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Faced with the new scenario caused by the period of lockdown, schools and teachers had to redirect their education methods with regard to different aspects, including homework. The main objective of this descriptive-inferential, cross-sectional, non-experimental and quantitative study is to identify the quantity, difficulty and types of homework done during the period of lockdown, according to the type of centre, stage of education and the presence of educational needs, with a sample of 1,787 families. The results show that parents perceive that homework during lockdown was characterised by a greater quantity, difficulty, individualisation and technologization. Regarding school variables, the stage of education significantly modifies the perception of the difficulty, quantity and types of homework. Moreover, the presence of special educational needs influences the difficulty, and ownership of the centre influences the exercise of individual or group tasks. In conclusion, the need is highlighted for families to be counselled in Secondary Education and for teachers to receive better training with regard to homework for pupils with special educational needs. © 2023 Authors. All rights reserved.
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The transition from secondary education to university education has become a critical moment for the lifestyle of young people, especially for the practice of physical activity. Therefore, the main objective of the present study was to assess the levels of physical activity in university students, by correlating the results of the IPAQ-SF and the different physical fitness variables (Eurofit). The sample consisted of 194 students of the Primary Education Degree, with a mean age of 21.37 +/- 2.66 years. The main results obtained reflect the direct relationship between the practice of physical activity in general, and vigorous physical activity in particular, and optimal physical fitness of university students, linked above all to the strength component. As for the comparison between prepandemic ( 18/19) and post-pandemic (21/ 22) university students, the increase in physical activity after the pandemic did not show substantial differences in the physical fitness components. In conclusion, these results should lead us to reflect on the influence of an active lifestyle on physical fitness, which has an impact on overall health status and quality of life.
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Background: The ZUMA-1 safety management Cohort 6 (N=40), which evaluated whether prophylactic corticosteroids and earlier corticosteroids and/or tocilizumab could improve safety outcomes, demonstrated an improved safety profile (no Grade >=3 cytokine release syndrome [CRS];15% Grade >=3 neurologic events [NEs]) vs pivotal Cohorts 1+2, without compromising response rate or durability (95% ORR, 80% CR rate, and 53% ongoing response rate with >=1 y of follow-up;Oluwole, et al. ASH 2021. 2832). Here, 2-y updated outcomes are reported. Method(s): Eligible pts with R/R LBCL underwent leukapheresis (followed by optional bridging therapy) and conditioning chemotherapy, then a single axi-cel infusion. Pts received corticosteroid prophylaxis (once-daily oral dexamethasone 10 mg on Days 0 [before axi-cel], 1, and 2) and earlier corticosteroids and/or tocilizumab for CRS and NE management vs Cohorts 1+2 (Oluwole, et al. Br J Haematol. 2021). The primary endpoints were incidence and severity of CRS and NEs. Secondary endpoints included ORR (investigator-assessed), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and chimeric antigen receptor (CAR) T-cell levels in blood. Result(s): As of December 16, 2021, the median follow-up time for the 40 treated pts was 26.9 mo. Since the 1-y analysis, no new CRS events were reported (no pts had Grade >=3 CRS to date). The incidence of Grade >=3 NEs increased from 15% to 18%between the 1-y and 2-y analyses. Two new NEs occurred in 2 pts: 1 pt had Grade 2 dementia (onset on Day 685 and ongoing at time of data cutoff;not related to axi-cel) and 1 had Grade 5 axi-cel-related leukoencephalopathy. Since the 1-y analysis, 6 new infections were reported (Grades 1, 2, and 5 COVID-19 [n=1 each], Grade 3 Pneumocystis jirovecii pneumonia [n=1], Grade 3 unknown infectious episode with inflammatory syndrome [n=1], and Grade 2 herpes zoster [n=1]). In total, 8 deaths occurred since the 1-y analysis (progressive disease [n=5], leukoencephalopathy [n=1], and COVID-19 [n=2]). The ORR was 95% (80% CR), which was unchanged from the 1-y analysis. Median DOR and PFS were since reached (25.9 mo [95% CI, 7.8-not estimable] and 26.8 mo [95% CI, 8.7-not estimable], respectively). Median OS was still not reached. Kaplan- Meier estimates of the 2-y DOR, PFS, and OS rates were 53%, 53%, and 62%, respectively. Of 18 pts (45%) in ongoing response at data cutoff, all achieved CR as the best response. By Month 24, 14/20 pts with evaluable samples (70%) had detectable CAR T cells (vs 23/36 pts [64%] in Cohorts 1+2). Conclusion(s): With 2 y of follow-up, the ZUMA-1 Cohort 6 toxicity management strategy continued to demonstrate an improved long-term safety profile of axi-cel in pts with R/R LBCL. Further, responses remained high, durable, and similar to those observed in Cohorts 1+2 (Locke, et al. Lancet Oncol. 2019).Copyright © 2023 American Society for Transplantation and Cellular Therapy
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This article looks at the Covid-19 pandemic as a contingent factor in, and its revelatory effect on, various contemporary expressions of neoliberal ideology in Latin America. Based on philosophical and psychoanalytical concepts of a Lacanian nature fundamentally proposed by Slavoj Žižek, it examines the critical uses of the notion of ideology in its various manifestations: fear of the other, imposition of the logic of self-promotion, destruction of social ties, extractivism of nature, and fetishization of the discourses of unity in the face of the pandemic. The hypothesis is that the pandemic offers an opportunity to rethink contemporary subjectivity, through a confrontation with the Real that borders on symbolization and, ultimately, ideological capture, in order to question the assertion that there is no alternative. © 2023 Universitat Autonoma de Barcelona and Universitat de Girona. All rights reserved.
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This study aims to investigate the prevalence of various degrees of depression among faculty members at Universidad Católica de Cuenca during the COVID-19 pandemic. The methodology used for the study was exploratory, descriptive, and correlational. A non-probabilistic sample of 661 participants was used;53.56 percent of them were men, and 46.44 percent were women. A questionnaire that was validated by three specialists was employed to record the emotional states of academics throughout the pandemic. The IBM SPSS Statistics program was used for data analysis and information processing. The research findings made it possible to theoretically analyze and demonstrate that depression is an illness that affects everyone and impacts how individuals go about their daily lives. The bilateral correlation analysis revealed that depression is a mental disorder that affects faculty performance. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.
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COVID-19 has aspects on its pathogenesis that still need elucidating and an analysis of clinical and immunogenetic factors in each cohort of patients is paramount to understanding how genetic variability can explain the multiple clinical spectra seen in patients infected with SARS-CoV-2. The aim of this study was to correlate the KIR polymorphism/HLA class I ligand interactions from patients and healthy subjects with either the susceptibility or severity to COVID-19. Genotyping of HLA-A, -B, -C and KIR genes were carried out from 459 symptomatic as well as 667 non-infected Spanish Caucasian individuals using Lifecodes HLA-SSO and KIR-SSO kits (ImmucorTM, USA) and analyzed in the Luminex in this uni-centre case-control study performed at the University Hospital of Salamanca, Spain. Comparative KIR gene analysis showed that KIR2DS4 was significantly more representative in healthy versus infected individuals. When comparing subgroups of infected patients, KIR2DS3 had a higher frequency in those who progressed to a more severity disease and yet with higher mortality rate. Three functional combinations were significant on univariate analysis: KIR2DL2/C1, KIR2DS2/C1, and KIR2DS3/C1. However, in the multivariate analysis, only the KIR2DL2/C1 interaction remained significant (OR = 15.2 (95% CI 1.5-147), p = 0.0189). Compared with the solo-clinical characteristics predictive model, that included well-known comorbidity variables such as hypertension, age, sex, diabetes, C-reactive protein, dyslipidemia, smoking, ferritin, and fibrinogen, the clinical-and-KIR-based model showed a better ability to discriminate between severe and nonsevere patients with higher sensitivity and specificity. Our results support a fundamental role of KIR/ligand interaction in the clinical course of COVID-19. Since the KIR2DL2 gene has a high frequency in Spain (60%), the analysis of the KIR2DL2/C1 in symptomatic patients who require hospitalization could be helpful to better determine their prognosis.
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Purpose: This paper aims to analyze the volatility transmission between an energy stock index and a financial stock index in emerging markets during recent high instability periods. The study considers the impact of both the period under analysis and the data frequency on the direction and intensity of the contagion, as well as the effect of the potential spillovers on the risk measures. These questions still lack definitive answers and have become more relevant in a context of financially unsettling events such as COVID-19 crises. Design/methodology/approach: This study employs an extension of the dynamic conditional correlation (DCC) model that allows for the time-varying dependence relationship between the variables. This dependence is analyzed at daily, weekly and monthly basis using data from the Bloomberg platform on energy and stock market indices for emerging markets between 2001 and 2021. Findings: The results for a sample spanning from 2001 to mid-2021 show bidirectional volatility transmission on a daily basis, whereas only evidence of volatility transmission from the financial to the energy exists for weekly and monthly frequencies. However, considering different subsamples of daily data, the authors only find volatility transmission from financial (energy) index to the energy (financial) during the Great Recession (COVID-19) as a consequence of the different source of the shock and transmission channels. Originality/value: This study reveals that volatility transmission between energy and stocks in emerging markets has changed and presents a unidirectional pattern from energy to financial markets during the COVID-19 period in contrast to calm and the sub-prime crisis intervals. These results differ from previous studies, focused on global markets, that show bidirectional spillovers during this period. © 2023, Emerald Publishing Limited.
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COVID-19 is a disease that directly affects the respiratory tract, being harmful in asthmatic patients because this condition causes a lack of oxygen, even to the extent that it requires external equipment to combat drowning. Likewise, it highlights the importance of maintaining a treatment or therapy correctly to prevent your disease from worsening or being exposed to other diseases, putting your health at risk. The diseases that asthmatic patients can acquire can result from pathologies, which have been growing over the years due to lack of equipment or efficient examinations that generate complete information about respiratory conditions about asthmatic patients, therefore, by developing an advanced system, the chances of detecting pathologies prematurely increase considerably, which is an essential tool today. According to the problem exposed, in this research an automatic system of detection of pathologies in the respiratory system was carried out for the care of the patient with bronchial asthma visualized by computerized radiography, so that any pathology can be detected by means of a premature diagnosis in the respiratory system and the doctor can perform a correct treatment on the asthmatic patient. Through the tests carried out by the system, its performance was accurate and efficient, being suitable to be implemented in various hospitals so that the doctor can treat the disease in time, since the system presented a 98.79% efficiency in the detection of pathologies. © 2023 International Journal on Recent and Innovation Trends in Computing and Communication. All rights reserved.
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The debate on homework opens up again in pandemic times to remind us not only of the responsibility of the agents involved, but also of the controversies that exist around the time, emotional exhaustion, benefits and competencies it promotes. With the aim of finding out the status of homework during confinement, an empirical study was carried out with a descriptive-correlational, cross-sectional and non-experimental design. For this purpose, an ad hoc instrument called "Coping with homework in the family during confinement", validated by experts, was administered telematically, in which a total of 1982 families from all over Spain participated. The results show that there are significant differences for each of the study variables (quantity, benefits, competencies and emotional exhaustion) between the different educational stages (infant, primary and secondary), with the academic performance of the students and with the presence of specific educational support needs, except for the quantity variable. On the other hand, no significance was found with the type of school. In this way, both teachers and educational centers have to establish non-mechanistic creative tasks and, in turn, articulate support and collaboration with families in the performance of school tasks, especially those with children with specific needs. © 2023 Asociacion Interuniversitaria de Investigacion en Pedagogia. All rights reserved.
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BACKGROUND AND OBJECTIVE: Chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by partial (hyposmia) or total (anosmia) loss of smell, is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), worsens disease severity and quality of life. Objectives. The objective of this study was to determine whether, in real-life conditions, biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare smell improvement in N-ERD and non-N-ERD subgroups. METHODS: A multicenter, non-interventional, retrospective, observational study was performed, including 206 patients with severe asthma undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab) with CRSwNP. RESULTS: Improved olfaction was found after treatment with all monoclonal antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab (35.7%), and benralizumab (39.1%), with no differences between groups. Patients with atopy, greater use of short course systemic corticosteroids, and larger polyp size were more likely to experience improvement in smell. The proportion of patients experiencing smell improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. CONCLUSION: This is the first study to compare real-life improvement in sense of smell among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in sense of smell (with non-significant differences between biologic drugs). No differences were found in smell improvement between the N-ERD and non-N-ERD group.
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Information and Communication Technologies (ICTs) are of great importance in today's society and have permeated different aspects of human life. In fact, access to them is now considered a fundamental right. There exists, however, a gap between individuals and populations who have access to these technologies and those who do not, which has led to social exclusion. In addition, the COVID-19 pandemic has exacerbated the effects of this disparity. In this regard, digital inclusion, through ICTs, becomes a strategy to close not only technical but also social gaps, thereby bringing well-being to vulnerable groups and favouring compliance with the Sustainable Development Goals (SDGs). Given the importance and topicality of this matter, we conducted a bibliometric analysis, which aims to answer what are the main trends in digital inclusion and digital divide studies and what are the challenges facing digital inclusion initiatives in the social context? For this purpose, we applied a search equation in Scopus and used VOSviewer. With this analysis, we were able to identify the evolution of publications over time and the main authors, countries and topics in the field, and the trends and challenges in digital inclusion initiatives. Finally, we conclude that this study can be used to address other research topics, such as the role of ICTs in the promotion of the SDGs through digital inclusion initiatives, the psychosocial aspects of technology adoption and the need for public policies that serve as a platform for digital and social inclusion. © The Author(s) 2023.
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Objective: To analyse the COVID-19-related lockdown impact on University workers, to identify groups based on this information, and to study the factors associated with each group. Study design: Cross-sectional study. Methods: A survey was conducted 3.5 weeks after COVID-19-related lockdown in University workers in Spain. Sociodemographic variables, housing, work, health conditions, levels of anxiety, stress and depression (DASS-21), and social support (MSPSS) were collected. A cluster analysis was performed to identify groups depending on the impact of the lockdown. Differences between groups were tested using Chi-square and Mann-Whitney-U tests, and associated factors with binary logistic regression. Results: We identified two groups of workers. "G1: Consequences in the daily life routine" was mainly composed of men, Research and Teaching Personnel (RTP) with more stable professional categories, higher income level, and bigger houses than people in G2. Participants in "G2: Concerns for the current and future well-being" presented worse intensity of pain than before the lockdown, more anxiety, depression, stress and less social support than people in G1. ASP (Administration and Services Personnel) had more risk of belonging to G2 than RTP (OR = 5.863). A higher number of people living at home decreased the risk of being in G2 (OR = 0.439). People with lower pain intensity had less risk of being in G2 (OR = 0.014), and this risk decreased as friends support increased (OR = 0.833). Conclusions: In G1, the consequences were immediately reflected in the stress resulting from changes in their daily work routine. In G2, the concerns were related to their professional future, with worse mental health, greater intensity of pain and less social support.
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Even before the COVID-19 pandemic, careers in medicine were challenging, and the academic journey could be a lonely one. The pandemic presented both challenges and opportunities in mentoring such as utilizing technology to transform formal mentorship programs into those that are beneficial for women and minorities because these programs can offer critical engagement, opportunities to hear and express multiple perspectives, expand our capacity to understand and talk about complex social issues, and meaning-making frameworks. Medical schools can utilize innovative and creative mentoring programs to support medical students as they enter the medical profession. © Common Ground Research Networks, Joseph Muñoz et al., All Rights Reserved.
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The lockdown caused by COVID-19 led to the adoption of new virtual methodo-logies using digital tools. The aim of this study was to design and validate a ques-tionnaire on the use of digital media in the virtual teaching of STEM subjects in Foundation Courses. For this purpose, a descriptive non-experimental quantitative design was used and, with the administra-tion of the designed questionnaire, data were collected from 61 students enrolled in these courses during the academic year 2021/2022 at Northumbria University (United Kingdom). The results showed that the reliability and internal consistency of the implemented questionnaire were good (Cronbach's Alpha = .78;Composite Reliability = .79;Mean Extracted Varian-ce = .48;Omega = .95;KMO = .64) and that in general the student body stated that they had good access to and use of digital media and smooth communication with lecturers during the placement. In addition, they stated that they had adap-ted favourably to virtual teaching and that they had successfully acquired subject competences. The pandemic has brought about the implementation of these new methodologies and has meant a renewal and implementation of new resources, with the consequent acquisition of digital competences by both teaching staff and students.
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Background: Prognosis of COVID-19 is poor in the setting of immunosuppression. Casirivimab/imdevimab (REGEN-COV), bamlanivimab, and sotrovimab are investigational monoclonal antibodies (MoAbs) authorized for treatment of mild/moderate COVID-19 for patients (pts) 12 years or older and who are at high-risk for progression to severe COVID-19. These neutralizing antibodies, against SARS-CoV-2 spike proteins, have been shown to decrease risk of progression to severe disease. Recipients of allogeneic stem cell transplants (allo-SCT) or chimeric antigen T cell therapy (CAR T cell) represent a high risk population. However, treatment outcomes with these MoAbs in these pts are not well described. Methods: This retrospective study included 33 consecutive adult pts who developed mild/moderate COVID-19 and received anti-spike SARS-CoV-2 MoAbs between December 2020 and November 2021. Allo-SCT (N=27) or CAR T cell (N=6) recipients were included, and outcomes were analyzed separately. Pts received REGEN-COV (N=19), bamlanivimab (N=11), or sotrovimab (N=1), missing (N=2). Results: In the allo-SCT cohort (N=27), median age at time of COVID-19 was 55 (23-76) years. Median time from allo-SCT to COVID-19 was 31 (22-64) months. Two pts received CAR T-cell therapy prior to allo-SCT. Diagnoses included leukemia or myeloid diseases (82%), lymphoma (11%), or myeloma (7%). Transplant characteristics are summarized (Table). Thirteen pts were vaccinated against SARS-CoV-2 prior to breakthrough COVID-19. Events considered included hospitalization due to COVID- 19, disease progression, or death from any cause. The 6-month event-free and overall survivals were 81% and 91%, respectively. In the CAR T cell recipients cohort (N=6), 4 pts received axicabtagene ciloleucel for diffuse large B-cell or follicular lymphoma and 2 received brexucabtagene autoleucel for mantle cell lymphoma. The median follow-up was 8 (1-11) months. Two pts received autologous SCT prior to COVID-19. Median time from CAR T cell therapy to COVID-19 was 10 (3-24) months. Three pts were vaccinated prior to COVID-19. Only 1 pt was hospitalized due to severe COVID- 19 requiring mechanical ventilation leading to death. Conclusions: These results show a potential benefit of MoAbs in high-risk pts, namely allo-SCT or CAR T cell recipients. Future studies should evaluate the role of prophylactic use MoAbs in these populations. A comparative analysis with a matched control cohort (who did not receive MoAbs) will be provided at the meeting.
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Background: Fractures are a common cause of pediatric injury. The coronavirus disease 2019 (COVID-19) pandemic resulted in significant changes in daily life including social distancing, partial cessation of youth sports, and school closings, all of which could have a major impact on the incidence of pediatric fractures. Prior work has demonstrated a significant reduction in fracture burden during the early pandemic;however, few have examined pediatric fractures in the period after lifted restrictions or on a national level. The purpose of this study was to compare pediatric fracture rates in the United States during the COVID-19 pandemic to previous seasonally-adjusted injury rates using the National Electronic Injury Surveillance System (NEISS) database. Methods: The NEISS database was queried from 2016 to 2020 for fractures occurring in pediatric (0-17yo) patients. Studied demographic variables included age, sex, body region injured, disposition, and location of injury. Using a quasi-experimental, interrupted time series design, we constructed linear regression models for number of fractures per month that included a linear time trend, month of injury, a binary variable representing whether the fracture occurred after February 2020, and number of months post-March 2020 to allow the effect of restrictions to change over time. The differential impact of COVID-19 on fracture rate by each demographic variable was then tested using interaction terms. Results: Our sample consisted of 121,803 cases representing 2,959,421±372,337 fractures nationally. Monthly incidences (Figure 1) identified a 32% decrease in fractures per month after February of 2020 (Overall B=-11,400 fractures 95% Credible Interval[-17,600, -5,200]), and the decay of this effect did not reach significance. We found significant effect modification by age, body region, location, and disposition (p<0.05, Table 1). Children (6-11yo) experienced 44% fewer fractures (-5,070 [-7,590, -2,570]) while adolescent injuries declined 34% (-5,300 [-7,760, -3,020]). A 93% reduction in fractures at school (-5,050 [-6,870, -3,250]) and a 69% decrease in those during sports (-7,570 [-9,380, -5,750]) was identified. Fractures that did not require hospitalization decreased by 35% (-11,200 [-16,890, -5,630]). Conclusion: A nationally representative injury database demonstrated a 32% decline in monthly pediatric fractures during the COVID-19 pandemic that persisted into the latter half of 2020. These trends were identified to be most attributable to a reduction in less severe, extremity fractures among older children sustained at school and in sports. In contrast, more severe injuries or those in younger children remained relatively unaffected. Our findings provide unique insight into the epidemiology of pediatric fractures and demonstrate a baseline need for musculoskeletal care among young children and orthopaedic injuries necessitating hospitalization, even in the setting of a national shutdown. (Table Presented).
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BACKGROUND: In coronavirus disease (COVID-19), physical capacity is one of the most impaired sequelae. Due to their simplicity and low cost, field tests such as the six-minute walk test (6MWT) are widely used However, in many places it is difficult to perform them and alternatives can be used such as the 1 min sit-to-stand test (1min-STST) or the Chester step test (CST). Therefore, our objective was to compare the 6MWT, 1min-STST and the CST in post-COVID-19 patients. METHODS: We conducted a cross-sectional analysis in post-COVID-19 patients, compared with matched controls (CG). Demographic characteristics and comorbidities were collected. We analysed oxygen saturation (SpO2), heart rate (HR), and the modified Borg scale in the 6MWT, 1min-STST, and CST. Additionally, the correlations between tests were analysed. RESULTS: We recruited 27 post-COVID-19 patients and 27 matched controls. The median age was 48 (IQR 43-59) years old (44% female). The median distance walked in 6MWT was 461 (IQR 415-506) m in post-COVID-patients and 517 (IQR 461-560) m in CG (p = 0.001). In 1min-STST, the repetitions were 21.9 ± 6.7 and 28.3 ± 7.1 in the post-COVID-19 group and CG, respectively (p = 0.001). In the CST, the post-COVID-19 group performed 150 (86-204) steps vs the CG with 250 (250-250) steps (p < 0.001). We found correlations between the 6MWT with the 1min-STST in COVID-19 patients (r = 0.681, p < 0.001) and CG (r = 0.668, p < 0.001), and between the 6MWT and the CST in COVID-19 patients (r = 0.692, p < 0.001). CONCLUSION: The 1min-STST and the CST correlated significantly with the 6MWT in patients post-COVID-19 being alternatives if the 6MWT cannot be performed.
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This article is a response to the need for economic reactivation because of the crisis resulting from the context of COVID-19. The purpose of the research was to elaborate a theoretical construct through the application of Confirmatory Factor Analysis that gathers observable variables around dimensions or factors. The study begins with a review of the literature that approximates the causal relationship of the phenomenon. The research has a quantitative approach with exploratory, descriptive and correlational designs. The following factors such as associativity, sustainable tourism, competitive advantage, market orientation, digital inclusion, agricultural innovation and knowledge transfer were found and they are linked with the economic reactivation. The Confirmatory Factorial Analysis was used in this study which helped to reduce from 117 to 47 items in the measurement instrument for the research of economic reactivation in the province of Cañar in Ecuador with factor loadings higher than 0.6. As a conclusion, it is said that it is possible to study the phenomenon with a validated questionnaire on the bivariate association of the researching variables. © 2022, Universidad del Zulia. All rights reserved.
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Introduction: Although the effects of SARS-CoV-2 infection on the cardiovascular system are well known in the acute phase, the cardiovascular impact in the elderly population surviving respiratory COVID-19 infection after 1-year follow-up has not been sufficiently studied. Methods: Observational registry of 240 elderly patients (75 years or older) consecutively admitted for and surviving COVID-19 respiratory infection between March 1 and April 30, 2020. The incidence of major cardiovascular events [MACE] (cardiovascular death [CD], acute coronary syndrome [ACS], cerebrovascular disease [CVD], venous thromboembolic disease [VTE], and heart failure [HF]) was prospectively analyzed. Results: The mean age was 83.8 ± 5.6 years (range 75-103 years). A total of 54.2% were women. Most patients had a personal history of cardiovascular risk factors: hypertension (83.3%), diabetes mellitus (27.9%), dyslipidemia (43.8%). Among the main cardiological comorbidities, a history of atrial fibrillation was the most frequent (18.8%). Of note was the high percentage of institutionalized patients (37.1%) and those with moderate-severe dementia (16.7%). After a mean follow-up of 352.2±70.4 days, 13.8% of patients died and 9.6% had MACE, the most frequent being heart failure (7.5%), with no differences in the severity or overall evolution of the acute disease. Of the 33 patients who developed HF, only 3 died of cardiovascular causes. Only 2 patients suffered a stroke, in both cases without a history of AF or anticoagulants. Only 2 patients had a thromboembolic event (0.8%). The low incidence of thrombotic events may be due in part to the high rate of anticoagulation and chronic antiplatelet therapy and the high percentage of prophylactic heparin prescription at discharge, as well as the fact that only cases with clinical repercussions. COPD, CKD, institutionalization and moderate-severe dementia are associated with an increased risk of MACE, although only COPD and prescription of loop diuretics were identified as independent risk markers in the multivariate analysis. Conclusions: In elderly COVID-19 survivors, the incidence of MACE after one year of follow-up is high, the main manifestation being heart failure. COPD and the prescription of loop diuretics were identified as independent risk markers for the development of MACE in the multivariate analysis. Baseline clinical characteristics Cox survival analysis.Predictors of MACE.
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Introduction: The management of antihypertensive drugs and especially ACEI/ARA2 during the first wave of the SARS-CoV-2 pandemic was a matter of debate. The change in antihypertensive treatment during the pandemic and its repercussions have not been sufficiently studied. Methods: Observational and prospective study that analyzed consecutive patients admitted for respiratory infection and positive polymerase chain reaction (PCR) between March 1 and April 30, 2020. During the period analyzed, 921 patients were registered, of whom 673 patients were discharged;among them 359 were patients with a diagnosis of arterial hypertension and pharmacological treatment. These patients were followed up in days, from the time of discharge to data analysis, with a mean of 352±70.4 days. Results: The mean age was 74.4±12.9 years, and 50.7% were male. A total of 28.7% were diabetic patients, 49% were dyslipidemic, 17.8% were smokers, and 19.8% were obese. Of the patients analyzed, 13.4% had a previous diagnosis of ischemic heart disease, a similar percentage, 13.1% had heart failure, and 13.6% had atrial fibrillation. The antihypertensive drugs analyzed were ACE inhibitors (angiotensin-converting enzyme inhibitors), ARA-2 (angiotensin II receptor antagonists), calcium antagonists, thiazide diuretics, loop diuretics, aldosterone antagonists, beta-blockers and alpha-blockers. At discharge, 75.8% of the patients maintained their antihypertensive treatment, and the remaining 24.2% were modified. Prior to admission, 77.2% were taking ACE inhibitors or ARA-2;however, in 16.4% of the patients they were discontinued after admission. In contrast, treatment with calcium antagonists increased from 27.6% to 34.1% after hospitalization. In both cases there were statistically significant differences in the bivariate analysis in the McNemar test (p < 0.05 in both cases), with no differences in the other antihypertensive drugs analyzed. After follow-up, the combined event occurred in 28 patients, with the most frequent event being the development of HF;in contrast, only 0.8% presented ACS. Overall mortality was 8.9%. Picture 1 shows the events recorded according to the change in antihypertensive treatment and the maintenance or discontinuation of ACEI/ARA-2 in those patients who were already taking it on admission. Similarly, a survival analysis was performed in which no differences were observed in terms of all-cause mortality or major cardiovascular events between patients who maintained their antihypertensive treatment and those who modified it. Conclusions: In the population surviving SARS-CoV-2 respiratory infection, maintaining or discontinuing treatment with ACEI/ARA-2 did not influence mortality or the appearance of major cardiovascular events after the first year of follow-up. (Table Presented).