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Background: The situation of the COVID‐19 global pandemic has generated an unprecedented state of emergency worldwide that has had a psychological impact on health care workers working in the ICU and this has created the need to implement different psychological strategies. Aim: This study explores (a) the prevalence of symptoms associated with generalized anxiety disorder (GAD), (b) the relationship between GAD symptoms and resilience skills, and (c) which of the resilience skills were associated with a probable GAD among the ICU professionals during the COVID‐19 pandemic. Study design Cross‐sectional survey design. Methods: We explored anxiety and resilience in 448 ICU health care workers using an online survey. Results: The participants showed high resilience levels and more than half of them presented symptoms consistent with a possible diagnosis of GAD. The GAD symptoms were more prevalent among women, nursing assistants, interns, staff who worked on rotation and health care workers who had to attend to more than 20 COVID patients. Significant negative correlations between resilience skills and GAD symptoms were found. The multiple regression analysis showed that resilience skills contribute to 14.4% of the variance for GAD symptoms. The binary logistic regression showed that the only skill that had a significant and negative predictive effect was "I usually take things in my stride" (OR = 0.774, 95% CI 0.67, 0.88; P =.000). This ability was the differentiating skill between professionals who equal or exceed the cut‐off point established for the diagnosis of a probable GAD regarding those who do not. Conclusion: ICU professionals developed symptoms consistent with a possible diagnosis of GAD due to their exposure to extremely stressful circumstances. However, resilience skills acted as a protective factor. Relevance to clinical practice: The importance of incorporating programmes that mitigate these psychological effects and to promote adaptive coping styles during pandemics has become a need after what ICU professionals have gone through. [ABSTRACT FROM AUTHOR]

Many human pathogens use Type III, Type IV, and Type VI secretion systems to deliver effectors into their target cells. The contribution of these secretion systems to microbial virulence was the main focus of a workshop organised by the International University of Andalusia in Spain. The meeting addressed structure–function, substrate recruitment, and translocation processes, which differ widely on the different secretion machineries, as well as the nature of the translocated effectors and their roles in subverting the host cell. An excellent panel of worldwide speakers presented the state of the art of the field, highlighting the involvement of bacterial secretion in human disease and discussing mechanistic aspects of bacterial pathogenicity, which can provide the bases for the development of novel antivirulence strategies. [ABSTRACT FROM AUTHOR]

Background: The clinical presentation of COVID-19 ranges from a mild, self-limiting disease, to multiple organ failure and death. Most severe COVID-19 cases present low lymphocytes counts and high leukocytes counts, and accumulated evidence suggests that in a subgroup of patients presenting severe COVID-19, there may be a hyperinflammatory response driving a severe hypercytokinaemia which may be, at least in part, signalling the presence of an underlying endothelial dysfunction. In this context, available data suggest a prognostic role of neutrophil-lymphocyte ratio (NLR) in various inflammatory diseases and oncological processes. Following this rationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may be useful in identifying patients with a poor prognosis in hospitalized COVID-19 cases., Design: A retrospective observational study performed at Hospital Universitario HM Puerta del Sur, Madrid, Spain, which included 119 patients with COVID-19 from 1 March to 31 March 2020. Patients were categorized according to WHO R&D Expert Group., Results: Forty-five (12.1%) patients experienced severe acute respiratory failure requiring respiratory support. Forty-seven (12.6%) patients died. Those with worse outcomes were older (P = .002) and presented significantly higher NLR at admission (P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed of NLR (P = .003) compared with follow-up patients. In a multivariable logistic regression, age, cardiovascular disease and C-reactive protein at admission and Peak NLR were significantly associated with death., Conclusions: NLR is an easily measurable, available, cost-effective and reliable parameter, which continuous monitoring could be useful for the diagnosis and treatment of COVID-19., (© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)