The Safety Profile of Common COVID-19 Vaccines in Patients With Multiple Sclerosis.

Background and objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). In light of the COVID-19 pandemic that emerged in late 2019, the World Health Organization (WHO) has endorsed mass immunization to enhance the population's immunity against the virus. However, certain concerns have been raised about the safety of COVID-19 vaccines among patients with autoimmune disorders, including those with multiple sclerosis (MS). Further research is required to address these concerns and to gain deeper insights into the possible complications of COVID-19 vaccines among MS patients. This study aimed to assess the side effects of COVID-19 vaccines among MS patients. Methods An observational cross-sectional study was conducted between May and November 2023 at the National Guard Hospital, Jeddah, Saudi Arabia. All MS patients enrolled in our local registry system and provided phone numbers were included in the study. A total of 208 MS patients were surveyed via phone interviews, and data were collected regarding their demographics, MS history, COVID-19 history, SARS-CoV-2 vaccination status, and their exposure to disease-modifying therapies (DMTs). All results were analyzed using Stata software. Statistical significance was set at a CI of 95% and a p-value <0.05. Results In our cohort, 128 (61.5%) patients had received three doses of the COVID-19 vaccine, while 68 (32.7%) had received two doses; four patients (2.0%) had received only one dose, five (2.4%) had not received the vaccine, and the number of doses was unknown for the remaining three patients (1.4%). The BNT162b2 mRNA COVID-19 Vaccine from Pfizer-BioNTech was the most commonly administered (n=136 patients, 66.0%), followed byChAdOx1 nCoV-19 Vaccine from Oxford-AstraZeneca (n=47 patients, 22.8%), and mRNA-1273 SARS-CoV-2 Vaccine from Moderna (n=5 patients, 2.4%). Of note, 139 patients (69.5%) reported experiencing adverse events after receiving the vaccine, and the ChAdOx1 nCoV-19 Vaccine from Oxford-AstraZeneca was significantly associated with higher rates of side effects, in 87.8% of the patients. Conclusion A sizable proportion of MS patients experienced self-limiting side effects from exposure to the COVID-19 vaccine. The rates and incidence of side effects were similar to those encountered in the general population. None of the adverse effects recorded in our population of MS patients were serious or life-threatening. We recommend that physicians encourage patients with MS who have never received COVID-19 vaccination to get promptly vaccinated as the risks of COVID-19 infection far outweigh the minor risks associated with COVID-19 vaccination.

Blood filtering system for COVID-19 management: novel modality of the cytokine storm therapeutics.

The newly emerged coronavirus (SARS-CoV-2) is virulent, contagious, and has rapidly gained many mutations, which makes it highly infectious and swiftly transmissible around the world. SARS-CoV-2 infects people of all ages and targets all body organs and their cellular compartments, starting from the respiratory system, where it shows many deleterious effects, to other tissues and organs. Systemic infection can lead to severe cases that require intensive intervention. Multiple approaches were elaborated, approved, and successfully used in the intervention of the SARS-CoV-2 infection. These approaches range from the utilization of single and/or mixed medications to specialized supportive devices. For critically ill COVID-19 patients with acute respiratory distress syndrome, both extracorporeal membrane oxygenation (ECMO) and hemadsorption are utilized in combination or individually to support and release the etiological factors responsible for the "cytokine storm" underlying this condition. The current report discusses hemadsorption devices that can be used as part of supportive treatment for the COVID-19-associated cytokine storm.

Sales trends of psychotropic drugs in the COVID-19 pandemic: A national database study in Brazil.

Background: The social restrictions among coronavirus disease 2019 (COVID-19) pandemic have posed a thoughtful risk to mental health and have implications in the use of drugs, including antidepressants, anxiolytics and other psychotropics. Objective: This study analyzed the sales data of the psychotropics prescribed in Brazil, in order to verify the change in consumption trends of these drugs during the COVID-19 pandemic. Methods: This interrupted time-series analyzed psychotropic sales data, between January 2014 and July 2021, using the National System of Controlled Products Management from The Brazilian Health Regulatory Agency. The monthly mean DDDs per 1,000 inhabitants per day of psychotropic drugs was evaluated by analysis of variance (ANOVA) followed by Dunnett Multiple Comparisons Test. The changes in monthly trends in the use of the psychotropic studied were evaluated by Joinpoint regression. Results: During the period studied, clonazepam, alprazolam, zolpidem and escitalopram were the most sold psychotropic drugs in Brazil. According to Joinpoint regression, an upward trend was observed in sales during the pandemic of pregabalin, escitalopram, lithium, desvenlafaxine, citalopram, buproprion and amitriptyline. An increase in psychotropic consumption was noted throughout the pandemic period, with the maximum consumption (2.61 DDDs) occurring in April 2021, with a downward trend in consumption that accompanied the drop in the number of deaths. Conclusions: The increase in sales, mainly of antidepressants during the COVID-19 pandemic, draws attention to issues related to the mental health of the Brazilian population and on the need for greater monitoring in the dispensing of these drugs.

Mathematical model based on fractional trace operator for COVID-19 image enhancement.

The medical image enhancement is major class in the image processing which aims for improving the medical diagnosis results. The improving of the quality of the captured medical images is considered as a challenging task in medical image. In this study, a trace operator in fractional calculus linked with the derivative of fractional Rényi entropy is proposed to enhance the low contrast COVID-19 images. The pixel probability values of the input image are obtained first in the proposed image enhancement model. Then the covariance matrix between the input image and the probability of a pixel intensity of the input image to be calculated. Finally, the image enhancement is performed by using the convolution of covariance matrix result with the input image. The proposed enhanced image algorithm is tested against three medical image datasets with different qualities. The experimental results show that the proposed medical image enhancement algorithm achieves the good image quality assessments using both the BRISQUE, and PIQE quality measures. Moreover, the experimental results indicated that the final enhancement of medical images using the proposed algorithm has outperformed other methods. Overall, the proposed algorithm has significantly improved the image which can be useful for medical diagnosis process.

Atendimento remoto à saúde no contexto da pandemia: revisão integrativa / Atención remota de la salud en el contexto de la pandemia: revisión integradora / Remote health care in the context of the pandemic: integrative review

Objetivo: Identificar na literatura como se configurou, durante a pandemia, o teleatendimento pelos profissionais da saúde, quais ferramentas foram utilizadas; e o nível de evidência dos estudos publicados. Método: Revisão integrativa da literatura com busca realizada em janeiro de 2021, delimitando os últimos 5 anos, nas bases de dados: Cinahl, Cochrane, Lilacs, Scopus, PubMed, Web of Science e Embase. Resultados: Total de 912 títulos; 13 artigos incluídos. Os profissionais que utilizam a teleconsulta foram médicos, enfermeiros e fisioterapeutas. Os meios e ferramentas utilizados foram videochamadas; ligações telefônicas; e-mail, Zoom e Skype; iMessage e aplicativos como R-MAPP. Conclusão: a telemedicina foi um importante meio de educação em saúde e continuidade de tratamento; as áreas e profissões que utilizaram o teleatendimento e teleconsulta incluíram a equipe de saúde de um modo geral(AU)

Objective: To identify in the literature how telecare and teleconsultation by health professionals were configured during the pandemic, which tools were used; and the level of evidence of published studies. Method: Integrative literature review with a search carried out in January 2021, delimiting the last 5 years, in the following databases: Cinahl, Cochrane, Lilacs, Scopus, PubMed, Web of Science and Embase. Results: Total of 912 titles; 13 articles included. The professionals who use teleconsultation were doctors, nurses and physiotherapists. The means and tools used were video calls; phone calls; email, Zoom and Skype; iMessage and apps like R-MAPP. Conclusion: telemedicine was an important means of health education and continuity of treatment; the areas and professions that used teleservice and teleconsultation included the health team in general.(AU)

Objetivo: Identificar en la literatura cómo, durante la pandemia, se configuró el teleservicio por parte de los profesionales de la salud, qué herramientas se utilizaron; y el nivel de evidencia de los estudios publicados. Método: Revisión integrativa de la literatura con búsqueda realizada en enero de 2021, delimitando los últimos 5 años, en las siguientes bases de datos: Cinahl, Cochrane, Lilacs, Scopus, PubMed, Web of Science y Embase. Resultados: Total de 912 títulos; 13 artículos incluidos. Los profesionales que utilizaron la teleconsulta fueron médicos, enfermeras y fisioterapeutas. Los medios y herramientas utilizados fueron las videollamadas; llamadas telefónicas; correo electrónico, Zoom y Skype; iMessage y aplicaciones como R-MAPP. Conclusión: la telemedicina fue un importante medio de educación en salud y continuidad del tratamiento; las áreas y profesiones que utilizaron el teleservicio y la teleconsulta incluyeron al equipo de salud en general(AU)

Impacto de la edad gestacional en la gravedad de la infección por Sars-CoV-2 en personas gestantes, en un hospital del conurbano bonaerense / Impact of gestational age on the severity of Sars-CoV-2 infection in pregnant people, in a hospital in the Buenos Aires surroundings

ntroducción: La información sobre la evolución de la infección por COVID-19 en personas gestantes (PG) continúa en desarrollo.Objetivos: Describir la presentación de la infección por Sars-CoV-2 en PG y determinar variables asociadas a mayor gravedad.Materiales y métodos: Estudio observacional retrospectivo. Periodo: 01/03/2020-31/07/2021. Se incluyeron PG con diagnóstico de COVID-19 asistidas en una maternidad de gestión pública: se clasificaron según gravedad y se dividieron en dos grupos: Grup o1 leve y de manejo ambulatorio; Grupo 2 moderado, severo y crítico, con internación. Se analizó la relación entre gravedad y obesidad, DBT, hipertensión inducida por el embarazo (HIE), edad gestacional, edad materna, vacunación antigripal. Recién nacidos (RN) de madres infectadas se estudiaron con PCR para Sars-CoV-2 24-48 hs postnacimiento. Análisis estadístico: Chi-cuadrado o test exacto de Fisher. Significancia= p<0,05. Aprobado porComité Ética Institucional.Resultados: 52 PG con diagnóstico de COVID-19. Edadmediana 29,6 años. Grupo 1: 29 PG (55,5%). Grupo 2: 23 PG(44%), 19 (36,5%) moderados, 2 (4%) severos y 2 (4%) críticos. No hubo fallecimientos maternos ni fetales. Edad gestacional ≥ 28 semanas fue la única variable asociada a mayor gravedad,p=0,00004. 48% de los embarazos finalizaron por cesárea.48/52 RN fueron estudiados con PCR para Sars-CoV-2, siendo 1 (2%) positivo (fue el único RN sintomático).Conclusiones: La infección por COVID-19 en PG se asoció a presentaciones clínicas más graves cuando la infecciónse cursó en el tercer trimestre de gestación y se asociócon mayor incidencia de cesáreas

ntroduction: The information concerning the impact of COVID-19 infection in pregnant people (PP) continues to be established.Aim: to describe the evolution of the Sars-CoV-2 infection in pregnant people and to determine variables associated with clinical severity.Materials and Methods: Retrospective observational study. Period: 01-03-2020 to 31-07-2021. We included PP with diagnosis of COVID-19, assisted in a public maternity hospital. The cases were classified according to clinical severity based on the NIH guidelines. The patients were divided into 2 groups: Group 1: mild (ambulatory manage-ment). Group 2: moderate, severe and critical (requiring hospitalization). The relationship between variables and clinical severity was analyzed. Variables studied: obesity, DBT, gestational hypertension, gestational age, maternal age, influenza vaccination. Newborns of infected mothers were studied with PCR for Sars-CoV-2 24 to 48 hours af-ter birth. Statistical analysis: Chi-square or Fisher's exact test, significance = p <0.05. Study approved by the Institu-tional Ethics Committee.Results: 52 PP with diagnosis of COVID-19 were includ-ed. Median age 29.6 years. 23 patients (44%) required hospitalization and 2 (4%) MRA (mechanical respiratory assistance). 29 (55.5%) were mild, 19 (36.5%) moderate, 2 (4%) severe, and 2 (4%) critical. There were no mater-nal or fetal deaths. Gestational age ≥ 28 weeks was the only variable associated with more severe clinical forms, p = 0.0001. 48% of the pregnancies ended by cesarean section. 48/52 newborns were studied with PCR for Sars-CoV-2, with only 1 (2%) being positive. This was the only symptomatic newborn.Conclusions: In our study, Sars-CoV-2 infection during pregnancy was associated with more severe clinical pre-sentations when the infection occurred in the 3rd trimes-ter of pregnancy. COVID-19 was also associated with a higher incidence of ter

Examining the immune signatures of SARS-CoV-2 infection in pregnancy and the impact on neurodevelopment: Protocol of the SIGNATURE longitudinal study.

The COVID-19 pandemic represents a valuable opportunity to carry out cohort studies that allow us to advance our knowledge on pathophysiological mechanisms of neuropsychiatric diseases. One of these opportunities is the study of the relationships between inflammation, brain development and an increased risk of suffering neuropsychiatric disorders. Based on the hypothesis that neuroinflammation during early stages of life is associated with neurodevelopmental disorders and confers a greater risk of developing neuropsychiatric disorders, we propose a cohort study of SARS-CoV-2-infected pregnant women and their newborns. The main objective of SIGNATURE project is to explore how the presence of prenatal SARS-CoV-2 infection and other non-infectious stressors generates an abnormal inflammatory activity in the newborn. The cohort of women during the COVID-19 pandemic will be psychological and biological monitored during their pregnancy, delivery, childbirth and postpartum. The biological information of the umbilical cord (foetus blood) and peripheral blood from the mother will be obtained after childbirth. These samples and the clinical characterisation of the cohort of mothers and newborns, are tremendously valuable at this time. This is a protocol report and no analyses have been conducted yet, being currently at, our study is in the recruitment process step. At the time of this publication, we have identified 1,060 SARS-CoV-2 infected mothers and all have already given birth. From the total of identified mothers, we have recruited 537 SARS-COV-2 infected women and all of them have completed the mental health assessment during pregnancy. We have collected biological samples from 119 mothers and babies. Additionally, we have recruited 390 non-infected pregnant women.

Fighting Social Isolation With Nostalgia: Nostalgia as a Resource for Feeling Connected and Appreciated and Instilling Optimism and Vitality During the COVID-19 Pandemic.

In two experiments, we tested the influence of bringing to mind a memory of a special moment versus an ordinary moment on nostalgia and whether this elicited nostalgia was related directly to gratitude and the satisfaction of need for relatedness and indirectly to optimism and vitality. Participants from Mexico were first asked to state how the pandemic of COVID-19 has affected their lives. After, participants were randomly assigned to one of two conditions: Memory of special moment versus memory of ordinary recent moment (study 1) or memory of special moment versus or memory of ordinary moment from the same life period as the special moment (study 2). After, participants completed a battery of questionnaires assessing nostalgia, gratitude and optimism (study 1) or nostalgia, satisfaction of need for relatedness, and vitality (study 2). Results from study 1 showed a positive influence of bringing to mind a special moment on nostalgia. Nostalgia was positively related to gratitude, which was then related positively to optimism. Similarly, results from study 2 showed a positive influence of bringing to mind a special moment on nostalgia. Nostalgia was positively related to satisfaction of need for relatedness, which then had a positive relationship with vitality. In both studies, the indirect sequential effect of bringing to mind a special moment on optimism and vitality was significant.

Assessment of the Effect of the COVID-19 Pandemic on the Lifestyle of the Population in Saudi Arabia: A Cross-Sectional Online Survey Study.

Background The coronavirus (COVID-19) pandemic has created an unprecedented problem in people's lives around the world. Lockdown measures altered the routine lifestyle aspects of people including diet, exercise, sleep, stress, smoking, job status, recreation, and application of modern technologies. Understanding the lifestyle profile of individuals could help in designing effective interventions to minimize the risk factors of COVID-19-related health problems. Objectives The aim of this research is to investigate the lifestyle changes among adults living in Saudi Arabia (SA) during the COVID-19 pandemic.  Methods A cross-sectional survey study was done to investigate the lifestyle changes during the COVID-19 pandemic in Saudi Arabia from August to September 2020. A pre-designed questionnaire was used for data collection and distributed online through social media. The questionnaire included items about sleep patterns, dietary habits, physical activity, employment status, recreation activities, use of social media, and screen time before and during the pandemic. Results A total of 338 adults with a median age of 40 years participated in the study. During the pandemic, employment, smoking decreased significantly (53.3 vs. 55.6%, p<0.001 & 15.7% vs. 18.3%, p=0.049) with significant increases in daily intake of fruits or vegetables (47% to 60.2%, p<0.001), caffeinated beverages (seven or more times caffeine, 3% vs. 0.9%, p<0.001), and water (more than eight water cups daily, 18.4 vs. 11.9, p<0.001). Overweight group increased significantly from 28.5% to 32% (p=0.009). Sleeping more than nine hours increased significantly from 8.3% to 21.8% (p<0.001) with increasing sleeping aids from 11.6% to 15.7% (p<0.001). Both the screen and the social media times increased significantly for six or more hours daily (14.8% vs. 35.3% and 9.5% vs. 28.2% respectively, p=<0.001 for both). There were significant decreases in socialization (91.4% vs. 37.8%) and fast food (71.98% vs. 47.04%), and increases in physically inactivity (19% vs. 5.3%) and stress (90.8% vs. 85.2%) (p<0.001 for all). Most participants perceived stress during the pandemic (307, 90.8%). Conclusion There were remarkable behavioral changes in all aspects of the lifestyle of the participants living in SA during the COVID-19 pandemic with some positive effects on smoking and dietary habits. However, negative changes included unemployment, physical inactivity, sleep disturbances, social isolation, and excessive weight gain. There is a need to study the possible consequences of such changes on the future population health in SA.

Ischemic stroke revealing COVID-19 infection: Case report.

INTRODUCTION: SARS-COV-2 viral infection primarily targets the respiratory system with a clinical picture that varies from simple symptoms to respiratory distress syndrome requiring hospitalization in the intensive care unit; SARS-CoV-2 also has neuro-invasive capabilities and could spread from the respiratory system to the central nervous system. Recently, some patients with COVID-19 have been shown to have neurological symptoms such as headache, anosmia, dysgeusia, dizziness, impaired consciousness, and ischemic stroke. CASE PRESENTATION: we describe a case of ischemic stroke as the main presentation of COVID-19 in a 68 years old man with no previous history, without any associated respiratory signs; clinical examination revealed left hemiparesis with dysarthria and left facial paralysis, NIHSS score was at 11, the brain CT scan performed 1h30min later, completed by a brain MRI that came back in favor of right frontal, temporal and parietal ischemic stroke. The decision of thrombolysis was indicated in urgency, and the patient benefited from thrombolysis, which proceeded without incidents; the outcome was favorable with regression of symptoms.Ischemic stroke has been widely described among the thromboembolic complications of COVID-19, but only a few papers have reported it as a primary manifestation of COVID-19. CONCLUSION: SARS-COV 2 infection can spread from the respiratory system to the central nervous system, resulting in an inflammatory response and excessive secretion of inflammatory markers, leading to ischemic stroke.

Ingesta de dióxido de cloro para la COVID-19

Durante muchos años, el dióxido de cloro ha sido utilizado por su principal característica como desinfectante, abarcando diversas áreas de aplicación como la sanitaria, alimenticia, industrial, etc. La evidencia reportada hasta la fecha cita diversos estudios en modelos animales, desde revisiones sobre la toxicocinética hasta la aplicación o usos del compuesto. Su poder como bactericida, virucida y eliminador microbiológico lo convirtió en una fuente de control y potabilización de aguas. La controversia generada actualmente es sobre el uso de este compuesto para el tratamiento y control de la COVID-19. Se ha evidenciado incongruencia con algunos resultados reportados y que su aplicación en pacientes positivos a SARS-CoV-2 o para prevenir COVID-19 puede tener efectos adversos, como un acrecentado número de intoxicaciones y, en otros casos, la muerte. En la presente revisión se detalla, a partir de la evidencia científica reportada, los efectos de este compuesto sobre la salud y la interacción con el virus SARS-CoV-2.

Manifestaciones cutáneas de la infección por COVID-19

Se presenta el caso de un paciente de 45 años que inicio con tos no productiva, malestar general y disnea progresiva, confirmándose el diagnostico COVID-19 severo con respuesta favorable al tratamiento. En la evolución clínica presentó lesiones tipo papulovesicular pruriginosas que se resolvieron de forma espontánea en el transcurso de las semanas.

Predicting mortality in SARS-COV-2 (COVID-19) positive patients in the inpatient setting using a novel deep neural network.

BACKGROUND: The nextwave of COVID-19 pandemic is anticipated to be worse than the initial one and will strain the healthcare systems even more during the winter months. Our aim was to develop a novel machine learning-based model to predict mortality using the deep learning Neo-V framework. We hypothesized this novel machine learning approach could be applied to COVID-19 patients to predict mortality successfully with high accuracy. METHODS: We collected clinical and laboratory data prospectively on all adult patients (≥18 years of age) that were admitted in the inpatient setting at Aga Khan University Hospital between February 2020 and September 2020 with a clinical diagnosis of COVID-19 infection. Only patients with a RT-PCR (reverse polymerase chain reaction) proven COVID-19 infection and complete medical records were included in this study. A Novel 3-phase machine learning framework was developed to predict mortality in the inpatients setting. Phase 1 included variable selection that was done using univariate and multivariate Cox-regression analysis; all variables that failed the regression analysis were excluded from the machine learning phase of the study. Phase 2 involved new-variables creation and selection. Phase 3 and final phase applied deep neural networks and other traditional machine learning models like Decision Tree Model, k-nearest neighbor models, etc. The accuracy of these models were evaluated using test-set accuracy, sensitivity, specificity, positive predictive values, negative predictive values and area under the receiver-operating curves. RESULTS: After application of inclusion and exclusion criteria (n=)1214 patients were selected from a total of 1228 admitted patients. We observed that several clinical and laboratory-based variables were statistically significant for both univariate and multivariate analyses while others were not. With most significant being septic shock (hazard ratio [HR], 4.30; 95% confidence interval [CI], 2.91-6.37), supportive treatment (HR, 3.51; 95% CI, 2.01-6.14), abnormal international normalized ratio (INR) (HR, 3.24; 95% CI, 2.28-4.63), admission to the intensive care unit (ICU) (HR, 3.24; 95% CI, 2.22-4.74), treatment with invasive ventilation (HR, 3.21; 95% CI, 2.15-4.79) and laboratory lymphocytic derangement (HR, 2.79; 95% CI, 1.6-4.86). Machine learning results showed our deep neural network (DNN) (Neo-V) model outperformed all conventional machine learning models with test set accuracy of 99.53%, sensitivity of 89.87%, and specificity of 95.63%; positive predictive value, 50.00%; negative predictive value, 91.05%; and area under the receiver-operator curve of 88.5. CONCLUSION: Our novel Deep-Neo-V model outperformed all other machine learning models. The model is easy to implement, user friendly and with high accuracy.

The effect of negationism on public health / O efeito do negacionismo na saúde pública

Negacionism refers to the choice to deny a scientifically proven reality, which can reduce life expectancy and quality of life. Within this context, the uncontrolled trajectory of the COVID-19 Pandemic in Brazil has generated great concern due to the lack of consensus on how to manage the pandemic in a scenario of denial of the seriousness of the disease by the government, since on August 2nd, 2021, there are 556,437 Brazilians killed due to the disease. The denial of COVID-19 and the immunizing agent is another pandemic and turns the current scenario into a syndemic.

O negacionismo refere-se à escolha de negar uma realidade cientificamente comprovada, o que pode reduzir a expectativa e a qualidade de vida. Dentro desse contexto, a trajetória descontrolada da Pandemia de COVID-19 no Brasil tem gerado grande preocupação pela falta de consenso sobre como administrar a pandemia em um cenário de negação da gravidade da doença por parte do governo, visto que na data de 02 de agosto de 2021 há 556.437 brasileiros mortos por conta da doença. O negacionismo da COVID-19 e do imunizante é outra pandemia e torna o cenário atual numa sindemia.

La investigación en odontología en tiempos de pandemia por la COVID 19

Hace año y medio, en diciembre del 2019, el COVID-19 apareció por primera vez en Wuhan, China y luego, se extendió rápidamente a otros países del mundo. En un principio, lo veíamos como una epidemia muy lejana y con pocas probabilidades de llegar a nuestro medio.

Children with COVID-19 behaving milder may challenge the public policies: a systematic review and meta-analysis.

BACKGROUND: The emerging virus is rampaging globally. A growing number of pediatric infected cases have been reported. Great efforts are needed to cut down the transmission. METHODS: A single-arm meta-analysis was conducted. We searched PubMed, Google Scholar, Web of Science, and several Chinese databases for studies presenting characteristics of children confirmed with Coronavirus Disease 2019 (COVID-19) from December 12, 2019 to May 10, 2020. Quality Appraisal of Case Series Studies Checklist was used to assess quality and publication bias was analyzed by Egger's test. Random-effect model was used to calculate the pooled incidence rate (IR) or mean difference (MD) with 95% confidence intervals (CI), or a fixed model instead when I2 < 50%. We conducted subgroup analysis according to geographic region. Additionally, we searched United Nations Educational Scientific and Cultural Organization to see how different countries act to the education disruption in COVID-19. RESULTS: 29 studies with 4300 pediatric patients were included. The mean age was 7.04 (95% CI: 5.06-9.08) years old. 18.9% of children were asymptomatic (95% CI: 0.121-0.266), 37.4% (95% CI: 0.280-0.474) had no radiographic abnormalities. Besides, a proportion of 0.1% patients were admitted to intensive care units (0, 95% CI: 0.000-0.013) and four deaths were reported (0, 95% CI: 0.000-0.000). Up to 159 countries have implemented nationwide school closures, affecting over 70% of the world's students. CONCLUSION: Children were also susceptible to SARS-CoV-2, while critical cases or deaths were rare. Characterized by mild presentation, the dilemma that children may become a potential spreader in the pandemic, while strict managements like prolonged school closures, may undermine their well-beings. Thus, the public policies are facing challenge.

COVID-19: Un reto más allá de lo imaginable

Cuando los primeros días de enero de 2020, China dio a conocer la notificación de los primeros casos de neumonía atípica por un nuevo coronavirus (poco después denominado SARS-CoV-2), la comunidad médica tuvo la impresión de estar nuevamente frente a una amenaza similar a los predecesores SARS-Cov del año 2002 y el MERS-CoV del año 2012 y que, probablemente, con la experiencia epidemiológica adquirida, se manifestaría sólo en focos epidémicos pasibles de un adecuado control sanitario.

COVID-19 y los desafíos que plantea a la humanidad / COVID-19 and the challenges it poses to humanity

Las imágenes del mundo actual parecían salir de una película de ciencia ficción: calles vacías, fronteras cerradas, escasa circulación por los espacios aéreos o marítimos, salvo viajes esenciales. La supuesta superioridad tecnológica humana fue vapuleada por un simple agente natural y prácticamente ha puesto al mundo en cuarentena, el SARS CoV-2. El mundo se detuvo y con ello la naturaleza se dio literalmente un respiro, los indicadores de contaminación ambiental disminuyeron considerablemente.

Pruebas rápidas de anticuerpos contra el SARS-CoV-2: reporte de una experiencia en un Servicio de Emergencia / Rapid testing of SARS-CoV-2 antibodies: Report of an experience in an Emergency Service

Objetivo: Determinar la positividad y los patrones de los resultados positivos de las pruebas rápidas de anticuerpos contra el SARS-CoV-2 en los pacientes atendidos en un Servicio de Emergencia. Materiales y métodos: Evaluación retrospectiva de las pruebas rápidas de anticuerpos contra el SARS-CoV-2 aplicadas durante el mes de junio/2020 en el Servicio de Emergencia del Hospital EsSalud G. Almenara, Lima, Perú. Resultados: Fueron evaluadas 1 805 pruebas realizadas en igual número de pacientes. En 864 (48%) de las pruebas fueron positivas, en el siguiente orden: patrón combinado de IgM-IgG en 635 (73%), IgM en 134 (16%) y, finalmente, de IgG en 95 (11%). Conclusiones: La positividad de las pruebas rápidas de anticuerpos contra el SARS-CoV-2 fue de 48%, y el patrón combinado de IgM-IgG fue el más frecuente, en tres cuartas partes de los casos confirmados.