Novel clinical and immunological features associated with persistent post-acute sequelae of COVID-19 after six months of follow-up: a pilot study.

BACKGROUND: Currently, there is scant information regarding the features associated to the persistence of post-COVID-19 syndrome, which is the main aim of the present study. METHODS: A cohort study of 102 COVID-19 patients was conducted. The post-COVID-19 symptoms were assessed by a standardised questionnaire. Lymphocyte immunophenotyping was performed by flow cytometry and chemokines/cytokines, neutrophil extracellular traps, the tripartite motif 63, anti-cellular, and anti-SARS-CoV-2 IgG antibodies were addressed in serum. The primary outcome was the persistence of post-COVID-19 syndrome after six months follow-up. RESULTS: Thirteen patients (12.7%) developed the primary outcome and had a more frequent history of post-COVID-19 syndrome 3 months after infection onset (p = .044), increased levels of IL-1α (p = .011) and IP-10 (p = .037) and increased CD57 expression in CD8+ T cells (p = .003). There was a trend towards higher levels of IFN-γ (p = .051), IL-1ß (p = .062) and IL-6 (p = .087). The history of post COVID-19 in the previous 3 months, obesity, baseline serum MIP-1α and IP-10, and CD57 expression in CD8+ T cells were independently associated with the persistence of post-COVID-19 syndrome. CONCLUSION: Our data suggest an important relationship between a pro-inflammatory state mediated through metabolic pathways related to obesity and increased cellular senescence as a key element in the persistence of post-COVID-19 syndrome at six months of follow-up.

Learning from the community to improve maternal-child health and nutrition: the Positive Deviance/Hearth approach.

The "traditional" use of the Positive Deviance approach to behavior change involves studying children who thrive despite adversity, identifying uncommon model behaviors among Positive Deviant families, and then designing and implementing an intervention to replicate these behaviors among mothers of malnourished children. This article presents the results of a literature review designed to gather information on the role of the Positive Deviance/Hearth methodology in social and behavior change. Examples of how the methodology has been applied beyond infant and child malnutrition to address other health areas, such as improving pregnancy outcomes, are explored. An analysis of Positive Deviance programming being carried out by Project Concern International in Guatemala and Indonesia is conducted. The role of cultural context in the design and implementation of Positive Deviance/Hearth, as well as the role of Positive Deviance in affecting social and behavior change, require further exploration. The issues related to cultural context and the challenges for monitoring and evaluation of program outcomes are presented.