turning the international health crisis into a piece of positive propaganda. This study aims to verify whether and how the paper did so, and to question the assumption that the outlet’s media discourse can be equated to the CCP official discourse. The research is developed as a case study and blends quantitative and qualitative tools grounded on Applied Linguistics, Discourse-Historical Approach, and Frame Analysis, in order to analyse a corpus of commentaries that have appeared in the outlet’s online edition in 2020. By applying a Genre Analysis approach, the study also offers insights into the possibility to identify distinguishing characteristics and communicative goals in the different sub-genres of Renmin Ribao commentaries.

Introduction: It has been suggested that the social isolation due to the coronavirus disease 2019 (COVID-19) may increase the incidence of child and adolescent sexual abuse (CASA)., Objective: To compare the incidence and characteristics of medical consultations made to the Department of Gynecology due to CASA before and during the COVID-19 pandemic., Material and Methods: Descriptive, observational, and comparative study about suspected CASA events occurred during the COVID-19 pandemic compared to those occurred in the previous year at a tertiary care children's hospital., Results: One hundred and twenty-two medical consultations due to suspected CASA were recorded; 78 before and 44 during the pandemic. In both groups, the most common reason for consultation at the hospital was an account of CASA and, at the Department of Gynecology in particular, the external genitalia examination. Most subjects had a normal physical examination. There was a higher prevalence of STI in the pandemic group. In addition, there were also more hospitalizations and police reports for victims protection in this group. The abuser was known to the victim in almost 90% of cases in both groups., Conclusions: During the pandemic, the total number of medical consultations to the Department of Gynecology decreased so the percentage of those due to suspected CASA was higher. However, the presence of severe lesions, STIs or pregnancy did not change., Competing Interests: None., (Sociedad Argentina de Pediatría.)

This paper explores how parents in Hong Kong perceive the impact of the COVID-19 pandemic on the use of academic and non-academic private tutoring (PT) for their children, using a thematic analysis of interviews with 80 parents from diverse ethnic and socioeconomic backgrounds. We seek to understand the role of PT in parents' thinking about their children's learning and developmental needs in uncertain times, which foregrounds parents' temporalities in the face of disruption. We find that maintaining pre-pandemic PT levels was the most common attitude for almost half of the sample, followed by roughly similar groups of parents who increased or decreased their use of PT. Parental perceptions of the functions of PT converged on three main uses: mitigating the effects of schooling disruptions, making productive use of newfound free time and providing a sense of normality. Using a timescapes lens, we identify temporal elements in how PT factored into parents' experiences and perceptions of managing "gained" and "lost" time, adapting to remote learning, avoiding health risks and reflecting on inequalities during the COVID-19 pandemic. [Translation from Spanish by Mercè Rius.]

This paper presents the generation of a plausible data set related to the needs of COVID-19 patients with severe or critical symptoms. Possible illness’ stages were proposed within the context of medical knowledge as of January 2021. The parameters chosen in this data set were customized to fit the population data of the Valencia region (Spain) with approximately 2.5 million inhabitants. They were based on the evolution of the pandemic between September 2020 and March 2021, a period that included two complete waves of the pandemic. Contrary to expectation and despite the European and national transparency laws (BOE-A2013-12887, 2013; European Parliament and Council of the European Union, 2019), the actual COVID-19 pandemic-related data, at least in Spain, took considerable time to be updated and made available (usually a week or more). Moreover, some relevant data necessary to develop and validate hospital bed management models were not publicly accessible. This was either because these data were not collected, because public agencies failed to make them public (despite having them indexed in their databases), the data were processed within indicators and not shown as raw data, or they simply published the data in a format that was difficult to process (e.g., PDF image documents versus CSV tables). Despite the potential of hospital information systems, there were still data that were not adequately captured within these systems. Moreover, the data collected in a hospital depends on the strategies and practices specific to that hospital or health system. This limits the generalization of "real" data, and it encourages working with "realistic" or plausible data that are clean of interactions with local variables or decisions (Gunal, 2012; Marin-Garcia et al., 2020). Besides, one can parameterize the model and define the data structure that would be necessary to run the model without delaying till the real data become available. Conversely, plausible data sets can be generated from publicly available information and, later, when real data become available, the accuracy of the model can be evaluated (Garcia-Sabater and Maheut, 2021). This work opens lines of future research, both theoretical and practical. From a theoretical point of view, it would be interesting to develop machine learning tools that, by analyzing specific data samples in real hospitals, can identify the parameters necessary for the automatic prototyping of generators adapted to each hospital. Regarding the lines of research applied, it is evident that the formalism proposed for the generation of sound patients is not limited to patients affected by SARS-CoV-2 infection. The generation of heterogeneous patients can represent the needs of a specific population and serve as a basis for studying complex health service delivery systems.

Objective: Several studies stated greater impact on mental health among psychiatric population during the first wave of the COVID-19 pandemic. The aim of this paper was to study the pandemic effects more than a year after its outbreak on the mental state of adult patients with pre-existing psychopathology attending a Mental Health Center in Madrid (Spain)., Methods: A cross-sectional observational study was carried out with a sample of fifty-eight patients using a questionnaire that collected different descriptive variables. Results of the PHQ-9 Depression Scale, the GAD-7 Anxiety Scale, the IES-R Impact of Event Scale-Revised, the Clinical Global Impression scale CGI-GI, and the assessment of the professionals responsible for the patients about their clinical state were also collected. A descriptive analysis and binary logistic regression models were performed., Results: There was a prevalence of 70% anxiety, 76% depression and 57% stress due to a stressful event more than one year after the start of the pandemic. Likewise, associations were found between the symptoms and certain clinical, mediating variables and gender., Conclusions: The psychological state of patients with pre-existing psychopathology attended at the Mental Health Center is negatively affected by the COVID-19 pandemic up to a year and a half after its onset., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: Healthcare professionals were subjected to very demanding working conditions during the COVID-19 pandemic. The aim of this paper was to assess the level of risk of suffering a psychosocial disorder in the professionals of the Epidemiological Surveillance Services of Catalonia (EVS) during the sixth wave of the COVID-19 pandemic., Methods: An epidemiological study of prevalence was carried out in SVE workers in Catalonia. The information was collected through a questionnaire of sociodemographic and occupational data and the Goldberg General Health Questionnaire (GHQ-28) from January to March 2022. A score equal to or greater than 7 on the GHQ-28 was considered positive and indicated a risk of suffering some disorder. The dependent variables were the score and positivity of the GHQ-28 test. The relationship between the GHQ-28 score and the rest of the independent variables of the study was studied with the Odds Ratio (OR) and its 95% confidence intervals (IC)., Results: The mean age of the population studied was 37 years (SD=±11.4) and 75% were women. 53.8% of the participants presented a positive result in the GHQ-28. The participants with the highest psychosocial risk were workers with a history of psychological problems (OR 2.8; IC95% 1.2-6.7). The risk was also higher in women (OR 1.8; IC95% 0.8-4.1), participants with health professions (OR 1.2: IC95% 0.6-2.5), those who were taking pharmacological treatment (OR 2.4; IC95% 0.6-9.7) or those who were undergoing psychological therapy (OR 1.5; IC95% 0.6-3.6) at the time of data collection and workers who did not had a perception of work support and recognition from their work teams (OR 1.8; IC95% 0.9-3.8), although some differences were not statistically significant., Conclusions: The professionals of the SVE professionals presented, during the sixth pandemic wave, a high risk of psychosocial disorder. As measures to be adopted, and with the aim of reducing psychosocial risk among its professionals, it is recommended to introduce organizational changes in surveillance services to prevent psychosocial disorders among its professionals.

Objective: The COVID-19 pandemic indirectly affected other communicable diseases, such as human immunodeficiency virus (HIV) infection. The aim of this paper was to evaluate the impact of the COVID-19 pandemic on the epidemiological surveillance of HIV through epidemiological indicators., Methods: Data collected in the New HIV Diagnosis Information System (SINIVIH, acronym in Spanish) in the period 2013-2021 was analyzed. The epidemiological indicators analyzed were: 1) Reporting delay of new diagnoses; 2) Under diagnosis of cases, calculated per month of diagnosis and for each year of diagnosis; 3) Late diagnosis, cases diagnosed with less than 350 CD4 cell/mm 3 ., Results: Regarding the reporting delay of new diagnoses, in 2022 2,770 diagnoses were reported in 2020, 43.8% more than those reported in 2021 for that year. The cases diagnosed per month between 2016 and 2019 followed a constant trend. In 2020, a significant decrease in diagnoses was observed between March and May that was not recovered after correcting for reporting delay. When comparing the rates of cases diagnosed in 2013 with the successive years, a continuous decrease was interrupted in the last year of the study period. The percentage of cases with late diagnosis had remained stable in the study period (between 46% and 50%), and a decrease in this percentage was observed after correcting for reporting delay., Conclusions: The epidemiological surveillance of HIV suffered a significant reporting delay. A decrease in cases diagnosed is confirmed, partly due to lockdown and lack of access to the health system. Changes on late diagnosis is not observed.

Objective: Bronchiolitis is the leading cause of hospitalization in children under one year of age, with annual epidemics. Since the onset of the SARS-CoV-2 coronavirus disease pandemic (COVID-19), there has been a change in the transmission of other respiratory viruses. Our aim in this paper was to describe how COVID-19 had affected the distribution of acute bronchiolitis in our country., Methods: We conducted a retrospective descriptive study of the cases of bronchiolitis treated in a sample of Spanish hospitals belonging to four autonomous communities. A chi-square test and Student's t- test were used to compare epidemiological and demographic variables between patients attending the hospital with bronchiolitis during January 2021-June 2021 with patients attending the hospital in the previous three years (2018-2020)., Results: We analyzed 6,124 cases of bronchiolitis (58.8% males and 41.2% females). The mean age was 0.5 years (SD: 0.4). In 2020, we observed a decrease of bronchiolitis cases compared to 2019 of 67%. During 2020 and 2021, the epidemic season started in January-February and peaked in June. During the first half of 2021, the highest percentage of admissions for bronchiolitis associated with RSV infection was observed in hospitals in central Spain corresponding to the Autonomous Community of Madrid (78.5% of admissions)., Conclusions: The COVID-19 pandemic significantly modifies the seasonality of bronchiolitis. In our country, the flow and distribution of the disease are not uniform. It starts in the center of Spain and ends on the coast.

Objective: There are controversies regarding the effect of the influenza vaccine on the risk of suffering from COVID-19. The aim of this paper was to compare the risk of suffering from COVID-19 between vaccinated and unvaccinated patients against influenza., Methods: A retrospective case-control study of patients assigned to an urban CAP (coverage: 44,564 inhabitants) was carried out during 2020. Patients with diagnostic confirmation of COVID-19 (ART, PCR or serology) were defined as cases, and those who have not had said infection, selected by simple random sampling, were defined as controls. The case/control ratio was 1:1. The data sources used were the Khalix health data registry databases and the computerized medical record (E-cap). Data were analyzed with a multivariable logistic regression model., Results: A total of 4,320 patients were included in the study: 2,160 cases (50%) and 2,160 controls. 18% of the cases and 14.3% of the controls were vaccinated against influenza [OR=1.3 (95% CI: 1.2-1.5; p=0.001)]. Multivariate analysis showed that in patients under eighty years of age, there were no differences between vaccinated and unvaccinated patients [OR=1.02 (95% CI: 0.8-1.3; p=0.8)]; while in those over eighty years of age, there was a lower risk of presenting COVID-19 in vaccinated patients [OR=0.4 (95% CI: 0.3-0.7; p<0.001)]., Conclusions: The adjusted model shows that at ages above than 80 years, flu-vaccinated patients have decreased risk of COVID-19 with statistical significance.

Objective: Functional assessment is part of geriatric assessment. How it is performed in hospital Emergency Departments (ED) is poorly understood, let alone its prognostic value. The aim of this paper was to investigate whether baseline disability to perform basic activities of daily living (BADL) was an independent prognostic factor for death after the index visit to the ED during the first wave of the COVID-19 pandemic and whether it had a different impact on patients with and without diagnosis of COVID-19., Methods: A retrospective observational study of the EDEN-Covid (Emergency Department and Elder Needs during COVID) cohort was carried out, consisting of all patients aged ≥65 years seen in 52 Spanish EDs selected by chance during 7 consecutive days (30/3/2020 to 5/4/2020). Demographic, clinical, functional, mental and social variables were analyzed. Dependence was categorized with the Barthel index (BI) as independent (BI=100), mild-moderate dependence (100>BI>60) and severe-total dependence (BI<60), and their crude and adjusted association was evaluated with mortality at 30, 180 and 365 days using COX proportional hazards models., Results: Of 9,770 enrolled patients with a mean age of 79 years, 51% were men, 6,305 (64.53%) were independent, 2,340 (24%) had mild-moderate dependence, and 1,125 (11.5%) severe-total dependence. The number of deaths at 30 days in these three groups was 500 (7.9%), 521 (22.3%) and 378 (33.6%), respectively; at 180 days it was 757 (12%), 725 (30.9%) and 526 (46.8%); and at 365 days 954 (15.1%), 891 (38.1%) and 611 (54.3%). In relation to independent patients, the adjusted risks (hazard ratio) of dying within 30 days associated with mild-moderate and severe-total dependency were 1.91 (95% CI: 1.66-2.19) and 2.51. (2.11-2.98); at 180 days they were 1.88 (1.68-2.11) and 2.64 (2.28-3.05); and at 365 days they were 1.82 (1.64-2.02) and 2.47 (2.17-2.82). This negative impact of dependency on mortality was greater in patients diagnosed with COVID-19 than in non-COVID-19 (p interaction at 30, 180 and 365 days of 0.36, 0.05 and 0.04)., Conclusions: The functional dependence of older patients who attend Spanish EDs during the first wave of the pandemic is associated with mortality at 30, 180 and 365 days, and this risk is significantly higher in patients treated for COVID-19.

This review addresses the impact of the COVID-19 pandemic on workers' mental health, in particular, teleworking conditions. Our analysis is based on documents from several international organizations and specialized scientific publications. The retrieved information reveals that the pandemic has had a significant effect on the mental health of frontline workers and employees who had to migrate to a virtual environment without prior warning. However, a positive aspect is reflected in the development of several remote mental health care devices implemented to protect vulnerable population, frontline workers, and the general population. Finally, this paper underscores the importance of developing public policies for protecting workers' mental health.

Background: Solid Organ Transplant recipients (SOTR) appear to be at particular high risk for critical COVID-19 due to immunosuppressive drugs and comorbidities. We report the first description of clinical course and short-term outcomes of kidney and liver transplant recipients with confirmed COVID-19 in Mexico. The objective of this paper was evaluate the clinical course of transplant patients with COVID-19 infection., Material and Methods: We retrospectively evaluated SOTR (kidney and liver) over 18 years of age with confirmed diagnosis of COVID-19 from tertiary care centers in Mexico., Results: Data from 45 kidney transplant recipients were recorded. Median (IQR) age was 43 (IQR 25-70) years. Admission to hospital was required in 37 (75.5 %) patients, of which 8 (16.3%) were hospitalized at Intensive Care Unit (ICU). Acute kidney injury (AKI) stage was documented in 33 (67%) patients. The time of hospitalization was 8 (IQR 6-12) days. Six patients died (12.2%). Additionally, data from 10 liver transplant recipients were included. During their evolution, 5 / 10 required hospital admission and there were no deaths in this group., Conclusions: Transplant recipients show a higher fatality rate and complications from SARS-CoV-2 infection; more studies are needed to identify prognostic factors and effective anti-SARS-CoV-2 therapies.

Objective: Home Hospitalization (HH) is an alternative hospitalization modality that can be very useful in times of health stress such as the COVID-19 pandemic. This paper includes the management of patients admitted with COVID-19 in HH in two county spanish hospitals for two years., Methods: A descriptive, observational and retrospective study of all patients admitted at HH with a diagnosis of COVID-19 disease was carried out. Subsequently, further analysis was carried out to characterize the patients who died in HH or 30 days after discharge and another to compare the management between the first phase of the study (2020) and the second one (2021 and part of 2022)., Results: A total of 167 patients were recruited. A 52.1% moved to watch that the recovery continued compared to 40.7% in which it was done to watch that they did not worsen. The patients who died in HAD were older (mean 87.5 years), more comorbid and more likely to have do-not resucitate orders (DNR) in case of cardiac arrest (85%). In the second phase of the study, older patients, more comorbid patients and with a greater degree of DNR orders were admitted than those admitted throughout 2020., Conclusions: HAD is a useful resource to increase the resilience of health systems in cases of stress such as the disease caused by COVID-19. The development and growth of existing units, as well as the creation of new ones where they do not exist, could be a basic tool for the medicine of the future., (©The Author 2023. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

This paper describes the means of health care used in a primary health care centre (PHCC) in a rural area to care for patients during the COVID-19 pandemic. After conducting a cross-sectional study using health questionnaire with 243 patients (100 COVID-19 and 143 other pathologies), we observed that general medical care was 100% by telephone, and little use was made of the portal for citizen information and appointment requests of the Conselleria de Sanitat de la Comunidad Valenciana. Nursing attended 100% by telephone, as did the PHCC doctors and the PHCC emergencies; in the case of taking samples, blood samples and wound care it was face-to-face (men 91%, women 88%), and at home (9% and 12%). In conclusion, different care patterns are observed according to the PHCC professionals, and the need to improve the online pathway with care management., (Copyright © 2023 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

As a part of the EIS-COVID project on the access and use of information during the COVID-19 pandemic in Chile, the objective of this paper was to ascertain how people's informational environment was constructed during the first stage of the pandemic. It discusses the results of a qualitative study of people belonging to risk groups for COVID-19: people over 18 and under 65 with chronic diseases (hypertension and diabetes) and people 65 and over. Ninety semi-structured interviews were conducted in the Metropolitan and Valparaíso regions between September 2020 and January 2021. The results reveal the problematic nature of the information overload encountered by these groups and the strategies they used to navigate it: a) information avoidance; b) content corroboration and active search for reliable sources; and c) differentiated media use.

Objective: During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects; ii) to identify the scales or questions for the assessment of loneliness; iii) what were the main variables or dimensions that were related to loneliness in old age., Methods: A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and abstracts, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review., Results: The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quantitative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning., Conclusions: The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed.

Objective: Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19, may be relevant in the development of preventive and control strategies. The aim of this paper was to determine the context in which COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin, occupational social class and gender, which is essential in order to designing public health strategies., Methods: A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables., Results: The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1) than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast, during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%), inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers (44.1%) than in non-manual workers (26.6%)., Conclusions: The context in which COVID-19 cases were infected is different according to social inequalities related to country of origin, gender and occupational social class., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

The COVID-19 pandemic induced changes in the dynamics of the life of women in the perinatal phase who, due to the health crisis, restructured social care and coexistence practices. The scope of this paper was to assess the experiences of high-risk perinatal pregnancy risk among COVID-19 positive women through social interaction. The work was conducted in a hospital of tertiary perinatal care. Qualitative methodology was used, whereby questionnaires and interviews were conducted via zoom with 14 COVID-19 positive women in the perinatal phase. Critical-interpretative discourse analysis was applied based on the concept of social interaction and complex thinking. Three types of social interaction were developed to assess the results: a) Initial social interaction: experiences when becoming aware of being COVID-19 positive; b) Acquired social interaction: experiences of care prior to COVID-19; c) Enduring social interaction: experience required in the face of COVID-19. The result of experience leads to new forms of social interaction after notification ranging from care to resilience. The conclusion drawn is that the experience of COVID-19 of women in the perinatal period remodeled their ways of coexistence and care within the institutional, family, and personal spheres.

This paper presents a synchronic analysis of the diseases during the emergence of COVID-19, the management and impact of the lockdown, and how the media narrated these events in working-class neighborhoods of the metropolitan areas of Buenos Aires and Gran Resistencia from March to November 2020. We resorted to quantitative methods on secondary sources to describe poverty and syndemics and conducted week-by-week ethnographic and media research on 38 neighborhoods with water shortages and critical overcrowding. As a result, COVID-19 syndemically emerged with dengue, measles, and tuberculosis, and the preventive measures exacerbated institutional and gender violence, the Werther effect, and the neglect of other illnesses. Ethnography revealed syndemics with noncommunicable diseases and the influence of structural violence on health. The media analysis shows interest in the districts associated with the fear of contagion, but they disappear from the media agenda once dispelled.

The paper analyzes, from a qualitative perspective, how the COVID-19 pandemic has significantly reduced medical care for chronic patients at the three levels of the Mexico City health sector due to community mitigation strategies, the perceived risk of infection of health personnel and patients, the focus on pandemic care, and how these processes are articulated with the previous underfunding conditions of the public health system. Thus, we adopted the Grounded Theory approach based on the description and analysis of the experiences of 42 doctors interviewed at the three care levels. The pandemic iatrogenesis concept is proposed to address the interrelation between the material and symbolic organization of the dominant model of medical care and specific structural and cultural dimensions of massive and systemic neglect since the arrival of the pandemic. We point out some strategies and possibilities to avoid similar future settings based on this theoretical proposal and the experiences of the doctors interviewed.

Objective: One of the problems associated to SARS-CoV-2 was its persistence in nasopharyngeal tract. The existence of markers that help to predict this situation could be useful to management of the patients. The objective of this paper was to determine the relationship between the CT value from the initial PCR of patients with COVID-19 and the persistence of the infection., Methods: It was performed an observational retrospective study of patients with positive PCR to SARS-CoV-2 attended in emergency department of a general hospital. Data about compatible symptoms, radiological findings and the CT value obtained with each PCR kit were collected. The control group (G0) included patients with a positive PCR followed by two negative PCR results (P-N-N), while problem group (G1) included patients with at least three consecutive positive PCR results (P-P-P). Chronic infections were discarded selecting only patients with negative serology, and only were included those whose PCR were separated by a minimum of five and maximum of twenty days. The comparison between the study groups was carried out using the t-student test for quantitative variables and the χ 2 test for qualitative variables., Results: The mean CT value were 30.8 and 21.5 (p<0.001) on G0 and G1, respectively. G0 reported higher CT values than G1, regardless of symptoms, radiological pattern and the PCR kit utilized., Conclusions: The CT value from the SARS-CoV-2 initial PCR is related to the persistence of its positivity, regardless of the patient´s symptoms or radiological pattern. Thus, low CT values could be related to persistent infections., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

The paper is aimed to analyze if religion plays a relevant role in health promotion and, thus, if it can be included in the interpretations on the positive role of religions in the public sphere. In this regard, Habermas refers to a crisis of meaning in secular societies that has been caused, among other reasons, by individualistic and selfish lifestyles that fail to encourage a moral action when it goes beyond the law. In contrast, it seems that the strong social ties of religious communities foster solidarity and altruistic attitudes, which could be interpreted as a sign of greater social cohesion; but is it really like that? Pandemic and its consequences help to assess whether the religious element (analyzed as belief, belonging, bonding and behavior) has created positive attitudes in the face of the health challenges (i.e., compliance with rules of social distance, vaccination) or, on the contrary, the motivational deficits of some societies have to do with other factors not related to the religious/secular dichotomy., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

COVID-19 pandemics gave us relevant lessons that are going to leave a durable mark in our individual and collective experience. Those lessons are both practical and endowed with a moral import. But the pandemic has left a trail of experiences poorly elaborated that leads, with some urgency, to forced silence and to the cancellation of emotional trauma. The aim of this paper was to disentangle the complex relationship that arises, under conditions of uncertainty, between knowledge and ignorance, both from the perspective of experts and of policy makers, and even of the ordinary people, struck or not by the SARS-CoV-2 virus. To that end, I distinguish between three different levels of analysis (agency, institutions, and ideological frameworks) so to argue that the mismatches that occur in all of them, and between them, are sources of avoidable harm. The purpose of this exploration was, therefore, to bring to the floor, relying on the conceptual tools of the political epistemology, both the aspects of the traumatic experience that still lack an adequate elaboration and the features that provide an improved resilience for individuals and societies in tackling with the frightful consequences of the pandemic., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: In Madrid, during the pandemic, due to hospital saturation, medicalisation of hotels was required for the transfer of patients infected by SARS-CoV-2 with favourable evolution. Their typical clinical situation was one of fatigue and physical deconditioning, requiring and benefiting from a rehabilitative approach. The Rehabilitation Department developed educational material in paper format on therapeutic exercise adapted to the different functional situations detected. To describe the profile of patients admitted to a medicalised hotel and to analyse the degree of satisfaction, utility and adherence to the exercise prescribed during hospitalisation and at home and the related factors., Material and Method: We conducted a descriptive study of patients admitted to the Hotel Colon during April and May 2020. We analysed the socio-demographic and clinical variables, as well as the responses to the adherence and satisfaction questionnaires about rehabilitation management during admission and at discharge., Results: 100 patients participated in the study with a mean age of 52±14.5 years, where 61% (n=61) were women. 99% (n=99) reported they understood the material with a 90% (n=90) adherence to exercise during admission and 58% (n=58) at discharge. 92% (n=92) were "very satisfied" with the educational material and considered it easy to perform in 100% (n=100) of cases., Conclusion: The use of paper-based educational material of therapeutic exercise appears to be an effective resource in the management of patients with SARS-CoV-2 infection during admission, thus minimising the exposure of healthcare staff., (Copyright © 2021 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

In this paper we compared brand-specific COVID-19 vaccine effectiveness (VE) during August 2021 in persons born 1962-1971 and vaccinated during June. For SARS-CoV-2 symptomatic infection, protection was lower for Janssen (56%; CI95%: 53-59) or AstraZeneca [Vaxzevria] (68%; CI95%: 65-70), compared to Pfizer-BioNTech [Comirnaty] (78%; CI95%: 77-78), AstraZeneca/Pfizer (86%; CI95%: 80-90) or Moderna [Spikevax] (89%; CI95%: 88-90). VE against hospitalization was ranged 86% for Janssen to 97%-98% for other vaccines.

Results from the European project RESISTIRÉ show that the pandemic outbreak and policies adopted to contain the virus have reinforced pre-existing gender inequalities, resulting in a “spiral of increasing inequalities” (Axelsson et al., 2021: 110). The care domain is a key part of this spiral and has been at the centre of debates and of some of the COVID-19 policy responses. However, for the most part, policy interventions in the care domain have focused primarily on work-life balance, neglecting the impact of health-related policy restrictions on domestic workers – a highly feminised and racialised sector. Yet these workers have been dramatically affected by the pandemic and related policies, not only in terms of exposure to infection, but also in terms of exacerbation of pre-existing and intersecting inequalities. Moreover, when policies did address the domestic sector, they often reproduced gender stereotyped understandings of the nature of care work, and reinforced racist assumptions on migration. This paper compares the policies on domestic workers enacted during the pandemic in Italy and Spain, which illustrate how public policy engages in gendering and racializing domestic workers. Drawing on Bacchi’s methodology, it seeks to unfold and problematise the representations and implicit assumptions related to care work, and the gender and racial hierarchies underpinning them.

(Series Information) European Papers - A Journal on Law and Integration, 2022 7(1), 481-506 | Article | (Table of Contents) I. Introduction. - II. The case of the ESM: why the Eurozone's governance does not question the unity of the EU institutional framework. - II.1. The establishment of the ESM. - II.2. The institutional functioning of the ESM. - III. The impact of tasks entrusted to the EU institutions under the ESM on the institutional equilibrium within the EU legal order. - III.1. How are new tasks entrusted to the EU institutions? - III.2. What impact do these new tasks produce on the institutional equilibrium within the EU? - IV. The post-Covid institutional set-up: back to a "community" mode of governance? - V. Conclusion. | (Abstract) In the aftermath of the global financial crisis, the EU and its Member States had to face very pragmatic issues: how to avoid the economic collapse of Greece, Portugal and Ireland? Decisions had to be taken quickly in any institutional or legal forum that was immediately available. For this specific reason, legal solutions entailing the conclusion of international agreements by some of the EU Member States outside the EU legal framework were taken as a new normal. Due to a close legal relationship between these new international treaties and the EU legal order, a decision was also taken to "borrow" already existing EU institutions and entrust them with new tasks. In this Article, we question the role of EU institutions outside the EU legal framework. We first address the evolution of the EU institutional framework in the context of the euro crisis in relation to art. 13 TEU and recital 7 of the TEU preamble and the requirement of "unity of the institutional framework". Section II shows that "borrowing" the EU institutions outside the EU legal framework does not seem to alter the nature of the single EU institutional setting. Section III questions whether the tasks entrusted to the EU institutions outside the EU legal framework do not undermine the existing institutional equilibrium within the EU legal order. Section IV addresses the EU response to the Covid-19 pandemic from an institutional perspective as raising similar concerns within the EU legal order. The last section concludes.

Objective: The aim of this paper was to estimate the SARS-CoV-2 infection incidence regarding the occupation in Catalonia, globally and in the different waves of the pandemic., Methods: We performed a retrospective cohort study. We included all people between 16 and 65 years old with an occupation identified from the sick leave recorded in the primary care electronic health records of the Institut Català de la Salut (ICS) (total n=2,199,745 people). The study period was from March 1 st , 2020 to September 16 th , 2021., Results: Healthcare workers had the highest incidence, with an age and sex adjusted cumulative rate of 27.7% [95% CI: 27.3%-28.1%]: 29.4% in nursing assistants, 27.3% in medical professions and 26.3% in nursing professionals; followed by the elementary occupations group with an adjusted incidence of 16.9% [95% CI: 16.7%-17%], such as the agricultural laborers (23% [95% CI: 21%-25.1%]) and rural occupations (19.1% [95% CI: 18.3%-19.8%) -especially during the 2020 summer period-, the domestic employees (20.5% [95% CI: 18.9%-22.2%]) and cleaning professionals (17.5% [95% CI: 17.2%-17.9%])., Conclusions: Healthcare workers are the hardest hit during the pandemic. On the other hand, the less qualified professions have high incidences, highlighting the different inequities in access to telework, working conditions and other social determinants of health.

The COVID-19 pandemic has been a challenge for countries and health professionals worldwide. Viral entry by ACE-2 receptor and an excessive activation of the immune system are key to understand both incidence and severity of disease. Inflammatory Bowel Disease (IBD) represents a special condition associated with an inordinate response of the immune system to external agents. IBD treatments have been associated to an increased risk of bacterial and viral infections. This has raised the question of possible higher incidence and severity of COVID-19 infection in IBD patients. Several papers have been published during this year of pandemic to answer that question. Moreover, COVID-19 vaccination offers great promise in controlling infection in patients with IBD. Based on current evidence, patients with IBD do not have a higher incidence of COVID-19 than the general population, and they do not have worse disease evolution. Advanced age and presence of a greater number of comorbidities have been associated with worse outcomes, similar to the general population. Corticosteroids are associated to an increased risk of COVID-19 infection, higher hospitalization rate and higher risk of severe COVID-19. 5-ASA/Sulfasalazine and Thiopurines have a possible increased risk of severe COVID-19, although studies are lacking. On the other hand, Anti-TNF may have a possible protective effect. It is recommended to maintain the treatment. Anti-IL-12/23, anti-integrins and tofacitinib have results comparable to anti-TNF. Based on the efficacy, expert recommendations, and the absence of other evidence, it is recommended that patients with IBD be vaccinated., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Introduction: Neuropsychiatric symptoms are common in patients with mild cognitive impairment and dementia. This symptomatology can appear or be exacerbated with changes in routine and in the patient's usual environment. The lockdown situation during the COVID-19 pandemic has meant a drastic and unexpected change in the daily life of the general population, with a particular impact on the most physically and mentally vulnerable groups, including patients with cognitive impairment., Aim: To know the impact of lockdown measures imposed due to the COVID-19 pandemic on neuropsychiatric symptomatology in people with mild cognitive impairment and dementia., Materials and Methods: Exploratory systematic review, in accordance with the PRISMA guidelines, of Pubmed and Psycinfo databases papers published from January 2020 to April 2021 which related confinement due to COVID-19 with the presentation or worsening of neuropsychiatric symptoms in patients with mild cognitive impairment mild or dementia., Results: Worsening of neuropsychiatric symptoms was observed in patients with dementia and mild cognitive impairment, especially agitation/aggression, anxiety, depression and apathy. Neuropsychiatric symptoms were more common in patients with dementia than in those with mild cognitive impairment, although their typology varied depending on the severity of dementia., Conclusions: During lockdown a worsening in the psychobehavioral area has been observed in people with mild cognitive impairment or dementia. Therefore, considerations arise on the need of promoting social contact in people with mild cognitive impairment and dementia, avoiding situations of isolation and low stimulation.

Behavioural economics (a combination of economics and psychology) provides keys to understand decisions made by politicians and citizens along the COVID-19 pandemic through the so-called cognitive biases. These biases can be offset by implementing behavioural interventions named "nudges" in order to promote responsible behaviours in the "new normality". This paper analyses, from a behavioural economics perspective, past, present and future of behavioural aspects surrounding the pandemic. Besides, this paper proposes different ways to formalize nudges according to law, which needs the fulfilment of three minimum requirements, namely: transparency, non-arbitrariness and efficiency. Furthermore, it is also suggested that protocols and contingency plans are set up to face future pandemics, in which both soft (nudge-type) interventions and hard legal regulations play different roles but complementary ones. Nudges can be implemented in a fast and less coercive way, so they are particularly suitable for changing mild misbehaviour, reserving legal sanctions for the more serious ones., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

The aim of this paper is to explore the legal tools the Spanish constitutional system holds to face a health crisis as serious in its scope and consequences and as lengthy in time such as that of the COVID-19 pandemic. First, we explain the state of alarm provided for in Organic Law 4/1981, 1st June, regulating the states of alarm, exception and siege; then, the provisions included in Organic Law 3/1986, on extraordinary measures in the field of public health. Both regulations have been the legal basis to adopt different state and regional health measures during this almost year and a half of the pandemic. The last July 14, the Spanish Constitutional Court made public the appeal of unconstitutionality lodged by more than fifty deputies of the Vox parliamentary group against Royal Decree 463/2020, of March 14 (articles 7, 9, 10 and 11), by which the state of alarm was declared for the management of the health crisis caused by COVID-19 and several regulations that modified that Decree or extended it. This judgement suggests a different legal response -the declaration of the state of exception- to deal with the health crisis and be critically analyzed in third place., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To provide recommendations regarding surgery, follow-up, and management of possible complications related to penile prostheses implantation, during the COVID-19 pandemic., Material and Methods: We designed a critical narrative review of the studies investigating the impact of COVID-19 on urology practice and on penile prosthetic implantology. A comprehensive search in the MEDLINE database was performed. Different combinations of the following keywords were used according to a free-text protocol:: "SARS-CoV-2", "COVID19", "COVID Urology", "COVID19 surgery", "penile prostheses". Papers in English and Spanish language, published until September 2020 were included in the review., Results: Penile prosthesis implantation is an elective surgery which should always be deferred when it cannot be performed in maximum safety conditions. However, it may lead to complications wich must be resolved urgently even within the COVID-19 Era., Conclusions: Currently, it is mandatory to develop shared strategies to avoid potential COVID-19-related complications for surgical patients. Penile prosthesis implantation should be deferred to avoid unnecessary risks and all preventive measures should be taken to minimize the risks in the event of non-delayable surgery., (Copyright © 2021 Asociación Española de Andrología, Medicina Sexual y Reproductiva. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: The World Health Organization declared the global SARS-CoV-2 infection a pandemic on March 11, 2020. The objective of this paper is to present its impact in terms of physical and mental health 22 months later., Method: We have reviewed results from published meta-analysis and systematic reviews, and some individual articles on specific aspects of special interest. National information on infection comes for the Red Nacional de Vigilancia Epidemiológica (RENAVE)., Results: Up to the end of October, more than 250 million infections and 5 million deaths had been reported globally. In Spain, 4.7 million infections have been documented although the real figure might be above 7 million. The pandemic has reduced life expectancy, and its effects have been especially dramatic in people with comorbidities and the elderly. There is a worsening of mental health in the general population. It is foreseeable that some groups, such as health professionals, mostly women, and front-line workers, may have a greater risk of developing mental health pathologies. The pandemic and the control measures have had other undesirable consequences such as a decrease in healthcare utilization, an increase in sedentary lifestyle or an increase in gender violence. In addition to its immediate effect on morbidity and mortality, the control measures have damaged the overall health status of the global population., Conclusions: Longitudinal studies are necessary to determine the mid and long consequences of the pandemic and the control measures, and to identify and evaluate effective health interventions., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: The COVID-19 pandemic has imposed a great challenge on health research because of the pressing need to respond promptly and effectively to this crisis situation. It is important to offer a high level perspective of the main barriers and facilitators found when conducting health science studies during the COVID-19 crisis and to discuss the research initiatives suggested by global, regional or local health research authorities., Materials and Methods: A systematic scoping review was carried out. A literature search was conducted in the Medline, Cochrane Library, Lilacs and Google Scholar databases. Original research studies, review and opinion articles and editorials available in full text published in Spanish, English or Portuguese between January 2020 and May 2021 were included. Two authors working independently selected the papers and collected the data. The barriers and facilitators identified were described and organized in four categories according to the literature: sociocultural, administrative, organizational and methodological. Official documents and communications from global, regional and local health and research authorities were also included. Results are presented in narrative and table form., Results: Overall, 26 documents were selected for data analysis and synthesis. The barriers most frequently mentioned in the literature include issues with access to participants, ethics committees paperwork, biological risk for the researchers, and lack of inter and intra-institutional coordination. On the other hand, the facilitators identified include the adoption of on-line solutions, cooperative work among research actors, and a more flexible informed consent process. Regarding the initiatives disseminated by health and research authorities, four strategies were identified: prioritization of research questions, cooperation and inclusion promotion, fight against infodemia, and strengthening of the methodological quality of the studies., Conclusions: Continued cooperation and interoperability among institutions, countries and disciplines to facilitate future research processes is a challenge in the context of the pandemic; similarly, it is now important to maintain open science and funding of cooperative studies when other priorities emerge. Likewise, there is an evident need to develop and sustain efficient information management systems to help with decision-making. Ongoing review of the effects of the pandemic on health research practice is needed in order to gain comprehensive insights of what we need to learn as a society from this crisis., (Copyright (c) 2021 Revista Colombiana de Obstetricia y Ginecología)

Coagulopathy and thrombosis associated with coronavirus disease 2019 (COVID-19) represent a major issue in the management of this disease. In the past months, clinical studies have demonstrated that COVID-19 patients present with a particular hypercoagulable state, in which a markedly increased D-dimer concomitant with increased levels of fibrinogen are observed. This hypercoagulable state leads to an increased risk of thrombosis, which seems to be higher among those patients with critical symptoms of COVID-19. The best therapeutic approach to prevent thrombotic events in COVID-19 has not been determined yet and several questions regarding thromboprophylaxis therapy, such as the time to initiate anticoagulation, type of anticoagulant and dose regimen, have emerged among physicians. To address these concerns, several medical societies have published position papers to provide the opinion of thrombosis experts on the management of coagulopathy and thrombosis associated with COVID-19. In line with this, the Latin America Cooperative Group of Hemostasis and Thrombosis (Grupo CLAHT) has constituted a panel of experts in thrombosis and hemostasis to discuss the available data on this topic. The aim of this review is to summarize the current evidence regarding hemostatic impairment and thrombotic risk in COVID-19 and to provide a carefully revised opinion of Latin American experts on the thromboprophylaxis and management of thrombotic events and coagulopathy in patients with suspected COVID-19.

El fenómeno de la soledad se está convirtiendo, cada vez más, en un problema amplio y relevante de las sociedades contemporáneas. En consecuencia, son muchas las investigaciones que abordan esta realidad, como numerosas son también las intervenciones que tratan de hacerle frente, en especial tras la pandemia provocada por la COVID-19. Para acercar al lector a esta realidad, en el presente artículo se exponen de forma heurística las diversas posturas existentes sobre la soledad mediante una novedosa cartografía teórica que propone un nuevo recorrido por el actual estado de la cuestión del campo de la soledad, formado por las aportaciones de distintas disciplinas. Para ello se ha seguido un método de revisión bibliográfica reflexiva con el objetivo de generar nuevos alineamientos teóricos que esclarezcan las posiciones desde las que hoy se escribe acerca de la soledad. Finalmente, el texto esboza algunas líneas reflexivas que el acercamiento sociológico a la soledad deberá tener en cuenta para constituirse como interlocutor válido y valioso en el actual campo de estudio de la soledad.

RESEARCH OBJECTIVE: Governments across the world were forced to impose social distancing and lockdown measures to prevent the spread of COVID-19, caused by coronavirus SARS-CoV-2 that emerged in December 2019. Following the declaration of COVID-19 as a pandemic, the disruptions, including restrictive measures such as school closures had severe impacts on the physical, emotional and mental health of all people, especially children with special needs. There was also scant data, particularly in low-to-middle-income countries. Existing literature stems mostly from western countries, thus the need to perform a comprehensive review on this topic. THE RESEARCH PROBLEM AND METHODS: The primary objective of the systematic review is to understand the impact of COVID-19 and restrictive measures such as school closures on the educational outcomes and physical and mental health of school-going children with special needs. THE PROCESS OF ARGUMENTATION: This systematic review used the PRISMA 2020 checklist where four databases and grey literature were searched for full text articles, peer reviewed publications in the English language that were published during January 2019–December 2021. RESEARCH RESULTS: The literature search identified 1294 publications, of which 25 key papers were selected. These studies investigate the impact on children with special needs across the globe, with a majority of papers from Europe. We found that COVID-19 and the digitalization of schooling had severe impacts on the physical and mental health of children with special needs and their parents/caregivers. CONCLUSIONS, RECOMMENDATIONS AND APPLICABLE VALUE OF RESEARCH: These studies highlight the need for an inclusive school environment to ensure that the learning outcomes for children everywhere are achieved. Further, a hybrid model that includes classroom learning with novel inventive methods would be beneficial for children with special needs.

The aim of this paper is a study on Covid-19 pandemic and restrictions that came along. With restrictions, violations. The principle of legality, the basic historical construction of the rule of law, had been solemnly and repeatedly vilified and carried with it many constitutional rights and principles, which, more than indispensable for us, are so on a universal level, such as the restless go and come and exercise economic activity. Under the auspices of teratological decrees, of congenital malformation, our rights were restricted. But what is worse: often under the parsimonious eye of those who should be keeping the Constitution. Is it deference to the political propaganda pieces, based on biopower, that invade the everyday? Is it a fear of contributing to health discouragement, justifying non-legality? In this paper, more than addressing the unconstitutionality of restrictions, we propose to discuss the reasons for this passivity and acceptance. Methodologically, we use inductive guidance, choosing some characteristics as a starting point to build a broader conclusion, using a wide bibliographic and jurisprudential review.

Objective: The COVID-19 pandemic caused by the SARS-CoV-2 virus has generated a great burden on health systems, and healthcare workers have been the most affected. In Spain, the Health Ministry issued common protocols regarding the return-to-work of healthcare workers presenting a negative PCR (Polymerase Chain Reaction) test result and complete resolution of symptoms. Some autonomous communities decided to include a CT (Cycle Threshold) value criterion as well. The aim of this paper was to compare the time intervals required to obtain a negative PCR result by means of both criteria., Methods: A multicenter, cross-sectional study was performed from March to September of 2020, in the health areas of Navarra, La Rioja and Vigo (Galicia), managed by their own Occupational Risk Prevention Units. The PCR negativization time intervals were analyzed according to gender, age, professional category and the PCR repetition criteria used (clinical or defined by CT). Mean difference calculation by Student's t-test and Kaplan-Meier survival analyzes were conducted., Results: The sample amounted to a total of 1,052 workers: 673 from Navarra, 335 from La Rioja and 44 from Vigo, with an average age of 46 years, and of which 81% were women, 35.48% nursing personnel and 23.65% physicians. No statistically significant differences were found between the PCR negativization time periods with any of the variables, except with the CT criterion, which presented a mean of 6.49 days (95% CI, 4.96-8.02), longer and displaying positively displaced survival curves., Conclusions: The CT criterion for carrying out the control PCR test lengthened the reincorporation of essential personnel in the fight against the pandemic., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

The Spanish Vaccination Strategy against COVID-19 has been prepared by a multidisciplinary Technical Working Group. It has considered the situation of the different socio-occupational groups against COVID-19, having assessed the criteria of risk of exposure, transmission, serious illness and death, negative social and economic impact, feasibility and acceptability of vaccination, in addition to taking into consideration the ethical pillars that govern the Strategy. In the working population, priority has been given to first-line health and social-healthcare personnel in the first stage and, later, to the rest of healthcare and social-healthcare personnel (Groups 1, 2 and 3 of the Strategy). Group 6 included emergency personnel, security and army forces, and early childhood, special, primary and secondary education teaching personnel, due to the role that they played during the state of alarm, the significant risk of exposure, and the essential role they play in maintaining the proper functioning of society. This paper describes the stages of vaccination and their prioritization by groups in the labour context, and shows the strategy by age groups, together with the prioritization of Group 6, has been shown to be efficient and to reach workers with high risk of COVID-19 early.

In this paper we analyze the role of Labor and Social Security Inspectorate (Inspección de Trabajo y Seguridad Social in Spanish) in the assessment and management of the risks associated to COVID-19 in the workplaces, since the beginning of the pandemic until the enforcement of the Royal Decree-Law 26/2020, with special focus on the Operative and Technical Criteria issued by the Directorate of the State Labor and Social Security Inspectorate. The paper describes the differentiation of those situations where the infection risk is derived from the work activity itself and, therefore, has a professional nature, from those where the risk is external to the work activity, thus lacking such character. A specific part of this paper is dedicated to the study of the collaboration and coordination between the Labor and Social Security Inspectorate and the Public Health Authorities, which has been become essential to effectively protect the health of workers.

Non-parametric survival analysis has become a very popular statistical method in current medical research. However, resorting to survival analysis when its fundamental assumptions are not fulfilled can severely bias the results. Currently, hundreds of clinical studies are using survival methods to investigate factors potentially associated with the prognosis of coronavirus disease 2019 (COVID-19) and test new preventive and therapeutic strategies. In the pandemic era, it is more critical than ever to base decision-making on evidence and rely on solid statistical methods, but this is not always the case. Serious methodological errors have been identified in recent seminal studies about COVID-19: One reporting outcomes of patients treated with remdesivir and another one on the epidemiology, clinical course, and outcomes of critically ill patients. High-quality evidence is essential to inform clinicians about optimal COVID-19 therapies and policymakers about the true effect of preventive measures aiming to tackle the pandemic. Though timely evidence is needed, we should encourage the appropriate application of survival analysis methods and careful peer-review to avoid publishing flawed results, which could affect decision-making. In this paper, we recapitulate the basic assumptions underlying non-parametric survival analysis and frequent errors in its application and discuss how to handle data on COVID-19.