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Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination., (Sociedad Argentina de Pediatría.)

Objective: Contributing to elucidate the pathophysiology of dyspnoea and exertion intolerance in post-COVID syndrome patients with normal cardiopulmonary imaging and functional tests at rest, while determining their fitness and level of endurance in order to individualize working parameters for physical rehabilitation., Material and Methods: After an anamnesis and clinical examination at rest, 27 subjects (50±11.9 years) (14 women) with post-COVID syndrome of more than 6 months of evolution performed a continuous maximal-incremental graded cardiopulmonary exercise test (CPET) with breath-by-breath gas-exchange monitoring and continuous ECG registration, on an electromagnetically braked cycle ergometer. The values obtained were compared with those of reference, gender or controls, using the Chi-square, t-Student or ANOVA test., Results: The clinical examination at rest and the CPET were clinically normal and without adverse events. Reasons for stopping exercise were leg discomfort. It is only worth noting a BMI=29.9±5.8kg/m 2 and a basal lactate concentration of 2.1±0.7mmol/L. The physiological assessment of endurance showed the following results relative to predicted VO 2máx : 1)peakVO 2 =80.5±18.6%; 2)VO 2 at ventilatory threshold1 (VO 2 VT1): 46.0±12.9%; 3)VO 2 VT2: 57.2±16.4%; 4)working time in acidosis: 5.6±3,0minutes; and 5)maximum lactate concentration: 5.1±2.2mmol/L., Conclusions: The CPET identified limited aerobic metabolism and early increase in glycolytic metabolism as causes of dyspnoea and exercise intolerance, determined fitness for physical rehabilitation, and individualized it based on the level of endurance., (Copyright © 2024 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

This study evaluated the explanatory factors of humoral immune response in older adults admitted to long-term care institutions in Buenos Aires, Argentina, up to 180 days after vaccination. An open-label, prospective, multicenter cohort study was conducted with volunteers who received two doses of the Sputnik V, Sinopharm, or AZD1222 vaccines. Plasma samples were analyzed at 0 and 21 days after the first dose, 21 days after the second dose, and 120 and 180 days after the first dose. Marginal linear models and generalized additives mixed models were adjusted to determine the behavior of anti-spike IgG antibody concentration over time according to exposure group (naïve/no-naïve) and vaccine. Occurrence of an outbreak of COVID-19 in long-term care institutions and comorbidities were the covariates analyzed. A total of 773 participants were included, with a mean age of 83 years (IQR: 76-89). Results showed that antibody levels in the naïve: Sinopharm group were significantly lower to the other groups (p < 0.05). Antibody levels in the no-naïve: Sinopharm group were similar to those in the naïve group who received AZD1222 (p = 0.945) or Sputnik V (p = 1). Participants exposed to outbreaks in long-term care institutions had significantly higher antibody levels, regardless of exposure group and vaccine (p < 0.001). In conclusion, previous exposure to COVID-19, type of vaccine, and admittance into a long-term care institution with a history of outbreaks are factors to be considered in future epidemic events with transmission dynamics and immunological mechanisms similar to COVID-19, in populations similar to the one analyzed.

Introduction: The rapid emergence of COVID-19 urged policy responses worldwide, focusing on vaccination and mobility restrictions. Chile represents a unique scenario for analyzing personal preventive measures amid intensive communication and vaccination campaigns. This study aims to explore changes in population adherence to non-pharmacological preventive measures during the pandemic and the factors that explain this adherence each year., Methods: 386 individuals who participated in two population-based studies (2021 and 2022) were considered. An interview was conducted to measure adherence to self-care practices, and case and contact tracing by the health authorities. The Wilcoxon signed-rank test was performed to measure change between 2021 and 2022, bivariate analysis, and a linear regression model for each year were performed., Results: Mask-wearing in public places was the most commonly used measure (95.9% in 2021, 89.9% in 2022). Follow-up of cases and cases contacts by the health authority had high coverage in 2021 (94.3% and 83% respectively). A greater decrease was observed in contact tracing in 2022 totaling 33.3%. An increase in the score of adherence to preventive practices was observed in 2022 (p < 0.00). The regression model showed in 2021 that women were more likely to adopt preventive behaviors (95% confidence interval: 0.27 to 1.13) and the overweight/obese had higher adherence compared to normal body mass index (95% confidence interval: 0.06 to 0.98). In 2022 being a young adult (30 to 49 years) predicted the adoption of behavioral precautions (95% confidence interval: 0.00 to 1.32)., Conclusions: Adherence to preventive measures increased even with high vaccination coverage, likely due to the epidemiological situation with the Omicron variant circulating in 2022., Competing Interests: The authors declare no conflict of interest. At the same time, the funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background: Motivation for the study. To document the evolution of COVID-19 in rural Amazonian populations, which are still little known., Background: Main findings. COVID-19 spread rapidly through rural communities, initially spreading to mestizo hamlets and later affecting indigenous communities. Rural mortality varied by region and ethnicity. Social distancing was difficult, and travel to receive government vouchers contributed to contagion., Background: Implications. Identifying the factors that contributed to contagion and the barriers to the adoption of protective measures in rural Amazonian populations will help to face future pandemics., Objectives.: To analyze the evolution of COVID-19 in rural populations of Loreto and Ucayali in the early stage of the pandemic., Materials and Methods.: A community-level longitudinal observational study was conducted and based on two rounds of telephone surveys with local authorities of more than 400 indigenous and non-indigenous rural communities in Loreto and Ucayali, in July and August 2020. We collected information on cases and deaths by COVID-19 in their communities, protective measures adopted and if state assistance was received in the early stage of the pandemic. Descriptive statistics allowed us to evaluate the evolution of the pandemic after the initial outbreak and compare the trends of the two regions, as well as between indigenous and non-indigenous populations., Results.: In July 2020, COVID-19 had reached 91.5% of the communities, although deaths from COVID-19 were reported in 13.0% of the communities, with rural mortality being higher in Ucayali (0.111%) than in Loreto (0.047%) and in non-indigenous communities. By August, prevalence decreased from 44.0% to 32.0% of communities, but became more frequent in indigenous communities, and those in Ucayali. Traveling to the city to receive state bonuses and difficulties maintaining social distancing contributed to the spread., Conclusions.: Our findings show the evolution of COVID-19 in rural communities and point to important areas of attention in future public policies, for the adoption of protective measures and reconsidering strategies for the distribution of assistance in the face of future pandemics., Background: Motivation for the study. To document the evolution of COVID-19 in rural Amazonian populations, which are still little known., Background: Main findings. COVID-19 spread rapidly through rural communities, initially spreading to mestizo hamlets and later affecting indigenous communities. Rural mortality varied by region and ethnicity. Social distancing was difficult, and travel to receive government vouchers contributed to contagion., Background: Implications. Identifying the factors that contributed to contagion and the barriers to the adoption of protective measures in rural Amazonian populations will help to face future pandemics.

After the COVID-19 pandemic, the omicron variant of the SARS-CoV-2 virus became the dominant lineage in Spain in 2022. Although it possesses a milder pathogenicity than previous variants, it still poses a high risk of causing severe COVID-19 for immunocompromised populations. A systematic review was conducted to assess the burden of COVID-19 in Spain among immunocompromised patients during the omicron predominance (1/04/2022-1/04/2023), using PubMed, Cochrane Library, and EPICOVIDEHA between May and July 2023. The search retrieved 217 articles, of which a total of 5 were included. Upon analysis, it was observed that immunocompromised patients during the omicron lineage predominance continue to exhibit higher rates of hospitalizations, ICU admissions, and mortality compared to the general population affected by COVID-19. Although the pandemic has ended, the risk persists for immunocompromised individuals., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To analyze the experiences regarding the implementation of COVID-19 vaccination strategies, emphasizing the opportunities and challenges identified during its implementation., Design: A systematic review of the literature published between 2020 and 2022., Data Sources: The study was conducted across four databases: PubMed, ScienceDirect, Scielo, and Lilacs., Selection of Studies: Publications selection followed the PRISMA methodology (Preferred Reporting Items for Systematic Review and Meta-Analysis)., Data Extraction: A database was created where key elements of the selected study were identified and recorded, such as results, discussion, and conclusions. In addition, analysis categories were created such as: stages of the implementation plan, challenges identified and opportunity areas., Results and Conclusions: 292 publications were found, of which 25 were selected for analysis. Of these, 64% came from high-income countries and 32% from upper-middle-income countries. According to the stages of the implementation plan, 20% of the studies focused on regulations, planning and coordination; 28% in prioritization of the population to be vaccinated; 16% in acceptance, demand, and risk communication; and 16% in administration and information systems. Reflection on the response to the pandemic invites us to consider various aspects, such as the organization and function of health systems, the importance of collaborative work, efforts to achieve equity, communication strategies, as well as ethical dilemmas when seeking preserve health., (Copyright © 2024 The Author(s). Publicado por Elsevier España S.L.U. All rights reserved.)

Introduction: The importance of knowing the impact of work on people's health has increased after the COVID-19 pandemic. Burn Out (BO) syndrome arises from the tension emerging from the conflictive interaction between the worker and his or her employment. The objective was to describe the prevalence and frequency of diagnosis of BO in the health human resources of critical services of the Bahía Blanca Municipal Hospital in the context of the COVID-19 pandemic.Methods: Descriptive, cross-sectional study. The study population was the medical and nursing staff of the Intensive Care (IT), Emergency Medicine (SMU) and Clinic services who worked with COVID-19 during 2021. The Maslach Burnout Inventory (MBI) questionnaire was used and complementary closed questions to identify, among these cases, those that were diagnosed and treated by the institution.Results: Of the 219 workers, 55.3% (121/219) were nurses. In the SMU, 25% (24/96) of respondents had BO, followed by 20.4% (11/54) in Clinic and 8.7% (6/69) in IT (p value=0.004). Only 5.5% (12/219) of the total were diagnosed with BO by the institution and of this group, two people (0.9%) had previously consulted for characteristic symptoms.Discussion: A high prevalence of BO and a marked underdiagnosis were evident at the institutional level during the pandemic. Although the IT Service had the highest demand for attention, it was the one that presented the lowest BO values in relation to other services., (Universidad Nacional de Córdoba)

Introduction: The Long Coronavirus Disease (COVID) Symptom and Impact Tools (ST and IT) were published in English in 2022 to monitor the symptoms and impact of persistent COVID-19. ST includes 53 symptoms selected by the patient. IT includes six aspects of life that the patient must rate from 1 to 10 points. We aim to report the results of the cultural adaptation of both instruments for the Chilean population, together with the content validity of the adapted instrument., Methods: The cultural adaptation was carried out in five steps: 1) translation from English to Spanish, 2) synthesis, 3) back-translation, 4) review by the editorial board, and 5) testing the questionnaire with ten patients; they answered both questionnaires and seven questions assessing their understanding of the TI and their opinion on whether the instrument reflected the impact of prolonged COVID-19 on their lives. The content validity of the final version of the IT was assessed by 14 experts., Results: The main outcome is the two final questionnaires adapted for use in Chile. Most patients responded with the best concept or approval for all items. Content validity showed acceptable results, with an average content validity index of 0.9 and Aiken's V for the relevance of the questionnaire in general of 0.83 (95% CI 0.69 to 0.92). For one item, Aiken's V was less than 0.7 (95% CI 0.5 to 0.8)., Conclusions: This study provides Chilean health authorities and health providers with an instrument for assessing the impact of prolonged COVID-19 on core aspects of people's lives., Competing Interests: The authors declare that they have no conflicts of interest with this work., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background: Motivation for the study. The COVID-19 pandemic contributed to the development of mental disorders among medical students, including obsessive-compulsive symptoms. However, evidence on this problem in this population is still limited., Background: Main findings. One in 10 medical students presented clinically significant obsessive-compulsive symptoms., Background: Implications. The health crisis has had a negative impact on the mental health of medical students. Therefore, it is crucial to implement future interventions to promote the preservation of their psychological well-being., Objectives.: To determine the prevalence of obsessive-compulsive symptoms among medical students in Peru during the COVID-19 pandemic and its associated factors., Materials and Methods.: Cross-sectional study in 270 medical students from a Peruvian public university. Participants were recruited through non-probability sampling. Obsessive-compulsive symptoms were assessed with the Yale-Brown Obsessive Compulsive Disorder Scale (Y-BOCS). After the descriptive analysis, Poisson regression with robust variance was used to determine the factors associated with probable obsessive compulsive disorder (probable OCD). The crude (PRc) and adjusted (PRa) prevalence ratios were calculated, along with their respective 95% confidence intervals (95% CI)., Results.: The prevalence of obsessive-compulsive symptoms was 13.3% in medical students. During bivariate analysis, students with probable OCD were younger (p=0.044) and had a lower level of knowledge about COVID-19 (p=0.045). The crude model showed a lower prevalence of probable OCD among those with an adequate level of knowledge compared to those with an inadequate level (PR: 0.52, 95% CI: 0.28 to 0.98). However, after adjusting for other variables, none of the described variables were statistically significant., Conclusions.: One in ten medical students presented clinically significant obsessive-compulsive symptoms. Implementing future interventions is crucial to preserve the mental well-being of this vulnerable population.

Introduction: At the beginning of the COVID-19 pandemic, confinement measures were applied in many states around the world, producing changes in lifestyle and health habits, whose metabolic impact was different in different populations., Objectives: Describe the metabolic and anthropometric changes in office patients in the City of Córdoba during the confinement period and determine possible associated factors., Methods: Retrospective analytical observational study based on the review of the medical records of patients seen in an endocrinology clinic in Córdoba, Argentina. They were followed up during the 1-year period by evaluating metabolic and anthropometric characteristics., Results: 149 patients were included, of which 116 (77.9%) were female and the median:IQR age was 50:36.5-58 years. At the end of follow-up, a significant increase in alcohol consumption (18.1% vs 11.4%, p=0.001) was observed, as well as the number of diabetic patients (diagnosis of 20 new cases). 49.67% of patients increased their body weight, with a median of 3.1 kg (IQR 25-75%: 1.4-7.5 kg). Patients who had longer follow-up (3 or more controls during the year) decreased their Body Mass Index and increased physical activity., Conclusions: Although confinement was generally associated with an increase in obesity, diabetes and consumption of toxic substances, in patients who were monitored more frequently, better control of body weight and increased activity was observed. physical., (Universidad Nacional de Córdoba)

Background: Anti-GQ1B syndrome includes a group of diseases characterized by antibody-mediated polyneuropathy. Guillain Barre syndrome (GBS) and the Miller-Fisher syndrome (MFS) have been related to COVID-19 vaccine application., Clinic Case: 48-year-old man, with history of Pfizer-BioNTech vaccination against COVID-19, 5 days prior to the symptoms, who assisted to the Emergency room with blurred vision and diplopia; adding dysarthria, facial diplegia and left upper limb weakness after 48 hours. In his first evaluation it was found ophthalmoplegia, facial diplegia, decreased gag reflex, weakness of thoracic limbs, bilateral trapezius muscle and areflexia. Serum studies and nuclear magnetic resonance of the brain were performed without alterations. It was complemented with IgG anti-ganglioside GQ1b antibodies with a positive result. Once the diagnosis was confirmed, treatment was started with immunoglobulin calculated at 2 g per kg for 5 days. The patient was discharged once the immunoglobulin was administered with evaluation at 2 months without ataxia, ophthalmoplegia, areflexia and weakness., Conclusions: Following the documented reports of GBS and its variants secondary to vaccination, neurological side effects have been catalogued as being of great importance. Therefore, the reported case can be used as a point of reference to consider this clinical spectrum as a differential diagnosis in patients with post-vaccination neurological symptomatology., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

Objective: This study addressed a COVID-19 outbreak in a nursing home, where the residents were vaccinated with two doses of Comirnaty® and thirty of them had previously had the infection. Outbreaks in closed communities are opportunities to study the entire clinical spectrum of the disease and, as in this case, the effect of hybrid immunity on transmission, infection progression and viral load., Methods: A descriptive and retrospective cohort study in the resident population was carried out. Attack rates were calculated for one of four stages of the disease: infection, symptomatic infection, hospitalization, and death. Relative risks (RR) were then estimated using simple and multivariate Poisson regression for each of these stages., Results: The attack rate was 59% (56/95). The clinical spectrum was the same in both sexes. There was a notable protective effect of hybrid immunity against transmission (67%). In terms of progression, those with hybrid immunity had a lower risk of symptomatic infection. Nasopharyngeal viral load was significantly lower in individuals with hybrid immunity and asymptomatic individuals, supporting the idea of lower transmissibility in this group. Age was identified as a risk factor for disease progression. Molecular analysis identified the Delta B.1.617.2 variant in the patients and an air sample, supporting aerosol transmission in closed, poorly ventilated environments., Conclusions: This study provides a comprehensive view of an outbreak in a vaccinated nursing home, highlighting the importance of hybrid immunity. The results support the individual consideration of previous infection history when assessing the risk of COVID-19, contributing to the understanding of the evolution of the pandemic in the future.

Following the authorization the use of COVID-19 vaccines in babies age six months through children four years old in the United States, some individuals (parents, pediatricians, and communicators) framed COVID-19 vaccination as an issue of access, while many others expressed hesitancy and some resisted recommendations from the US Centers for Disease Control and Prevention. In this context, this study aimed to explore: 1) divergent reactions to the authorization of COVID-19 vaccine use in children aged six months to four years; and 2) opposing logics underlying attitudes towards pro-vaccination, anti-vaccination, and vaccine hesitancy regarding COVID-19 vaccines. To achieve this, a digital ethnography was conducted, involving monitoring of 5,700 reactions to a series of eight infographics published on social media by the John Hopkins Bloomberg School of Public Health, and participant observation in an online focus group over a one-year period, from December 2021 to December 2022, consisting of 18 mothers. The findings suggest that healthcare professionals should consider different notions of "risk" when interacting with patients, especially those who are hesitant to vaccinate.

Introduction. The onset of the SARS-CoV-2 pandemic raised questions about its behavior in different scenarios. Objective. To describe the clinical and epidemiological behavior of COVID-19 in pediatric patients living in an agricultural-industrial city across 3 periods (2020 to 2022). Population and methods. Observational, analytical study of children under 18 years diagnosed with COVID-19 in General Cabrera. Sex, age, symptoms, comorbidities, hospitalization, and death were analyzed. The χ² test was used to analyze the association between symptoms and period and the KruskalWallis test, to analyze differences in symptom duration per period. Confidence level: 95%. Results. In the study period, 194 cases in children under 18 years were confirmed. Only 1% required hospitalization; no deaths were recorded. Children's median age was 14 years; 51% were boys; 68% were asymptomatic; 2% had associated comorbidities. Conclusion. SARS-CoV-2 infection was low in pediatrics and showed a distinct behavior by period., (Sociedad Argentina de Pediatría.)

Introduction: Data on the prevalence of fungal coinfections/superinfections in patients with COVID-19 are limited., Objective: To describe the prevalence of fungal coinfections/superinfections in patients with COVID-19, as well as risk factors and demographic, clinical, and microbiological characteristics., Material and Methods: We included patients with a confirmed COVID-19 diagnosis and a confirmed fungal infection hospitalized in the ICU from March 2020 to December 2021. We collected data on age, sex, comorbidities, hospital length of stay (days), laboratory (ferritin) and microbiological results, treatment for COVID-19, antifungal therapy, and outcomes obtained from the clinical records., Results: Only 11 out of 740 patients met the inclusion criteria. The coinfection rate was 0.3% and the superinfection was 1.2%. The most affected population was male adults. The coinfections/superinfections diagnosed were candiduria and candidemia, caused by Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae, and Kluyveromyces marxianus (C. kefyr). In addition, tracheobronchitis due to Aspergillus fumigatus was found. The most used antifungals were fluconazole and caspofungin. The lethality in patients with fungal coinfections was 50% and superinfections, 22%. The length of hospital stay was 11-65 days. Eight patients required mechanical ventilation and six received corticosteroids. The main comorbidity was diabetes mellitus (81.8%)., Conclusions: The rate of fungal coinfections/superinfections in COVID-19 patients was low, but the lethality found urges for routine fungal screening in patients with severe COVID-19 to timely detect fungal infections that may further compromise the patient’s life.

Introduction: Due to the cross-reactivity between SARS-CoV-2 and common human coronaviruses, previous infections with these viruses could contribute to serological or cellular cross-protection against severe COVID-19. However, protective immunity may not develop, or pre-existing immunity could increase COVID-19 severity., Objective: To determine the seroprevalence of IgG antibodies against HCoV-NL63 and HCoV-HKU1 and correlate previous exposure with COVID-19 signs in patients from Villavicencio., Materials and Methods: A cross-sectional retrospective study was conducted. ELISA technique was used to search for IgG antibodies against HCoV-NL3 and HCoV-HKU1 in patients with positive RT-qPCR results for SARS-CoV-2. Patients were grouped according to COVID-19 clinical characteristics in four groups: group 1: asymptomatic (n = 23); group 2: hospitalized (n = 24); group 3: intensive care units (n = 24), and group 4: dead (n = 22)., Results: The overall seroprevalence of IgG antibodies against HCoV was 74.2% (n = 69; 95% CI: 65.3-83.1), with 66.7% of HCoV-NL63 (n = 62; 95% CI: 57,1-76,2), and 25.8% of HCoV-HKU1 (n = 24; 95% CI: 16,9-34,7). Based on crosstab analysis, prior exposure to HCoV-NL63 was associated with protection against severe COVID-19 (p = 0.042; adjusted OR = 0.159; 95% CI: 0.027-0.938), and previous coinfection of HCoV-NL63 and HCoVHKU1 was considered a positive association to severe COVID-19 (p = 0.048; adjusted OR = 16.704; 95% CI: 1.020 - 273.670)., Conclusion: To our knowledge, this is the first study addressing seroprevalence of HCoV IgG antibodies in Colombia and Latin America. Previous exposure to HCoV-NL63 could protect against severe COVID-19, whereas patients with underlying HCoV-NL63 and HCoVHKU1 coinfection could be hospitalized with severe signs of COVID-19.

Introduction. The COVID-19 pandemic has had a profound impact on the health of young people worldwide, especially on people with eating disorders (EDs) due to the stress, anxiety, and changes experienced in access to health care. Objective. To explore adolescents' perceptions on changes in their social ties and the modalities of health care for patients with EDs. Population and methods. Qualitative study using in-depth interviews with adolescents with EDs seen at a teaching hospital during the COVID-19 pandemic. Results. Fifteen adolescents were interviewed; their mean age was 18 years; 93% were girls. Anorexia nervosa was observed in 86.6%. The most relevant negative aspects perceived were discomfort with family life (80%) and dissatisfaction with social media content regarding body image and dieting (73%). The aspects perceived as positive were peer support (66%) and improvements in eating habits (66%). The main change identified regarding the management before the COVID-19 pandemic was online followup by the mental healthcare team (73%). Conclusion. The adolescent population with EDs during the mandatory social isolation period reported discomfort with family life and dissatisfaction with social media content regarding body image and dieting. Notwithstanding this, adolescents highlighted peer support and improvements in their eating habits as positive aspects., (Sociedad Argentina de Pediatría.)

Introduction. The COVID-19 pandemic impacted on the health care of patients with type 1 diabetes mellitus (DM1). An increase in diabetic ketoacidosis (DKA) as a form of diagnosis was reported. Objectives. To assess whether there were changes in the time from symptom onset, the causes of hospitalization due to DM1, and the proportion of severe forms, and to describe SARS-CoV-2 infection in these patients. Population and methods. Cross-sectional study in patients younger than 19 years hospitalized due to DM1 from March 2018 to August 2019 (pre-pandemic) and from March 2020 to August 2021 (pandemic). Results. The assessment included 135 hospitalizations in the pre-pandemic period and 96 during the pandemic. The time from symptom onset during the pandemic in those with debut of diabetes was shorter than in the pre-pandemic period (18.8 ± 10.2 versus 52.1 ± 12.1 days, respectively; p < 0.001). Hospitalizations due to all forms of diabetes debut and debut with DKA were more common during the pandemic than before it (59.4% versus 39.3%; odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.3-3.8; p = 0.003 and 40.6% versus 20.7%; OR: 2.6; 95% CI: 1.4-5.2; p = 0.006, respectively). Severe forms of DKA did not change between both periods (48.1% versus 59.9%; p = 0.3). Only 6 patients developed SARS-CoV-2 infection; 3 were severe. Conclusion. During the pandemic, the time from symptom onset decreased and the frequency of hospitalizations due to debut of DM1 increased. The proportion of severe forms of DKA did not change., (Sociedad Argentina de Pediatría.)

Introduction: the pandemic of COVID-19 has led to clinical complications such as avascular necrosis of the femoral head (AVNFH) associated with the use of corticosteroids. The aim of the study is to report the functional and radiographic results of 13 patients with post-COVID-19 ANFH after decompression using Forage and bone marrow aspirate concentrate (BMAC)., Material and Methods: single-center, prospective, uncontrolled clinical study. From April 2020 to September 2021, 13 patients (21 hips) with post-COVID-19 ANFH were treated. All received corticosteroids during infection (average daily dose: 480 mg). Clinical, radiographic and magnetic resonance imaging evaluations were performed; the Ficat classification was applied for the classification of AVNFH. The surgical technique used was decompression with Forage and ACMO., Results: the mean age was 47 years, with a follow-up of 30.4 months. Symptoms appeared with a mean of 4.2 months after COVID-19 infection. Harris score improved from 41.2 ± 5.2 to 86.6 ± 3.4. Radiographic evaluation showed that 14.3% of the sample experienced femoral head collapse and underwent total hip arthroplasty., Conclusions: post-COVID-19 ANFH is a clinical entity with rapid progression and different degrees of severity. Decompression with Forage and ACMO seems a promising initial treatment, however, the variable response and the probability of collapse emphasize the importance of long-term follow-up and identification of patients who may require additional interventions.

Objective: To determine the prevalence of COVID-19 and the characteristics of infected patients, as well as the prevalence of mental disorders associated with the infection and the associated risk factors. Secondary: to know the prevalence of the long COVID syndrome and the characteristics of this cohort., Design: Incidence study of mental disorder in patients diagnosed with COVID-19 and case-control study of long COVID syndrome in the subsample of patients diagnosed with COVID-19 without a history of mental disorder. SITE: Primary care setting in Lleida., Participants: The 46,258 patients diagnosed of COVID-19 without a history of mental disorder were followed for 2 years., Main Measurements: The dependent variable was the mental disorder in the period 03/11/2020 to 03/11/2022; and the independent variables were clinical and social variables. Its association with mental disorder was analyzed by calculating the adjusted hazard ratio using a logistic regression model., Results: The average age of 46,258 patients at the beginning of the study was 43±17.9 years. 47% were women. The mental disorder rate for all period was 3.46% (59.20% anxiety). A predictive score was elaborated. The long COVID syndrome was more common in older women, without toxic habits, with obesity and associated comorbidity., Conclusions: COVID-19 has had an impact on the mental health of patients. Knowing the risk factors for developing these mental disorders and the long COVID syndrome would allow the clinician to be able to identify patients at risk in order to establish preventive measures and avoid their appearance., (Copyright © 2023 The Author(s). Publicado por Elsevier España S.L.U. All rights reserved.)

Motivation for the study. There are very few studies on the educational inequalities in COVID-19 mortality, taking into account social contextual factors. Main findings. We found educational inequalities of COVID-19 mortality during both the 2020 and 2021 waves, regardless of the level of poverty and urbanization in the departments of Mendoza and San Juan provinces (Argentina). Implications. Preventive policies should focus not only in areas with high levels of poverty, but also in areas with adults of low educational level. With the aim of describing the association between sociodemographic characteristics and contextual factors with COVID-19 mortality during 2020-2021 in the provinces of Mendoza and San Juan in Argentina, we conducted an ecological study, which included the sociodemographic factors: age, sex and educational level, and the contextual factors: poverty and urbanization at the departmental level. The analyses were estimated using negative binomial Bayesian hierarchical models. Educational inequalities existed regardless of socioeconomic context and level of urbanization. The exception was the age group 65 years and older during 2021, which, regardless of educational level, showed a higher risk of death by COVID-19 in departments with high levels of structural poverty. In conclusion, educational inequality is an indicator of social inequality that increases vulnerability to COVID-19 mortality.

Introduction. Children with neuromuscular disease (NMD) require chronic health care (CHC) and may develop severe COVID-19. Objectives. To describe CHC for children with NMD during the pandemic and the course of COVID-19 in this group. Population and methods. Prospective, single-center cohort. Patients aged 2 to 18 years with ≥ 1 year of follow-up prior to the pandemic were included. Demographic variables in relation to CHC and COVID-19 were collected from medical records and via telephone surveys. Results. A total of 226 patients with a median age of 11.3 years were included; 71% were males. They had muscular dystrophy (55.7%) and spinal muscular atrophy (23%). When comparing the first year of the pandemic with the previous year, 30% did not have a health checkup and 25% did not receive kinesiotherapy. Others did, but with a lower frequency. A total of 52 COVID-19 cases were reported; 82% were symptomatic: 88.4% were mild/moderate and 11.6%, severe. No patient died. Conclusions. The pandemic had a negative impact on CHC, and COVID-19 cases were mostly mild., (Sociedad Argentina de Pediatría.)

Objective: Neutralizing antibodies against SARS-CoV-2 have shown to be an effective tool for the analysis of the immunity generated against COVID-19. Numerous seroprevalence studies carried out in different groups have made it possible to draw a global map of vaccination coverage through the use of rapid lateral flow immunochromatography serological tests for clinical and epidemiological purposes. The objective of our study was to determine the degree of immunity against SARS-CoV-2 associated with the presence of neutralizing antibodies in administrative staff, teachers and students at the University of Alicante by means of a rapid serological test and to learn about their experience with vaccination against COVID-19., Methods: A cross-sectional epidemiological study was designed, based on the prevalence of antibodies against the S protein (spike) of SARS-CoV-2. A total of 888 people participated. The study was carried out with a single test (July 6 to July 22, 2021). Using logistic regression, adjusted Odds Ratios were calculated according to sex, age, type of vaccine, number of vaccine doses received, complete vaccination schedule, and having had COVID-19., Results: The vaccines received mostly were Vaxzevria® and Comirnaty®, with 73.3% between both, although 67.2% presented a complete regimen. The results of the OJABIO rapid neutralizing antibody test gave a positive result in 61.4% of the sample. There was a high association between the variables COVID-19 infection, two doses of vaccine, Spikevax® or Comirnaty® vaccine, and eighteen/twenty-nine years old group with a positive result on the OJABIO test. A total of 712 subjects answered the parallel survey (80%) on adverse effects and preferences between the different vaccines against COVID-19., Conclusions: The vaccination status against COVID-19 in the university community after six months of the start of national immunization strategies reflects low coverage despite the excellent willingness to get vaccinated. Neutralizing antibodies (NAb) rapid tests can be useful to guide immunization strategies and decide when to administer new booster doses.

Introduction: The COVID-19 pandemic has impacted the mental health of healthcare workers. Studying the care perspective is essential to understanding the causes of specific mental health findings and proposing strategies to address them., Methods: Cross-sectional study with a thematic analytical approach, derived from the international initiative "The Health Care Workers Study" (HEROES), conducted among healthcare workers in Chile during the second semester of 2022 and the first of 2023 through semi-structured interviews and inductive coding., Results: A narrative synthesis of 35 interviews in four themes: care at work: the presence of changes in work tasks, concern about becoming infected, collective "mystique", stigma due to being a healthcare worker, conflicts with patients; care at home: multiple ways of arranging household tasks, the relevance of living with others, interrelation with work dynamics, "double burden" among women; relationship with one's own mental health: recognition of mental health impact, the stress associated with change and uncertainty, perception of work overload, feelings of guilt or responsibility for infecting family members; and beliefs and values about the pandemic and its effects: acceptance of psychological impact on healthcare workers, organizational culture as a relevant element in postponing one's own mental health, initial disbelief in the effects of the pandemic, similarities with previous periods of social upheaval, and equality among people in terms of vulnerability to the disease., Conclusions: Five elements emerge as potential areas for intervention: gender perspective, previous exposure to crisis experiences, self-care spaces, peer support, and institutional response. The care perspective helps study the relationship between some stressors and healthcare workers' mental health in the context of a pandemic., Competing Interests: The authors declare no potential conflicts of interest related to this study's research, authorship and/or publication., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Objective: The recommendations of the Spanish Ministry of Health on vaccination in risk groups include mesalazine among the treatments with a possible negative effect on its effectiveness. However, this is not the recommendation of most experts. Our objective was to evaluate the effect of mesalazine on the humoral response to the SARS-CoV-2 vaccine in patients with inflammatory bowel disease (IBD)., Methods: VACOVEII is a Spanish, prospective, multicenter study promoted by GETECCU, which evaluates the effectiveness of the SARS-CoV-2 vaccine in patients with IBD. This study includes IBD patients who have recieved the full vaccination schedule and without previous COVID-19 infection. Seroconversion was set at 260BAU/mL (centralized determination) and was assessed 6 months after full vaccination. In this subanalysis of the study, we compare the effectiveness of the vaccine between patients treated with mesalazine and patients without treatment., Results: A total of 124 patients without immunosuppressive therapy were included, of which 32 did not receive any treatment and 92 received only mesalazine. Six months after full vaccination, no significant differences are observed in the mean concentrations of IgG anti-S between both groups. In the multivariate analysis, antibody titers were independently associated with the use of mRNA vaccines and with SARS-CoV-2 infection., Conclusion: Mesalazine does not have a negative effect on the response to SARS-CoV-2 vaccines in IBD patients., (Copyright © 2024 Elsevier España, S.L.U. All rights reserved.)

In the face of declining vaccination coverage and the dissemination of health-related information, conversations in the public/mediatic digital sphere constitute a relevant study area for the field of health communication. Through a qualitative study based on the analysis of government publications, digital press, and social media, we characterize the public conversation on vaccines - in terms of topics, moments, axes, and framings in Argentina during the 2020-2021 period - marked by the debate on covid-19 vaccines. The results show that public conversation focused on covid-19 vaccination, structured in two distinct moments (vaccine production and vaccination campaign), and under moral framings grounded in vaccination as a care practice and science as an authoritative voice. Simultaneously, doubts about the safety and efficacy of vaccines shaped arguments of vaccine hesitancy, which we understand as part of extended practices associated with distrust towards institutions and reinterpretations of scientific knowledge and care.

This is a qualitative study that explores the perspectives and experiences of a group of Mexican women who experienced institutionalized childbirth care in the first and second waves of the COVID-19 pandemic. Through a semi-structured script, nine women who experienced childbirth care were interviewed between March and October 2020 in public and private hospitals in the city of San Luis Potosí, Mexico. Under the Grounded Theory analysis proposal, it was identified that the health strategies implemented during the pandemic brought with them a setback in the guarantee of humanized childbirth. Women described themselves as distrustful of the protocols that personnel followed to attend to their births in public sector hospitals and very confident in those implemented in the private sector. The intervention of cesarean sections without a clear justification emerged as a constant, as did early dyad separation. Healthcare personnel's and institutions' willingness and conviction to guarantee, protect and defend the right of women to experience childbirth free of violence remain fragile. Resistance persists to rethink childbirth care from a non-biomedicalizing paradigm.

Introduction. During 2020 and 2021, the circulation of influenza virus remained below expectations worldwide. In Argentina, in 2022, we observed an uninterrupted circulation of influenza all year round. Our objectives were to describe the circulation patterns and clinical characteristics of hospitalized children with influenza. Population and methods. Retrospective, analytical, observational study. All children with influenza virus admitted to a children's hospital during the 2019-2022 period were included. Results. A total of 138 patients were admitted over 4 years; in 2019, the rate of hospital discharges was 4.5/1000, compared to 15.1/1000 in 2022. No cases were recorded in 2020 and 2021. In 2019, most cases were observed in the winter; in 79%, the cause was acute lower respiratory tract infection (ALRTI); influenza A was detected in 92%. In 2022, most cases occurred in the spring; 62% developed ALRTI; and influenza A was detected in 56%. Similar rates of vaccination and comorbidities were observed in both periods. Conclusions. In 2022, more hospitalizations due to influenza were recorded, which may have correlated with the use of more sensitive molecular diagnostic testing and a change in seasonality, with more cases observed in the spring. In 2019, influenza A predominated in lower respiratory tract infections, while in 2022, cases of influenza A and B were similar, with more extra-pulmonary forms., (Sociedad Argentina de Pediatría.)

The objective was to analyze the changes in cannabis use during lockdown considering sex, age, living situation and level of addiction. This descriptive and non-probabilistic study used a convenience sample of 208 participants with ages between 18-57 years (64.3% men; mean age = 31.39 years), that reported consuming cannabis. The frequency of distinct typologies of cannabis use was analyzed and the level of addiction with the Cannabis Abuse Screening Test (CAST). An online survey was used to collect the variables under study. A total of 25% consumers increased their spliff (marijuana mixed with tobacco) consumption, 11.9% increased their joint (marijuana cigarette) consumption and 11.8% increased their hashish spliff consumption. Men had higher levels of cannabis addiction, however, during lockdown they reduced their marijuana spliff consumption while both men and women increased their joint consumption. Marijuana spliff consumption showed a greater increase in the 25-29 age group, in those living with people other than relatives or a partner, alone, or with a partner and was reduced mainly in those living with parents or other relatives. The living alone 18-24 years old group, and the living with parents 35-44 years old group showed higher levels of cannabis addiction (CAST). The rate of dependent consumers who increased their marijuana spliff consumption (49%) doubled compared to consumers with no addiction and moderate addiction. Regarding joints, consumption was 1.5 times higher than for moderate addiction consumers and three times higher than those with no addiction. The risk of cannabis addiction increased in certain groups during lockdown.

Introduction: COVID-19 vaccination aids pandemic limitation. In Argentina, three vaccines are approved, and healthcare workers are priorized (HCWs). The aim was to determine the effectiveness of COVID-19 vaccines, analyzing change in Immunoglobulin G levels and the incidence of new COVID-19 cases up to 12 months after the second dose., Methods: Prospective cohort of HCWs between March 2021- 2022. COVIDAR IgG test was used to measure antibodies. A mixed-effects model was employed to compare the levels of immunoglobulin G at different time points, Kaplan Meier was used to estimate incident COVID-19 cases., Results: 82 participants were included Adverse events were frequent but mild. All participant showed positive antibody at 12 months. Antibodies levels showed an increase one year after 2nd dose. Sinopharm took a long time to yield positive results. More than half of the people had mild COVID-19 disease., Conclusion: COVID-19 vaccines are safe and effective., (Universidad Nacional de Córdoba)

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.

Mucormycosis is an invasive opportunistic fungal infection with high mortality, mainly detected in people with COVID-19, especially those with underlying diseases such as diabetes mellitus. Mucormycosis prevalence is 0.005 to 1.7 cases per million inhabitants, and it has been increasing in countries like India and Pakistan. This mycosis can affect different organs, and clinical manifestations reflect the transmission mechanism. Frequent forms are rhino-orbital-cerebral and pulmonary. This disease should be suspected in patients with necrotic injuries on mucous membranes or skin. We present a case of a patient with diabetes mellitus and diagnosed with oral mucormycosis associated with COVID-19.

From the theoretical perspective of the cartography of the micropolitics of living labor in action, the objective was to analyze the work process of the "street clinic" team based in a primary care unit in the city of Rio de Janeiro, Brazil, in the management of tuberculosis cases in the context of the Covid-19 pandemic. This is an exploratory qualitative research. Between May and December 2021, seven professionals from the street clinic team were interviewed, and participant observation was conducted with field diary records. Three thematic axes emerged from the interviews related to people experiencing homelessness in the context of the Covid -19 pandemic: 1) Challenges, potentialities, and weaknesses of tuberculosis care; 2) Building intersectoral care networks for monitoring individuals with tuberculosis; and 3) The street as a space for care production: the work process of the street clinic in tuberculosis management. It is concluded that caring for people experiencing homelessness with tuberculosis in the context of the Covid -19 pandemic requires not only managing clinical protocols but also building shared work with the intra and intersectoral network. In addition to the task of being in the territory, the outpatient service in the territory must also be a street outpatient service, especially regarding tuberculosis treatment.

Objectives.: Motivation for the study. No study conclusively recommends the use of medicinal plants to treat COVID-19 symptoms, and their indiscriminate use may present health risks. Main findings. Sixty percent of participants consumed medicinal plants to prevent COVID-19. This was particularly true for those living in the Peruvian highlands and individuals with family members diagnosed or deceased from COVID-19, who perceive a higher risk of infection and use medications or chlorine dioxide as preventive measures. Implications. Communication strategies emphasizing validated preventive practices and educating about the risks of consuming medicinal plants should be tailored to the predominant characteristics of the consumer. Determine the factors associated with the consumption of medicinal plants as a preventive measure against COVID-19 in the Peruvian population., Materials and Methods.: A population over 18 years of age, living in Peru and without a history of COVID-19 disease, was evaluated. The factors associated with the consumption of medicinal plants were evaluated using a Poisson regression model with robust variances., Results.: Of the 3231 participants included, 84.6% were young adults (18-29 years old), 62.7% were women, and 59.7% consumed a medicinal plant to prevent COVID-19 infection. The factors associated with the consumption of medicinal plants to prevent COVID-19 infection were residing in the Peruvian highlands, having had a family member diagnosed with COVID-19, having had a family member die from COVID-19, considering their family to be at increased risk of infection, having used medications or chlorine dioxide to prevent COVID-19, having medical information as the main source of information about COVID-19, thinking that medicinal plants are effective in preventing COVID-19 disease, or not being informed about their effectiveness., Conclusion.: Sixty percent of the participants reported having consumed a medicinal plant to prevent COVID-19. Authorities must apply communication strategies about the implications of consuming medicinal plants, prioritizing population groups with higher consumption patterns.

After the SARS-CoV-2 pandemic we face a new global epidemic: the Post-COVID Syndrome. This novel condition has fluctuating progression and a wide range of symptoms, such as fatigue, headaches, muscle pain or breathlessness. Although its pathophysiology is not clear, a multiorganic affection is suspected, altering the immune, cardiorespitatory and nervous systems. Whereas there is no consensus over its treatment, most of the researches conclude the effectiveness of therapeutic exercise and a multicomponent rehabilitation, coordinating and cooperating between different health professionals. A functional, respiratory and strength evaluation prior to treatment prescription is highly recommended, since it will help professionals to precisely prescribe and objectively measure the evolution of our patients. In this article we suggest a few tests, adequate to primary health requirements, to evaluate our patients' initial condition, as well as the most secure way to initiate a therapeutic exercise programme, together with other healthcare providers., (Copyright © 2023 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Argentina, as other countries, showed several public policies related to the health technologies implemented to fight and treat the COVID-19 pandemic. This study sought to analyze how articulation vs. cooperation and autonomy vs. division of powers between entities occurred in Argentina, exploring asymmetries between several entities in implementing public policies related to health technologies during the pandemic and the influences of other actors. For this, a documentary research was carried out related to 2020-2021 (technical reports published by the World Health Organization, national agencies and scientific societies, laws, court decisions, press, and research and in-depth interviews with members of the Argentine Ministries of Health). The processes and results of decision-making in the Ministries of Health were analyzed, outlining the coverage and orientations of each technology and the political party in power in the province. This study found heterogeneous results and processes between Ministries and disputes within them. It also observed the poor adherence to official guidelines due to technical-political criteria (power relations, social, media, academic, judiciary, and legislative pressure). Some cases showed a strong tension between the government and its opposition over the discussion of technologies. Each province in Argentina has autonomously defined its policies on health technologies for COVID-19, and decision-making in public administration was disorderly, complex, and non-linear during the pandemic.

The purpose of this research is to identify predominant problematizations in Colombian feminist Instagram accounts regarding gender-based violence during the first year of the COVID-19 pandemic. Employing a qualitative approach, a digital ethnography based on the principles of netnography was conducted as an alternative to detail the social worlds constructed from online groups. Fifty pieces of content from @lainsumisa and twenty pieces of content from @feministasenconstrucción, published between March 2020 and March 2021, were selected based on observations made within the online fieldwork framework. These were analyzed using discourse analysis techniques. The findings discuss the following emerging categories: unpaid household work, romanticized harassment, fatphobia, and the violation of Black and racialized women's rights. In this context, cyberactivism is presented as an opportunity for the emergence of collectives and support networks for women advocating for gender equality and their rights, towards questioning patriarchal ideas that jeopardize their well-being.

Objectives: To determine whether in patients with type 2 diabetes (DM2) the changes in their relationship with family doctors during the COVID-19 pandemic, in-person (iPC) and telematic (TC) consultations, were associated with control of their disease., Design: Multicentric study of retrospective follow-up., Setting: Seven health centers in Tenerife, Spain., Participants: 3543 patients with DM2., Main Measurements: Sex, age, iPC, TC and DM2 control using glycosylated hemoglobin (A1c) during the period 2019-2021. Logistic regression models were fitted with DM2 control as an effect, and with the other measurements as independent variables., Results: 50% were women. 38% were less than 65 years old. A1c was measured in 84% of patients in 2019, 68% in 2020, and 77% in 2021. 58.4% had good control in 2019, 46.1% in 2020, and 50.3% in 2021. Median iPC were 7 in 2019, 4 in 2020 and 5 in 2021 (p<0.001). The OR(95%CI) of good control in 2019 were 1.04(1.04-1.05) per year of age and 1.03(1.01-1.04) for each iPC; In 2020 they were 1.04 (1.03-1.05) per year of age, 1.05 (1.04-1.07) for each iPC and 1.04 (1.02-1.07) for each TC; in 2021 they were 1.04 (1.04-1.05) per year of age, 1.05 (1.03-1.06) for each iPC and 1.02 (1.00-1.04) for each TC., Conclusions: The control of patients with DM2 during the period 2019-2021 had a direct relationship with the change in the frequency of consultations at the health center, with differences depending on the type of consultation and the age of the patient., (Copyright © 2023 The Author(s). Publicado por Elsevier España S.L.U. All rights reserved.)

Introduction: During the COVID-19 pandemic, patients with worse evolution presented clinical deterioration 7-10 days after the onset of symptoms, which suggests that the inflammatory response could participate in the pathophysiology of the disease. The objective of this study was to evaluate the association between plasma C-reactive protein (PCr) on hospital admission and mechanical ventilation requirement during hospitalization in adults with COVID-19., Methods: Retrospective, observational cohort at a private center in the province of Buenos Aires. Hospitalized adults diagnosed with COVID-19 by nasal swab using real time transcription polymerase chain reaction or antigen were included. The primary outcome was the association between high plasma PCr values on hospital admission (≥8 mg/L) and mechanical ventilation requirement during hospitalization., Results: Of the 1,242 patients enrolled, 19.4% required mechanical ventilation and 11.7% died during the hospitalization. The PCr of the patients who required mechanical ventilation was higher than that of those who did not require mechanical ventilation (9.45 [5.20-18.70] mg/L vs 4.95 [1.80-10.70] mg/L; p < 0.01). PCr analyzed as a continuous variable (OR = 1.39; 95%CI 1.21-1.60; p < 0.001) and as a categorical variable (≥8 mg/L) (OR = 2.66; 95%CI 2.19 -3.78, p < 0.001) presented a significant association with the requirement of mechanical ventilation during hospitalization. Additionally, a significant association was found between PCr and in-hospital mortality., Conclusion: Plasma PCr on hospital admission could predict clinical evolution in adult patients hospitalized for COVID-19., (Universidad Nacional de Córdoba)

Objective: Readmission for COVID-19 is associated with high mortality, saturation of health services, and high costs. This study aimed to assess the incidence and risk factors of readmissions in COVID-19 patients in a regional hospital of Spain from February 2020 to March 2021., Methods: A retrospective cohort study describing the characteristics of adult patients readmitted within thirty days of discharge after being infected with SARS-CoV-2 was carried out. Readmission associated risk factors were analysed using a binary logistic regression model., Results: Of the 967 patients who survived their first COVID-19 admission, 70 (7.2%) were readmitted within thirty days. Of these, 34.3% presented pneumonia progression, 15.7% functional deterioration, and 12.9% other infections. The mortality rate during readmission was 28.6%. There were no statistically significant differences in the cumulative incidence of readmissions between the epidemic periods (p=0.241). Factors independently associated with readmission were: diabetes mellitus (aOR 1.96, 95%CI 1.07-3.57, p=0.030); acute kidney failure (aOR 2.69, 95%CI 1.43-5.07, p=0.002); not being a candidate for intensive care (aOR 7.68, 95% CI 4.28-13.80, p<0.001); and not being prescribed corticosteroids at discharge (aOR 2.15, 95% CI 1.04-4.44; p=0.039)., Conclusions: A substantial proportion of patients admitted due to COVID-19 are readmitted, and they carry a high letality. Diabetes mellitus, acute kidney failure, not being a candidate for ICU admission, and not being prescribed corticosteroids on discharge are independently associated with an increased risk of readmission.

This study presents a content analysis of headlines featured on the front pages of Colombia's two most prominent newspapers during the COVID-19 health emergency. The objective was to examine the framing strategies employed by El Tiempo and El Espectador during their journalistic coverage of the initial phase of the pandemic. Criteria for analysis included informational tone, thematic approaches, grammatical structures in the headlines, information sources, coverage scope, and media perspective. Regarding interpretative frameworks, both newspapers predominantly adopted a negative approach towards the crisis and the structural impact the pandemic had on the country, especially within a context marked by uncertainty and tension. Primary themes were associated with economic and social aspects. The most prominent terms in the headlines during this period were linked to the pandemic, Covid-19, and the virus, concepts that consistently maintained a significant presence in the media agenda of the studied outlets.