Outcome of SARS-CoV-2 Infection in 121 Patients with Inborn Errors of Immunity: A Cross-Sectional Study.

PURPOSE: There is still scarce data on SARS-CoV-2 infection in patients with Inborn Errors of Immunity (IEI) and many unresolved questions. We aimed to describe the clinical outcome of SARS-CoV-2 infection in Brazilian IEI patients and identify factors influencing the infection. METHODS: We did a cross-sectional, multicenter study that included patients of any age affected by IEI and SARS-CoV-2 infection. The variables studied were sex, age, type of IEI, comorbidities (number and type), treatment in use for IEI, clinical manifestations and severity of SARS-CoV-2 infection. RESULTS: 121 patients were included: 55.4% female, ages from six months to 74 yo (median age = 25.1 yo). Most patients had predominantly antibody deficiency (n = 53). The infection was mostly asymptomatic (n = 21) and mild (n = 66), and one child had multisystem inflammatory syndrome (MIS-C). We could not observe sex-related susceptibility, and there was a weak correlation between age and severity of infection. The number of comorbidities was higher in severe cases, particularly bronchiectasis and cardiopathy. There were no severe cases in hereditary angioedema patients. Six patients aged 2 to 74 years died, three of them with antibody deficiency. CONCLUSION: The outcome was mild in most patients, but the Case Fatality Ratio was higher than in the general population. However, the type of IEI was not a determining factor for severity, except for complement deficiencies linked to milder COVID-19. The severity of SARS-CoV-2 infection seems to be more related to older age, a higher number of comorbidities and type of comorbidities (bronchiectasis and cardiopathy).

Avaliação das Estratégias de Autoaprendizagem em Alunos de um Curso de Medicina em Belém - Pará / Evaluation of Self-Directed Learning Strategies in Students of a Medicine Course in Belém - Pará

RESUMO Introdução A Aprendizagem Baseada em Problemas (ABP) é uma metodologia de ensino-aprendizagem que tem sido incorporada aos currículos das escolas médicas que priorizam o estudante no centro da discussão. O diagnóstico e a mensuração das estratégias de estudo e aprendizagem constituem um dos aspectos fundamentais à melhoria do processo de ensino-aprendizagem. Objetivo O estudo teve como objetivo identificar as estratégias do discente em desenvolver seu estudo autodirigido, avaliando a utilização de ferramentas úteis no contexto do seu ensino-aprendizagem. Metodologia Foi realizado um estudo transversal observacional descritivo e analítico, aplicando-se 348 questionários a alunos de um curso de Medicina, uniformemente distribuídos do segundo ao nono semestres. Os questionários, do tipo Likert, foram direcionados para investigar as estratégias utilizadas no estudo individual e sua percepção desses alunos em relação à aprendizagem. A análise estatística foi feita por diferentes métodos, de acordo com as variáveis e categorias observadas, e executada com auxílio do software BioEstat 5.45. Resultados com p ≤ 0,05 (bilateral) foram considerados significativos. Resultados A média de idade foi de 22,7 anos, com 57,3% de mulheres. A maioria mostrou hábito de estudo superior a três vezes por semana (72,2%), em lugares fixos, sobretudo na biblioteca (96,8%). A maioria dos alunos dispunha de recursos eletrônicos para acessar a internet. A maioria dos respondentes (43,6%) utilizou muito pouco o recurso de videoaula. Cinquenta por cento dos alunos julgaram fácil cumprir o horário de estudo e evitaram situações que desviavam sua atenção. Cinquenta por cento deles estudaram sozinhos todos os objetivos e mantiveram foco nos mesmos. O uso do mapa conceitual não foi frequente, mas a maioria elaborou esquemas durante o estudo. Para a maioria dos estudantes, a busca de artigos científicos no idioma inglês aconteceu apenas em 50% das vezes. Apenas 25% dos alunos fizeram "sempre" a síntese do estudo em forma de resumo. No mínimo 25% dos estudantes utilizaram mais de um livro-texto em seus estudos, e o acesso a artigos por meio de plataformas de bases de dados científicos ocorreu "sempre". Em relação ao uso de apostilas comerciais e resumos não próprios, até 75% dos alunos responderam que isso ocorre em aproximadamente "50% das vezes". A autopercepção da retenção do conhecimento, para 50% dos estudantes, ocorreu "cerca de 50% das vezes" ou com "muita frequência". Conclusão Alunos deste estudo que trabalham com a metodologia ABP utilizaram recursos apropriados para seu estudo, planejando e organizando sua aprendizagem. O hábito de planejar o estudo esteve positivamente associado às melhores estratégias de aprendizagem e à busca por fontes de melhor qualidade técnica, resultando em maior percepção da retenção do conhecimento pelo aluno. Como houve falhas nas estratégias de aprendizagem, sugere-se a criação de um guia de orientações de autoaprendizagem para auxiliar o aluno no desempenho de seu estudo.

ABSTRACT Introduction Problem-Based Learning (PBL) is a teaching and learning methodology that has been incorporated into the curricula of medical schools, which prioritize the student to the center of the discussion. The diagnosis and measurement of learning strategies has become a key aspect in the improvement of the teaching and learning process. Objective The study aims to identify students' strategies in developing their self-directed learning, evaluating the application of useful tools in the context of their learning. Methods A descriptive and analytical observational cross-sectional study was carried out, applying 348 questionnaires to the students of a medical school, uniformly distributed from the 2nd to 9th semesters of the course. The Likert-scaled questionnaires were aimed at investigating the strategies used for individual study as well as student perception regarding learning. Statistical analysis was performed by different methods, according to the variables and categories observed and executed with the aid of BioStat 5.45 software. Results with p ≤ 0.05 (bilateral) were considered significant. Results The mean age was 22.7 years, with 57.3% being female. The majority showed a study habit higher than three times a week (72.2%), in fixed places, especially in the library (96.8%). Most of the students have electronic resources to access the internet. Most of the respondents (43.6%) use the video-lecture feature infrequently. 50% of the students find it easy to follow scheduled study hours and avoid situations that distract their attention. 50% of them studied all proposed learning objectives alone, and kept their focus. The use of the conceptual map is not frequent. However, most developed schemes during study. The majority of the students conducted searches for scientific articles in the English language only 50% of the time. Only 25% of the students «always¼ synthesize the study in summary form. At least 25% of the students used more than one textbook in their studies and 'always' accessed articles through scientific database platforms. Regarding the use of commercial e-books and non-self summaries, up to 75% of the students answered that this happens approximately 50% of the time. Regarding self-perception of knowledge retention, for 50% of the students the answers varied between this happens «about 50% of the time¼ and «very frequently". Conclusion The medical students using PBL methodology, use appropriate resources for their study, planning and organizing their learning, however there have been failures in learning strategies. A habit of planning study is positively associated with the best learning strategies and the search for sources of better technical quality, resulting in a greater perception of student retention of knowledge. Therefore, it is suggested that self-learning guidelines be created to assist the student in his or her study performance.