RESUMEN
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that leads to severe respiratory failure (RF). It is known that host exposure to viral infection triggers an iron-lowering response to mitigate pathogenic load and tissue damage. However, the association between host iron-lowering response and COVID-19 severity is not clear. This two-center observational study of 136 adult hospitalized COVID-19 patients analyzed the association between disease severity and initial serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) levels. Serum iron levels were significantly lower in patients with mild RF than in the non-RF group; however, there were no significant differences in iron levels between the non-RF and severe RF groups, depicting a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron and TSAT levels were independently associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.
RESUMEN
<B>Objectives:</B> Since 2006, Japan has admitted foreign nurses as nurse trainees as a part of the country’s Economic Partnership Agreement (EPA) with the Philippines. However, as the government has no regulations regarding how agencies should conduct training, it is mostly conducted through trial and error. In order to find a more effective system, an investigation was conducted into the system in place in the UK, another advanced nation admits foreign nurses. <BR><B>Method:</B> Interviews were carried out with people in charge of the Overseas Nurses Programme (ONP) at two UK universities, and information was gathered regarding the foreign nurse admission system.<BR><B>Results:</B> Through the Nursing and Midwifery Council (NMC), which manages training of foreign nurses, the UK has a system that assesses and guarantees the quality of foreign nurses. The NMC determines the acceptability of foreign nurses by testing English ability, nursing experience, and formal education. UK nurse certification applicants also must join an ONP. The ONP consists of 20 days protected learning and supervised practice. Supervised training is normally six months long but the NMC determines how long an applicant nurse must spend in the programme based upon the content of the nursing education the applicant received. Supervised training must be carried out at an NHS-approved independent facility, and an NMC-qualified mentor must supervise the applicant. The ONP’s final assessment is sent to the NMC to certify the registration with the NMC.<BR><B>Discussion:</B> The UK’s system assesses and confirms the quality of nursing applicants individually in several ways whereas Japan does so only through the national nursing examination. Clinical training content is left up to the agencies employing the nurse trainees. Existing training course at college and nurses association may be a good resource to develop foreign nurses and to guarantee the quality of foreign nurses.